Otolaryngology Exam (Ear, Nose And Throat) Questions And 100% Verified Answers With Rationales - Comprehensive Final Assessment -
Graded A+ Latest
Otolaryngology | Ear Nose Throat | ENT | High Yield | Graded A+ Latest
TABLE OF CONTENTS
1. I. Otology External Ear - Otitis Externa Swimmers Ear Pain Pulling Tragus Purulent Discharge Swimming Pseudomonas aeruginosa S. aureus Treat
Ciprofloxacin-Dexamethasone Ear Drops Keep Ear Dry
2. II. Otology Middle Ear - Acute Otitis Media Ear Pain Fever Bulging TM Erythema Decreased Mobility Pneumatic Otoscopy S. pneumoniae H.
influenzae M. catarrhalis Treat Amoxicillin 80-90 mg/kg/day First Line Allergy Azithromycin Severe Augmentin, Otitis Media with Effusion Conductive
Hearing Loss Speech Delay Flat Tympanogram Type B Observation 3 Months Tympanostomy Tubes
3. III. Audiology Hearing Loss - Sudden Sensorineural Hearing Loss Unilateral Sudden No Pain After Viral URI Emergency Audiogram High Dose Oral
Steroids Prednisone 60 mg Within 72 Hours ENT Referral MRI Acoustic Neuroma, Acoustic Neuroma Vestibular Schwannoma Tinnitus Hearing Loss
Vertigo Unilateral SNHL Cerebellopontine Angle Mass MRI NF2 Bilateral
4. IV. Vestibular - Meniere Disease Vertigo Tinnitus Hearing Loss Ear Fullness Episodes Hours Endolymphatic Hydrops Low Salt Diuretic Meclizine,
BPPV Brief <1 min Positional Rolling Over Dix-Hallpike Positive Nystagmus Otoconia Displaced Epley Maneuver Canalith Repositioning
5. V. Rhinology - Acute Bacterial Rhinosinusitis Nasal Congestion Purulent Discharge Facial Pain Pressure Maxillary Fever >10 Days Double Worsening
S. pneumoniae H. influenzae M. catarrhalis Treat Amoxicillin-Clavulanate, Allergic Rhinitis Sneezing Clear Rhinorrhea Itchy Eyes Seasonal IgE
Intranasal Corticosteroid Fluticasone First Line Antihistamine Loratadine Cetirizine, Samter Triad Nasal Polyps Asthma Aspirin Sensitivity AERD
Anosmia
6. VI. Epistaxis - Anterior Epistaxis Kiesselbach Plexus Little Area Most Common Direct Pressure 10-15 min Pinching Nares Oxymetazoline Cautery
Silver Nitrate Visible Vessel Anterior Packing Persistent, Posterior Woodruff Plexus Posterior Packing ENT
7. VII. Pharyngology Laryngology - Strep Pharyngitis Group A Strep pyogenes Sore Throat Fever Exudates Anterior Cervical No Cough Centor 4 Rapid
Strep Positive Treat Penicillin V Amoxicillin 10 Days, Peritonsillar Abscess Trismus Uvula Deviation Hot Potato Voice Fever Needle Aspiration Incision
Drainage Antibiotics Amoxicillin-Clavulanate Steroids ENT, Croup Barky Cough Inspiratory Stridor Night Steeple Sign Parainfluenza Dexamethasone 0.6
mg/kg Racemic Epi, Epiglottitis Hib Drooling Tripod Muffled Voice Stridor Fever Thumbprint Sign Enlarged Epiglottis Do Not Examine Throat Secure
Airway Ceftriaxone
8. VIII. Head and Neck Cancer - Laryngeal Carcinoma Squamous Cell Risk Smoking Alcohol Hoarseness >3 Weeks Weight Loss Hemoptysis Neck
Mass Ulcerated Lesion Vocal Cord Biopsy CT Staging Surgery Radiation Chemoradiation, Painless Neck Mass Smoker Alcohol Weight Loss Dysphagia
Hoarseness Squamous Cell Carcinoma Exam Laryngoscopy Biopsy FNA CT HPV Oropharynx
9. IX. Pediatric ENT - Choanal Atresia Birth Respiratory Distress Cyanosis Improved Crying Obligate Nasal Breather Bilateral Emergency Airway
Unilateral Later CT Surgical Repair, Esophageal Zenker Diverticulum Dysphagia Regurgitation Undigested Food Halitosis Neck Mass Gurgling Barium
Swallow Posterior Hypopharynx Surgery Diverticulectomy
10. X. Practice Questions - Each Asked Like Real Otolaryngology Exam
11. XI. Answer Key with 100% Verified Answers With Rationales Graded A+ Latest
,OTOLARYNGOLOGY EXAM - PRACTICE QUESTIONS - EACH QUESTION ASKED LIKE REAL EXAM
Based on Otolaryngology ENT Blueprint - Otology Rhinology Laryngology Head Neck Cancer Pediatric ENT Airway Emergencies Vertigo Hearing Loss. High Yield Graded A+ Latest.
