Otolaryngology UQU 2012

Otolaryngology

UQU
 Otolaryngology UQU 2012
1. 56 y old present with vasomotor rhinitis
a) Local anti histamine
b) Local decongestion
c) Local steroid
d) Systemic antibiotic.

2. 9 yrs pt come with ear pain, red tense tympanic membrane, and negative Rhine's test with positive Weber
test with lateralization (conductive loss) for TOW days only?
a) Otitis media
b) Otosclerosis
c) cholesteatoma

3. The same case above BUT he said conductive hearing loss directly without those tests
a) Otitis media

4. Patient was presented by ear pain , red tympanic membrane , apparent vessels , with limited mobility of
the tympanic membrane , what the most likely diagnosis
a) Acute otitis media.
b) Tympanic cellulites.
c) Mastoditis.

5. Pt with difficulty getting air. Nasal exam showed unilateral swelling inside the nose. What is the initial
treatment for this pt:
a) Decongestant
b) Sympathomimitics
c) Corticosteroid

6. Nasal decongestant (Vasoconstrictive) can cause:

a) Rhinitis sicca
b) Rebound phenomena
c) Nasal septal perforation

7. best treatment of otits media scenario …

a) Amoxcillin

8. Patient with ear pain and discharge, on examination he feels pain with moving ear pinna, normal tympanic
membrane erythematous auditory canal. diagnosis
a) otitis media
b) otitis externa

9. Patient with recurrent congested nose and congectivitis what would u give him.
a) Antihistamine and oral decongestant

10. epistaxis treatment:

a) site upright forward w mouth open and firm press on nasal alar for 5 min

11. One of the steps in managing epistaxis:

a) Packing the nose
b) Press the fleshy parts of nostrils
c) Put patient of lateral lying position

12. Patient febrile 38.5, ear ache, discharge, parasthesia and hemiparesis on the same side
a) HZV
b) epidural abscess
c) subdural hematoma
 Otolaryngology UQU 2012
13. Young patient with congested nose, sinus pressure, tenderness and green nasal discharge, has been
treated three times with broad spectrum antibiotics previously, what is your action:
a) Give antibiotic
b) Nasal corticosteroid (answered by ENT doctor)
c) Give anti histamine ( the answered from SLE study group)
d) Decongestant

14. Old man with cognitive deficit what we will screen?

a) Iq teat
b) Involuntary movement test
c) MEMOY score test
d) Hearing test

15. Young man came with nasal bleeding from posterior septum Not known to have any medical disese or
bleeding disorder MANGEMENT
a) Tampon in posterior septum
b) Screen for blood and coagulation
c) Inject septum by vasoconstrictor

16. What is the best diagnostic test for maxillary sinusitis:

a) CT scan
b) X ray
c) Torch examination
d) MRI
e) US

17. Which of the following is an indication for tonsillectomy?

a) Sleep apnea
b) Asymptomatic large tonsils
c) Peripharygeal abscess
d) Retropharyngeal abscess

18. A 45 years old lady was complaining of dizziness, sensory neural hearing loss on her left ear (8th nerve
palsy), tingling sensation & numbness on her face, loss of corneal reflex. MRI showed a dilated internal ear
canal ( other Q C.T scan shows intracranial mass). The diagnosis is:
a) Acoustic neuroma
b) Glue ear
c) Drug toxicity
d) Herpes zoster
e) Cholesteatoma

19. A child presented with earache. On examination there was a piece of glass deep in the ear canal. The
mother gave a history of a broken glass in the kitchen but she thought she cleaned that completely. The
best management is:
a) Refer to ENT
b) Remove by irrigation of a steam of solution into the ear
c) Remove by forceps (don't irrigate )
d) Remove by suction catheter
e) Instill acetone into the external auditory canal

 N.B: Consult an ENT specialist if the object cannot be removed or if tympanic membrane perforation is
suspected.
 Otolaryngology UQU 2012
20. A 15 years old boy present with 5 days history of pain behind his left ear and 3 days history of swelling
over the mastoid. He had history of acute otitis media treated by amoxicillin but wasn’t a complete
course ( or in other Qs he didn’t took the medication). On examination he has tenderness over the
mastoid bone with swelling, tympanic membrane shows absent cone reflex and mild congestion. what is
the diagnosis:
a) acute otitis media
b) serious otitis media
c) acute mastoiditis
d) glue ear

