Chapter 4 of 156% of exam

Eyes, Ears, Nose, and Throat

EENT content ranges from sight-threatening emergencies to common primary-care complaints. The blueprint lists eye, ear, nose, sinus and oropharyngeal disorders, foreign bodies, trauma and neoplasms.

Eye emergencies

Painful versus painless vision loss is the first branch point. Angle-closure glaucoma is painful; arterial occlusion and retinal detachment are painless. Orbital infection is separated from eyelid infection by examination of the globe.

Acute angle-closure glaucoma
Severe eye pain, halos, headache and vomiting with a hazy cornea and fixed mid-dilated pupil; treat as an emergency and arrange laser iridotomy.
Merck Manual Professional Edition, Angle-Closure Glaucoma
Central retinal artery occlusion
Sudden painless monocular vision loss with a pale retina and cherry-red spot.
Merck Manual Professional Edition, Central Retinal Artery Occlusion
Retinal detachment
Flashes, new floaters and a curtain-like field loss need urgent ophthalmology.
Merck Manual Professional Edition, Retinal Detachment
Orbital cellulitis
Proptosis, painful or impaired eye movement and reduced vision separate it from preseptal cellulitis; CT or MRI and IV antibiotics.
Merck Manual Professional Edition, Preseptal and Orbital Cellulitis

Ear and vestibular disorders

Ear questions combine the otoscopic picture with hearing and balance findings. The duration of vertigo attacks and whether hearing is affected narrow the diagnosis quickly. External, middle and inner ear disorders have different examinations and treatments.

Acute otitis media
A bulging tympanic membrane is the key sign; high-dose amoxicillin is generally the preferred antibiotic when one is used.
Merck Manual Professional Edition, Otitis Media (Acute)
Meniere disease
Episodes of vertigo lasting hours with fluctuating sensorineural hearing loss, tinnitus and aural fullness.
Merck Manual Professional Edition, Meniere Disease
Cerumen and external ear
Cerumen impaction and otitis externa are external-ear disorders managed locally.
Merck Manual Professional Edition, How to Remove Cerumen

Throat and deep neck infections

Most sore throats are self-limited, so exam items focus on the findings that signal a drainable collection or an airway threat. Trismus, drooling, voice change and stridor are warning signs. Nosebleeds are common and usually anterior.

Peritonsillar abscess
Severe sore throat, trismus, a hot potato voice and uvular deviation; drain and give antibiotics.
Merck Manual Professional Edition, Peritonsillar Abscess and Cellulitis
Epiglottitis
Rapid fever, drooling, stridor and tripod posture; protect the airway first.
Merck Manual Professional Edition, Epiglottitis
Epistaxis
Most nosebleeds arise anteriorly from Kiesselbach area and often stop with direct pressure.
Merck Manual Professional Edition, Epistaxis

Keep going: the full PANCE — Physician Assistant National Certifying Examination (NCCPA) guide covers every section of the exam. PANCE Study Guide — 2026 Edition — PDF + EPUB, $24.99 · 14-day refund →

Practice this topic →← All chapters
Studying in order?

Practice stays free. The full PANCE — Physician Assistant National Certifying Examination (NCCPA) study guide is the material itself, taught start to finish — a downloadable PDF + EPUB you keep.

Get the book — $24.99
Report