1. A 25-year-old with epistaxis anterior, Kiesselbach plexus bleeding. What is management?
A. Posterior packing
B. No pressure
C. Only posterior
D. Anterior epistaxis Kiesselbach plexus Little area most common - management direct pressure 10-15 min, pinching nares, topical oxymetazoline, cautery silver nitrate if
visible vessel, anterior packing if persistent
Answer: D
Rationale: Anterior epistaxis Kiesselbach plexus Little area most common direct pressure 10-15 min pinching nares oxymetazoline cautery silver nitrate visible vessel
anterior packing persistent.
2. A 5-year-old with ear pain, fever, bulging tympanic membrane, erythema, decreased mobility on pneumatic otoscopy. What is diagnosis and treatment?
A. Acute otitis media - ear pain fever bulging TM erythema decreased mobility pneumatic otoscopy - most common S. pneumoniae H. influenzae M. catarrhalis - treat
amoxicillin first line 80-90 mg/kg/day, if allergy azithromycin, if severe augmentin
B. No AOM
C. Otitis externa
D. Only chronic
Answer: A
Rationale: Acute otitis media ear pain fever bulging TM erythema decreased mobility pneumatic otoscopy S. pneumoniae H. influenzae M. catarrhalis treat amoxicillin 80-90
mg/kg/day first line.
3. A 30-year-old with brief vertigo <1 minute when rolling over in bed, positive Dix-Hallpike maneuver with nystagmus. Diagnosis and treatment?
A. BPPV benign paroxysmal positional vertigo - brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced - treat Epley maneuver canalith
repositioning
B. No BPPV
C. Meniere hours
D. Only Meniere
Answer: A
Rationale: BPPV brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced Epley maneuver canalith repositioning.
4. A 30-year-old with sore throat, fever, tonsillar exudates, anterior cervical lymphadenopathy, no cough, Centor 4. What is diagnosis and treatment?
A. Only mono
B. Viral pharyngitis
C. Strep pharyngitis Group A Strep pyogenes - sore throat fever exudates anterior cervical no cough Centor 4 - rapid strep test positive treat penicillin V or amoxicillin 10 days
D. No strep
Answer: C
Rationale: Strep pharyngitis Group A Strep pyogenes sore throat fever exudates anterior cervical no cough Centor 4 rapid strep positive treat penicillin V amoxicillin 10 days.
5. An 18-month-old with fever, drooling, tripod position, muffled voice, inspiratory stridor, thumbprint sign on lateral neck X-ray. Diagnosis?
A. Only croup
B. No emergency
C. Croup steeple sign
D. Epiglottitis Hib - medical emergency drooling tripod muffled voice stridor fever thumbprint sign epiglottis enlarged - do not examine throat, secure airway ENT anesthesia,
ceftriaxone
Answer: D
Rationale: Epiglottitis Hib emergency drooling tripod muffled voice stridor fever thumbprint sign enlarged epiglottis do not examine throat secure airway ceftriaxone.
6. A 4-year-old with recurrent otitis media, hearing loss, speech delay, flat tympanogram. What is complication and management?
A. No tubes
B. Otitis media with effusion and conductive hearing loss speech delay flat tympanogram type B - complication recurrent AOM eustachian tube dysfunction - treat observation
3 months, consider tympanostomy tubes if persistent >3 months hearing loss speech delay
C. No complication
D. Only sensorineural
Answer: B
Rationale: Otitis media with effusion conductive hearing loss speech delay flat tympanogram type B complication recurrent AOM eustachian dysfunction observation 3
months tympanostomy tubes if persistent >3 months.
7. A 4-year-old with recurrent otitis media, hearing loss, speech delay, flat tympanogram. What is complication and management?
A. Otitis media with effusion and conductive hearing loss speech delay flat tympanogram type B - complication recurrent AOM eustachian tube dysfunction - treat observation
3 months, consider tympanostomy tubes if persistent >3 months hearing loss speech delay
B. No complication
C. Only sensorineural
D. No tubes
Answer: A
Rationale: Otitis media with effusion conductive hearing loss speech delay flat tympanogram type B complication recurrent AOM eustachian dysfunction observation 3
months tympanostomy tubes if persistent >3 months.
8. A 30-year-old with brief vertigo <1 minute when rolling over in bed, positive Dix-Hallpike maneuver with nystagmus. Diagnosis and treatment?
A. No BPPV
B. Meniere hours
C. Only Meniere
D. BPPV benign paroxysmal positional vertigo - brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced - treat Epley maneuver canalith
repositioning
Answer: D
,Rationale: BPPV brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced Epley maneuver canalith repositioning.
9. A 20-year-old with nasal congestion, purulent discharge, facial pain pressure maxillary, fever >10 days or double worsening. Diagnosis and treatment?
