PED ENT – Flashcard
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1. In adults, the length of the external auditory canal is _____ cm. A. 0.5 B. 1 C. 2.5 D. 4 E. 5
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C. 2.5
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2. The middle ear contains the A. cerumen and sebaceous glands. B. umbo and malleus. C. vestibule and cochlea. D. pars tensa and semicircular canals. E. helix and antihelix.
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B. umbo and malleus.
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3. The middle ear is normally filled with A. mucous collections. B. blood. C. serous fluid. D. cerebrospinal fluid. E. air.
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E. air.
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4. The hair cells of Corti and membrane of Corti A. maintain equilibrium. B. protect the ear from foreign particles. C. stimulate the eighth cranial nerve. D. transmit vibrations to the ossicles. E. produce a waxy lubricant.
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C. stimulate the eighth cranial nerve.
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5. The organ of Corti is a coiled structure located inside the A. cochlea in the inner ear. B. pars flaccida in the tympanic membrane. C. eustachian tube. D. lateral aspect of the pinna. E. tragus.
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A. cochlea in the inner ear.
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6. Which ear structure is responsible for equalizing atmospheric pressure when swallowing, sneezing, and yawning? A. Eustachian tube B. Inner ear C. Semicircular canals D. Triangular fossa E. Oval window
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A. Eustachian tube
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7. The structures that lie along the lateral wall of the nasal cavity near the facial cheek are the _____ sinuses. A. ethmoid B. frontal C. maxillary D. cribriform E. sphenoid
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C. maxillary
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8. A 5-year-old child presents with nasal congestion and a headache. To assess for sinus tenderness, you should palpate over the A. sphenoid and frontal sinuses. B. maxillary and frontal sinuses. C. maxillary sinuses only. D. sphenoid sinuses only. E. ethmoid and frontal sinuses.
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B. maxillary and frontal sinuses
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9. A 30-year-old woman presents with rapid swelling beneath her jaw that suddenly appears while she is eating. The swelling is mildly painful but is not hot or red. You suspect Wharton salivary duct stones and proceed to palpate A. bilaterally along the buccal mucosa. B. under the tongue, along each side of the frenulum. C. dorsum of the tongue. D. beside the gingivae near each molar. E. along the roof of the mouth.
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B. Under the tongue, along each side of the frenulum.
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10. An infant's auditory canal, when compared with an adult's, is A. short, narrow, and straight. B. short and curved upward. C. long, narrow, and curved forward. D. short and curved downward. E. long, wide, and straight.
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B. short and curved upward
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11. When examining an infant's middle ear, the practitioner should use one hand to stabilize the otoscope against the head while using the other hand to A. pull the auricle down and back. B. hold the speculum in the canal. C. distract the infant. D. stabilize the chest. E. pull the auricle up.
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A. Pull the auricle down and back
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12. The eruption of permanent teeth most commonly begins with the A. upper central incisors. B. upper canines. C. lower central incisors. D. lower canines. E. upper lateral incisors.
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C. lower central incisors.
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13. The pregnant woman can expect to experience A. more nasal stuffiness. B. a sensitive sense of smell. C. drooling. D. enhanced hearing. E. decreased vascularity of the gums.
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A. more nasal stuffiness.
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14. During what developmental stage are hoarseness, voice cracking, and a persistent cough a common finding? A. Adolescence B. Infancy C. Menopause D. Pregnancy E. Childhood
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D. Pregnancy
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15. Which of the following is associated with age-related hearing loss? A. Degeneration of the hair cells of the organ of Corti B. Excess resorption of bone cells of the ossicle chain C. Increased pliability of the tympanic membrane D. More serous cerumen E. Proliferation of the stria vascularis
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A. Degeneration of the hair cells of the organ of Corti
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16. You are performing hearing screening tests. Difficulty in hearing the highest frequencies would be expected in a ___-year-old patient. A. 7 B. 12 C. 20 D. 40 E. 65
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E. 65
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17. Mr. S presents with the complaint of hearing loss. You specifically inquire about current medications. Which medications, if listed, are likely to contribute to his hearing loss? A. Chlorothiazide B. Acetaminophen C. Salicylates D. Cephalosporins E. Penicillins
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C. Salicylates *
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18. Mr. W, age 25 years, has recovered recently from an upper and lower respiratory infection. He describes long-standing nasal dripping. He is seeking treatment for a mild hearing loss that has not gone away. Information concerning his chronic postnasal drip should be documented in which section of his history? A. Age-specific data B. Past medical data C. Family history D. Social history E. Personal history
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B. Past medical data
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19. A newborn whose serum bilirubin is greater than 20 mg/100 mL risks later A. hearing loss. B. lichen planus. C. tooth decay. D. meningitis. E. sinusitis.