21. Most common cause of otorrhea:

a) acute otitis media
b) cholesteatoma
c) leakage of cerumen
d) estichian tube dysfunction

22. Most common cause of hearing loss in children:

a) Chronic serous otitis media
b) Estuchian tube dysfunction
c) Ototoxic drugs

 N.B: presbycusis the most sensorineural hearing loss in adult and otosclerosis commonest cause of
conductive hearing loss

23. 23 years old lady with one month history of nasal discharge & nasal obstruction, she complained of pain
on the face, throbbing in nature, referred to the supraorbital area, worsen by head movement, walking,&
stopping. On examination , tender antrum with failure of transillumination ( not clear ), the most likely the
diagnosis is:
a) frontal sinusitis
b) maxillary sinusitis (not sure)
c) dental abscess
d) chronic atrophic rhinitis
e) chronic sinusitis

24. Treatment of cholesteatoma is

a) Antibiotic
b) Steroid
c) surgery
d) Grommet tube

25. Child with ear pain with positive pump test for tympanic membrane, treatment is:
a) Maryngiotomy
b) Amoxicillin/Potassium

26. Child came with inflammation and infection of the ear the most complication is:
a) Labrynthitis
b) Meningitis
c) Encephalitis
d) Mastoiditis
 N.B: If they are implying an Otitis media, then Mastoiditis is more likely to occur than Meningitis.

27. child with unilateral nasal obstruct with bad odor (Fetid i.e: offensive odor)
a) unilateral adenoid hypertrophy
b) FB
 Otolaryngology UQU 2012
28. most common site of malignancy in paranasal sinuses :
a) 90% Maxillary and ethmoid sinus

29. 2 years old child with ear pain & bulging tympanic membrane, what is the diagnosis?
a) Otitis media
b) Otitis externa
c) Otomycosis
d) Bullous myringitis

30. child swallowing battery in the oesophegus m:

a) osephageoscopy

31. First step in management of epistaxis:

a) Pinching the fleshy part of the nose
b) Adrenaline
c) Nasal packs
d) Not interfering

32. Case of temporal arteritis, what's the ttt:

a) Corticosteroids

33. The most common cause of cough in adults is

a) Asthma
b) Gerd
c) Postnasal drip

34. A 5 year old child came with earache on examination there is fluid in middle ear and adenoid hypertrophy.
Beside adenoidectomy on management, which also you should do:
a) Myringotomy
b) Grommet tube insertion
c) Mastidectomy
d) Tonsillectomy
 N.B:
 Myringotomy (is used for bulging acute otitis media)
 Grommet tube insertion (is used for recurrent acute otitis media)

35. boy 3 day after flu symptom develop conjunctivitis with occipital and nick L.N enlarged so diagnosis is
a) adenoviruses
b) streptococcus
c) HSV

36. 50 y with uncontrolled diabetes, complain of black to brown nasal discharge. So diagnoses is
a) mycomyosis
b) aspirglosis
c) foreign body
 N.B: mycomyosis (fungal infection caused by Mycorales, affect nasal sinus & lungs, characterized by black
nasal discharge, diagnosis by biopsy).

37. Glue ear (secretory otitis media, otitis media w effusion, or serious otitis media )
a) Managed by grommet tube
b) Lead to sensorineural hearing loss
c) Pus in middle ear

d) Invariably due to adenoid
 Otolaryngology UQU 2012
38. MOST Prominent symptom of Acute otitis media
a) Pain
b) Hearing loss
c) Discharge
d) tinnitus

39. 12 yr old girl with malaise, fatigue, sore throat & fever. On examination: Petechial rash on palate, large
tonsils with follicles, cervical lymphadenopathy & hepatosplenomegaly. All are complications EXCEPT:
a) Aplastic anemia
b) Encephalitis
c) Transverse myelitis

d) Splenic rupture

e) Chronic active hepatitis (not sure)

40. All are true about hoarseness in adult , EXCEPT :


a) due to incomplete opposition of the vocal cord
b) if > 3 weeks : need laryngoscopy

c) if due to overuse, advise to whisper a few weeks
d) commonly seen in bronchus Ca

e) feature of myxedema

41. Regarding tinnitus......all true except:

a) A symptom that is not experienced by children.
b) Present in anemia
( iron deficiency anemia, B12 def)
c) As salicylate complication that improves with drug withdrawal
d) If associated with deafness it improves if hearing loss improves.

