BATES HEENT EXAM 2025/2026 QUESTIONS WITH
SOLUTIONS GRADED A+
✔✔Which Trigimenal nerve division are more common with cranial neuralgia? - ✔✔V2
(Maxillary) and V3 (Mandibular) are more common than V1 (Opthalmic)
✔✔*Pattern of redness:* Diffuse dilation of conjuctival vessels
*Pain:* Mild discomfort rather than pain
*Vision:* Not affected
*Discharge:* Watery, mucoid, or mucopurulent
*Pupil:* Not affected
*Cornea:* Clear - ✔✔Conjuctivitis
✔✔*Pattern of redness:* Homogenous, sharply demarcated, red area that resolves over
2 weeks
*Pain:* None
*Vision:* Not affected
*Discharge:* None
*Pupil:* Not affected
*Cornea:* Clear - ✔✔Subconjuctival henorrhage
✔✔Dilation of deeper vessels of the eye that are visible as radiating vessels or a
reddish violet flush around the limbus. May not be apparent the eye may just be
diffusely red. - ✔✔Ciliary injection
✔✔*Pattern of redness:* Ciliary injection
*Pain:* Moderate to severe; superficial
*Vision:* Usually decreased
*Discharge:* Watery or purulent
*Pupil:* Not affected unless iritis develops
*Cornea:* Changes depending on cause - ✔✔Corneal injury or infection
✔✔*Pattern of redness:* Ciliary injection
*Pain:* Moderate, aching, deep
*Vision:* Decreased; photophobia
*Discharge:* Absent
*Pupil:* Small; irregular
*Cornea:* Clear or slightly clouded; *ciliary injection confined to corneal limbus* -
✔✔Acute iritis
✔✔*Pattern of redness:* Ciliary injection
*Pain:* Severe; aching; deep
*Vision:* Decreased
*Discharge:* Absent
,*Pupil:* Dilated; fixed
*Cornea:* Steamy; Cloudy - ✔✔Acute angle closure glaucoma
✔✔Spinning sensation accompanied by nystagmus and ataxia; usually from *peripheral
vestibular dysfunction* but maybe from *central brainstem lesions* - ✔✔Vertigo
✔✔*Felling faint or lightheaded;* causes included orthostatic hypotension, especially
from medication, arrhythmia, and vasovagal attacks - ✔✔Presyncope
✔✔Unsteadiness or imbalance when walking, especially in older patients, causes
include fear of walking, visual loss, weakness from musculoskeletal problems,
peripheral neuropathy - ✔✔Disequilebrium
✔✔Causes include anxiety, panic disorder, hyperventilation, depression, somatzation
disorder, alcohol, and substance abuse - ✔✔Psychiatric dizziness
✔✔Peripheral vertigo types - ✔✔1. Benign positional vertigo
2. Vestibular neurontitis (acute labyrinthitis)
3. Menieres disease
4. Drug toxicity
5. Acoustic neruoma
✔✔*Onset:* Sudden a few seconds to <1 minute; upon rolling onto affected side or
tilting head up
*Duration and course:* Lasts a few weeks and may recur
*Hearing:* Unaffected
*Tinnitus:* Absent - ✔✔Benign positional vertigo
✔✔*Onset:* Sudden; Onset hours up to 2 weeks
*Duration and course:* May recur over 12-18 months
*Hearing:* Unaffected
*Tinnitus:* Absent - ✔✔Vestibular neurontitis (Acute labyrinthitis)
✔✔*Onset:* Sudden; Onset several hours to >1 day
*Duration and course:* Recurrent
*Hearing:* Hearing loss recurs and eventually progresses
*Tinnitus:* Present and fluctuating - ✔✔Menieres disease
✔✔*Onset:* Insidious or acute; linked to loop
*Duration and course:* Partial adaptation
*Hearing:* May be impaired
*Tinnitus:* May be present - ✔✔Drug toxicity
, ✔✔*Onset:* Insidious from CN VII compression, vestibular branch
*Duration and course:* Variable
*Hearing:* Impaired, one side
*Tinnitus:* Present - ✔✔Acoustic neuroma
✔✔*Onset:* Often sudden; causes include athersclerosis, MS, vertebrobasilar
