ENT PRACTICE EXAM QUESTIONS
WITH VERIFIED ANSWERS
As you are palpating for your patients (15yoM) thyroid gland, under the hyoid bone
you feel a mass, and when you ask the patient to swallow, it is mobile. What are you
concerned for, how would you dx, and what would your treatment be? - ANSWER-
Congenital nech mass: thryoglossal duct cyst
Tx: excision
45 yo patient who is chronic drinker and smoker comes to your office complaining of
recents illness. As you are palpating the LN of the anterior chain, you feel persistent
enlargement, >1.5 cm. What are you concerned for, how would you dx, and what
would your treatment be? - ANSWER-Infectious/inflammatory neck mass- reactive
cervical lymphadenopathy
if necrotic needs FNA bx
Patient states their cat scratched them at their neck. and now it is inflamed. What are
you concerned for, how would you dx, and what would your treatment be? -
ANSWER-Infectious/inflammatory neck mass-granulomatous
Bartonella henselae
FNA bx or excisional
Tx: w/abx
other pathogen: mycobacterium, sarcoidosis
Patient states they were out in the woods and recently feels ill. You palpate their
neck, and feel cervical lymphadenopathy. You also see bells palsy. What are you
concerned for, how would you dx, and what would your treatment be? - ANSWER-
Infectious/inflammatory neck mass- Lyme disease
Borrelia burgdorferi
Tx: doxy
You palpate a 50YOM smoker/alcoholics neck on PE. you feel a firm, persistent
enlarging mass. What are you concerned for, how would you dx, and what would
your treatment be? - ANSWER-Malignant SCC or head/neck that metastasis to
cervical LN. You are worries about potential lung, GI, breast tumors
Dx: laryngoscopy, esophagoscopy, branchoschoy. Open Bx, and FNA bx
Patient comes in because his wife is very concerned about his snoring. On your PE,
you can see his palate is enlarged with excessive mucus. You send him to do a
polysomnography to evaluate for OSA. In the meantime, what do you tell him? -
ANSWER-You tell him he is at risk for obstructive sleep apnea, and that its causes
by his upper airway narrowing in sleep due to his position, the muscle tone, and the
soft tissue enlargement. You tell the patient that diet and exercise, sleep position,
are all things he can change on his own. You inform him about CPAP, to prevent the
closing of his upper airway.
,10 yo child comes in complaining of tooth pain when exposed to hot or cold
sensations. On examine you see visible pits. You ask about the diet, and mom says
she feeds them gummy's a lot. She says they have been struggling with income, and
it is one of the few things they can afford. They say they haven't been able to go to
the dentist. What are you concerned for, how would you dx, and what would your
treatment be? - ANSWER-Dental Caries
S. mutans
Calculus forming around tooth can lead to gum disease
Tx: GO TO DENTIST.
ABX: PCN, if it occurs with fever, lymphadenopathy
Preventatives: Fluoride, oral hygiene, sealants.
30 yo presents with lots of inflammation of the gingival soft tissue. You ask if it
bleeds when they brush, and they say a lot, and that it's painful so they have stopped
brushing. What are you concerned for, how would you dx, and what would your
treatment be? - ANSWER-Gingivitis
Tell them it is reversible, however if it continues it may become irreversible, and that
they are at a higher risk of CVD, DM.
Tx: GO TO DENTIST
Proper oral hygiene, OTC antimicrobial rinse (chlorhexidene mouth wash), stop
smoking
what is the treatment for oral pain in general - ANSWER-acetaminophen or NSAIDS
if believed to be non dental
Patient comes into office saying their child chipped their tooth while playing soccer.
You see that the dentin is not involved. What are you concerned for, how would you
dx, and what would your treatment be? - ANSWER-Enamel Fracture
No treatment, send to dentist to smooth with a file
Patient comes into office saying their child chipped their tooth while playing soccer.
You see that the dentin and enamel is involved. What are you concerned for, how
would you dx, and what would your treatment be? - ANSWER-Enamel and dentin Fx
Cover with CaOH2
Send to dentist within 24 hours
Patient comes into office saying their child chipped their tooth while playing soccer.
You see that the dentin and enamel is involved and that the pulp is exposed. What
are you concerned for, how would you dx, and what would your treatment be? -
ANSWER-Crown fracture
Cover with CaOH2
Abx and pain control (amoxicillin and NSAID/acetaminophen)
Patient comes into office saying their child chipped their tooth while playing soccer.
You see an adult tooth is loosened from its socket. What are you concerned for, how
would you dx, and what would your treatment be? - ANSWER-Tooth subluxation
tooth can be splinted with periodontal pack
Urgent dental consult in 24 hours
, Patient comes into office saying their child chipped their tooth while playing soccer.