A. Viral rhinosinusitis <10 days
B. No sinusitis
C. Acute bacterial rhinosinusitis - nasal congestion purulent discharge facial pain pressure maxillary fever >10 days or double worsening after improvement - S. pneumoniae
H. influenzae M. catarrhalis - treat amoxicillin-clavulanate first line if bacterial criteria
D. Only allergic
Answer: C
Rationale: Acute bacterial rhinosinusitis nasal congestion purulent discharge facial pain pressure maxillary fever >10 days double worsening S. pneumoniae treat
amoxicillin-clavulanate if bacterial criteria.
10. A 4-year-old with recurrent otitis media, hearing loss, speech delay, flat tympanogram. What is complication and management?
A. No tubes
B. Otitis media with effusion and conductive hearing loss speech delay flat tympanogram type B - complication recurrent AOM eustachian tube dysfunction - treat observation
3 months, consider tympanostomy tubes if persistent >3 months hearing loss speech delay
C. Only sensorineural
D. No complication
Answer: B
Rationale: Otitis media with effusion conductive hearing loss speech delay flat tympanogram type B complication recurrent AOM eustachian dysfunction observation 3
months tympanostomy tubes if persistent >3 months.
11. A 2-year-old with barky cough, inspiratory stridor, low grade fever, worse at night, steeple sign on X-ray. Diagnosis?
A. Croup laryngotracheobronchitis parainfluenza most common barky cough inspiratory stridor night low grade fever steeple sign subglottic narrowing cool mist
dexamethasone 0.6 mg/kg racemic epinephrine moderate-severe
B. Only asthma
C. Epiglottitis thumbprint sign
D. No croup
Answer: A
Rationale: Croup barky cough inspiratory stridor night low grade fever steeple sign subglottic narrowing parainfluenza cool mist dexamethasone 0.6 mg/kg racemic epi.
12. A 30-year-old with sore throat, fever, tonsillar exudates, anterior cervical lymphadenopathy, no cough, Centor 4. What is diagnosis and treatment?
A. No strep
B. Only mono
C. Viral pharyngitis
D. Strep pharyngitis Group A Strep pyogenes - sore throat fever exudates anterior cervical no cough Centor 4 - rapid strep test positive treat penicillin V or amoxicillin 10 days
Answer: D
Rationale: Strep pharyngitis Group A Strep pyogenes sore throat fever exudates anterior cervical no cough Centor 4 rapid strep positive treat penicillin V amoxicillin 10 days.
13. A 25-year-old with epistaxis anterior, Kiesselbach plexus bleeding. What is management?
A. Posterior packing
B. No pressure
C. Only posterior
D. Anterior epistaxis Kiesselbach plexus Little area most common - management direct pressure 10-15 min, pinching nares, topical oxymetazoline, cautery silver nitrate if
visible vessel, anterior packing if persistent
Answer: D
Rationale: Anterior epistaxis Kiesselbach plexus Little area most common direct pressure 10-15 min pinching nares oxymetazoline cautery silver nitrate visible vessel
anterior packing persistent.
14. A 2-year-old with barky cough, inspiratory stridor, low grade fever, worse at night, steeple sign on X-ray. Diagnosis?
A. Epiglottitis thumbprint sign
B. Croup laryngotracheobronchitis parainfluenza most common barky cough inspiratory stridor night low grade fever steeple sign subglottic narrowing cool mist
dexamethasone 0.6 mg/kg racemic epinephrine moderate-severe
C. No croup
D. Only asthma
Answer: B
Rationale: Croup barky cough inspiratory stridor night low grade fever steeple sign subglottic narrowing parainfluenza cool mist dexamethasone 0.6 mg/kg racemic epi.
15. A 30-year-old with sore throat, fever, tonsillar exudates, anterior cervical lymphadenopathy, no cough, Centor 4. What is diagnosis and treatment?
A. No strep
B. Only mono
C. Viral pharyngitis
D. Strep pharyngitis Group A Strep pyogenes - sore throat fever exudates anterior cervical no cough Centor 4 - rapid strep test positive treat penicillin V or amoxicillin 10 days
Answer: D
Rationale: Strep pharyngitis Group A Strep pyogenes sore throat fever exudates anterior cervical no cough Centor 4 rapid strep positive treat penicillin V amoxicillin 10 days.
16. A 30-year-old with brief vertigo <1 minute when rolling over in bed, positive Dix-Hallpike maneuver with nystagmus. Diagnosis and treatment?
A. No BPPV
B. Only Meniere
C. BPPV benign paroxysmal positional vertigo - brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced - treat Epley maneuver canalith
repositioning
D. Meniere hours
Answer: C
Rationale: BPPV brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced Epley maneuver canalith repositioning.
17. A 4-year-old with recurrent otitis media, hearing loss, speech delay, flat tympanogram. What is complication and management?
