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Exam (elaborations)

HEENT Practice Exam Latest Updates 2024/2025

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HEENT Practice Exam Latest Updates 2024/2025

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  • October 2, 2024
  • 33
  • 2024/2025
  • Exam (elaborations)
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HEENT Practice Exam Latest Updates
2024/2025

A 14 year old female presents to your office with a sudden onset of unilateral red
eye. She reports a foreign body sensation and has watery to serous discharge.
Which of the following is not true about this condition?

a) it is the MCC of conjunctivitis

b) she can continue to wear contacts during treatment

c) this will self resolve in 10-12 days

d) this is highly contagious, so take precautions not to spread to others ANS✔✔ b)
she can continue to wear contacts during treatment



This is a case of adenoviral conjunctivitis



A 35 year old female who is sexually active presents to your office with
mucopurulent discharge from the eye that is stringy and thick. She also has a
foreign body sensation and photophobia. She has a history of cervicitis and PID.
Physical exam reveals a palpable preauricular LN and diffuse hyperemia. She also
has lid swelling, slight ptosis, and a marked tarsal follicular response. What is her
most likely diagnosis?

a) adult inclusion conjunctivitis

b) trachoma

c) adenoviral conjunctivitis

d) foreign body in the eye

BONUS: What are the 3 most common organisms in bacterial conjunctivitis? ANS✔✔
a) adult inclusion conjunctivitis



BONUS: staph aureus, H flue, and strep pneumo

,Tx: azithromycin, treat sexual contacts



Which of the following is not a part of SAFE efforts from WHO to eradicate
trachoma?

a) surgery

b) antibiotics (azithromycin)

c) facial cleanliness

d) education ANS✔✔ d) education



E should stand for environmental improvement



trachoma is the leading infectious cause of irreversible blindnss worldwide caused
by chlamydia



Which of the following is the test of choice for a patient with profuse purulent
exudate from the eye described as a "waterfall of pus"?

a) tissue culture

b) skin allergy testing

c) NAAT

d) clinical dx

BONUS: what is the treatment of this condition? ANS✔✔ c) NAAT



BONUS: tx chlamydia with azithromycin 1g orally, ceftriaxone 250mg IV,
cirpofloxacin eye ointment 4x daily, and saline irrigation 4x daily



Which of the following is not a treatment option for moderate to severe allergic
conjunctivitis?

a) topical mast cell stabilizers

,b) topical histamine H1 receptor agonists

c) oral antihistamines

d) exposure to cooler climates ANS✔✔ b) topical histamine H1 receptor agonists



This should be ANTAGONISTS



With these pts, you should see itching, tears with strings of discharge, and
hyperemia



The types of vernal keratosis (large cobblestone papillae on upper tarsal
conjunctiva) and atopic keratoconjunctivitis (abnormalities of both tarsal
conjunctiva)



Which of the following are you most likely to see in a patient who has been
diagnosed with posterior blepharitis?

a) pouting of the meibomian glands

b) crusting on the eyelid margins

c) collarettes on the eyelid margins

d) affects the outside from of the eyelid at the eyelash base ANS✔✔ a) pouting of
the meibomian glands



You will also likely see telangiectasis along the posterior lid margin



All other options are consistent with anterior blepharitis



Which of the following diagnoses is best described as a hard, nontender swelling on
the upper lid?

a) internal hordeolum

b) anterior blepharitis

, c) posterior blepharitis

d) chalazion ANS✔✔ d) chalazion



Hordeolum (styes) are often swollen and tender



tip: extneral hordeolum is a gland of zeis infection



Which of the following tests is the best way to diagnose keratoconjunctivitis sicca?

a) fluorescein stain dye

b) rose bengal slit lamp

c) schirmer test

d) corneal scraping ANS✔✔ c) schirmer test



A 16 year old contact lens wearing patient returns from iceland, where he swam in
the baltic sea waters. He complains today of unilateral ocular pain and is extremly
sensitive to light. The sx wax and wane over time and a PE reveals ring shaped
stromal infiltrates. Which of the following is the most likely diagnosis?

a) bacterial keratitis

b) parasitic keratitis

c) viral keratitis

d) allergic keratitis

BONUS: what is the treatment? ANS✔✔ b) parasitic keratitis



BONUS: topical anti-infective agents such as biguanide (duration is 6 months to a
year)



Which of the following is the hallmark sign seen with herpes simplex keratitis?

a) small branching epithelial dendrites

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