Head
Eyes
Ears
Nose
Throat/Neck
100
You suspect a patient has a central cause of vertigo. This type of imaging is indicated to rule out vertebrobasilar insufficiency.
What is MRI (Magnetic Resonance Imaging)?
100
A 14-year-old girl has had a small, round, slightly tender swelling in her right lower eyelid for 2-3 days that has gradually enlarged, becoming round and painless. There has not been any drainage or itching noted or visual changes. She has been well otherwise. On exam, vitals are normal, extraocular muscles are intact, and pupils are equal and reactive to light. Her mid right lower eyelid has a 1.5 cm round, nontender, swollen mass that is mildly erythematous without any drainage. The underside of the lid is grayish-red. Based on these findings, this is the most likely diagnosis.
What is a Chalazion.
100
A 12-year-old girl comes to your office with a 2-day history of right ear pain. She has been taking swimming lessons over the past two weeks. Past medical history is unremarkable. She has no allergies and she is taking acetaminophen for pain relief. The patient experiences pain with the examination and you note edema of the external auditory canal. The tympanic membrane appears normal. This is the most likely diagnosis.
What is otitis externa?
100
Bacterial rhinosinusitis is commonly caused by these pathogens. Name at least two.
What is
1. Moraxella catarrhalis
2. H. influenzae
3. S pneumoniae
4. S auerus
5. streptococci
100
A 20 year old college student presents with persistent sore throat, fatigue and mild abdominal discomfort. You review the patient's chart and notice that he was seen 3 days ago by your colleague with a sore throat and on exam the patient was found to have exudative tonsillitis, a fever and anterior cervical adenopathy. He was then started on amoxicillin. Now the patient presents to you with persistent symptoms and a macular erythematous rash. The patient's reaction to antibiotics revealed this likely diagnosis.
What is Mononucleosis (What is EBV or CMV)?
200
A patient brought into the ER unconscious after a head trauma is found to have this finding on non-contrast head CT. 
What is a subdural hematoma?
200
Topical fluorescein staining and Wood's lamp evaluation can be used to diagnose this ophthalmic injury.
What is corneal abrasion.
200
Bernice has been complaining of progressive hearing loss and you send her for audiology evaluation. Your tympanogram report returns showing this result.
What is Type AS tympanogram (shallow/fixed TM most consistent with otosclerosis)?
200
These benign tumors are commonly seen in patients with allergic rhinitis, and treated with intranasal corticosteroids.
What are nasal polyps?
200
Examination of a 14-year old female patient shows elevated temp of 102 degrees, pain with swallowing and opening her mouth, and cervical lymph node enlargement. An image from her exam is shown below.
This is the most likely diagnosis. 
What is peritonsillar abscess?
300
Your patient presents to the ER with "the worst headache of my life." Symptoms were spontaneous in onset without trauma and are worsened on exertion. During the first 2 hours in the ER the patient develops neck pain and stiffness. Your non-contrast CT reveals this suspected diagnosis. 
What is SAH (Subarachoid Hemorrhage).
300
A 60 year old male presents to the emergency department with gradually worsening left sided flashes of lights and floaters over the last three days. He denies eye pain and now admits to vision loss in the upper L visual field "like a shade coming down." Left pupil is reactive to direct and consensual light. An ultrasound of the left eye is completed (shown below) revealing this suspected diagnosis. 
What is retinal detachment?
-Flashes
-Floaters
-Curtain of darkenss
300
Chronic otitis media can result in this complication which erodes bone and otoscopic examination reveals tympanic membrane perforation which exudes keratin debris.
What is cholesteatoma?
300
This population is at higher risk of nasopharyngeal carcinoma.
Who are people of southern Chinese descent?
300
According to Nexus criteria, this finding indicates a patient needs cervical spine imaging before removing a cervical collar. Name at least 2.
400
A 23 year-old female presents with gradual onset dizziness x 48 hours. She describes a constant sensation of the room spinning around her, and she also has uncontrollable nausea and vomiting. She denies hearing loss, tinnitus or ear aches. Five days ago she started to have symptoms of rhinorrhea, sore throat, and a nonproductive cough. This is the likely cause of her symptoms.
What is Vestibular neuronitis?
