Rafi ENT- Questions & Answers 100&
Solved
A 35-year-old man has an 8-month history of fluctuating deafness, fullness and buzzing/ringing
in both his ears. He also describes episodes of vertigo, where the room is spinning around him
and he feels extremely nauseated. Rinne's test demonstrates that air conduction is better than
bone conduction in both ears and Weber's test does not show lateralisation.
What is the most likely diagnosis?
Benign paroxysmal positional vertigo
Acoustic neuroma
Labyrinthitis
Otitis media
Meniere's disease" Correct Ans-Meniere's disease
"
John Doe, a 19-year-old male was referred to the ENT clinic by his GP due to a chronic sore
throat and cough, as well as mild hoarseness of voice for the past 6 months. The patient is lactose
intolerant but otherwise healthy. He doesn't smoke and isn't living or working in an environment
that exposes him to second-hand smoking or air pollution. He sometimes experiences a bitter
taste at the back of his throat which causes him to retch and drink water to clear the throat. There
is no history of weight loss or other systemic symptoms.
,Clinical examination is unremarkable. Fibreoptic nasendoscopy reveals minor lacerations on the
vocal fold, ventricular fold and corniculate cartilage. Nasendoscopy also identifies mild vocal
cord oedema, partial ventricular obliteration and excess endolaryngeal mucus. The appearance of
the throat was otherwise normal.
Based upon the history and clinical findings what is the most likely Correct Ans-GORD
"
10-year-old Billy Glue-Ear presents to general practice accompanied by his mother, who is
concerned that she has to call his name repeatedly before he seems to notice. The problem has
been worsening recently and is no longer limited to times when he is engrossed by the television.
He has a past history of recurrent ear infections, and currently has purulent yellow discharge
leaking from the right ear.
On otoscopic examination, there is a considerable defect in the tympanic membrane and purulent
debris in the auditory canal. You place the hilt of a ringing 256Hz tuning fork in the centre of
Billy's head, and he reports hearing it in the right ear. When the hilt of the tuning fork is placed
on his right mastoid he can hear it, but when the tips are held close to his external acoustic
meatus he hears nothing.
How would you summarise the findings of this examination?
Right conductive deafness: Rinne's Negative; Weber' Correct Ans-Right conductive deafness:
Rinne's Negative; Weber's lateralising to the right]
"
,You are a GP registrar working in a deprived area. You see James, a 14-month-old child who
attends with his mother. For the last three weeks he has been unsettled, and for the last two
weeks, he has had a discharging left ear.
You note from his records that he saw your colleague two weeks ago, who diagnosed otitis media
with perforation, took swabs for culture and started a course of amoxicillin orally.
On examination he is withdrawn but content, with a good strong cry when disturbed. He is
afebrile, with a heart rate of 124 and a respiratory rate of 28. ENT examination shows lots of
thick purulent discharge out of the left ear which is obscuring the view of the tympanic
membrane. There is no mastoid tenderness or bogginess.
Here are the swab results:
Candida culture: not isolated
Sample culture: Heavy growth of Pseudomonas species. Sensitivities not yet determined.
Which is the most appropriate action?
St Correct Ans-Start a course of topical ciprofloxacin
The tympanic membrane develops from:
Ectoderm
, Endoderm
Mesoderm
All 3 layers Correct Ans-All 3 layers
Stapes footplate covers
Round window
Oval Window
Sinus tympani
Pyramid Correct Ans-Oval Window
Sensory nerve supply to the middle ear comes from
Vagus
Caroticotympanic Nerves
Glossopharyngeal nerves
Chorda tympani Correct Ans-Glossopharyngeal
Endolymph is formed in
Utricle
Endolymphatic sac
Solved
A 35-year-old man has an 8-month history of fluctuating deafness, fullness and buzzing/ringing
in both his ears. He also describes episodes of vertigo, where the room is spinning around him
and he feels extremely nauseated. Rinne's test demonstrates that air conduction is better than
bone conduction in both ears and Weber's test does not show lateralisation.
What is the most likely diagnosis?
Benign paroxysmal positional vertigo
Acoustic neuroma
Labyrinthitis
Otitis media
Meniere's disease" Correct Ans-Meniere's disease
"
John Doe, a 19-year-old male was referred to the ENT clinic by his GP due to a chronic sore
throat and cough, as well as mild hoarseness of voice for the past 6 months. The patient is lactose
intolerant but otherwise healthy. He doesn't smoke and isn't living or working in an environment
that exposes him to second-hand smoking or air pollution. He sometimes experiences a bitter
taste at the back of his throat which causes him to retch and drink water to clear the throat. There
is no history of weight loss or other systemic symptoms.
,Clinical examination is unremarkable. Fibreoptic nasendoscopy reveals minor lacerations on the
vocal fold, ventricular fold and corniculate cartilage. Nasendoscopy also identifies mild vocal
cord oedema, partial ventricular obliteration and excess endolaryngeal mucus. The appearance of
the throat was otherwise normal.
Based upon the history and clinical findings what is the most likely Correct Ans-GORD
"
10-year-old Billy Glue-Ear presents to general practice accompanied by his mother, who is
concerned that she has to call his name repeatedly before he seems to notice. The problem has
been worsening recently and is no longer limited to times when he is engrossed by the television.
He has a past history of recurrent ear infections, and currently has purulent yellow discharge
leaking from the right ear.
On otoscopic examination, there is a considerable defect in the tympanic membrane and purulent
debris in the auditory canal. You place the hilt of a ringing 256Hz tuning fork in the centre of
Billy's head, and he reports hearing it in the right ear. When the hilt of the tuning fork is placed
on his right mastoid he can hear it, but when the tips are held close to his external acoustic
meatus he hears nothing.
How would you summarise the findings of this examination?
Right conductive deafness: Rinne's Negative; Weber' Correct Ans-Right conductive deafness:
Rinne's Negative; Weber's lateralising to the right]
"
,You are a GP registrar working in a deprived area. You see James, a 14-month-old child who
attends with his mother. For the last three weeks he has been unsettled, and for the last two
weeks, he has had a discharging left ear.
You note from his records that he saw your colleague two weeks ago, who diagnosed otitis media
with perforation, took swabs for culture and started a course of amoxicillin orally.
On examination he is withdrawn but content, with a good strong cry when disturbed. He is
afebrile, with a heart rate of 124 and a respiratory rate of 28. ENT examination shows lots of
thick purulent discharge out of the left ear which is obscuring the view of the tympanic
membrane. There is no mastoid tenderness or bogginess.
Here are the swab results:
Candida culture: not isolated
Sample culture: Heavy growth of Pseudomonas species. Sensitivities not yet determined.
Which is the most appropriate action?
St Correct Ans-Start a course of topical ciprofloxacin
The tympanic membrane develops from:
Ectoderm
, Endoderm
Mesoderm
All 3 layers Correct Ans-All 3 layers
Stapes footplate covers
Round window
Oval Window
Sinus tympani
Pyramid Correct Ans-Oval Window
Sensory nerve supply to the middle ear comes from
Vagus
Caroticotympanic Nerves
Glossopharyngeal nerves
Chorda tympani Correct Ans-Glossopharyngeal
Endolymph is formed in
Utricle
Endolymphatic sac