A. Otitis media with effusion and conductive hearing loss speech delay flat tympanogram type B - complication recurrent AOM eustachian tube dysfunction - treat observation
3 months, consider tympanostomy tubes if persistent >3 months hearing loss speech delay
, B. Only sensorineural
C. No tubes
D. No complication
Answer: A
Rationale: Otitis media with effusion conductive hearing loss speech delay flat tympanogram type B complication recurrent AOM eustachian dysfunction observation 3
months tympanostomy tubes if persistent >3 months.
18. A 4-year-old with recurrent otitis media, hearing loss, speech delay, flat tympanogram. What is complication and management?
A. No tubes
B. No complication
C. Otitis media with effusion and conductive hearing loss speech delay flat tympanogram type B - complication recurrent AOM eustachian tube dysfunction - treat observation
3 months, consider tympanostomy tubes if persistent >3 months hearing loss speech delay
D. Only sensorineural
Answer: C
Rationale: Otitis media with effusion conductive hearing loss speech delay flat tympanogram type B complication recurrent AOM eustachian dysfunction observation 3
months tympanostomy tubes if persistent >3 months.
19. A 25-year-old with epistaxis anterior, Kiesselbach plexus bleeding. What is management?
A. Only posterior
B. No pressure
C. Anterior epistaxis Kiesselbach plexus Little area most common - management direct pressure 10-15 min, pinching nares, topical oxymetazoline, cautery silver nitrate if
visible vessel, anterior packing if persistent
D. Posterior packing
Answer: C
Rationale: Anterior epistaxis Kiesselbach plexus Little area most common direct pressure 10-15 min pinching nares oxymetazoline cautery silver nitrate visible vessel
anterior packing persistent.
20. A 4-year-old with recurrent otitis media, hearing loss, speech delay, flat tympanogram. What is complication and management?
A. Otitis media with effusion and conductive hearing loss speech delay flat tympanogram type B - complication recurrent AOM eustachian tube dysfunction - treat observation
3 months, consider tympanostomy tubes if persistent >3 months hearing loss speech delay
B. No complication
C. Only sensorineural
D. No tubes
Answer: A
Rationale: Otitis media with effusion conductive hearing loss speech delay flat tympanogram type B complication recurrent AOM eustachian dysfunction observation 3
months tympanostomy tubes if persistent >3 months.
21. A 4-year-old with recurrent otitis media, hearing loss, speech delay, flat tympanogram. What is complication and management?
A. Only sensorineural
B. No tubes
C. No complication
D. Otitis media with effusion and conductive hearing loss speech delay flat tympanogram type B - complication recurrent AOM eustachian tube dysfunction - treat observation
3 months, consider tympanostomy tubes if persistent >3 months hearing loss speech delay
Answer: D
Rationale: Otitis media with effusion conductive hearing loss speech delay flat tympanogram type B complication recurrent AOM eustachian dysfunction observation 3
months tympanostomy tubes if persistent >3 months.
22. A 30-year-old with sore throat, fever, tonsillar exudates, anterior cervical lymphadenopathy, no cough, Centor 4. What is diagnosis and treatment?
A. No strep
B. Strep pharyngitis Group A Strep pyogenes - sore throat fever exudates anterior cervical no cough Centor 4 - rapid strep test positive treat penicillin V or amoxicillin 10 days
C. Viral pharyngitis
D. Only mono
Answer: B
Rationale: Strep pharyngitis Group A Strep pyogenes sore throat fever exudates anterior cervical no cough Centor 4 rapid strep positive treat penicillin V amoxicillin 10 days.
23. A 30-year-old with brief vertigo <1 minute when rolling over in bed, positive Dix-Hallpike maneuver with nystagmus. Diagnosis and treatment?
A. BPPV benign paroxysmal positional vertigo - brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced - treat Epley maneuver canalith
repositioning
B. No BPPV
C. Meniere hours
D. Only Meniere
Answer: A
Rationale: BPPV brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced Epley maneuver canalith repositioning.
24. A 20-year-old with nasal congestion, purulent discharge, facial pain pressure maxillary, fever >10 days or double worsening. Diagnosis and treatment?
A. Only allergic
B. Acute bacterial rhinosinusitis - nasal congestion purulent discharge facial pain pressure maxillary fever >10 days or double worsening after improvement - S. pneumoniae
H. influenzae M. catarrhalis - treat amoxicillin-clavulanate first line if bacterial criteria
C. No sinusitis
D. Viral rhinosinusitis <10 days
Answer: B
Rationale: Acute bacterial rhinosinusitis nasal congestion purulent discharge facial pain pressure maxillary fever >10 days double worsening S. pneumoniae treat
amoxicillin-clavulanate if bacterial criteria.
25. A 20-year-old with nasal congestion, purulent discharge, facial pain pressure maxillary, fever >10 days or double worsening. Diagnosis and treatment?