migraines or TIA
*Duration and course:* Variable but rarely continusous
*Hearing:* Unaffected
*Tinnitus:* Absent - ✔✔Central vertigo
✔✔*Moon face* with red cheeks. Excessive hair growth may be present in the
mustache and sideburn areas on on the chin. - ✔✔Cushing's syndrome
✔✔Face is edematous and often pale. Swelling usually appears first around the eyes
and in the morning. Look for *periorbital edema, puffy face, and possibly swollen lips* -
✔✔Nephrotic syndrome
✔✔*Severe hyperthyroidism.* Dull, puffy face with dry skin. *Non-pitting* periorbital
edema. Hair and eyebrows are *dry, coarse, and thinned.* - ✔✔Myxedema
✔✔Swelling anterior to the ear lobes and above the angles of the jaw. Gradual
unilateral enlargement suggests neoplasm. Acute enlargement is seen in mumps. -
✔✔Parotid gland enlargement
✔✔Head is elongated with prominent brow, enlarged soft tissue, and prominent jaw. -
✔✔Acromegaly
✔✔Decreased facial mobility. *Masklike* face. Since the neck and upper trunk tend to
flex forward, the patient seems to peer upward toward the observe. Facial skin becomes
oily and drooling may occur. - ✔✔Parkinson's disease
✔✔Drooping of the upper eyelid. Causes include *Horner's syndrome* which is damage
to sympathetic nerve supply, myasthenia gravis, damage to occulomotor nerve, and it
may be congenital. - ✔✔Ptosis
✔✔More common in the elderly. *Inward* turning of the lid margin. Lower lashes which
are often visible when turned inward, irritate the conjunctiva and lower cornea. Ask the
patient to squeeze the lids together and then open them. - ✔✔Entropion
✔✔*Outward* turning of the lower lid, which exposed the palpebral conjunctiva. Eye no
longer drains well, so *tearing occurs.* - ✔✔Ectropion
SOLUTIONS GRADED A+
✔✔Which Trigimenal nerve division are more common with cranial neuralgia? - ✔✔V2
(Maxillary) and V3 (Mandibular) are more common than V1 (Opthalmic)
✔✔*Pattern of redness:* Diffuse dilation of conjuctival vessels
*Pain:* Mild discomfort rather than pain
*Vision:* Not affected
*Discharge:* Watery, mucoid, or mucopurulent
*Pupil:* Not affected
*Cornea:* Clear - ✔✔Conjuctivitis
✔✔*Pattern of redness:* Homogenous, sharply demarcated, red area that resolves over
2 weeks
*Pain:* None
*Vision:* Not affected
*Discharge:* None
*Pupil:* Not affected
*Cornea:* Clear - ✔✔Subconjuctival henorrhage
✔✔Dilation of deeper vessels of the eye that are visible as radiating vessels or a
reddish violet flush around the limbus. May not be apparent the eye may just be
diffusely red. - ✔✔Ciliary injection
✔✔*Pattern of redness:* Ciliary injection
*Pain:* Moderate to severe; superficial
*Vision:* Usually decreased
*Discharge:* Watery or purulent
*Pupil:* Not affected unless iritis develops
*Cornea:* Changes depending on cause - ✔✔Corneal injury or infection
✔✔*Pattern of redness:* Ciliary injection
*Pain:* Moderate, aching, deep
*Vision:* Decreased; photophobia
*Discharge:* Absent
*Pupil:* Small; irregular
*Cornea:* Clear or slightly clouded; *ciliary injection confined to corneal limbus* -
✔✔Acute iritis
✔✔*Pattern of redness:* Ciliary injection
*Pain:* Severe; aching; deep
*Vision:* Decreased
*Discharge:* Absent
,*Pupil:* Dilated; fixed
*Cornea:* Steamy; Cloudy - ✔✔Acute angle closure glaucoma
✔✔Spinning sensation accompanied by nystagmus and ataxia; usually from *peripheral
vestibular dysfunction* but maybe from *central brainstem lesions* - ✔✔Vertigo
