Hoarseness of Voice (1434/1700)

A 22yo man reports a 2d hx of hoarseness of voice. He denies any weight loss but he has been smoking for 4yrs. What is the single most appropriate inv?
a. None
b. Laryngoscopy
c. Bronchoscopy
d. BAL
e. CXR

Perforated tympanic membrane (1299/1700)

A 16yo boy presents with acute pain in the right ear and little bleeding from the same ear. He had been in a boxing match and had sustained a blow to the ear. There is little amount of blood in the auditory canal and a small perforation of the eardrum. What is the most appropriate management?

a. Admission for parental antibiotics
b. Nasal decongestant
c. Oral amoxicillin
d. OPD review
e. Packing of ear
f. Surgical intervention
g. Syringing ENT

Tonsillitis (930/1700)

 A 4yo boy presents with fever, sore throat and lymphadenopathy. The dx of tonsillitis has been
made. He had 3 episodes last yr. What is the most appropriate management for this pt?
a. Tonsillectomy
b. Paracetamol/ibuprofen
c. Oral penicillin V
d. IV penicillin
e. None

Hearing loss (559/1700)

A 10yo girl has been referred for assessment of hearing as she is finding difficulty in hearing her
teacher in the class. Her hearing tests show: BC normal, symmetrical AC threshold reduced
bilaterally, weber test shows no lateralization. What is the single most likely dx?

a. Chronic perforation of tympanic membrane
b. Chronic secretory OM with effusion
c. Congenital sensorineural deficit
d. Otosclerosis
e. Presbycusis

Hoarseness and difficulty swallowing (539/1700)

A 40yo man with a 25y hx of smoking presents with progressive hoarseness of voice, difficulty
swallowing and episodes of hemoptysis. He mentioned that he used to be a regular cannabis
user. What is the single most likely dx?
a. Nasopharyngeal cancer
b. Pharyngeal carcinoma
c. Sinus squamous cell carcinoma
d. Squamous cell laryngeal cancer
e. Hypopharyngeal tumor

Parotid swelling (518/1700)

A 70yo woman presents with recurrent episodes of parotid swelling. She complains of difficulty
in talking and speaking and her eyes feel gritty on waking in the morning. What is the single
most likely dx?

a. C1 esterase deficiency
b. Crohns disease
c. Mumps
d. Sarcoidosis
e. Sjogrens syndrome

SNHL, loss of corneal reflex (806/1700)

A 35yo man presents with balance problems, headache, SNHL and loss of corneal reflex on the
left side. What is the most definitive inv?

a. CT scan of internal auditory meatus
b. Nuclear imagine of the brain
c. MRI of internal auditory meatus
d. MRI brain

Vertigo, hearing loss, N&V (690/1700)

 A 28yo man complains of vertigo, nausea and vomiting for more than 30 mins and tinnitus,
hearing loss in the left ear. What is the tx for this pt?
a. Buccal prochlorperazine (2nd line)
b. Metachlorpromide
c. Cyclazine (1st line)
d. Cotrimazole
e. Ondansetron

Epistaxis (513/1700)

A 30yo lady has epistaxis for 30mins. Her Hgb is normal, MCV normal, WBC normal,
PT/APTT/Bleeding time are normal. Where is the defect?
a. Plts
b. Coagulation factor
c. Sepsis
d. Anatomical
e. RBC

Hearling loss, recent pregnancy (503/1700)

A 26yo woman has become aware of increasing right sided hearing deficiency since her recent
pregnancy. Her eardrums are normal. Her hearing tests show: BC-normal. Weber test lateralizes
to the right ear. What is the single most likely dx?
a. Encephalopathy
b. Functional hearing loss
c. Tympano-sclerosis
d. Otosclerosis
e. Sensorineural deafness

Ear ache and pre-auricular swelling (497/1700)

A 17yo man has acute pain and earache on the right side of his face. Temp=38.4C and has
extensive pre-auricular swelling on the right, tender on palpation bilaterally. What is the single
most likely dx?

a. Acute mastoiditis
b. Acute otitis externa
c. Acute OM
d. Mumps
e. OM with effusion

Vertigo on movement sideways (449/1700)

A young pt is complaining of vertigo whenever she moves sideways on the bed while lying
supine. What would be the most appropriate next step?
a. Head roll test
b. Reassure
c. Advice on posture
d. Carotid Doppler
e. CT

Sore Throat (422/1700)

A 5yo child complains of sore throat and earache. He is pyrexial. Exam: tonsils enlarged and
hyperemic, exudes pus when pressed upon. What is the single most relevant dx?
a. IM
b. Acute follicular tonsillitis
c. Scarlet fever
d. Agranulocytosis
e. Acute OM

Epistaxis following polypectomy (405/1700)

A 31yo man has epistaxis 10 days following polypectomy. What is the most likely dx?
a. Nasal infection
b. Coagulation disorder
c. Carcinoma

Vertigo, hearing loss, numbness of face (395/1700)

 A 32yo man presents with hearing loss. AC>BC in the right ear after Rhine test. He also
complains of tinnitus, vertigo and numbness on same half of his face. What is the most
appropriate inv for his condition?

a. Audiometry
b. CT
c. MRI
d. Tympanometry
e. Weber’s test

Pea in the ear (373/1700)

A mentally retarded child puts a green pea in his ear while eating. The carer confirms this.
Otoscopy shows a green colored object in the ear canal. What is the most appropriate single
best approach to remove this object?
a. By magnet
b. Syringing
c. Under GA
d. By hook
e. By instilling olive oil

Hemoptysis 7d post-tonsillectomy (345/1700)

Pt presented with hemoptysis 7d post-tonsillectomy. What is the next step?
a. Packing
b. Oral antibiotics + discharge
c. Admit + IV antibiotics
d. Return to theatre and explore
e. Ice cream and cold fluids

Pus in auditory canal, normal TM (342/1700)

An 8yo returned from Spain with severe pain in one ear. Exam: pus in auditory canal, tempanic
membrane looks normal. What is the tx option?
a. Gentamicin topical
b. Amoxicillin PO
c. Analgesia
d. Amoxicillin IV

Muffled hearing, tinnitus, vertigo, double vision (324/1700)

A man presents with muffled hearing and feeling of pressure in ear with tinnitus and vertigo. He
also complains of double vision when looking to the right. What is the most appropriate dx?

a. Meniere’s disease
b. Acoustic neuroma
c. Acute labyrinthytis
d. Meningioma
e. Otosclerosis

Epistaxis (305/1700)

A 10yo boy presents with nose bleed. What measure should be taken to stop the bleeding?
a. Press base of the nose
b. Ice packs
c. Press soft parts of the nose
d. Start tranexemic acid
e. IV fluids