A. Acute bacterial rhinosinusitis - nasal congestion purulent discharge facial pain pressure maxillary fever >10 days or double worsening after improvement - S. pneumoniae
H. influenzae M. catarrhalis - treat amoxicillin-clavulanate first line if bacterial criteria
Graded A+ Latest
Otolaryngology | Ear Nose Throat | ENT | High Yield | Graded A+ Latest
TABLE OF CONTENTS
1. I. Otology External Ear - Otitis Externa Swimmers Ear Pain Pulling Tragus Purulent Discharge Swimming Pseudomonas aeruginosa S. aureus Treat
Ciprofloxacin-Dexamethasone Ear Drops Keep Ear Dry
2. II. Otology Middle Ear - Acute Otitis Media Ear Pain Fever Bulging TM Erythema Decreased Mobility Pneumatic Otoscopy S. pneumoniae H.
influenzae M. catarrhalis Treat Amoxicillin 80-90 mg/kg/day First Line Allergy Azithromycin Severe Augmentin, Otitis Media with Effusion Conductive
Hearing Loss Speech Delay Flat Tympanogram Type B Observation 3 Months Tympanostomy Tubes
3. III. Audiology Hearing Loss - Sudden Sensorineural Hearing Loss Unilateral Sudden No Pain After Viral URI Emergency Audiogram High Dose Oral
Steroids Prednisone 60 mg Within 72 Hours ENT Referral MRI Acoustic Neuroma, Acoustic Neuroma Vestibular Schwannoma Tinnitus Hearing Loss
Vertigo Unilateral SNHL Cerebellopontine Angle Mass MRI NF2 Bilateral
4. IV. Vestibular - Meniere Disease Vertigo Tinnitus Hearing Loss Ear Fullness Episodes Hours Endolymphatic Hydrops Low Salt Diuretic Meclizine,
BPPV Brief <1 min Positional Rolling Over Dix-Hallpike Positive Nystagmus Otoconia Displaced Epley Maneuver Canalith Repositioning
5. V. Rhinology - Acute Bacterial Rhinosinusitis Nasal Congestion Purulent Discharge Facial Pain Pressure Maxillary Fever >10 Days Double Worsening
S. pneumoniae H. influenzae M. catarrhalis Treat Amoxicillin-Clavulanate, Allergic Rhinitis Sneezing Clear Rhinorrhea Itchy Eyes Seasonal IgE
Intranasal Corticosteroid Fluticasone First Line Antihistamine Loratadine Cetirizine, Samter Triad Nasal Polyps Asthma Aspirin Sensitivity AERD
Anosmia
6. VI. Epistaxis - Anterior Epistaxis Kiesselbach Plexus Little Area Most Common Direct Pressure 10-15 min Pinching Nares Oxymetazoline Cautery
Silver Nitrate Visible Vessel Anterior Packing Persistent, Posterior Woodruff Plexus Posterior Packing ENT
7. VII. Pharyngology Laryngology - Strep Pharyngitis Group A Strep pyogenes Sore Throat Fever Exudates Anterior Cervical No Cough Centor 4 Rapid
Strep Positive Treat Penicillin V Amoxicillin 10 Days, Peritonsillar Abscess Trismus Uvula Deviation Hot Potato Voice Fever Needle Aspiration Incision
Drainage Antibiotics Amoxicillin-Clavulanate Steroids ENT, Croup Barky Cough Inspiratory Stridor Night Steeple Sign Parainfluenza Dexamethasone 0.6
mg/kg Racemic Epi, Epiglottitis Hib Drooling Tripod Muffled Voice Stridor Fever Thumbprint Sign Enlarged Epiglottis Do Not Examine Throat Secure
Airway Ceftriaxone
8. VIII. Head and Neck Cancer - Laryngeal Carcinoma Squamous Cell Risk Smoking Alcohol Hoarseness >3 Weeks Weight Loss Hemoptysis Neck
Mass Ulcerated Lesion Vocal Cord Biopsy CT Staging Surgery Radiation Chemoradiation, Painless Neck Mass Smoker Alcohol Weight Loss Dysphagia
Hoarseness Squamous Cell Carcinoma Exam Laryngoscopy Biopsy FNA CT HPV Oropharynx
9. IX. Pediatric ENT - Choanal Atresia Birth Respiratory Distress Cyanosis Improved Crying Obligate Nasal Breather Bilateral Emergency Airway
Unilateral Later CT Surgical Repair, Esophageal Zenker Diverticulum Dysphagia Regurgitation Undigested Food Halitosis Neck Mass Gurgling Barium
Swallow Posterior Hypopharynx Surgery Diverticulectomy
10. X. Practice Questions - Each Asked Like Real Otolaryngology Exam
11. XI. Answer Key with 100% Verified Answers With Rationales Graded A+ Latest
,OTOLARYNGOLOGY EXAM - PRACTICE QUESTIONS - EACH QUESTION ASKED LIKE REAL EXAM
Based on Otolaryngology ENT Blueprint - Otology Rhinology Laryngology Head Neck Cancer Pediatric ENT Airway Emergencies Vertigo Hearing Loss. High Yield Graded A+ Latest.