✔✔*Felling faint or lightheaded;* causes included orthostatic hypotension, especially
from medication, arrhythmia, and vasovagal attacks - ✔✔Presyncope
✔✔Unsteadiness or imbalance when walking, especially in older patients, causes
include fear of walking, visual loss, weakness from musculoskeletal problems,
peripheral neuropathy - ✔✔Disequilebrium
✔✔Causes include anxiety, panic disorder, hyperventilation, depression, somatzation
disorder, alcohol, and substance abuse - ✔✔Psychiatric dizziness
✔✔Peripheral vertigo types - ✔✔1. Benign positional vertigo
2. Vestibular neurontitis (acute labyrinthitis)
3. Menieres disease
4. Drug toxicity
5. Acoustic neruoma
✔✔*Onset:* Sudden a few seconds to <1 minute; upon rolling onto affected side or
tilting head up
*Duration and course:* Lasts a few weeks and may recur
*Hearing:* Unaffected
*Tinnitus:* Absent - ✔✔Benign positional vertigo
✔✔*Onset:* Sudden; Onset hours up to 2 weeks
*Duration and course:* May recur over 12-18 months
*Hearing:* Unaffected
*Tinnitus:* Absent - ✔✔Vestibular neurontitis (Acute labyrinthitis)
✔✔*Onset:* Sudden; Onset several hours to >1 day
*Duration and course:* Recurrent
*Hearing:* Hearing loss recurs and eventually progresses
*Tinnitus:* Present and fluctuating - ✔✔Menieres disease
✔✔*Onset:* Insidious or acute; linked to loop
*Duration and course:* Partial adaptation
*Hearing:* May be impaired
*Tinnitus:* May be present - ✔✔Drug toxicity
, ✔✔*Onset:* Insidious from CN VII compression, vestibular branch
*Duration and course:* Variable
*Hearing:* Impaired, one side
*Tinnitus:* Present - ✔✔Acoustic neuroma
✔✔*Onset:* Often sudden; causes include athersclerosis, MS, vertebrobasilar
migraines or TIA
*Duration and course:* Variable but rarely continusous
*Hearing:* Unaffected
*Tinnitus:* Absent - ✔✔Central vertigo
✔✔*Moon face* with red cheeks. Excessive hair growth may be present in the
mustache and sideburn areas on on the chin. - ✔✔Cushing's syndrome
✔✔Face is edematous and often pale. Swelling usually appears first around the eyes
and in the morning. Look for *periorbital edema, puffy face, and possibly swollen lips* -
✔✔Nephrotic syndrome
✔✔*Severe hyperthyroidism.* Dull, puffy face with dry skin. *Non-pitting* periorbital
edema. Hair and eyebrows are *dry, coarse, and thinned.* - ✔✔Myxedema
✔✔Swelling anterior to the ear lobes and above the angles of the jaw. Gradual
unilateral enlargement suggests neoplasm. Acute enlargement is seen in mumps. -
✔✔Parotid gland enlargement
✔✔Head is elongated with prominent brow, enlarged soft tissue, and prominent jaw. -
✔✔Acromegaly
✔✔Decreased facial mobility. *Masklike* face. Since the neck and upper trunk tend to
flex forward, the patient seems to peer upward toward the observe. Facial skin becomes
oily and drooling may occur. - ✔✔Parkinson's disease
✔✔Drooping of the upper eyelid. Causes include *Horner's syndrome* which is damage
to sympathetic nerve supply, myasthenia gravis, damage to occulomotor nerve, and it
may be congenital. - ✔✔Ptosis
✔✔More common in the elderly. *Inward* turning of the lid margin. Lower lashes which
are often visible when turned inward, irritate the conjunctiva and lower cornea. Ask the
patient to squeeze the lids together and then open them. - ✔✔Entropion
✔✔*Outward* turning of the lower lid, which exposed the palpebral conjunctiva. Eye no
longer drains well, so *tearing occurs.* - ✔✔Ectropion
