HEENT ROSH REVIEW Exam Questions With Verified And Updated Answers.

HEENT ROSH REVIEW Exam Questions With Verified And Updated Answers. A 28-year-old woman presents with intense pain, tearing, and ocular foreign body sensation in both eyes that began yesterday. She denies any trauma, past medical problems, or contact lens use and reports that she works as ski patrol for a local resort. Her physical examination is significant for bilateral decreased visual acuity, injected conjunctiva, and diffuse punctuate corneal lesions with a discrete superior border. Her pupils are equal, round, and reactive to light. Given this patient's clinical presentation, which of the following is the most likely diagnosis? - answerUltraviolet ketartitis What is another name for ultraviolet keratitis and how is it caused? - answerThis patient has ultraviolet keratitis, also known as snow blindness. This is a radiation burn that occurs when an individual comes in close contact with an ultraviolet-ray-containing light source. It may be caused by sun lamps, tanning booths, or exposure to intense reflected sunlight, particularly in high-altitude environments How will flouresence staining present with ultraviolet keratitis? - answerFluorescein staining reveals superficial punctate epithelial surface irregularities, which usually cover the entire surface of the cornea. This condition is usually referred to as superficial punctate keratitis (SPK) What is the treatment for ultraviolet keratitis? - answerTreatment consists of flushing the eye for several minutes with water or saline solution and prescribing a short-acting cycloplegic agent for pain management. The use of ophthalmic antibiotics has not been shown to improve healing. While oral pain medications are often needed, topical anesthetics should be avoided due to an increased risk of corneal ulceration. What is episcleritis and how is it caused? - answerEpiscleritis (B) is a common, benign inflammatory condition of the episclera and most often occurs in young adults. It is usually idiopathic but may be associated with systemic conditions such as diabetes mellitus, systemic lupus erythematosus, rheumatoid arthritis, and inflammatory bowel disease. Patients typically complain of a foreign body sensation, mild pain, photophobia, and lacrimation. The condition is usually self-limiting. What is iritis? - answerIritis (C), also known as anterior uveitis, is an inflammation of the anterior portions of the uvea (iris, ciliary body, and choroid). It is often idiopathic but may be associated with systemic diseases such as rheumatoid arthritis, sarcoidosis, Reiter syndrome, and tuberculosis. How do cycloplegics work? - answerThey relax ciliary muscle spasm and prevent contraction of the iris, reducing pupillary photoresponse. What is leukoplakia? - answerLeukoplakia is a premalignant white patch or plaque that may eventually progress to an ulcer or mass. It is a pre-malignant oral lesion. The biggest risk factors are tobacco and alcohol use. If oral leukoplakia is persistent for more than 2 weeks what is required? - answerIf oral leukoplakia persists for more than 2 weeks, biopsy and treatment is required. What is the 5-year survival rate for oral cancer? - answer50-55%. The histopathologic findings of this disease includes endolymphatic hydrops, which is thought to be caused by either overproduction or underresorption of endolymph in the inner ear. - answerMeniere's disease What percentage of vertigo is due to central vestibular etiologies? - answerLess than 10% What is the treatment for menieres disease? - answerVestibular rehabilitation, low-salt diet, HCT, surgery What is the treatment for a subconjunctival hemmorrage? - answerReassurance and follow up What is the cause of a subconjunctival hemmorrhage? - answerSubconjunctival hemorrhage results from rupture of small subconjunctival blood vessels. It is thought to occur from trauma or Valsalva maneuvers (e.g. coughing) although patients often have no memory of an inciting event. What history with subconjunctival hemorrhage would prompt investigation into a bleeding diathesis? - answerBilateral or recurrent subconjunctival hemorrhage should have a bleeding diathesis workup. What is the cause of mastoiditis? - answerThis patient has acute mastoiditis, an infection of the mastoid air cells that usually results from extension of untreated or inadequately (as in this case) treated otitis media. What are the symptoms of mastoiditis? - answerPatients typically present with fever, chills, postauricular (mastoid) erythema and tenderness, and discharge from the external auditory canal. It is critical to identify and treat mastoiditis because untreated mastoiditis can progress to meningitis, encephalitis, sinus thrombosis, brain abscess, facial nerve palsy, and sepsis. What imaging is required to confirm the diagnosis of mastoiditis? - answerA contrast- enhanced CT scan of the head with inclusion of the petrous portion of the temporal bones should be obtained to confirm the diagnosis (primarily through visualization of fluid in the mastoid air cells) and identify the presence of any complications.