NR 661 Ears, Eyes, Nose, and Throat (EENT) Exam
, 1. A 30 year old male has been diagnosed with non-allergic rhinitis. What finding is more likely in
non-allergic rhinitis than allergic rhinitis?
Older age of symptom onset
Male gender
Post nasal drip
Sneezing
Older age of symptom onset
Explanation:
Non-allergic rhinitis, often called vasomotor rhinitis, is very common in the US. It is typically diagnosed
and differentiated from allergic rhinitis by history. Although both conditions may co-exist in patients,
non-allergic rhinitis typically has onset after age 20 years. Allergic rhinitis typically presents prior to age
20 years. The most common symptoms associated with non-allergenic rhinitis are nasal congestion and
post-nasal drip. It is predominantly reported in females. Common precipitants of non-allergic rhinitis
symptoms can occur with exposure to spicy foods, cigarette smoke, strong odors, perfumes, and
alcohol consumption. This is frequently treated with topical azelastine.
2. The throat swab done to identify Streptococcal infection was negative in a 12 year-old female
with tonsillar exudate, fever, and sore throat. What statement is true regarding this?
A second swab should be done to repeat the
test. The patient does not have Strept throat.
The patient probably has mononucleosis.
A second swab should be collected and sent to microbiology.
A second swab should be collected and sent to microbiology.
Explanation:
,A second swab is collected, but it is not used to repeat the test. The second swab is sent to microbiology
for culture. The sensitivity varies in office Strept tests. Some are as low as 50% and a second swab
should be collected. If beta-hemolytic Strept organisms are grown out, then the patient can be
diagnosed with Streptococcal infection
3. What is the usual age for vision screening in young children?
2 years
3 years
4 years
5 years
3 years
Explanation:
Initial vision screening should take place at 3 years of age. If the child is not cooperative, screening
should be attempted 6 months later. If the child is still not cooperative at 3.5 years, it should be
attempted at 4 years. Generally, children are cooperative at 4 years of age. The usual vision of a 3 year-
old is 20/50
4. Epstein-Barr virus is responsible for:
mononucleosis.
the most common cause of pharyngitis.
most teenage cases of pharyngitis.
viral pharyngitis in young children.
mononucleosis.
Explanation:
Infectious mononucleosis is caused by Epstein-Barr virus (EBV). This commonly affects adolescents but
can affect various age groups. The most prominent feature of mononucleosis is fever, fatigue and
pharyngitis.
, 5. A patient with environmental allergies presents to your clinic. She takes an oral antihistamine
every 24 hours. What is the most effective single maintenance medication for allergic rhinitis?
Antihistamine
Decongestant
Intranasal glucocorticoids
Leukotriene blockers
Intranasal glucocorticoids
Explanation:
These agents are particularly effective in the treatment of nasal congestion and would be a good choice
for the patient in this scenario. Intranasal glucocorticoids are effective in relieving nasal congestion,
discharge, itching, and sneezing. A trial of stopping the oral antihistamine could be tried in this patient.
Symptoms would determine whether the antihistamine should be resumed.
6. Conjunctivitis:
produces blurred vision in the affected eye.
usually begins as a viral infection.
produces anterior cervical lymphadenopathy.
is common in patients who are nearsighted.
usually begins as a viral infection.
Explanation:
Conjunctivitis or "pink eye" usually begins as a viral infection. As the conjunctiva becomes irritated, the
eye is rubbed and fingers introduce bacteria. A secondary bacterial infection develops. Conjunctivitis
produces a red (or pink) eye, but should never produce blurred vision. A patient with a red eye and
blurred vision should be referred to ophthalmology. The pre-auricular nodes may be palpable when a
patient has conjunctivitis, not the anterior cervical ones.
, 1. A 30 year old male has been diagnosed with non-allergic rhinitis. What finding is more likely in
non-allergic rhinitis than allergic rhinitis?
Older age of symptom onset
Male gender
Post nasal drip
Sneezing
Older age of symptom onset
Explanation:
Non-allergic rhinitis, often called vasomotor rhinitis, is very common in the US. It is typically diagnosed
and differentiated from allergic rhinitis by history. Although both conditions may co-exist in patients,
non-allergic rhinitis typically has onset after age 20 years. Allergic rhinitis typically presents prior to age
20 years. The most common symptoms associated with non-allergenic rhinitis are nasal congestion and
post-nasal drip. It is predominantly reported in females. Common precipitants of non-allergic rhinitis
symptoms can occur with exposure to spicy foods, cigarette smoke, strong odors, perfumes, and
alcohol consumption. This is frequently treated with topical azelastine.
2. The throat swab done to identify Streptococcal infection was negative in a 12 year-old female
with tonsillar exudate, fever, and sore throat. What statement is true regarding this?
A second swab should be done to repeat the
test. The patient does not have Strept throat.
The patient probably has mononucleosis.
A second swab should be collected and sent to microbiology.
A second swab should be collected and sent to microbiology.
Explanation:
,A second swab is collected, but it is not used to repeat the test. The second swab is sent to microbiology
for culture. The sensitivity varies in office Strept tests. Some are as low as 50% and a second swab
should be collected. If beta-hemolytic Strept organisms are grown out, then the patient can be
diagnosed with Streptococcal infection
3. What is the usual age for vision screening in young children?
2 years
3 years
4 years
5 years
3 years
Explanation:
Initial vision screening should take place at 3 years of age. If the child is not cooperative, screening
should be attempted 6 months later. If the child is still not cooperative at 3.5 years, it should be
attempted at 4 years. Generally, children are cooperative at 4 years of age. The usual vision of a 3 year-
old is 20/50
4. Epstein-Barr virus is responsible for:
mononucleosis.
the most common cause of pharyngitis.
most teenage cases of pharyngitis.
viral pharyngitis in young children.
mononucleosis.
Explanation:
Infectious mononucleosis is caused by Epstein-Barr virus (EBV). This commonly affects adolescents but
can affect various age groups. The most prominent feature of mononucleosis is fever, fatigue and
pharyngitis.
, 5. A patient with environmental allergies presents to your clinic. She takes an oral antihistamine
every 24 hours. What is the most effective single maintenance medication for allergic rhinitis?
Antihistamine
Decongestant
Intranasal glucocorticoids
Leukotriene blockers
Intranasal glucocorticoids
Explanation:
These agents are particularly effective in the treatment of nasal congestion and would be a good choice
for the patient in this scenario. Intranasal glucocorticoids are effective in relieving nasal congestion,
discharge, itching, and sneezing. A trial of stopping the oral antihistamine could be tried in this patient.
Symptoms would determine whether the antihistamine should be resumed.
6. Conjunctivitis:
produces blurred vision in the affected eye.
usually begins as a viral infection.
produces anterior cervical lymphadenopathy.
is common in patients who are nearsighted.
usually begins as a viral infection.
Explanation:
Conjunctivitis or "pink eye" usually begins as a viral infection. As the conjunctiva becomes irritated, the
eye is rubbed and fingers introduce bacteria. A secondary bacterial infection develops. Conjunctivitis
produces a red (or pink) eye, but should never produce blurred vision. A patient with a red eye and
blurred vision should be referred to ophthalmology. The pre-auricular nodes may be palpable when a
patient has conjunctivitis, not the anterior cervical ones.
