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SECTION A: HEENT ASSESSMENT
1. A 67-year-old patient presents for an annual
examination. On inspection of the eyes, you note a
,triangular thickening of the bulbar conjunctiva
across the outer surface of the cornea. What is the
most likely diagnosis?
A) Corneal arcus
B) Cataracts
C) Corneal scar
D) Pterygium
Correct Answer: D
Rationale: A pterygium is a triangular thickening of
the bulbar conjunctiva that grows across the
cornea, typically from the nasal side. It is
associated with chronic UV exposure and is more
common in older adults. Corneal arcus appears as
a gray-white ring around the cornea; cataracts
involve opacification of the lens; corneal scars
result from trauma or infection.
2. Which finding is considered a "red flag"
regarding patients presenting with headache?
,A) Unilateral headache
B) Pain over the sinuses
C) Age over 50
D) Phonophobia and photophobia
Correct Answer: C
Rationale: Age over 50 is a red flag for headache
that may indicate serious underlying pathology
such as giant cell arteritis, intracranial mass, or
subarachnoid hemorrhage. Other red flags include
sudden onset "thunderclap" headache, headache
with neurologic deficits, and headache associated
with fever or stiff neck.
3. A patient experiences sudden, painless
unilateral vision loss. What is the most likely
cause?
A) Retinal detachment
B) Corneal ulcer
, C) Acute glaucoma
D) Uveitis
Correct Answer: A
Rationale: Retinal detachment typically presents
with sudden, painless unilateral vision loss, often
described as a curtain or shadow coming over the
visual field. Corneal ulcers, acute glaucoma, and
uveitis are typically associated with pain.
4. A patient presents with sudden, painful
unilateral vision loss. Which condition is most
likely?
A) Vitreous hemorrhage
B) Central retinal artery occlusion
C) Macular degeneration
D) Optic neuritis
Correct Answer: D
Rationale: Optic neuritis causes sudden, painful
unilateral vision loss, often with pain on eye