42. Commonest cause of otorrhea:-

a) Otitis externa (if there's otitis media it'll be the answer)
b) CSF otorrhea
c) Liquefied eczema
d) Eustachian tube dysfunction


43. A lady with epistaxis after quttary of the nose, all true except:-
a) Don't snuff for 1-2 days
b) Use of nasal packing if bleeds again
c) Use of aspirin for pain
 N.B
 Common causes of epistaxis Chronic sinusitis, nose picking, Foreign bodies, Intranasal neoplasm or polyps,
Irritants (e.g cigarette smoke), Medications (e.g topical corticosteroids, aspirin, anticoagulants, NSAID),
Rhinitis, Septal deviation, Septal perforation, Trauma, Vascular malformation or telangiectasia, Hemophilia,
Hypertension, Leukemia, Liver disease, Platelet dysfunction, Thrombocytopenia
 Initial management includes compression of the nostrils (application of direct pressure to the septal area)
and plugging of the affected nostril with gauze or cotton that has been soaked in a topical decongestant.
Direct pressure should be applied continuously for at least five minutes, and for up to 20 minutes. Tilting
the head forward prevents blood from pooling in the posterior pharynx
44. regarding aphthous ulceration in the mounth all are true except:
a) there is no treatment for acut ulcer
b) tetracyclin suspension helps in healing

c) there is immunological role in its role in its development
d) mostly idiopathic in orgin
 Otolaryngology UQU 2012
45. patient had horsenss of voice for 3 weeks... next to do:
a) throat swab
b) laryngoscopy

46. A male presented with headache , tinnitus & nausea , thinking he has brain tumor he just secured a job in
a prestigious company he is thinks he might not meet its standards , CNS exam NL , CT = NL what is the
Dx.:
a) Generalized anxiety
b) Panic attack
c) Hypochondriasis (not sure)
d) Conversion reaction
e) Anxiety

47. Patient is complaining of right side pharynx tenderness on examination patient had inflamed right tonsil
and redness around tonsil with normal left tonsil. The diagnosis is:
a) Parenchymal tonsillitis
b) Quinse parapharyngeal abscess
c) peritonsillar abscess @hot potato voice@

48. Child patient after swimming in pool came complaining of right ear tenderness on examination patient has
external auditory canal redness, tender, and discharge the management is:
a) Antibiotics otic drops gentamicin or cipro avoid aminoglyco
b) Systemic antibiotics--only if cervical lymphadenopathy or cellulitis
c) Steroid drops--only if chronic
d) antibiotics and steroid drops ---best (not sure)

49. Child came with inflammation and infection of the ear the most complication is:
a) Labrynthitis can be but not the most common
b) Meningitis most common intracranial complication but for extracranial is posturicular abscess
c) Encephalitis

50. Anosmia (unable to smell)

a) Frontal
b) Occipital
c) Temporal
d) Parietal

51. pt suffer sensorineural loss ,vertigo, dizziness 3 years ago and now developed numeness and weakness of
facial muscles dx:
a) Menier disease
b) Acoustic neuroma
c) Acute labrinthitis

52. patient with seasonal nasal discharge , watery , what is the first mangment:
a) Decongestant
b) antihistamine
c) steroid

53. Pt presented with nausea and vomiting and nystagmus with tinnitus and inability to walk unless he
concentrates well on a target object. His Cerebellar function is intact:
a) Benign positional vertigo
b) meniere's disease (vertigo, tinnitus, hear loss, aural fullness)
c) vestibular neuritis(nausea ,vomiting, inability to stand, vertigo)
 Otolaryngology UQU 2012
54. 5 yr old adopted child their recently parents brought him to you with white nasal discharge. He is known
case of SCA. What you will do to him:
a) Give prophylactic penicillin

55. submandublar swelling & pain during eating what best investing
a) x ray-us-ct-MRI

56. Right ear pain with plugging of tympanic membrane

a) secretary otits media
 N.B: AOM presents with rapid onset of pain, fever & sometimes irritability, anorexia, or vomiting
 In AOM drum bulging causes pain then purulent discharge if it perforates

57. Facial nerve when it exits the tempromandibular joint and enter parotid gland it passes:
a) Deep to retromandibular vein
b) Deep to internal carotid artery
c) Superficial to retromandibular vein and ext. carotid artery
d) Deep to ext. carotid artery

e) Between ext. carotid artery and retromandibular vessels
 It is the most lateral structure within parotid gland

