Otolaryngology Exam (Ear, Nose And Throat) Questions And 100% Verified Answers With Rationales - Vertigo & Hearing Loss Excellence -
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 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. Meniere hours
C. No BPPV
D. Only Meniere
Answer: A
Rationale: BPPV brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced Epley maneuver canalith repositioning.
2. An 18-month-old with fever, drooling, tripod position, muffled voice, inspiratory stridor, thumbprint sign on lateral neck X-ray. Diagnosis?
A. Croup steeple sign
B. No emergency
C. Only croup
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.
3. 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. Croup steeple sign
C. No emergency
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.
4. 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. Viral pharyngitis
C. Only mono
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.
5. A 30-year-old with brief vertigo <1 minute when rolling over in bed, positive Dix-Hallpike maneuver with nystagmus. Diagnosis and treatment?
A. Meniere hours
B. No BPPV
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.
6. A 25-year-old with epistaxis anterior, Kiesselbach plexus bleeding. What is management?
A. 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
B. Posterior packing
C. Only posterior
D. No pressure
Answer: A
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.
7. 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
B. Only allergic
C. No sinusitis
D. Viral rhinosinusitis <10 days
Answer: A
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.
8. A 60-year-old male smoker with hoarseness >3 weeks, weight loss, hemoptysis, neck mass, history alcohol use. Laryngoscopy shows ulcerated lesion vocal
cord. Diagnosis?
A. No cancer
B. Laryngitis
C. Only benign
D. Laryngeal carcinoma squamous cell - risk smoking alcohol hoarseness >3 weeks weight loss hemoptysis neck mass ulcerated lesion vocal cord - biopsy, CT staging,
treatment surgery radiation chemoradiation
Answer: D
,Rationale: Laryngeal carcinoma squamous cell risk smoking alcohol hoarseness >3 weeks weight loss hemoptysis neck mass ulcerated vocal cord biopsy CT staging
surgery radiation.
9. 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. No croup
D. Epiglottitis thumbprint sign
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.
10. A 25-year-old with epistaxis anterior, Kiesselbach plexus bleeding. What is management?
A. No pressure
B. 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
C. Posterior packing
D. Only posterior
Answer: B
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.
11. A 45-year-old with vertigo, tinnitus, hearing loss, sensation of ear fullness, episodes lasting hours. What is diagnosis?
A. BPPV brief <1 min
B. No Meniere
C. Meniere disease - vertigo tinnitus hearing loss ear fullness episodes hours - endolymphatic hydrops - treat low salt diuretic meclizine, avoid triggers
D. Only labyrinthitis
Answer: C
Rationale: Meniere disease vertigo tinnitus hearing loss ear fullness episodes hours endolymphatic hydrops low salt diuretic meclizine.
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 45-year-old with vertigo, tinnitus, hearing loss, sensation of ear fullness, episodes lasting hours. What is diagnosis?
A. Meniere disease - vertigo tinnitus hearing loss ear fullness episodes hours - endolymphatic hydrops - treat low salt diuretic meclizine, avoid triggers
B. Only labyrinthitis
C. BPPV brief <1 min
D. No Meniere
Answer: A
Rationale: Meniere disease vertigo tinnitus hearing loss ear fullness episodes hours endolymphatic hydrops low salt diuretic meclizine.
14. A 30-year-old with brief vertigo <1 minute when rolling over in bed, positive Dix-Hallpike maneuver with nystagmus. Diagnosis and treatment?
A. Meniere hours
B. BPPV benign paroxysmal positional vertigo - brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced - treat Epley maneuver canalith
repositioning
C. Only Meniere
D. No BPPV
Answer: B
Rationale: BPPV brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced Epley maneuver canalith repositioning.
15. A 4-year-old with recurrent otitis media, hearing loss, speech delay, flat tympanogram. What is complication and management?
A. No complication
B. No tubes
C. Only sensorineural
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.
16. An 18-month-old with fever, drooling, tripod position, muffled voice, inspiratory stridor, thumbprint sign on lateral neck X-ray. Diagnosis?
A. Croup steeple sign
B. Only croup
C. No emergency
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.