1. A 25-year-old with epistaxis anterior, Kiesselbach plexus bleeding. What is management?
A. Posterior packing
B. No pressure
C. Only posterior
D. Anterior epistaxis Kiesselbach plexus Little area most common - management direct pressure 10-15 min, pinching nares, topical oxymetazoline, cautery silver nitrate if
visible vessel, anterior packing if persistent
Answer: D
Rationale: Anterior epistaxis Kiesselbach plexus Little area most common direct pressure 10-15 min pinching nares oxymetazoline cautery silver nitrate visible vessel
anterior packing persistent.
2. A 5-year-old with ear pain, fever, bulging tympanic membrane, erythema, decreased mobility on pneumatic otoscopy. What is diagnosis and treatment?
A. Acute otitis media - ear pain fever bulging TM erythema decreased mobility pneumatic otoscopy - most common S. pneumoniae H. influenzae M. catarrhalis - treat
amoxicillin first line 80-90 mg/kg/day, if allergy azithromycin, if severe augmentin
B. No AOM
C. Otitis externa
D. Only chronic
Answer: A
Rationale: Acute otitis media ear pain fever bulging TM erythema decreased mobility pneumatic otoscopy S. pneumoniae H. influenzae M. catarrhalis treat amoxicillin 80-90
mg/kg/day first line.
3. A 30-year-old with brief vertigo <1 minute when rolling over in bed, positive Dix-Hallpike maneuver with nystagmus. Diagnosis and treatment?
A. BPPV benign paroxysmal positional vertigo - brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced - treat Epley maneuver canalith
repositioning
B. No BPPV
C. Meniere hours
D. Only Meniere
Answer: A
Rationale: BPPV brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced Epley maneuver canalith repositioning.
4. A 30-year-old with sore throat, fever, tonsillar exudates, anterior cervical lymphadenopathy, no cough, Centor 4. What is diagnosis and treatment?
A. Only mono
B. Viral pharyngitis
C. Strep pharyngitis Group A Strep pyogenes - sore throat fever exudates anterior cervical no cough Centor 4 - rapid strep test positive treat penicillin V or amoxicillin 10 days
D. No strep
Answer: C
Rationale: Strep pharyngitis Group A Strep pyogenes sore throat fever exudates anterior cervical no cough Centor 4 rapid strep positive treat penicillin V amoxicillin 10 days.
5. An 18-month-old with fever, drooling, tripod position, muffled voice, inspiratory stridor, thumbprint sign on lateral neck X-ray. Diagnosis?
A. Only croup
B. No emergency
C. Croup steeple sign
D. Epiglottitis Hib - medical emergency drooling tripod muffled voice stridor fever thumbprint sign epiglottis enlarged - do not examine throat, secure airway ENT anesthesia,
ceftriaxone
Answer: D
Rationale: Epiglottitis Hib emergency drooling tripod muffled voice stridor fever thumbprint sign enlarged epiglottis do not examine throat secure airway ceftriaxone.
6. A 4-year-old with recurrent otitis media, hearing loss, speech delay, flat tympanogram. What is complication and management?
A. No tubes
B. Otitis media with effusion and conductive hearing loss speech delay flat tympanogram type B - complication recurrent AOM eustachian tube dysfunction - treat observation
3 months, consider tympanostomy tubes if persistent >3 months hearing loss speech delay
C. No complication
D. Only sensorineural
Answer: B
Rationale: Otitis media with effusion conductive hearing loss speech delay flat tympanogram type B complication recurrent AOM eustachian dysfunction observation 3
months tympanostomy tubes if persistent >3 months.
7. A 4-year-old with recurrent otitis media, hearing loss, speech delay, flat tympanogram. What is complication and management?
A. Otitis media with effusion and conductive hearing loss speech delay flat tympanogram type B - complication recurrent AOM eustachian tube dysfunction - treat observation
3 months, consider tympanostomy tubes if persistent >3 months hearing loss speech delay
B. No complication
C. Only sensorineural
D. No tubes
Answer: A
Rationale: Otitis media with effusion conductive hearing loss speech delay flat tympanogram type B complication recurrent AOM eustachian dysfunction observation 3
months tympanostomy tubes if persistent >3 months.
8. A 30-year-old with brief vertigo <1 minute when rolling over in bed, positive Dix-Hallpike maneuver with nystagmus. Diagnosis and treatment?
A. No BPPV
B. Meniere hours
C. Only Meniere
D. BPPV benign paroxysmal positional vertigo - brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced - treat Epley maneuver canalith
repositioning
Answer: D
,Rationale: BPPV brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced Epley maneuver canalith repositioning.
9. A 20-year-old with nasal congestion, purulent discharge, facial pain pressure maxillary, fever >10 days or double worsening. Diagnosis and treatment?