Also acceptable: (What is Peripheral vertigo)?
Labyrinthitis = severe vertigo lasting days to weeks +tinnitus +hearing loss
400
A 74 year old female with a past medical history including atrial fibrillation, diabetes, and glaucoma presents with painless, left sided vision loss. “Thirty minutes ago I was watching TV and all of a sudden it was like the room was turning black in one eye.” The patients vital signs are HR: 92, BP: 130/83, RR: 16, T: 36.9 degrees Celcius. On physical examination, the patient has in-tact light perception, and visual acuity is 20/25 on the right and 20/100 on the left. After your eye exam you recognize the time sensitive nature of this sight threatening emergency.
What is retinal artery occlusion?
400
This treatment improves the odds of recovery from sudden sensorineural hearing loss, which requires prompt evaluation and treatment.
Oral corticosteroids
- prednisolone 10 day taper
400
Identify the structure highlighted in blue. 
What are the ethmoid sinuses?
What are the ethmoid air cells?
400
A 4-year-old boy without vaccinations presents with a sore throat. Mom has also noted that the patient's voice sounds muffled. On physical examination, the patient is ill-appearing, sitting forward with some drooling. This exam maneuver should be avoided to prevent an acute airway.
What is examining the posterior oropharynx which might elicit a gag or cough.
500
A 58 year old male patient presents after suffering a head injury. With painful stimuli the patient opens his eyes and withdraws in response. The patient is speaking inappropriate words. Glasgow coma scale score is this number.
500
A 58 year old female with diabetes mellitus presents with worsening left sided eye pain/blurred vision that started three hours. The patient's vitals are HR: 80, BP: 156/80, RR: 18, T: 37.6 degrees Celsius. On physical examination you observe a steamy cornea in the left eye. Visual acuity is decreased in the left eye compared to the right eye. Tonometry reveals intraocular pressures of 30 on the left and 18 on the right. This is the most appropriate next step.
What is acute ophthalmology consultation?
What is administer eye drops to reduce IOP?
Carbonic anhydrase inhibitors (acetazolamide, dorzolamide) decrease aqueous humor formation and are used commonly as first-line therapy in combination with beta-blockers (timolol) and alpha-2 agonists (brimonidine).
500
Name one of these otalgic findings are associated with Meniere Syndrome (in combination with episodic vertigo).
What is:
1. fluctuating low-frequency sensorineural hearing loss
2. Low-tone "blowing" tinnitus
3. Unilateral aural pressure
500
Ernie is a 30 year old male presenting with pharyngitis. He notes that his symptoms have been present for about 1 week, no fevers, no abdominal pain, headache, or rhinorrhea. Ernie is in an open relationship with his partner Fred. Upon further questioning, Ernie recalls that Fred has been complaining of dysuria over the past week, but Ernie denies any GU symptoms of dysuria, or discharge. This is the most appropriate treatment option for Ernie?
What is dual antibiotic therapy (cefriaxone 250mg IM x 1 PLUS Azithrmax 1g PO x 1) ?
600
A 16 year old male presents with blunt force trauma to the left orbit.
Name the physical exam finding shown, most likely diagnosis, and precautions pre and post-operatively.
What are:
Extraocular muscle entrapment
Orbital blowout fracture
No straw sucking, coughing, blowing nose
600
Unilateral ptosis, miosis, and anhydrosis are associated with this diagnosis.
What is Horner's syndrome?
600
Jim is a 68 year old man who presents with a left sided ear rash x 1 day (shown below).
Jane is a 68 year old woman who presents with a similar rash x two days associated with vertigo and left sided facial paralysis.
Name the most likely diagnosis for each patient?
What is:
-Zoster oticus affecting Jim.
-Ramsay Hunt syndrome affecting Jane.
600
A 6 year old girl presents after a trampoline injury. She landed on her head and had sudden onset of pain. She had LOC for 10 seconds. A CT scan of her head is normal, and a CT scan of her cervical spine is shown below.
Name the most likely diagnosis, next best test, and next best step in management/treatment.
What is:
Dens/C2 fracture
Imaging of the thoracic and lumbar spine (x-ray acceptable); ~10% of C-spine injuries associated with other spine injuries
Neurosurgery consultation