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EENT Flashcards

7 cards from real PANCE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 EENT flashcards as text

  1. A 70-year-old hypertensive patient presents with sudden unilateral vision loss that lasted 10 minutes and resolved completely. Fundoscopic exam is normal. What is this episode called and what is the first-line imaging study?

    Answer: Amaurosis fugax; carotid duplex ultrasound

    Amaurosis fugax (transient monocular blindness from carotid emboli) requires urgent carotid duplex ultrasound to evaluate for significant ipsilateral carotid stenosis.

  2. A 15-year-old presents with bilateral nasal polyps. No history of asthma or aspirin sensitivity. A sweat chloride test is ordered. What underlying condition is being screened for?

    Answer: Cystic fibrosis

    Bilateral nasal polyps in a child or adolescent should prompt evaluation for cystic fibrosis, as nasal polyposis occurs in up to 50% of CF patients.

  3. A 55-year-old presents with a painless neck mass. Fine-needle aspiration shows squamous cell carcinoma. He has a 40 pack-year smoking history and drinks alcohol daily. Nasopharyngoscopy reveals an asymmetric, ulcerated lesion in the pyriform sinus. What is the most likely primary site?

    Answer: Hypopharynx (pyriform sinus)

    Pyriform sinus carcinoma of the hypopharynx commonly presents as a painless neck mass from nodal metastasis, given the rich lymphatic drainage and late local symptoms.

  4. A 45-year-old presents with chronic bilateral rhinorrhea, nasal congestion, and excessive sneezing, worst in spring. Nasal smear shows eosinophils. Skin-prick testing is positive for grass and tree pollens. What is first-line pharmacotherapy?

    Answer: Intranasal corticosteroids

    Intranasal corticosteroids are the most effective first-line treatment for moderate-to-severe allergic rhinitis, superior to antihistamines for nasal congestion and overall symptom control.

  5. A 6-year-old presents with 5 days of fever, purulent nasal discharge, and periorbital edema. CT scan shows opacification of the ethmoid sinuses and a subperiosteal abscess along the medial orbital wall. What is the most appropriate management?

    Answer: IV antibiotics and urgent surgical drainage

    Subperiosteal orbital abscess secondary to ethmoid sinusitis requires IV antibiotics plus urgent surgical drainage to prevent optic nerve compression and vision loss.

  6. A 30-year-old woman presents with bilateral proptosis, lid retraction, and a stare. Thyroid-stimulating hormone is suppressed and free T4 is elevated. What finding on extraocular muscle testing is most characteristic of her orbital condition?

    Answer: Limitation of elevation (inferior rectus restriction)

    Thyroid eye disease (Graves' orbitopathy) most commonly affects the inferior rectus muscle, causing restriction of elevation and hypotropia.

  7. A 65-year-old presents with progressive hoarseness of 8 weeks duration and a 15 lb weight loss. Laryngoscopy shows an ulcerated lesion of the true vocal cord with cord fixation. What staging feature does cord fixation indicate?

    Answer: T3 disease — fixed cord

    Vocal cord fixation in laryngeal cancer indicates T3 disease regardless of tumor size, reflecting deep invasion of the paraglottic space or cricoarytenoid joint.