58. Patient presented to you complaining of left submandibular pain and swelling when eating. O/E, there is
enlarged submandibular gland, firm. What is the most likely Dx?
a) Mumps
b) Sjogren’s syndrome

c) Hodgkin’s lymphoma

d) Salivary gland calculi

59. Frequent Use of nasal vasoconstrictors can cause:

a) Rhinitis sicca (sicca means dry)
b) Allergic rhinitis c) Septal perforation

60. Ranula:
a) Forked uvula
b) Thyroglossal cyst
c) Swelling at the floor of mouth

61. all are speech disorders except:

a) Stuttering
b) Mumping
c) Cluttering
d) Palilia
 Types of speech disorders
 Cluttering , Stuttering, Apraxia, Lisp, Rhotacism, Spasmodic dysphonia, Aphasia , Dysarthria, Huntington's
disease, Laryngeal cancer, Selective mutism, Specific Language Impairment, Speech sound disorder and
Voice disorders

62. Fetal unilateral nasal discharge is feature of:

a) Adenoid
b) Choanal atresia
c) Foreign body
d) RT atrophy
 N.B. forgets everything about ENT except this question. It is quite common
 Otolaryngology UQU 2012
63. the most common cause of epistaxis in children is:
a) polyps
b) trauma (ie, nose picking)
c) dry air
d) thrombocytopenia
• Epistaxis is more prevalent in dry climates and during cold weather.

64. Swallowed foreign body will be found in all of the following except:
a) Stomach
b) Tonsil
c) Pharyngeal pouch
d) Piriform fossa

65. Adenoids:

a) Can be a chronic source of infection.

b) Causes snoring.

c) Located at the back of the nasopharynx 1 inch above the uvula.
d) Involved in the immune system reaction.

e) All of the above.

66. All are normal in association with teething EXCEPT:

a) Rhinorrhea
b) Diarrhea

c) Fever > 39 C
d) Irritability
 Otitis media: Caused by infection with Strep. Pneumonia, H. influenza.
It follows URTI, this leads to swelling
of the Eustachian tube, thus compromising the pressure equalization.
Types: AOM: Viral & self-limiting.
Bacterial leading to puss Bacterial infection must be treated with ABx (augmentin) if not it can lead to:
Perforation of the drum, Mastoiditis, Meningitis, OM with effusion ( secretory OM or Glue ear):
Collection of
fluid in the middle ear, leading to –ve pressure in the Eustachian tube.
Can lead to conductive hearing
impairment. Treatment: Myringotomy (ventilation tube or Grommet tube). CSOM: Perforation in the ear
drums with active bacterial infection. Otorrhae is +ve.

67. tinnitus all of the following are true EXCEPT:

a) Symptom not experienced by children
b) Present in anemia (net source: anemia may present with tennitus: vascular tennitus)

c) As salicylate copmlication that improves with drug withdrawal
d) If associated with deafness, it improves as hearing loss improves

68. All features of tonsillar abscess except :

a) deviation of uvula to affected side

69. Case scenario ,child present with rhinorrhea & sore throat for 5 days present with middle ear perfusion,
examination of the ear : no redness in the ear
the cause of perfusion :
a) otitis media because no pain
b) Upper respiratory infection.

70. Patient smoker and alcoholic come with difficulty in swallowing and neck mass, Investigation ?
a) Indirect laryngoscope
b) Neck CT
c) Head CT
d) Biopsy
e) Aspiration
 Otolaryngology UQU 2012
71. child fall from stairs came with mild injury to the nose, no bleeding and edema in the nasal sputum ,ttt :
a) Nasal packing
b) Reassure
c) Analgesia
d) Refer to ENT (he will give analgesia)

72. 16 years old female become deaf suddenly.. her mother become deaf when she was 30.. Dx:
a) otosclerosis
b) acostic neuroma
c) tympanic perforation
 It is an autosomal dominant, conductive HL, stapesi footplate

73. Regarding barreteasophgitis which correct?

a) risk of adenocarcenoma 100% true
b) risk of Squamous cell CA ( if said in Qs w\o history of GERD it'll the correct answer)

74. 35 year old smoker , on examination shown white patch on the tongue, management: ‫ حالت‬leucoplakia
a) Antibiotics
b) No treatment
c) Close observation
d) excision biopsy
 biopsy if it pre-cancer then do excision biopsy

75. Patient was presented by ear pain , red tympanic membrane , apparent vessels , with limited mobility of
the tympanic membrane , what the most likely diagnosis :
a) Acute otitis media
b) Tympanic cellulitis.
c) Mastoditis.