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A. hearing loss
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20. To approximate vocal frequencies, which tuning fork should be used to assess hearing? A. 100 to 300 Hz B. 200 to 400 Hz C. 500 to 1000 Hz D. 1500 to 2000 Hz E. Greater than 2000 Hz
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C. 500 to 1000 Hz
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21. You are using a pneumonic attachment on the otoscope while assessing tympanic membrane movement. You gently squeeze the bulb but see no movement of the membrane. Your next action should be to A. remove all cerumen from the canal. B. make sure the speculum is sealed from outside air. C. squeeze the bulb with more force. D. insert the speculum to depth of 2 cm. E. use a smaller plastic speculum.
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B. make sure the speculum is sealed from outside air.
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22. An ear auricle with a low-set or unusual angle may indicate chromosomal aberration or A. digestive disorder. B. skeletal anomaly. C. renal disorder. D. Ménière disease. E. heart defect.
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C. renal disorder.
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23. When conducting an adult otoscopic examination, you should A. position the patient's head leaning toward you. B. grasp the handle of the otoscope as you would a baseball bat. C. select the largest speculum that will fit in the canal. D. ask the patient to keep his or her eyes closed. E. pull the auricle down and forward.
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C. select the largest speculum that will fit in the canal
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24. Normal tympanic membrane color is A. amber. B. chalky white. C. greenish. D. pearly gray. E. red.
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D. pearly gray
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25. Bulging of an amber tympanic membrane without mobility is most often associated with A. a middle ear effusion. B. a healed tympanic membrane perforation. C. impacted cerumen in the canal. D. repeated and prolonged crying cycles. E. a Pseudomonas infection of the auditory canal.
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A. a middle ear effusion.
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26. In the presence of otitis externa, tympanic membrane perforation, or a myringotomy tube, you should A. avoid performing otoscopic examinations. B. clean the inner ear with soap. C. instill alcohol into the ear. D. never use a cerumen spoon. E. avoid instilling fluids.
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E. avoid instilling fluids
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27. When hearing is evaluated, which cranial nerve is being tested? A. III B. IV C. VIII vestibulocochlear nerve D. IX E. XII
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C. VIII vestibulocochlear nerve
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28. Speech with a monotonous tone and erratic volume may indicate A. otitis externa. B. hearing loss. C. serous otitis media. D. sinusitis. E. dry cerumen
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B. hearing loss.
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29. Placing the base of a vibrating tuning fork on the midline vertex of the patient's head is a test for A. air conduction of sound. B. bone versus air conduction. C. otitis externa. D. otitis media. E. lateralization of sound.
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E. lateralization of sound.
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30. To perform the Rinne test, place the tuning fork on the A. top of the head. B. mastoid bone. C. forehead. D. preauricular area. E. occiput.
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B. mastoid bone.
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31. You are performing Weber and Rinne hearing tests. For the Weber test, the sound lateralized to the unaffected ear; for the Rinne test, the air conduction to bone conduction-to-ratio was less than 2:1. You interpret these findings as suggestive of A. a defect in the inner ear. (Weber test=sensorineural issue. AC(air conduction)>BC(bone conduction)) B. a defect in the middle ear. C. otitis externa. D. impacted cerumen. E. serous otitis.
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A. a defect in the inner ear. (Weber test=sensorineural issue. AC(air conduction)>BC(bone conduction))
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32. Nasal symptoms that imply an allergic response include A. purulent nasal drainage. B. bluish gray turbinates. ("Turbinates that appear bluish gray or pale pink with a swollen, boggy consistency may indicate allergies"-Seidel p.243) C. small, atrophied nasal membranes. D. a firm consistency of the turbinates. E. a deviated septum.
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B. bluish gray turbinates.
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33. When you ask the patient to identify smells, you are assessing which cranial nerve? A. I (olfactory nerve) B. II C. III D. IV E. VIII
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A. I
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34. Pallor of the lips and mucous membranes is one sign of A. anemia. B. hyperbilirubinemia. C. liver problems. D. carbon monoxide poisoning. E. Peutz-Jeghers syndrome.
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A. anemia. (pallor indicative of reduced blood flow)
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35. A smooth red tongue with a slick appearance may indicate A. a niacin or vitamin B12 deficiency. B. oral cancer. C. recent use of antibiotics. D. a fungal infection. E. a geographic tongue.
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A. a niacin or vitamin B12 deficiency
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36. White, rounded, or oval ulcerations surrounded by a red halo and found on the oral mucosa are A. Fordyce spots. B. aphthous ulcers. (canker sores) C. Stensen ducts. D. leukoedema. E. angular cheilitis.
