Physician Assistant Eyes, Ears, Nose and Throat (EENT) 4

Question 1

Most cases of anterior epistaxis originate from which structure?

Accepted Answer

Kiesselbach plexus

Answer

Kiesselbach plexus on the anterior nasal septum is the source of about 90% of nosebleeds.

Question 2

Which presentation most strongly supports acute bacterial rather than viral rhinosinusitis?

Accepted Answer

Symptoms improving then worsening again after day 5–6

Answer

Persistent symptoms beyond 10 days, severe onset, or 'double worsening' suggest bacterial sinusitis.

Question 3

After nasal trauma, a teenager has a tender, bluish, fluctuant swelling of the nasal septum. What is the most appropriate management?

Accepted Answer

Incision and drainage with nasal packing

Answer

Septal hematoma must be drained promptly to prevent cartilage necrosis, abscess, and saddle-nose deformity.

Question 4

Which is the most effective single-agent maintenance therapy for moderate persistent allergic rhinitis?

Accepted Answer

Intranasal corticosteroid

Answer

Intranasal corticosteroids are the most effective monotherapy for allergic rhinitis, including nasal congestion.

Question 5

A patient reports worsening nasal congestion after using oxymetazoline spray twice daily for 3 weeks. What is the diagnosis?

Accepted Answer

Rhinitis medicamentosa

Answer

Rebound congestion from topical decongestant use beyond 3 days defines rhinitis medicamentosa.

Physician Assistant Practice Test