17. A 4-year-old with recurrent otitis media, hearing loss, speech delay, flat tympanogram. What is complication and management?
A. No complication
B. Only sensorineural
C. No tubes
, 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.
18. A 25-year-old with epistaxis anterior, Kiesselbach plexus bleeding. What is management?
A. Posterior packing
B. 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
C. No pressure
D. Only posterior
Answer: B
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.
19. A 45-year-old with vertigo, tinnitus, hearing loss, sensation of ear fullness, episodes lasting hours. What is diagnosis?
A. Only labyrinthitis
B. Meniere disease - vertigo tinnitus hearing loss ear fullness episodes hours - endolymphatic hydrops - treat low salt diuretic meclizine, avoid triggers
C. BPPV brief <1 min
D. No Meniere
Answer: B
Rationale: Meniere disease vertigo tinnitus hearing loss ear fullness episodes hours endolymphatic hydrops low salt diuretic meclizine.
20. 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. Only mono
D. Viral pharyngitis
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.
21. A 5-year-old with ear pain, fever, bulging tympanic membrane, erythema, decreased mobility on pneumatic otoscopy. What is diagnosis and treatment?
A. Otitis externa
B. Only chronic
C. 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
D. No AOM
Answer: C
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.
22. 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. Viral rhinosinusitis <10 days
D. No sinusitis
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.
23. A 2-year-old with barky cough, inspiratory stridor, low grade fever, worse at night, steeple sign on X-ray. Diagnosis?
A. No croup
B. Epiglottitis thumbprint sign
C. 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
D. Only asthma
Answer: C
Rationale: Croup barky cough inspiratory stridor night low grade fever steeple sign subglottic narrowing parainfluenza cool mist dexamethasone 0.6 mg/kg racemic epi.
24. 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. Only chronic
D. Otitis externa
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.
25. A 20-year-old with nasal congestion, purulent discharge, facial pain pressure maxillary, fever >10 days or double worsening. Diagnosis and treatment?
A. No sinusitis
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. Only allergic
D. Viral rhinosinusitis <10 days
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 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. Meniere hours
C. No BPPV
D. Only Meniere
Answer: A
Rationale: BPPV brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced Epley maneuver canalith repositioning.
2. An 18-month-old with fever, drooling, tripod position, muffled voice, inspiratory stridor, thumbprint sign on lateral neck X-ray. Diagnosis?
A. Croup steeple sign
B. No emergency
C. Only croup
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.
3. 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. Croup steeple sign
C. No emergency
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.
4. 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. Viral pharyngitis
C. Only mono
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.
5. A 30-year-old with brief vertigo <1 minute when rolling over in bed, positive Dix-Hallpike maneuver with nystagmus. Diagnosis and treatment?
A. Meniere hours
B. No BPPV
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.
6. A 25-year-old with epistaxis anterior, Kiesselbach plexus bleeding. What is management?
A. 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
B. Posterior packing
C. Only posterior
D. No pressure
Answer: A
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.
7. 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
B. Only allergic
C. No sinusitis
D. Viral rhinosinusitis <10 days
Answer: A
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.
8. A 60-year-old male smoker with hoarseness >3 weeks, weight loss, hemoptysis, neck mass, history alcohol use. Laryngoscopy shows ulcerated lesion vocal
cord. Diagnosis?
A. No cancer
B. Laryngitis
C. Only benign
D. Laryngeal carcinoma squamous cell - risk smoking alcohol hoarseness >3 weeks weight loss hemoptysis neck mass ulcerated lesion vocal cord - biopsy, CT staging,
treatment surgery radiation chemoradiation
Answer: D
,Rationale: Laryngeal carcinoma squamous cell risk smoking alcohol hoarseness >3 weeks weight loss hemoptysis neck mass ulcerated vocal cord biopsy CT staging
surgery radiation.
9. 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. No croup
D. Epiglottitis thumbprint sign
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.
10. A 25-year-old with epistaxis anterior, Kiesselbach plexus bleeding. What is management?
A. No pressure
B. 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
C. Posterior packing
D. Only posterior
Answer: B
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.
