HEENT: Eye, Ear, Nose & Throat for the AANP FNP exam

Topics in this chapter

• The Red Eye DifferentialPain, vision change, and the pupil sort the harmless red eye from the sight-threatening one.
• Sudden Vision LossSudden painless vision loss is a stat referral, and one of these is treated with steroids before biopsy.
• The Ear: Otitis Media vs ExternaA bulging immobile drum versus a painful tragus tug, and one is treated orally, the other topically.
• Hearing Loss & Tuning-Fork TestsTwo tuning-fork combinations let you read any conductive-versus-sensorineural vignette.
• Pharyngitis & the Centor CriteriaThe Centor score decides who gets tested, and a few clues point straight away from strep.
• Rhinosinusitis & Allergic RhinitisThree time-based triggers tell viral sinusitis from bacterial, plus the first-line nose-drip fixes.
• Epistaxis, Oral Lesions & Peripheral VertigoThe right nosebleed move, the scrape-off test for oral lesions, and the BPPV-versus-Meniere split.
• Retinal & back-of-eye diseaseDiabetes, hypertension, and aging each leave a signature on the retina you can read on the fundus exam.
• Corneal & herpetic eye infectionsA red, painful eye with a branching corneal lesion, or a rash that hits the tip of the nose, both signal sight-threatening herpes.
• Lens & optic nerve conditionsA painless gradual clouding, a painful eye with color desaturation, and bilateral swollen discs each point somewhere different.
• Eyelid infections: preseptal vs orbital cellulitisBoth look like a swollen red eyelid, but pain on eye movement and a bulging eye flip a clinic problem into an emergency.
• Ear & throat: cholesteatoma and peritonsillar abscessA foul ear discharge with hearing loss and a hot-potato voice with a deviated uvula are the two HEENT lesions you cannot afford to miss.
• Vestibular Schwannoma (Acoustic Neuroma)One-sided sensorineural hearing loss with tinnitus is a tumor until an MRI says otherwise.
• Measles (Rubeola): Koplik Spots and the Three C'sThe three C's plus tiny white spots inside the cheek mark measles before the rash even shows.
• Nasal Polyps and Auricular HematomaAspirin-sensitive asthma points to polyps, a kid with polyps points to CF, and a smashed ear must be drained fast.
• Ectropion, Entropion, and Oral Mucosal LesionsLids that turn out or in, painful recurring mouth ulcers, and a white patch that won't wipe off each tell a different story.