EENT (Eyes, Ears, Nose, Throat) Exam Questions With
Complete Solutions
A 10-year-old boy who was recently diagnosed with acute otitis
media now presents with pain and swelling around his ear. On
examination his auricle is protruding and the pinna is displaced
downward and outward. What test would you order next?
A. radiograph of the soft tissues of the neck
B. radiograph of the orbits
C. CT scan of the temporal bones
D. MRI of the brain Correct Answer C. CT scan of the
temporal bones
In the case of mastoiditis, a CT scan of the temporal bones
should be ordered to determine the extent of the disease.
Radiographs and an MRI scan are neither indicated nor helpful.
A 10-year-old boy with type 1 diabetes mellitus presents with
otitis externa. He is treated with topical drops, but 4 days later
develops facial paralysis, vertigo, and sensorineural hearing loss.
What is the most likely causative agent associated with this
infection?
A. streptococcus pneumoniae
B. Haemophilus influenza
,C. Moraxella catarrhalis
D. Pseudomonas aeruginosa Correct Answer D. Pseudomonas
aeruginosa
Patients with diabetes mellitus are at risk for otitis externa
caused by P. aeruginosa. Immediate treatment with intravenous
antibiotics and an ENT referral is necessary.
A 10-year-old female is being treated with amoxicillin 80
milligrams/kilogram of body weight for 10 days for otitis media
with no improvement of symptoms. What would you do next?
A. change the antibiotic to erythromycin
B. change the antibiotic to azithromycin
C. change the antibiotic to penicillin
D. Change the antibiotic to amoxicillin/clavulanate Correct
Answer D. change the antibiotic to amoxicillin/clavulanate
Symptoms of otitis media should begin to improve within 72
hours of starting antibiotic therapy. If there is no improvement,
second-line therapy with amoxicillin/clavulanate should be
started. Azithromycin should be reserved for patients allergic to
penicillin. Erythromycin and penicillin have limited
effectiveness in treating acute cases of otitis media.
,A 12-year-old boy presents with a fever, sore throat, and swollen
lymph nodes. His quick strep is positive. He has no allergies to
medications. What is the initial treatment?
A. Penicillin VK
B. Amoxicillin
C. Azithromycin
D. Erythromycin Correct Answer Answer: A. Penicillin VK
Explanation: Children who are positive for group A beta
hemolytic streptococcus should be treated with penicillin VK
125 to 250 mg in four divided doses for 10 days. If the patient is
allergic to penicillin, then treat with erythromycin.
A 12-year-old girl was recently diagnosed clinically with a viral
pharyngitis but now presents with worsening of throat pain,
fever, tender lymph nodes, and a red rash over her shoulders
only. What is the most likely diagnosis?
A. Hand, foot, and mouth disease
B. Measles
C. Roseola
D. Scarlet fever Correct Answer D. Scarlet fever
, This patient most likely had a group A beta-hemolytic
streptococci (GABHS) and is now presenting with scarlet fever.
A scarlatiniform rash or strawberry tongue is also considered
pathognomonic of streptococcal disease. Hand, foot, and mouth
disease can present with upper respiratory symptoms, but
usually the rash is isolated to the hands and feet. Oral ulcers can
occur as well. Measles can also present with upper respiratory
symptoms, but subsequently the patient develops Koplik spots in
the mouth and a rash that starts at the head and then spreads
downward across the body. Roseola infantum is also referred to
as sixth disease. It starts as a high fever and once the fever
resolves, a characteristic rash appears on the trunk.
A 14-year-old girl presents with sore throat, dysphagia, neck
pain, stridor, and a fever. On examination of the throat she has
tonsillar enlargement and her uvula is deviated to the left. What
is the most likely diagnosis?
A. Epiglottitis
B. Tonsillitis
C. Mononucleosis
D. Peritonsillar abscess Correct Answer Answer: D.
peritonsillar abscess
Explanation: This is the classic presentation of a peritonsillar
abscess. Patients with tonsillitis can have neck pain, sore throat,
and tonsillar enlargement, but no deviation of the uvula should
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