You see that the tooth fell out of the socket. What are you concerned for, how would
you dx, and what would your treatment be? - ANSWER-Tooth Avulsion
-Reimplantation ASAP (every minute not done = 1% chance of failure)
use hanks solution or milk to coat the tooth
Splint with the periodontal pack
(if primary teeth- baby teeth, don't implant)
Tx: doxy or PCN
DENTIST IN 24 hours
Patient comes to office saying they feel congested, have a runny nose, for 5 days.
They admit to having a headache, a cough, and sore throat. On exam, you see
edematous mucosa, and on palpation of maxillary and frontal sinus they say it is
tender. What are you concerned for, how would you dx, and what would your
treatment be? - ANSWER-Acute viral rhinosinusitis
Cause: Rhinovrius, RSV, influenza, parainfluenza
Tx: Supportive care
-Zn acetate to help relieve symptoms
-nasal irrigation to clear sinus
-pseduoephedrine (cough meds)
What is a complication of using cold medicines for to long - ANSWER-rhinitis
medicamentosa
Patient states in the past 12 days he has felt purulent rhinorhhea, facial pain, nasal
obstruction, cough fever. He said on day 6 he felt great and then day 8/9 he felt
awful. On palpation he flinches hard when you touch the maxillary sinus. What are
you concerned for, how would you dx, and what would your treatment be? -
ANSWER-Acute bacterial rhinosinusitis
Dx: clinical, if concerned for malignancy, maybe MRI, and not responding to
treatment, do CT
Pathogen: S. pneumo, Hib, M catarrhalis
Tx: Augmentin (doxy or clinda if allergic), refer to ENT if this isn't working
NSAIDS, nasal saline, decongestant, intranasal steroid
An immunocompromised patient presents with severe facial oaubm basal discharge
that is clear-straw colored. On PE, on the middle turbinate you see black eschar.
What are you concerned for, how would you dx, and what would your treatment be?
- ANSWER-Invasive fungal sinusitis
Dx: Nasal bx for pathogen with silver strain
Pathogen: rhino cerebral mucormycosis or aspergillus
Tx: EMERGENCY
1st: Voriconazole IV with ampho B and maybe caspofungin
Surgery: surgical debridement
Prognosis- POOR, because fungus spreads rapidly through our vascular channels
80 YOF presents with anosmia. You test olfaction with UPSIT- scratch and sniff, and
determine what degree of smell she has lost. What are some reasons for loss of
WITH VERIFIED ANSWERS
As you are palpating for your patients (15yoM) thyroid gland, under the hyoid bone
you feel a mass, and when you ask the patient to swallow, it is mobile. What are you
concerned for, how would you dx, and what would your treatment be? - ANSWER-
Congenital nech mass: thryoglossal duct cyst
Tx: excision
45 yo patient who is chronic drinker and smoker comes to your office complaining of
recents illness. As you are palpating the LN of the anterior chain, you feel persistent
enlargement, >1.5 cm. What are you concerned for, how would you dx, and what
would your treatment be? - ANSWER-Infectious/inflammatory neck mass- reactive
cervical lymphadenopathy
if necrotic needs FNA bx
Patient states their cat scratched them at their neck. and now it is inflamed. What are
you concerned for, how would you dx, and what would your treatment be? -
ANSWER-Infectious/inflammatory neck mass-granulomatous
Bartonella henselae
FNA bx or excisional
Tx: w/abx
other pathogen: mycobacterium, sarcoidosis
Patient states they were out in the woods and recently feels ill. You palpate their
neck, and feel cervical lymphadenopathy. You also see bells palsy. What are you
concerned for, how would you dx, and what would your treatment be? - ANSWER-
Infectious/inflammatory neck mass- Lyme disease
Borrelia burgdorferi
Tx: doxy
You palpate a 50YOM smoker/alcoholics neck on PE. you feel a firm, persistent
enlarging mass. What are you concerned for, how would you dx, and what would
your treatment be? - ANSWER-Malignant SCC or head/neck that metastasis to
cervical LN. You are worries about potential lung, GI, breast tumors
Dx: laryngoscopy, esophagoscopy, branchoschoy. Open Bx, and FNA bx
Patient comes in because his wife is very concerned about his snoring. On your PE,
you can see his palate is enlarged with excessive mucus. You send him to do a
polysomnography to evaluate for OSA. In the meantime, what do you tell him? -
ANSWER-You tell him he is at risk for obstructive sleep apnea, and that its causes
by his upper airway narrowing in sleep due to his position, the muscle tone, and the
soft tissue enlargement. You tell the patient that diet and exercise, sleep position,
are all things he can change on his own. You inform him about CPAP, to prevent the
closing of his upper airway.