A. Viral rhinosinusitis <10 days
B. No sinusitis
C. Acute bacterial rhinosinusitis - nasal congestion purulent discharge facial pain pressure maxillary fever >10 days or double worsening after improvement - S. pneumoniae
H. influenzae M. catarrhalis - treat amoxicillin-clavulanate first line if bacterial criteria
D. Only allergic
Answer: C
Rationale: Acute bacterial rhinosinusitis nasal congestion purulent discharge facial pain pressure maxillary fever >10 days double worsening S. pneumoniae treat
amoxicillin-clavulanate if bacterial criteria.
10. A 4-year-old with recurrent otitis media, hearing loss, speech delay, flat tympanogram. What is complication and management?
A. No tubes
B. Otitis media with effusion and conductive hearing loss speech delay flat tympanogram type B - complication recurrent AOM eustachian tube dysfunction - treat observation
3 months, consider tympanostomy tubes if persistent >3 months hearing loss speech delay
C. Only sensorineural
D. No complication
Answer: B
Rationale: Otitis media with effusion conductive hearing loss speech delay flat tympanogram type B complication recurrent AOM eustachian dysfunction observation 3
months tympanostomy tubes if persistent >3 months.
11. A 2-year-old with barky cough, inspiratory stridor, low grade fever, worse at night, steeple sign on X-ray. Diagnosis?
A. Croup laryngotracheobronchitis parainfluenza most common barky cough inspiratory stridor night low grade fever steeple sign subglottic narrowing cool mist
dexamethasone 0.6 mg/kg racemic epinephrine moderate-severe
B. Only asthma
C. Epiglottitis thumbprint sign
D. No croup
Answer: A
Rationale: Croup barky cough inspiratory stridor night low grade fever steeple sign subglottic narrowing parainfluenza cool mist dexamethasone 0.6 mg/kg racemic epi.
12. A 30-year-old with sore throat, fever, tonsillar exudates, anterior cervical lymphadenopathy, no cough, Centor 4. What is diagnosis and treatment?
A. No strep
B. Only mono
C. Viral pharyngitis
D. Strep pharyngitis Group A Strep pyogenes - sore throat fever exudates anterior cervical no cough Centor 4 - rapid strep test positive treat penicillin V or amoxicillin 10 days
Answer: D
Rationale: Strep pharyngitis Group A Strep pyogenes sore throat fever exudates anterior cervical no cough Centor 4 rapid strep positive treat penicillin V amoxicillin 10 days.
13. A 25-year-old with epistaxis anterior, Kiesselbach plexus bleeding. What is management?
A. Posterior packing
B. No pressure
C. Only posterior
D. Anterior epistaxis Kiesselbach plexus Little area most common - management direct pressure 10-15 min, pinching nares, topical oxymetazoline, cautery silver nitrate if
visible vessel, anterior packing if persistent
Answer: D
Rationale: Anterior epistaxis Kiesselbach plexus Little area most common direct pressure 10-15 min pinching nares oxymetazoline cautery silver nitrate visible vessel
anterior packing persistent.
14. A 2-year-old with barky cough, inspiratory stridor, low grade fever, worse at night, steeple sign on X-ray. Diagnosis?
A. Epiglottitis thumbprint sign
B. Croup laryngotracheobronchitis parainfluenza most common barky cough inspiratory stridor night low grade fever steeple sign subglottic narrowing cool mist
dexamethasone 0.6 mg/kg racemic epinephrine moderate-severe
C. No croup
D. Only asthma
Answer: B
Rationale: Croup barky cough inspiratory stridor night low grade fever steeple sign subglottic narrowing parainfluenza cool mist dexamethasone 0.6 mg/kg racemic epi.
15. A 30-year-old with sore throat, fever, tonsillar exudates, anterior cervical lymphadenopathy, no cough, Centor 4. What is diagnosis and treatment?
A. No strep
B. Only mono
C. Viral pharyngitis
D. Strep pharyngitis Group A Strep pyogenes - sore throat fever exudates anterior cervical no cough Centor 4 - rapid strep test positive treat penicillin V or amoxicillin 10 days
Answer: D
Rationale: Strep pharyngitis Group A Strep pyogenes sore throat fever exudates anterior cervical no cough Centor 4 rapid strep positive treat penicillin V amoxicillin 10 days.
16. A 30-year-old with brief vertigo <1 minute when rolling over in bed, positive Dix-Hallpike maneuver with nystagmus. Diagnosis and treatment?
A. No BPPV
B. Only Meniere
C. BPPV benign paroxysmal positional vertigo - brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced - treat Epley maneuver canalith
repositioning
D. Meniere hours
Answer: C
Rationale: BPPV brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced Epley maneuver canalith repositioning.
17. A 4-year-old with recurrent otitis media, hearing loss, speech delay, flat tympanogram. What is complication and management?