11. A 45-year-old with vertigo, tinnitus, hearing loss, sensation of ear fullness, episodes lasting hours. What is diagnosis?
A. BPPV brief <1 min
B. No Meniere
C. Meniere disease - vertigo tinnitus hearing loss ear fullness episodes hours - endolymphatic hydrops - treat low salt diuretic meclizine, avoid triggers
D. Only labyrinthitis
Answer: C
Rationale: Meniere disease vertigo tinnitus hearing loss ear fullness episodes hours endolymphatic hydrops low salt diuretic meclizine.
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 45-year-old with vertigo, tinnitus, hearing loss, sensation of ear fullness, episodes lasting hours. What is diagnosis?
A. Meniere disease - vertigo tinnitus hearing loss ear fullness episodes hours - endolymphatic hydrops - treat low salt diuretic meclizine, avoid triggers
B. Only labyrinthitis
C. BPPV brief <1 min
D. No Meniere
Answer: A
Rationale: Meniere disease vertigo tinnitus hearing loss ear fullness episodes hours endolymphatic hydrops low salt diuretic meclizine.
14. A 30-year-old with brief vertigo <1 minute when rolling over in bed, positive Dix-Hallpike maneuver with nystagmus. Diagnosis and treatment?
A. Meniere hours
B. BPPV benign paroxysmal positional vertigo - brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced - treat Epley maneuver canalith
repositioning
C. Only Meniere
D. No BPPV
Answer: B
Rationale: BPPV brief <1 min positional rolling over Dix-Hallpike positive nystagmus otoconia displaced Epley maneuver canalith repositioning.
15. A 4-year-old with recurrent otitis media, hearing loss, speech delay, flat tympanogram. What is complication and management?
A. No complication
B. No tubes
C. Only sensorineural
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.
16. An 18-month-old with fever, drooling, tripod position, muffled voice, inspiratory stridor, thumbprint sign on lateral neck X-ray. Diagnosis?
A. Croup steeple sign
B. Only croup
C. No emergency
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.
17. A 4-year-old with recurrent otitis media, hearing loss, speech delay, flat tympanogram. What is complication and management?
A. No complication
B. Only sensorineural
C. No tubes
, 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.
18. A 25-year-old with epistaxis anterior, Kiesselbach plexus bleeding. What is management?
A. Posterior packing
B. 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
C. No pressure
D. Only posterior
Answer: B
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.
19. A 45-year-old with vertigo, tinnitus, hearing loss, sensation of ear fullness, episodes lasting hours. What is diagnosis?
A. Only labyrinthitis
B. Meniere disease - vertigo tinnitus hearing loss ear fullness episodes hours - endolymphatic hydrops - treat low salt diuretic meclizine, avoid triggers
C. BPPV brief <1 min
D. No Meniere
Answer: B
Rationale: Meniere disease vertigo tinnitus hearing loss ear fullness episodes hours endolymphatic hydrops low salt diuretic meclizine.
20. 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. Only mono
D. Viral pharyngitis
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.
21. A 5-year-old with ear pain, fever, bulging tympanic membrane, erythema, decreased mobility on pneumatic otoscopy. What is diagnosis and treatment?
A. Otitis externa
B. Only chronic
C. 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
D. No AOM
Answer: C
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.
22. 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. Viral rhinosinusitis <10 days
D. No sinusitis
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.
23. A 2-year-old with barky cough, inspiratory stridor, low grade fever, worse at night, steeple sign on X-ray. Diagnosis?
A. No croup
B. Epiglottitis thumbprint sign
C. 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
D. Only asthma
Answer: C
Rationale: Croup barky cough inspiratory stridor night low grade fever steeple sign subglottic narrowing parainfluenza cool mist dexamethasone 0.6 mg/kg racemic epi.
24. 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. Only chronic
D. Otitis externa
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.
25. A 20-year-old with nasal congestion, purulent discharge, facial pain pressure maxillary, fever >10 days or double worsening. Diagnosis and treatment?
A. No sinusitis
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. Only allergic
D. Viral rhinosinusitis <10 days