76. Waking up from sleep..cant talk, no fever, can cough, normal vocal cord, what is the diagnosis?
a) Functional aphonia “loss of speech without attributable cause”

77. Pt after swimming pool(clear Dx of otaitis externa) Rx:

a) nothing
b) amphotericin B
c) steroid
d) ciprofloxacin drops

78. Post partum female with recurrent attack of hearing loss , which diagnosed as conductive hearing loss ,
on CT the is adhesion in the of semi circular canal diagnosis >>>>
a) otosclerosis
b) miner's
c) Tuberous sclerosis.

79. Purulent discharge from middle ear how to treat him

a) systemic AB
b) local AB
c) steroid

80. Child with URTI then complained from ear pain on examination there is hyperemia of TM &+ve
insufflations test he tri 2 drug no benefit what is the best treatment?
a) ugmantine
b) azythromycin
c) ciprofloxacin/steroid
 Otolaryngology UQU 2012
81. Patient presented with sore throat, anorexia, loss of appetite , on throat exam showed enlarged tonsils
with petechiae on palate and uvula , mild tenderness of spleen and liver, what is the diagnosis?
a) infectious mononucleosis

82. URTI with meningiococcus type A,, ttt

a) Rifampicin
b) Penicillin, ampicillin, chloramphenicol, ceftriaxone

83. URTI with streptococcus type A,, ttt

a) penicilline for 10 days
 N.B: Treatment with penicillin should be started. Erythromycin or another macrolide can be used in patients
who are allergic to penicillin. Treatment with ampicillin/sulbactam is appropriate if deep oropharyngeal
abscesses are present. In cases of streptococcal toxic shock syndrome, treatment consists of penicillin and
clindamycin, given with intravenous immunoglobulin

84. 28 yrs old AOM he was treated with Amoxicillin, came after 3 wks for F/U there was fluid collection behind
tympanic membrane ,no blood wt to do nxt:
a) watchful waiting
b) myringotomy

85. The most common cause of cough in adults is

a) Asthma
b) Gerd
c) Postnasal drip

86. 5 yr old seen in ER presented with fever & sore throat , which of the fallowing suggest viral etiology :
a) Presence of thin membrane over the tonsils
b) Palpable tender cervical LN
c) Petechial rash over hard or soft palate
d) absence of cough
e) Rhinorrhea of colourless secretion

87. 4 years old presented with 2 day history of shortness of breath a seal like cough with no sputum and mild
fever. on examination he did not look ill or in distress
a) acute Epiglottitis
b) croup
c) angioedema
Croup Epiglottitis
Onset Days Hours
Flu-like symptoms Yes No
Cough Sever Absent
Able to drink Yes No
Drooling saliva No Yes
Fever < 38 > 38
Stridor Harsh Soft
Voice Hoarse Muffed

88. Child rt ear pain and tenderness on pulling ear , no fever , O/E inflamed edematous rt ear canal with
yellow discharge , dx
a) Otitis media
b) Otitis externa
c) Cholesteatoma
 Otolaryngology UQU 2012
89. Child with decrease hearing, her grandmother has deafness, Renie & Weber revealed bone conduction
more than air conduction, mx “osteosclerosis”
a) reassure
b) refer her to hearing aid
c) Prescribe hearing instrument.
d) Refer her to otolaryngologist

90. Gingivitis most likely cause

a) HSV

91. acute otitis media criteria

a) not should be w effusion
b) rapid sign and symptom

92. case with some symptoms I think the answer is:

a) Benign paroxysmal positional vertigo.

