PANCE EENT 2

Question 1

A 45-year-old patient presents with sudden painless vision loss in one eye described as a 'curtain coming down.' Fundoscopic exam reveals a pale retina with a cherry-red spot at the macula. What is the most likely diagnosis?

Accepted Answer

Central retinal artery occlusion

Answer

Central retinal artery occlusion presents with sudden painless monocular vision loss, pale retina with cherry-red macula due to ischemia from loss of blood supply.

Question 2

A 7-year-old is brought in for a school screening failure. Exam reveals the left eye deviates outward when the right eye fixates. The child has no diplopia. What is the most appropriate initial management?

Accepted Answer

Referral to ophthalmology for evaluation

Answer

Exotropia in a child requires ophthalmology referral to assess for amblyopia and determine the need for patching, glasses, or surgery.

Question 3

A 60-year-old with poorly controlled diabetes presents with right-sided facial pain, purulent nasal discharge, and black necrotic tissue visible in the nasal cavity. CT shows bony erosion of the turbinates. What organism is most likely responsible?

Accepted Answer

Mucor species

Answer

Mucormycosis (rhino-orbital-cerebral) is a life-threatening fungal infection in diabetics and immunocompromised patients, causing black necrotic tissue and bony invasion.

Question 4

A 30-year-old presents with recurrent episodes of severe unilateral eye pain, redness, and halos around lights. Each episode lasts 2-3 hours and resolves spontaneously. IOP during an attack is 45 mmHg. What is the treatment of choice for long-term prevention?

Accepted Answer

Laser peripheral iridotomy

Answer

Laser peripheral iridotomy creates an opening in the iris to relieve pupillary block and prevent recurrent acute angle-closure glaucoma attacks.

Question 5

A 55-year-old presents with progressive bilateral sensorineural hearing loss, tinnitus, and episodic vertigo lasting 20 minutes to several hours. Audiometry shows low-frequency hearing loss. What is the most likely diagnosis?

Accepted Answer

Ménière's disease

Answer

Ménière's disease is characterized by the triad of episodic vertigo, fluctuating sensorineural hearing loss (initially low-frequency), and tinnitus due to endolymphatic hydrops.

PANCE Test Practice Test

PANCE Test Practice Test

PANCE EENT 2