Otolaryngology Exam (Ear, Nose and Throat)
QUESTIONS AND 100% VERIFIED ANSWERS WITH
RATIONALES GRADED A+ LATEST
Question 1
A 35-year-old patient presents with unilateral ear pain, hearing loss, and a feeling
of fullness in the ear. Otoscopic exam reveals a bulging tympanic membrane with
an air-fluid level. Which of the following is the most likely diagnosis?
A. Acute otitis media
B. Otitis externa
C. Cholesteatoma
D. Eustachian tube dysfunction
Answer: A. Acute otitis media
Rationale: Acute otitis media typically presents with ear pain, bulging tympanic
membrane, and fluid behind the TM. Otitis externa affects the external canal,
cholesteatoma shows a pearly mass, and Eustachian tube dysfunction presents
more with fullness and popping than infection.
Question 2
Which cranial nerve is primarily responsible for sensory innervation of the external
ear?
A. Facial nerve (CN VII)
B. Trigeminal nerve (CN V)
C. Vestibulocochlear nerve (CN VIII)
D. Glossopharyngeal nerve (CN IX)
Answer: B. Trigeminal nerve (CN V)
Rationale: The auriculotemporal branch of CN V provides sensory innervation to
portions of the external ear. CN VII provides motor function to muscles of facial
expression.
,Question 3
A patient complains of sudden onset vertigo, nausea, and hearing loss after a viral
upper respiratory infection. Which condition is most consistent with these
findings?
A. Labyrinthitis
B. Benign paroxysmal positional vertigo (BPPV)
C. Ménière’s disease
D. Acoustic neuroma
Answer: A. Labyrinthitis
Rationale: Labyrinthitis presents with acute vertigo, nausea, and sensorineural
hearing loss, often following a viral infection. BPPV causes brief positional vertigo
without hearing loss. Ménière’s disease is episodic and chronic.
Question 4
Which of the following is the first-line treatment for acute bacterial rhinosinusitis
in adults?
A. Oral corticosteroids
B. Oral amoxicillin-clavulanate
C. Intranasal antihistamines
D. Observation only
Answer: B. Oral amoxicillin-clavulanate
Rationale: First-line treatment for bacterial sinusitis includes amoxicillin-
clavulanate. Observation may be appropriate in mild viral cases. Corticosteroids
are adjunctive, and antihistamines are not first-line.
,Question 5
A 50-year-old patient presents with persistent hoarseness for 3 months. Which of
the following is the most appropriate next step?
A. Reassure and observe
B. Prescribe proton pump inhibitors
C. Refer for laryngoscopy
D. Prescribe antibiotics
Answer: C. Refer for laryngoscopy
Rationale: Persistent hoarseness (>2–3 weeks) warrants visualization of the vocal
cords to rule out malignancy or structural lesions.
Question 6
Which structure separates the external ear from the middle ear?
A. Oval window
B. Tympanic membrane
C. Round window
D. Eustachian tube
Answer: B. Tympanic membrane
Rationale: The tympanic membrane separates the external auditory canal from the
middle ear cavity.
Question 7
A patient presents with painless, progressive hearing loss in one ear. Audiogram
shows sensorineural hearing loss. MRI reveals a mass at the cerebellopontine
angle. What is the most likely diagnosis?
A. Otosclerosis
B. Acoustic neuroma
C. Chronic otitis media
D. Cholesteatoma
, Answer: B. Acoustic neuroma
Rationale: A cerebellopontine angle mass with unilateral sensorineural hearing
loss is characteristic of vestibular schwannoma (acoustic neuroma).
Question 8
Which of the following is the most common bacterial cause of acute otitis media in
children?
A. Staphylococcus aureus
B. Streptococcus pneumoniae
C. Pseudomonas aeruginosa
D. Haemophilus influenzae type B
Answer: B. Streptococcus pneumoniae
Rationale: Streptococcus pneumoniae is the leading cause of acute otitis media. H.
influenzae and Moraxella catarrhalis are also common.
Question 9
A patient reports recurrent episodes of vertigo lasting 20–60 minutes, accompanied
by tinnitus and hearing loss. Which condition is most likely?
A. Benign paroxysmal positional vertigo
B. Ménière’s disease
C. Vestibular neuritis
D. Labyrinthitis
Answer: B. Ménière’s disease
Rationale: Ménière’s disease presents with episodic vertigo, fluctuating hearing
loss, tinnitus, and aural fullness.
