Correct Answer: C

Rationale: Rationale: The patient's symptoms of facial pain, fever, malaise, swollen turbinates, purulent nasal discharge, pain in cheeks and teeth, and pain upon palpation all point towards maxillary sinusitis. The maxillary sinuses are located in the cheek area, and infection can lead to the described symptoms. Frontal sinusitis typically presents with forehead pain, and nasal polyps would not cause the specific symptoms mentioned. Posterior epistaxis involves bleeding from the back of the nose and is not consistent with the patient's symptoms. Therefore, the correct answer is C: maxillary sinusitis.

Correct Answer: A

Rationale: The correct answer is A: Age-related hearing loss begins in the mid-40s. This is because presbycusis, or age-related hearing loss, typically starts around the mid-40s due to natural aging processes affecting the inner ear. Choice B is incorrect as the progression of hearing loss can vary, being gradual for some individuals but not necessarily slow for everyone. Choice C is incorrect as high-frequency tone loss, not low-frequency, is commonly associated with aging. Choice D is incorrect as difficulty hearing consonants is more related to specific types of hearing loss, not solely age-related changes.

Correct Answer: A

Rationale: The correct answer is A: allergies. The symptoms described such as chronic watery eyes, sneezing, and clear nasal drainage are classic signs of allergies. The presence of a transverse line across the bridge of the nose, dark blue shadows under the eyes, and a double crease on the lower eyelids are typical physical exam findings in children with allergic rhinitis. These signs are known as Dennie-Morgan lines, allergic shiners, and allergic crease respectively. Allergies are the most likely cause based on the symptoms and physical exam findings. Sinus infection (choice B) typically presents with purulent nasal discharge and facial pain. Nasal congestion (choice C) usually involves nasal stuffiness and may not present with the specific eye findings mentioned. An upper respiratory infection (choice D) may present with fever, cough, and nasal discharge, but the eye findings described are not characteristic of an upper respiratory infection.

Correct Answer: A

Rationale: The correct answer is A: No sensation. When the sinus areas are normal, the patient should not feel any discomfort or pain upon palpation. This indicates that there is no inflammation or infection present. Choices B, C, and D are incorrect because feeling firm pressure, experiencing pain during palpation, or feeling pain behind the eyes would suggest abnormalities in the sinuses, such as congestion, inflammation, or infection. Therefore, the absence of any sensation is the expected response when the sinuses are normal.

Correct Answer: A

Rationale: The correct answer is A: overlies the sclera. The bulbar conjunctiva is the transparent layer that covers the white part of the eye (sclera). This layer helps protect the eye and keeps it moist. It does not cover the iris and pupil (B), as that is the cornea's role. It is not visible at the inner canthus (C), which is where the lacrimal caruncle is located. Lastly, it is not a mucous membrane lining the lids (D), as that is the role of the palpebral conjunctiva. Therefore, the correct answer is A.