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B. aphthous ulcers. (canker sores
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37. A hairy tongue with yellowish brown to black elongated papillae on the dorsum A. is indicative of oral cancer. B. is sometimes seen after antibiotic therapy. C. usually indicates a vitamin deficiency. D. usually indicates anemia. E. is characteristic of a geographic tongue.
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B. is sometimes seen after antibiotic therapy.
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38. To inspect the lateral borders of the tongue, you should A. ask the patient to extend the tongue outward. B. insert the tongue blade obliquely against the tongue. C. lift the tongue upward with gloved fingers. D. pull the gauze-wrapped tongue to each side. E. ask the patient to lift the tongue upward.
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D. Pull gauze wrapped tongue to each side*
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39. A 6-month-old who can hear well can be expected to A. exhibit the Moro reflex. B. stop breathing in response to sudden noise. C. turn his or her head toward the source of sound. D. imitate simple words. E. understand simple phrases.
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C. turn his or her head toward the source of sound.
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40. Which variation may be an expected finding in the ear examination of a newborn? A. Diffuse light reflex B. Purulent material in the ear canal C. Redness and swelling of the mastoid process D. Small perforations of the tympanic membrane E. Increased mobility and clarity of the tympanic membrane
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A. Diffuse light reflex
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41. For best results, an otoscopic and oral examination in a child should be A. conducted at the beginning of the assessment. B. done after inspection. C. performed at the end of the examination. D. performed before palpation. E. deferred until they can fully cooperate
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C. performed at the end of the examination
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42. Which pediatric patient complaints would you refer immediately to the emergency department? A. A patient with a temperature of 100.4° F and a toothache B. A drooling patient with muffled voice and stridor C. A patient with purulent drainage from the ear and a cough D. A patient with a seal-like barking cough and anorexia E. A patient whose epiglottis is visible when the tongue is depressed (can be a normal finding in peds)
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B. A drooling patient with muffled voice and stridor
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43. Which abnormality is common during pregnancy? A. Eruption of additional molars B. Hypertrophy of the gums C. Epstein pearls D. Otitis media E. Koplik spots
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B. Hypertrophy of the gums
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44. Expected physical changes associated with older adults include A. shiny buccal mucosa. B. teeth appear shorter. C. wetter nasal mucosa. D. bristly hairs in the vestibule.
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D. bristly hairs in the vestibule
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45. Intense pain with movement of the pinna is most closely associated with A. sinusitis. B. otitis externa. C. purulent otitis media. D. bacterial otitis media. E. otitis media with effusion
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B. otitis externa
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46. Severe vertigo, tinnitus, and progressive hearing loss are characteristic of A. cholesteatoma. B. Ménière disease. C. otosclerosis. D. cocaine abuse. E. labyrinthitis.
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B. Ménière disease.
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47. Which of the following illicit drugs is commonly associated with nasal septum perforation? A. Heroin B. Marijuana C. PCP D. Ecstasy E. Cocaine
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E. Cocaine
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48. Evidence-based practice suggests that the strongest predictor of sinusitis is A. a maxillary toothache. B. dull or opaque sinus transilluminations. C. ineffective decongestants and colored nasal drainage. D. purulent nasal secretions. E. any combination of the above.
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E. any combination of the above
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49. You are interviewing a parent whose child has a fever, is batting at her right ear, and is irritable. You ask the parent about the child's appetite and find that the child has a decreased appetite. This additional finding is most suggestive of A. acute otitis media. B. otitis externa. C. serous otitis media. D. middle ear effusion. E. cerumen impaction.
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A. acute otitis media
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50. An alternative to "ahhh" suggests A. having the clinician gently stroke the soft palate with the tongue blade B. have the patient exhale and hold the breath for a few seconds with the mouth open C. having the clinician place a small amount on water in the patients nose D. have the patient inhale and hold the breath for a few seconds with the mouth open
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D. have the patient inhale and hold the breath for a few seconds with the mouth open
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51. A patient presenting with strep throat likely has A. Fever B. Cervical andenopathy C. Cough D. Pharyngeal exudate E. All of the above
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E. All of the above
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52. An earlobe crease may indicate A. Serous otitis media B. Purulent otitis media C. COPD D. CAD E. ICD-9
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D. CAD
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53. Consumption of which food has the highest statistical association with serous otitis media A. Wheat B. Corn C. Egg D. Dairy E. Peanut
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D. Dairy
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54. A Dix-Hallpike Maneuver is most useful in the diagnosis of A. BPV B. Meniere's C. Vestibular neuronitis D. Labrynthitis E. Choesteatoma
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A. BPV
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55. Which hearing test has the highest likelihood ratio of predicting hearing loss on PE. A. Abnormal whispered voice test B. Cannot hear strong finger rubbing C. Cannot hear faint finger rubbing D. Rinne Test E. Weber Test
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B. Cannot hear strong finger rubbing.