QUESTIONS AND 100% VERIFIED ANSWERS WITH
RATIONALES GRADED A+ LATEST
Question 1
A 35-year-old patient presents with unilateral ear pain, hearing loss, and a feeling
of fullness in the ear. Otoscopic exam reveals a bulging tympanic membrane with
an air-fluid level. Which of the following is the most likely diagnosis?
A. Acute otitis media
B. Otitis externa
C. Cholesteatoma
D. Eustachian tube dysfunction
Answer: A. Acute otitis media
Rationale: Acute otitis media typically presents with ear pain, bulging tympanic
membrane, and fluid behind the TM. Otitis externa affects the external canal,
cholesteatoma shows a pearly mass, and Eustachian tube dysfunction presents
more with fullness and popping than infection.
Question 2
Which cranial nerve is primarily responsible for sensory innervation of the external
ear?
A. Facial nerve (CN VII)
B. Trigeminal nerve (CN V)
C. Vestibulocochlear nerve (CN VIII)
D. Glossopharyngeal nerve (CN IX)
Answer: B. Trigeminal nerve (CN V)
Rationale: The auriculotemporal branch of CN V provides sensory innervation to
portions of the external ear. CN VII provides motor function to muscles of facial
expression.
,Question 3
A patient complains of sudden onset vertigo, nausea, and hearing loss after a viral
upper respiratory infection. Which condition is most consistent with these
findings?
A. Labyrinthitis
B. Benign paroxysmal positional vertigo (BPPV)
C. Ménière’s disease
D. Acoustic neuroma
Answer: A. Labyrinthitis
Rationale: Labyrinthitis presents with acute vertigo, nausea, and sensorineural
hearing loss, often following a viral infection. BPPV causes brief positional vertigo
without hearing loss. Ménière’s disease is episodic and chronic.
Question 4
Which of the following is the first-line treatment for acute bacterial rhinosinusitis
in adults?
A. Oral corticosteroids
B. Oral amoxicillin-clavulanate
C. Intranasal antihistamines
D. Observation only
Answer: B. Oral amoxicillin-clavulanate
Rationale: First-line treatment for bacterial sinusitis includes amoxicillin-
clavulanate. Observation may be appropriate in mild viral cases. Corticosteroids
are adjunctive, and antihistamines are not first-line.
,Question 5
A 50-year-old patient presents with persistent hoarseness for 3 months. Which of
the following is the most appropriate next step?
A. Reassure and observe
B. Prescribe proton pump inhibitors
C. Refer for laryngoscopy
D. Prescribe antibiotics
Answer: C. Refer for laryngoscopy
Rationale: Persistent hoarseness (>2–3 weeks) warrants visualization of the vocal
cords to rule out malignancy or structural lesions.
Question 6
Which structure separates the external ear from the middle ear?
A. Oval window
B. Tympanic membrane
C. Round window
D. Eustachian tube
Answer: B. Tympanic membrane
Rationale: The tympanic membrane separates the external auditory canal from the
middle ear cavity.
Question 7
A patient presents with painless, progressive hearing loss in one ear. Audiogram
shows sensorineural hearing loss. MRI reveals a mass at the cerebellopontine
angle. What is the most likely diagnosis?
A. Otosclerosis
B. Acoustic neuroma
C. Chronic otitis media
D. Cholesteatoma
, Answer: B. Acoustic neuroma
Rationale: A cerebellopontine angle mass with unilateral sensorineural hearing
loss is characteristic of vestibular schwannoma (acoustic neuroma).
Question 8
Which of the following is the most common bacterial cause of acute otitis media in
children?
A. Staphylococcus aureus
B. Streptococcus pneumoniae
C. Pseudomonas aeruginosa
D. Haemophilus influenzae type B
Answer: B. Streptococcus pneumoniae
Rationale: Streptococcus pneumoniae is the leading cause of acute otitis media. H.
influenzae and Moraxella catarrhalis are also common.
Question 9
A patient reports recurrent episodes of vertigo lasting 20–60 minutes, accompanied
by tinnitus and hearing loss. Which condition is most likely?
A. Benign paroxysmal positional vertigo
B. Ménière’s disease
C. Vestibular neuritis
D. Labyrinthitis
Answer: B. Ménière’s disease
Rationale: Ménière’s disease presents with episodic vertigo, fluctuating hearing
loss, tinnitus, and aural fullness.