93. Child came to you with barking cough , Stridor and by examination you see “ Steeple Sign “ what is your
diagnosis ?
a) Epiglottis
b) Croup

94. 50 years old male , smock 40 packs / year develop painless ulcer on the lateral border of the tongue
which is rolled in with indurated base and easily bleed what is you diagnosis ?
a) Squamous cell carcinoma
b) Aphthous ulcer
c) syphilis

95. Patient develop nasal discharge with frontal headache

a) Acute sinusitis
b) Migraine
c) Temporal arteritis
d) Temporal

96. about head and neck injury

a) Hoarseness of voice and Stridor can occur with mild facial injury 

b) Tracheotomies contraindicated

c) Facial injury may cause upper air way injures

97. 9 yrs pt come with ear pain, red tense tympanic membrane, -ve Rhine's test with + ve Weber test with
lateralization (conductive loss) for 2 days only?
a) Otitis media
b) Otosclerosis
c) Cholestiatoma

98. 55 years old male pt, presented with just mild hoarseness, on exam, there was a mid cervical mass, best
investigation is
a) Indirect laryngoscope
b) CT brain
c) CT neck

99. Old patient presented with Ear pain ,headache , hem paresis, most likely cause:
a) Epidural abscess
b) Spinal abscess (X)
c) Subd Subdural hematoma (X)
 Otolaryngology UQU 2012
100. Pat has snoring in sleeping and and on exam there is largtonsile,what u will do for him :
a) Weight reduction
b) Adenoidectomy

101. Which of the following doesn't cause ear pain?

a) Pharingitis
b) Otitis
c) Dental caries
d) Vestibular neuritis
 main symptom is vertigo lasts for several days or weeks, suddenly, with nausea and vomiting not lead to
loss of hearing

102. bad breath smell with seek like structure, no dental caries & Ix are normal, what's the likely cause:
a) cryptic tonsillitis
b) Sojreen's synd.

103. patient with a large nodule in the nose which is painful and telangiectasia on the face you will give:
a) deoxycycline (not sure)
b) clindamycin
c) retinoid

104. Old man came complain of progressive hearing loss , it is mostly propounded when he listening to the
radio, he does not has any symptoms like that before
Weber and rinne tests result in bilateral
sensorineuralhearig loss.. Diagnosis:
a) Meniere’s disease
b) Otosclerosis
c) Noise induced deffnese
d) Hereditary hearing loss

105. Patient find perforated tympanic membrane with foul withish discharge dX?
a) Otoseclerosis
b) Otitis externa
c) Cholestitoma

106. Young male had pharyngitis, then cough and fever,most likely org
a) staph aureus
b) streptococcus pneumonia

107. 7 y/o child coming with SOB and wheezing he was sitting in bed , leaning forward , with drooling &
strider what is Dx :
a) Epiglottits
b) Bronchial asthma

108. most common site of malignancy in paranasal sinuses :

a) Maxillary sinus

109. child is having a croup early morning, the most common cause is:
a) Post nasal drip

110. Patient is post rhynorophy, what could be the management “ present with brown discharge with foully
odor from the wound”
a) Debridement and antibiotic
 Otolaryngology UQU 2012
111. All the following are present in otitis media except:
a) Signs & symptoms of inflammation
b) Signs & symptoms of effusion
c) High grade fever
d) Pain
 Tympanostomy tube (also called a "grommet") into the eardrum IN OME

112. Indication to give prophylactic antibiotic to recurrent sapurative otitis media in children:
a) ???

113. 4 years old pt. comes with cystic swelling behind lower lib varying in size has bluish discoloration:
a) ranula “ ruptured salivary gland duct usually caused by local trauma”

114. generalized skin rash associated with lymph node enlargement:

a) EBV

115. offensive white ear discharge with white rigid tympanic membrane asking for diagnosis:
a) one of the chioses are spicteccusis

116. enlarger unilateral tonsils:

a) peripharangial abcses

117. For ear effusion , ttt is

a) conservative

118. Child with bilateral swelling in front of his ears,..,(hx does with mumps), what the most likely
complication he developed during this age:
a) Orchitis.
b) encephalitis
c) mastoiditis
d) Meningitis.

