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Worksheets

ER EEMT

Total questions: 50

Worksheet time: 25mins

Name
Class
Date
1.

A 72-year-old woman presents with sudden vision loss, severe eye pain, and halos around lights. Her intraocular pressure is 45 mmHg. What is the most appropriate first-line treatment?

a)

Oral prednisone

b)

Timolol eye drops

c)

Erythromycin ointment

d)

Acetazolamide IV and PO

2.

A patient presents with eye pain and dendritic corneal lesions seen on fluorescein staining. What is the most likely diagnosis?

a)

Bacterial conjunctivitis

b)

Corneal abrasion

c)

HSV keratitis

d)

Uveitis

3.

Which of the following is an early symptom of retinal detachment?

a)

Photophobia

b)

Purulent discharge

c)

Flashing lights and floaters

d)

Eye pruritus

4.

A 10-year-old presents with eyelid swelling, erythema, normal EOMs, and normal visual acuity. What is the next step?

a)

MRI brain

b)

Admit for IV antibiotics

c)

Outpatient amoxicillin-clavulanate

d)

Emergent CT orbit

5.

What finding differentiates orbital cellulitis from preseptal cellulitis?

a)

Erythematous eyelid

b)

Normal EOMs

c)

Normal visual acuity

d)

EOM impairment and proptosis

6.

Which organism is commonly associated with malignant otitis externa that spreads to the skull base?

a)

Staphylococcus aureus

b)

Streptococcus pneumoniae

c)

Moraxella catarrhalis

d)

Pseudomonas aeruginosa

7.

A patient presents with subconjunctival hemorrhage after coughing. What is the appropriate treatment?

a)

Topical antibiotics

b)

Artificial tears

c)

No treatment needed

d)

Oral NSAIDs

8.

A contact lens wearer presents with a painful red eye and photophobia. What complication must be ruled out?

a)

Corneal ulcer

b)

Acute glaucoma

c)

Optic neuritis

d)

Subconjunctival hemorrhage

9.

A fluorescein stain shows a linear uptake pattern on the cornea. Which condition is most likely?

a)

Retinal detachment

b)

Orbital cellulitis

c)

Corneal abrasion

d)

Preseptal cellulitis

10.

Which of the following would most likely require urgent ophthalmology consultation and CT imaging?

a)

Chalazion

b)

Viral conjunctivitis

c)

Orbital cellulitis

d)

Allergic conjunctivitis

11.

A 67-year-old diabetic presents with ear pain and purulent discharge unresponsive to otic drops. On exam, the ear canal is granulated. What is the most likely diagnosis?

a)

Acute otitis media

b)

Malignant otitis externa

c)

Cerumen impaction

d)

Cholesteatoma

12.

What is the first-line treatment for acute otitis externa with an intact tympanic membrane?

a)

Oral amoxicillin

b)

Oral azithromycin

c)

Ciprofloxacin-dexamethasone ear drops

d)

IV vancomycin

13.

Which of the following is an appropriate management step for a live insect in the external auditory canal?

a)

Immediate irrigation with cold water

b)

Use of topical lidocaine to immobilize

c)

Referral to ENT without intervention

d)

Removal with cerumen loop only

14.

A patient with a painful, swollen jaw and purulent discharge from Stensen’s duct likely has:

a)

Sialolithiasis

b)

Parotid neoplasm

c)

Suppurative parotitis

d)

Viral parotitis

15.

A 25-year-old male has jaw pain after yawning and cannot close his mouth. What is the best initial management?

a)

CT head

b)

Oral antibiotics

c)

Mandibular reduction

d)

Biopsy of masseter

16.

Which of the following patients with otitis externa is at highest risk of progression to malignant otitis externa?

a)

Healthy 20-year-old swimmer

b)

50-year-old with allergic rhinitis

c)

65-year-old with poorly controlled diabetes

d)

35-year-old with a history of frequent ear infections

17.

