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Rosh HEENT Exam | Questions & Answers (100 %Score) Latest Updated 2024/2025 Comprehensive Questions A+ Graded Answers | With Expert Solutions CA$19.30   Add to cart
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Rosh HEENT Exam | Questions & Answers (100 %Score) Latest Updated 2024/2025 Comprehensive Questions A+ Graded Answers | With Expert Solutions
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Rosh HEENT Exam | Questions & Answers (100 %Score) Latest Updated 2024/2025 Comprehensive Questions A+ Graded Answers | With Expert Solutions

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  • August 9, 2024
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  • 2024/2025
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Rosh HEENT Exam | Questions & Answers (100 %Score) Latest Updated 2024/2025
Comprehensive Questions A+ Graded Answers | With Expert Solutions


What presents with patient entering a dark room or movie theater complaining of acute
unilateral painful vision loss, vomiting, and seeing halos around lights, with cloudy
cornea and fixed mid-dilated pupil?

Dx and Tx? - Acute Angle Closure Glaucoma

Dx:
Labs show increased IOP >21 mmHg

Tx:
Topical ßBs: (TIMOLOL)

Carbonic anhydrase inhibitors: (Acetazolamide)

Steroids: (Prednisolone)

Miotics: (PILOCARPINE)

What presents with painful loss of vision with physical exam revealing circumlimbal
injection, steamy cornea, fixed mid-dilated pupil, decreased visual acuity and tearing?

Patient can have colored halos around lights nausea, vomiting, diaphoresis also. -
Angle-closure glaucoma

What most commonly presents with loss of peripheral vision with no other complaints? -
Open-angle glaucoma

What angle is closed in closed angle glaucoma? - Anterior chamber is narrowed

intraocular pressure is acutely elevated >21 mmHG

pressure builds on optic nerve leading to loss of vision

Treatment for closed angle glaucoma? - IMMEDIATE referral to ophthalmologist

1st line: ** Start IV ACETAZOLAMIDE (carbonic anhydrase inhibitor --> to decrease
aqueous humor production

Topical beta blocker (TIMOLOL) and LATANOPROST

USE Miotics--> Pilocarpine, Carbachol

,Definitive treatment: surgical iridotomy

DO NOT use Mydriatics

What nerve is damaged with glaucoma? - Optic Nerve

causes peripheral vision loss

What presents with unilateral ocular pain, nausea/vomiting, headache, intermittent
blurry vision, halos around lights, peripheral vision loss (tunnel vision)? - Acute closed
angle closure glaucoma

What presents with erythema, steamy cornea(corneal epithelial edema or cloudiness),
mid-dilated, nonreactive pupil, and eyes feel hard to palpation? - Acute narrow angle
closure glaucoma

What are diagnostics for acute closed angle glaucoma? - Increased intraocular pressure
>21 by Tonometry

Cupping of optic nerve

What is slow, bilateral, peripheral vision loss? - Open angle glaucoma

What presents with tunnel vision? - Open angle glaucoma

What is management of Open angle glaucoma? - Prostaglandin analogs 1st line:
Latanoprost

What is primary glaucoma? - Open angle

What is most common form of glaucoma? - Open angle glaucoma

What presents with unilateral ocular pain/redness/photophobia with excessive tearing
(no discharge)? - Anterior Uveitis (Iritis)

What is most common cause of Uveitis Iritis? - Idiopathic

Anterior: commonly follows blunt trauma

BOTH anterior and posterior can occur from SYSTEMATIC INFLAMMATORY
DISEASES (HLA-B27 Spondyloathropathies, or infection diseases of CMS,
toxoplasmosis, syphillis, TB)

How do you diagnose and treat Iritis (Uveitis)? - Ophthamalmoscopy and slit lamp
examination will reveal ciliary injection (LIMBIC FLUSH), consensual photophobia,
INFLAMMATORY CELLS AND FLARE within aqueous

, What presents with blurred/decreased vision, floaters and photophobia?

How do you treat? - Posterior Uveitis (Iritis)

Tx: systemic corticosteroids

What is treatment for anterior and posterior Uveitis? - Anterior: Topical steroids for
anterior Iritis

Posterior: Systemic corticosteroids

What presents with purulent nasal discharge, facial pain and pressure, nasal obstruction
and fever? - Acute Sinusitis

What are common organisms causing Acute Sinusitis?

What are risk factors? - Strep Pneumo, H. influenza, and less often Staph A

Risk factors: Cigarette smoking, history of trauma and presence of foreign body

What presents with tenderness to palpation over sinuses, decreased light transmission
(opacification) with transillumination of sinuses?

Treatment? - Sinusitis

Tx: NSAIDS (for pain)

Saline washes, steam and oral and/or nasal decongestants; intranasal corticosteroids

1st line antibiotic: AMOXICILLIN- CLAVULANATE

PCN allergy: Macrolides, TMP-SMX, or doxycycline

What presents with facial pressure/pain worsened with bending down and leaning
forward, headache and purulent sputum or nasal discharge?

Treatment? - Sinusitis

tx: Amoxicillin-Clavulanate, Doxycycline, Trimethoprim-Sulfamethoxazole

along with decongestants, antihistamines, mycolytics and intranasal steroids

What is the scan diagnostic test of choice for Sinusitis? - Ct scan

X ray: Water's view (45 angle to get better view of maxillary sinuses)

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