 N.B: mump complication orchitis in adult males, oophoritis in adult females and meningitis in children
 Complication of measles children, the most common one is otitis media; for adult, it is Pneumonia (not
interstitial pneumonia, it is the super infection by Strep.
 Complication of infectious mononucleosis Common Splenomegaly, spleen rupture, Hepatomegaly, hepatitis
and jaundice . Less common :Anemia ,Thrombocytopenia ,inflammation of the heart, meningitis,
encephalitis, Guillain-Barre syndrome, Swollen tonsils, leading to obstructed breathing

119. All features of tonsillar abscess except :

a) deviation of uvula to affected side:
 N.B: complication of tonsillitis and consists of a collection of pus beside the tonsil . Severe unilateral pain in
the throat , F (39ºC) Unilateral Earache Odynophagia and difficulty to swallow saliva. Trismus is common ,
muffled voice, “hot potato” voice. Intense salivation and dribbling, Thickened speech, Foetor oris, Halitosis
Pain in the neck causative. Commonly involved species include streptococci, staphylococci and hemophilus.
surgical incision and drainage of the pus and treat with penicilline or clindamycin
 Complications :Retropharyngeal abscess, airway compromise( Ludwig's angina), Septicaemia, necrosis of
surrounding deep tissues , rare mediastinitis

126. One of them causes conductive hearing loss :

a) Acute ottis media
b) Syphillis
c) Meneria disease
 Otolaryngology UQU 2012
120. Pt taking treatmen for TB came with imbalance, hearing loss which drug?
a) INH- peripheral neuritis
b) Strept (8th nerve damage"ototoxicity" , nephrotoxicity)
c) Rifampin - causes thrombocytopenia and pink orange color of urine and ocp are inafective if used with it
d) Ethambutol - causes reversible optic neuritis
e) Pyrazinamide - causes gout
 N.B: all causes hepatitis except streptomycin
 for memories the side effect …
 (R)ifampin: (R)ed secretions + (R)ash + CYP 450 inducer..
(E)thambutol: (E)ye .. optic or retrobulbar neuritis
(P)yrazinamide: g is the mirror image of p so: hepatotoxic + (g)out "hyperurecemia"
INH: CYP 450 INHibitor + Periphral neuropathy (so give Pyridoxine)
 Streptomycin belongs to aminoglycosides which are known for their ototoxic and nephrotoxic effects

121. Old Pt with abnormal ear sensation and fullness, hx of vertigo and progressive hearing loss , invx low
frequency sensorial hearing loss Dx
a) Acoustic neuroma
b) Neuritis
c) Meniere’s disease
 Meniere’s Disease: a cause of recurrent vertigo with auditory symptoms More common among females.
Hx/PE: Presents with recurrent episodes of severe vertigo, hearing loss, tinnitus, or ear fullness, often
lasting hours to days. Nausea and vomiting are typical. Patients progressively lose low-frequency hearing
over years and may become deaf on the affected side.

122. pt with URTIs , she said , I saw flash when I sneeze why :
a) Mechanical irritation
b) Chemical irritation

123. young male c/o of deformity of jaw .past h/o of nasoplasty and blepharoplasty O/E nothing abnormal
what is the diagnosis
a) Body dysmorphic syndrome

124. Pt came with peeling, redness, waxy appearance in the scalp margins, behind the ear and nasal fold best
treatment is
a) Topical antifungal
b) Antibiotic
c) Steroid
 N.B: Seborrhoeic dermatitis affecting the scalp, face, and torso. Typically, seborrheic dermatitis presents
with scaly, flaky, itchy, and red skin … Rx combines a dandruff shampoo, antifungal agent and topical
steroid

125. Child presented with dysphagia, sore throat, postnasal drip, drooling of saliva, rhonchi & fever of 38.5 0c.
The treatment is:
a) Hydrocortisone injection immediately
b) Call otorhinolaryngology for intubation
c) Admit to ICU
d) Give antibiotics & send him home
 N.B: acute epiglottitis If the pt was stable : ICU
 If Pt is unstable ; Airway must be secured Use of steroid is controversial
 Otolaryngology UQU 2012
126. Adult pt came with acute otitis media received amoxicillin for 1 week , f/u after 3 weeks u found fluid
behind tympanic membrane :
a) Give AB for 10 days
b) Antihistamine
c) Follow up after 1 m can resolve spontaneously (Assurance)
d) Give another AB

127. Picture of patient with neck swelling that moving with deglutition
a) Colloid goiter
b) Thyroglssal cyst
 However both move with deglutition But in picture its more likely goiter

128. Picture of large neck mass only no other manifestations or organomegaly or lymphadenopathy,
diagnosis is:
a) Mononucleosis
b) Lymphoma

129. Cholesteatoma treatment is:

a) surgery

130. what true about management of epistaxis:

a) compress carotid artery
b) compress flesh part of nose together
c) place nasal tampon
d) put the pt on side position
e) do nothing