A patient presents with jaw pain and clicking during chewing. No trauma is reported. What is the most likely diagnosis?

a)

Mandibular dislocation

b)

Temporomandibular joint disorder (TMJ)

c)

Mandibular fracture

d)

Parotitis

18.

What imaging modality is most appropriate for suspected mastoiditis?

a)

MRI brain with contrast

b)

Non-contrast CT mastoids

c)

X-ray skull

d)

PET scan

19.

Which of the following best describes the treatment for sialolithiasis?

a)

Immediate IV antibiotics

b)

Surgical excision of the gland

c)

Massage, hydration, and sialogogues

d)

Radiation therapy

20.

A child presents with post-auricular swelling, fever, and ear pain. Tympanic membrane is normal. What is the next best step?

a)

Watchful waiting

b)

CT scan of mastoid

c)

Start antihistamines

d)

Ear lavage

21.

A 12-year-old presents with a persistent foul-smelling unilateral nasal discharge. What is the most likely diagnosis?

a)

Allergic rhinitis

b)

Sinusitis

c)

Nasal foreign body

d)

Viral upper respiratory infection

22.

The majority of anterior nosebleeds originate from which structure?

a)

Sphenopalatine artery

b)

Woodruff's plexus

c)

Ethmoidal arteries

d)

Kiesselbach's plexus

23.

What is the most appropriate initial step in treating an anterior epistaxis?

a)

Posterior balloon packing

b)

Direct nasal pressure for 10-15 minutes

c)

CT of the sinuses

d)

IV vasopressors

24.

A 68-year-old with hypertension presents with continuous bleeding from both nares and blood flowing into the oropharynx. What is the most likely diagnosis?

a)

Anterior epistaxis

b)

Septal hematoma

c)

Posterior epistaxis

d)

Nasal polyp bleed

25.

Which of the following is an appropriate antibiotic choice if nasal packing is placed?

a)

Cephalexin

b)

Azithromycin

c)

Augmentin

d)

Ciprofloxacin

26.

A 23-year-old is punched in the face. His nose is tender with lateral deviation, swelling, and crepitus. What is the best initial management?

a)

Maxillofacial CT

b)

Immediate nasal surgery

c)

Plain X-ray of the nose

d)

Analgesics and ice, ENT follow-up in 5–7 days

27.

A patient has a nasal fracture with clear fluid dripping from the nose. What complication must be ruled out?

a)

Posterior epistaxis

b)

CSF leak

c)

Allergic rhinitis

d)

Orbital blowout fracture

28.

A nasal septal hematoma is suspected. What is the appropriate next step?

a)

Observe for resolution

b)

Apply nasal packing

c)

Incision and drainage

d)

Ice and elevation only

29.

What is the most appropriate step if a loose nasal foreign body is visible on inspection?

a)

Refer to ENT only

b)

Blind probing with metal curette

c)

Removal with bayonet forceps under visualization

d)

Flush aggressively with cold water

30.

What is the best management for a posterior epistaxis that is not controlled with nasal packing?

a)

Watchful waiting

b)

Intranasal corticosteroids

c)

Admission and ENT consultation for balloon catheter or surgical intervention

d)

Oral tranexamic acid

31.

A 35-year-old presents with facial pressure, purulent nasal discharge, and maxillary tenderness for 10 days. What is the most appropriate treatment?

a)

Nasal saline spray only

b)

Oral antihistamines

c)

Amoxicillin-clavulanate

d)

Intravenous ceftriaxone

32.

What is the most common bacterial cause of acute bacterial sinusitis?

a)

Moraxella catarrhalis

b)

Staphylococcus aureus

c)

Streptococcus pneumoniae

d)

Pseudomonas aeruginosa

33.

A patient has sinus pain, congestion, and purulent discharge for 3 days. What is the best initial management?

a)

Initiate antibiotics immediately

b)

Nasal corticosteroids and supportive care

c)

CT of the sinuses

d)

Sinus aspiration

34.