A. Otitis media with effusion and conductive hearing loss speech delay flat tympanogram type B - complication recurrent AOM eustachian tube dysfunction - treat observation
3 months, consider tympanostomy tubes if persistent >3 months hearing loss speech delay
, B. Only sensorineural
C. No tubes
D. No complication
Answer: A
Rationale: Otitis media with effusion conductive hearing loss speech delay flat tympanogram type B complication recurrent AOM eustachian dysfunction observation 3
months tympanostomy tubes if persistent >3 months.
18. A 4-year-old with recurrent otitis media, hearing loss, speech delay, flat tympanogram. What is complication and management?
A. No tubes
B. No complication
C. Otitis media with effusion and conductive hearing loss speech delay flat tympanogram type B - complication recurrent AOM eustachian tube dysfunction - treat observation
3 months, consider tympanostomy tubes if persistent >3 months hearing loss speech delay
D. Only sensorineural
Answer: C
Rationale: Otitis media with effusion conductive hearing loss speech delay flat tympanogram type B complication recurrent AOM eustachian dysfunction observation 3
months tympanostomy tubes if persistent >3 months.
19. A 25-year-old with epistaxis anterior, Kiesselbach plexus bleeding. What is management?
A. Only posterior
B. No pressure
C. Anterior epistaxis Kiesselbach plexus Little area most common - management direct pressure 10-15 min, pinching nares, topical oxymetazoline, cautery silver nitrate if
visible vessel, anterior packing if persistent
D. Posterior packing
Answer: C
Rationale: Anterior epistaxis Kiesselbach plexus Little area most common direct pressure 10-15 min pinching nares oxymetazoline cautery silver nitrate visible vessel
anterior packing persistent.
20. A 4-year-old with recurrent otitis media, hearing loss, speech delay, flat tympanogram. What is complication and management?
A. Otitis media with effusion and conductive hearing loss speech delay flat tympanogram type B - complication recurrent AOM eustachian tube dysfunction - treat observation
3 months, consider tympanostomy tubes if persistent >3 months hearing loss speech delay
B. No complication
C. Only sensorineural
D. No tubes
Answer: A
Rationale: Otitis media with effusion conductive hearing loss speech delay flat tympanogram type B complication recurrent AOM eustachian dysfunction observation 3
months tympanostomy tubes if persistent >3 months.
21. A 4-year-old with recurrent otitis media, hearing loss, speech delay, flat tympanogram. What is complication and management?
A. Only sensorineural
B. No tubes
C. No complication
D. Otitis media with effusion and conductive hearing loss speech delay flat tympanogram type B - complication recurrent AOM eustachian tube dysfunction - treat observation
3 months, consider tympanostomy tubes if persistent >3 months hearing loss speech delay
Answer: D
Rationale: Otitis media with effusion conductive hearing loss speech delay flat tympanogram type B complication recurrent AOM eustachian dysfunction observation 3
months tympanostomy tubes if persistent >3 months.
22. A 30-year-old with sore throat, fever, tonsillar exudates, anterior cervical lymphadenopathy, no cough, Centor 4. What is diagnosis and treatment?
A. No strep
B. Strep pharyngitis Group A Strep pyogenes - sore throat fever exudates anterior cervical no cough Centor 4 - rapid strep test positive treat penicillin V or amoxicillin 10 days
C. Viral pharyngitis
D. Only mono
Answer: B
Rationale: Strep pharyngitis Group A Strep pyogenes sore throat fever exudates anterior cervical no cough Centor 4 rapid strep positive treat penicillin V amoxicillin 10 days.
23. A 30-year-old with brief vertigo <1 minute when rolling over in bed, positive Dix-Hallpike maneuver with nystagmus. Diagnosis and treatment?
A. BPPV benign paroxysmal positional vertigo - brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced - treat Epley maneuver canalith
repositioning
B. No BPPV
C. Meniere hours
D. Only Meniere
Answer: A
Rationale: BPPV brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced Epley maneuver canalith repositioning.
24. A 20-year-old with nasal congestion, purulent discharge, facial pain pressure maxillary, fever >10 days or double worsening. Diagnosis and treatment?
A. Only allergic
B. Acute bacterial rhinosinusitis - nasal congestion purulent discharge facial pain pressure maxillary fever >10 days or double worsening after improvement - S. pneumoniae
H. influenzae M. catarrhalis - treat amoxicillin-clavulanate first line if bacterial criteria
C. No sinusitis
D. Viral rhinosinusitis <10 days
Answer: B
Rationale: Acute bacterial rhinosinusitis nasal congestion purulent discharge facial pain pressure maxillary fever >10 days double worsening S. pneumoniae treat
amoxicillin-clavulanate if bacterial criteria.
25. A 20-year-old with nasal congestion, purulent discharge, facial pain pressure maxillary, fever >10 days or double worsening. Diagnosis and treatment?
A. Acute bacterial rhinosinusitis - nasal congestion purulent discharge facial pain pressure maxillary fever >10 days or double worsening after improvement - S. pneumoniae
H. influenzae M. catarrhalis - treat amoxicillin-clavulanate first line if bacterial criteria