,10 yo child comes in complaining of tooth pain when exposed to hot or cold
sensations. On examine you see visible pits. You ask about the diet, and mom says
she feeds them gummy's a lot. She says they have been struggling with income, and
it is one of the few things they can afford. They say they haven't been able to go to
the dentist. What are you concerned for, how would you dx, and what would your
treatment be? - ANSWER-Dental Caries
S. mutans
Calculus forming around tooth can lead to gum disease
Tx: GO TO DENTIST.
ABX: PCN, if it occurs with fever, lymphadenopathy
Preventatives: Fluoride, oral hygiene, sealants.
30 yo presents with lots of inflammation of the gingival soft tissue. You ask if it
bleeds when they brush, and they say a lot, and that it's painful so they have stopped
brushing. What are you concerned for, how would you dx, and what would your
treatment be? - ANSWER-Gingivitis
Tell them it is reversible, however if it continues it may become irreversible, and that
they are at a higher risk of CVD, DM.
Tx: GO TO DENTIST
Proper oral hygiene, OTC antimicrobial rinse (chlorhexidene mouth wash), stop
smoking
what is the treatment for oral pain in general - ANSWER-acetaminophen or NSAIDS
if believed to be non dental
Patient comes into office saying their child chipped their tooth while playing soccer.
You see that the dentin is not involved. What are you concerned for, how would you
dx, and what would your treatment be? - ANSWER-Enamel Fracture
No treatment, send to dentist to smooth with a file
Patient comes into office saying their child chipped their tooth while playing soccer.
You see that the dentin and enamel is involved. What are you concerned for, how
would you dx, and what would your treatment be? - ANSWER-Enamel and dentin Fx
Cover with CaOH2
Send to dentist within 24 hours
Patient comes into office saying their child chipped their tooth while playing soccer.
You see that the dentin and enamel is involved and that the pulp is exposed. What
are you concerned for, how would you dx, and what would your treatment be? -
ANSWER-Crown fracture
Cover with CaOH2
Abx and pain control (amoxicillin and NSAID/acetaminophen)
Patient comes into office saying their child chipped their tooth while playing soccer.
You see an adult tooth is loosened from its socket. What are you concerned for, how
would you dx, and what would your treatment be? - ANSWER-Tooth subluxation
tooth can be splinted with periodontal pack
Urgent dental consult in 24 hours
, Patient comes into office saying their child chipped their tooth while playing soccer.
You see that the tooth fell out of the socket. What are you concerned for, how would
you dx, and what would your treatment be? - ANSWER-Tooth Avulsion
-Reimplantation ASAP (every minute not done = 1% chance of failure)
use hanks solution or milk to coat the tooth
Splint with the periodontal pack
(if primary teeth- baby teeth, don't implant)
Tx: doxy or PCN
DENTIST IN 24 hours
Patient comes to office saying they feel congested, have a runny nose, for 5 days.
They admit to having a headache, a cough, and sore throat. On exam, you see
edematous mucosa, and on palpation of maxillary and frontal sinus they say it is
tender. What are you concerned for, how would you dx, and what would your
treatment be? - ANSWER-Acute viral rhinosinusitis
Cause: Rhinovrius, RSV, influenza, parainfluenza
Tx: Supportive care
-Zn acetate to help relieve symptoms
-nasal irrigation to clear sinus
-pseduoephedrine (cough meds)
What is a complication of using cold medicines for to long - ANSWER-rhinitis
medicamentosa
Patient states in the past 12 days he has felt purulent rhinorhhea, facial pain, nasal
obstruction, cough fever. He said on day 6 he felt great and then day 8/9 he felt
awful. On palpation he flinches hard when you touch the maxillary sinus. What are
you concerned for, how would you dx, and what would your treatment be? -
ANSWER-Acute bacterial rhinosinusitis
Dx: clinical, if concerned for malignancy, maybe MRI, and not responding to
treatment, do CT
Pathogen: S. pneumo, Hib, M catarrhalis
Tx: Augmentin (doxy or clinda if allergic), refer to ENT if this isn't working
NSAIDS, nasal saline, decongestant, intranasal steroid
An immunocompromised patient presents with severe facial oaubm basal discharge
that is clear-straw colored. On PE, on the middle turbinate you see black eschar.
What are you concerned for, how would you dx, and what would your treatment be?
- ANSWER-Invasive fungal sinusitis
Dx: Nasal bx for pathogen with silver strain
Pathogen: rhino cerebral mucormycosis or aspergillus
Tx: EMERGENCY
1st: Voriconazole IV with ampho B and maybe caspofungin
Surgery: surgical debridement
Prognosis- POOR, because fungus spreads rapidly through our vascular channels
80 YOF presents with anosmia. You test olfaction with UPSIT- scratch and sniff, and
determine what degree of smell she has lost. What are some reasons for loss of