Which of the following symptoms indicates a likely bacterial rather than viral sinusitis?

a)

Headache and sore throat for 2 days

b)

Clear nasal discharge with sneezing

c)

Symptoms lasting >10 days with facial pain and purulent drainage

d)

Fever and fatigue for 24 hours

35.

Chronic sinusitis is defined as symptoms lasting:

a)

>7 days

b)

>2 weeks

c)

>3 weeks

d)

>12 weeks

36.

A patient has recurrent sinus infections unresponsive to antibiotics. What imaging is best to assess for anatomical abnormalities?

a)

Skull X-ray

b)

Sinus ultrasound

c)

CT sinuses

d)

MRI brain

37.

In sinusitis, transillumination of the sinuses may reveal:

a)

Hypertransparency

b)

Air-fluid levels

c)

Diminished light transmission

d)

Clear visualization of the septum

38.

Which of the following organisms is most commonly seen in chronic sinusitis?

a)

Group A streptococcus

b)

Pseudomonas aeruginosa

c)

Anaerobic bacteria (polymicrobial)

d)

Corynebacterium diphtheriae

39.

Which is an indication for ENT referral in a sinusitis patient?

a)

Symptoms less than 7 days

b)

Positive strep test

c)

Periorbital edema or orbital cellulitis

d)

Mild maxillary tenderness

40.

What is the role of cultures in diagnosing acute bacterial sinusitis?

a)

Always required for diagnosis

b)

Done routinely in urgent care

c)

Not typically needed unless invasive disease is suspected

d)

Used only in viral sinusitis

41.

A 3-year-old presents with white, curd-like plaques on the tongue that can be scraped off, revealing a red base. What is the most likely diagnosis?

a)

Oral leukoplakia

b)

Oral candidiasis

c)

Herpangina

d)

Hand-foot-and-mouth disease

42.

A patient with painful, shallow, round oral ulcers on the buccal mucosa but no systemic symptoms most likely has:

a)

HSV gingivostomatitis

b)

Aphthous stomatitis

c)

Herpangina

d)

Candidiasis

43.

Which virus is most commonly responsible for herpangina?

a)

Epstein-Barr virus

b)

HSV-1

c)

Coxsackie A virus

d)

Cytomegalovirus

44.

A child presents with painful oral ulcers and vesicles on hands and feet. What is the diagnosis?

a)

Herpetic stomatitis

b)

Scarlet fever

c)

Hand-foot-and-mouth disease

d)

Herpangina

45.

A patient presents with fever, trismus, muffled “hot potato” voice, and unilateral tonsillar bulge. What is the most likely diagnosis?

a)

Streptococcal pharyngitis

b)

Tonsillitis

c)

Peritonsillar abscess

d)

Ludwig’s angina

46.

A patient with a history of dental trauma presents with swelling and purulence at the gumline. What is the most likely cause?

a)

Pulpitis

b)

Dental caries

c)

Dental abscess

d)

Periodontitis

47.

What is the best storage medium for an avulsed permanent tooth if immediate reimplantation is not possible?

a)

Dry gauze

b)

Tap water

c)

Patient’s mouth under the tongue

d)

Ice pack

48.

A child presents after dental trauma with exposure of dentin but not pulp. What is the best next step?

a)

Immediate extraction

b)

Smoothing only

c)

Apply calcium hydroxide and refer to dentist in 24 hrs

d)

Leave untreated

49.

A trauma patient has a tooth avulsed for over 2 hours. What is the expected outcome after reimplantation?

a)

Full recovery

b)

90% survival

c)

50% survival

d)

<5% survival

50.

Which treatment is most appropriate for pseudomembranous oral candidiasis (thrush)?

a)

Oral clindamycin

b)

IV acyclovir

c)

Oral fluconazole or topical nystatin

d)

Supportive care only