EENT Exam Master
1. A 22-year-old woman presents with a 1-year history of flaking and scaling around her
lashes, along with itching and a burning sensation. She has also noted her lid margins are
red, and some of her lashes are missing.
Her history is significant for diabetes and for seborrheic dermatitis of the scalp, eyebrows,
and external ears.
Question
What is the most likely diagnosis?
Blepharitis
Chalazion
Conjunctivitis
Ectropion
Foreign body: Blepharitis
2. A 78-year-old Caucasian man presents with unilateral painless loss of vision in the
right eye of 3 hours duration. Examination reveals an elderly man who is anxious but in no
acute distress. Visual acuity is light perception only in the right eye and 20/30 in the left
eye. Pupillary examination is significant for an afferent pupillary defect on the right side.
Penlight examination of the eyes is otherwise unremarkable. Retinal examination of the
right eye reveals a cherry-red spot. Retinal examination of the left eye is unremarkable.
Question
What disease process most likely accounts for the patient's presentation?
Adult-onset Tay-Sachs disease
Open-angle glaucoma
Central retinal artery occlusion
Trauma
Cataract: Central retinal artery occlusion
, EENT Exam Master
3. A 30-year-old Black male patient is admitted to the hospital to undergo stapedectomy
for the treatment of otosclerosis. He has experienced increased hearing loss in the right
ear for a few years. The patient's mother had had the same condition when she was in her
40s, and she underwent a successful operation. Assessment is performed using the Weber
and Rinne tests.
Question
What physical exam finding is expected?
Bone conduction of the affected side is greater than air conduction. Bone conduction
of the affected side is equal to air conduction.
Air conduction of the affected side is greater than bone conduction.
Sound lateralizes to the unaffected ear.
Bone conduction of the unaffected ear is greater than air conduction.: Bone conduction of
the affected side is greater than air conduction
4. A 41-year-old woman presents to the local emergency department with a 14-day
history of nasal drainage, congestion, fever, and cheek pain. She was started on
amoxicillin/clavulanate initially, but she was switched to levofloxacin 7 days ago due to no
improvement in symptoms. After 7 days of levofloxacin therapy, she presents again,
reporting that she is no better. The fever continues and she now has upper tooth pain. On
exam, she is in mild distress, with thick purulent rhinorrhea and halitosis. Question
What is the next step in the care of this patient?
Admission for intravenous antibiotics
Continue current therapy for an additional 10 days
Switch to a broad spectrum antibiotic
Refer to ENT for sinus aspiration
Sinus surgery: Refer to ENT for sinus aspiration
5. A 44-year-old man presents for follow-up of poorly controlled type 1 diabetes mellitus
that was diagnosed 32 years ago. What change on his funduscopic examination would
indicate a need for urgent referral to an ophthalmologist?
, EENT Exam Master
Blot hemorrhages
Cotton wool spots
Microaneurysms
Neovascularization
Flame-shaped hemorrhages: Neovascularization
6. A 42-year-old man presents with a firm painless bump on his left upper eyelid. On
examination, you note a 5 mm mass within the tarsus of the left eye. The skin is freely
movable over the mass. The remainder of the eye exam is unremarkable. Question
What is the most likely diagnosis?
Pterygium
Ectropion
Hordeolum
Chalazion
Xanthelasma: Chalazion
7. A 25-year-old male patient presents with an acute otitis media with serous otitis in
the right ear. Weber and Rinne tests are performed.
Question
What results are expected?
A Weber—sound is heard louder in right ear; Rinne—bone conduction exceeds air
conduction in right ear
B Weber—sound is heard louder in left ear; Rinne—bone conduction exceeds air
conduction in right ear
C Weber—sound is heard louder in right ear; Rinne—air conduction exceeds bone
conduction in right ear
D Weber—sound is heard louder in left ear; Rinne—air conduction exceeds air conduction
in right ear
E Weber—sound is equal in both ears; Rinne—bone conduction greater than
, EENT Exam Master
air conduction in right ear: C Weber—sound is heard louder in right ear; Rinne—bone
conduction exceeds air conduction in right ear
8. A 67-year-old woman presents; according to her, her husband says she never listens
to anything he says. The patient states that occasionally she has to ask people to repeat
themselves when sitting to her right. She denies any dizziness, headaches, or visual
disturbances. Her current medication is furosemide. On physical examination, the Weber
test reveals lateralization to the left ear. On the left ear, air conduction lasted for 15 seconds
and bone conduction lasted 10 seconds. On the right ear, air conduction lasted for 22
seconds and bone conduction lasted 10 seconds.
Question
What is the most likely cause of this hearing loss?
Cerumen impaction
Otosclerosis
Ototoxicity
Ménière's disease
Middle ear effusion: Ototoxicity
9. A 35-year-old woman presents with a painful swelling of her left eyelid. On physical
exam, there is tenderness to palpation and erythematous swelling present on the lid
margin involving the eyelashes. Question
What is the most likely diagnosis?
Xanthelasma
Chalazion
Hordeolum
Pinguecula
Dacryocystitis: Hordeolum
1. A 22-year-old woman presents with a 1-year history of flaking and scaling around her
lashes, along with itching and a burning sensation. She has also noted her lid margins are
red, and some of her lashes are missing.
Her history is significant for diabetes and for seborrheic dermatitis of the scalp, eyebrows,
and external ears.
Question
What is the most likely diagnosis?
Blepharitis
Chalazion
Conjunctivitis
Ectropion
Foreign body: Blepharitis
2. A 78-year-old Caucasian man presents with unilateral painless loss of vision in the
right eye of 3 hours duration. Examination reveals an elderly man who is anxious but in no
acute distress. Visual acuity is light perception only in the right eye and 20/30 in the left
eye. Pupillary examination is significant for an afferent pupillary defect on the right side.
Penlight examination of the eyes is otherwise unremarkable. Retinal examination of the
right eye reveals a cherry-red spot. Retinal examination of the left eye is unremarkable.
Question
What disease process most likely accounts for the patient's presentation?
Adult-onset Tay-Sachs disease
Open-angle glaucoma
Central retinal artery occlusion
Trauma
Cataract: Central retinal artery occlusion
, EENT Exam Master
3. A 30-year-old Black male patient is admitted to the hospital to undergo stapedectomy
for the treatment of otosclerosis. He has experienced increased hearing loss in the right
ear for a few years. The patient's mother had had the same condition when she was in her
40s, and she underwent a successful operation. Assessment is performed using the Weber
and Rinne tests.
Question
What physical exam finding is expected?
Bone conduction of the affected side is greater than air conduction. Bone conduction
of the affected side is equal to air conduction.
Air conduction of the affected side is greater than bone conduction.
Sound lateralizes to the unaffected ear.
Bone conduction of the unaffected ear is greater than air conduction.: Bone conduction of
the affected side is greater than air conduction
4. A 41-year-old woman presents to the local emergency department with a 14-day
history of nasal drainage, congestion, fever, and cheek pain. She was started on
amoxicillin/clavulanate initially, but she was switched to levofloxacin 7 days ago due to no
improvement in symptoms. After 7 days of levofloxacin therapy, she presents again,
reporting that she is no better. The fever continues and she now has upper tooth pain. On
exam, she is in mild distress, with thick purulent rhinorrhea and halitosis. Question
What is the next step in the care of this patient?
Admission for intravenous antibiotics
Continue current therapy for an additional 10 days
Switch to a broad spectrum antibiotic
Refer to ENT for sinus aspiration
Sinus surgery: Refer to ENT for sinus aspiration
5. A 44-year-old man presents for follow-up of poorly controlled type 1 diabetes mellitus
that was diagnosed 32 years ago. What change on his funduscopic examination would
indicate a need for urgent referral to an ophthalmologist?
, EENT Exam Master
Blot hemorrhages
Cotton wool spots
Microaneurysms
Neovascularization
Flame-shaped hemorrhages: Neovascularization
6. A 42-year-old man presents with a firm painless bump on his left upper eyelid. On
examination, you note a 5 mm mass within the tarsus of the left eye. The skin is freely
movable over the mass. The remainder of the eye exam is unremarkable. Question
What is the most likely diagnosis?
Pterygium
Ectropion
Hordeolum
Chalazion
Xanthelasma: Chalazion
7. A 25-year-old male patient presents with an acute otitis media with serous otitis in
the right ear. Weber and Rinne tests are performed.
Question
What results are expected?
A Weber—sound is heard louder in right ear; Rinne—bone conduction exceeds air
conduction in right ear
B Weber—sound is heard louder in left ear; Rinne—bone conduction exceeds air
conduction in right ear
C Weber—sound is heard louder in right ear; Rinne—air conduction exceeds bone
conduction in right ear
D Weber—sound is heard louder in left ear; Rinne—air conduction exceeds air conduction
in right ear
E Weber—sound is equal in both ears; Rinne—bone conduction greater than
, EENT Exam Master
air conduction in right ear: C Weber—sound is heard louder in right ear; Rinne—bone
conduction exceeds air conduction in right ear
8. A 67-year-old woman presents; according to her, her husband says she never listens
to anything he says. The patient states that occasionally she has to ask people to repeat
themselves when sitting to her right. She denies any dizziness, headaches, or visual
disturbances. Her current medication is furosemide. On physical examination, the Weber
test reveals lateralization to the left ear. On the left ear, air conduction lasted for 15 seconds
and bone conduction lasted 10 seconds. On the right ear, air conduction lasted for 22
seconds and bone conduction lasted 10 seconds.
Question
What is the most likely cause of this hearing loss?
Cerumen impaction
Otosclerosis
Ototoxicity
Ménière's disease
Middle ear effusion: Ototoxicity
9. A 35-year-old woman presents with a painful swelling of her left eyelid. On physical
exam, there is tenderness to palpation and erythematous swelling present on the lid
margin involving the eyelashes. Question
What is the most likely diagnosis?
Xanthelasma
Chalazion
Hordeolum
Pinguecula
Dacryocystitis: Hordeolum
