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7 MCQ Undergraduate

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Oto-rhino-laryngologic illustrationsFree Gift from ENT department Prof Dr.Ahmed Allam

Oto-rhino-laryngologic illustrationsBy Prof.Dr. Ahmed AllamProf. & Head of ENT Department Benha Faculty of Medicine

Pro f. Dr. Mo ss ad Elsis yProf. of ENT Benha Faculty of Medicine

The following are anatomic structures of the auricle except 1- Helix 2-Tragus 3-Concha 4-Antrum

Answer : 4 The antrum is the largest air cells of the mastoid bone

The auriculo temporal nerve 1- supplies the skin of the upper 2/3 of the lateral surface of the auricle 2- is a branch of maxillary nerve 3- supplies the middle ear mucosa through the tympanic plexus 4- non of the above

Answer: 1 The auriculo-temporal nerve is a branch of mandibular division of the trigeminal nerve The middle ear mucosa is supplied by the tympanic branch of Glosspharyngeal nerve called Jacobson nerve

The lobule of the ear has its sensory innervation from 1- great auricular nerve 2- auriculotemporal nerve 3-arnold branch of vagus 4- facial nerve

Answer: 1

The tympanic membrane is divided into: 1- Two equal parts called pars tensa and pars flaccida 2- A major upper part called pars flaccida and a small lower part called pars tensa 3- A small upper part called pars flaccida and a major lower part called pars tensa 4- non of the above

Answer : 3

The bulge seen on the medial wall of the middle ear is 1- known as the promontory 2- formed by the bony semicirculr canal 3- is formed by the basal turn of the bony cochlea 4- all of the above 5- both 1 and 2 6- both 1 and 3

Answer : 3

The Eustachian tube is opened by contraction of 1- tensor tympani muscle 2-levator palati muscle 3- tensor palati muscle 4-Salpingopharyngeus muscle

Answer : 3

The sensory endorgan of the semicircular canal is 1- the organ of Corti 2- the macula 3- the crista 4- non of the above

Answer : 3 The organ of Corti is the sensory end organ of hearing in the cochlea The macula is the sensory end organ in the utricle and saccule

Auricular hematoma 1- may be complicated by otitis externa 2- cauliflower ear is one of its complications 3- evacuation of the extra-vasated blood is not essential 4- all of the above

Answer : 2 Auricular hematoma may be complicated by perichondritis and cauliflower ear evacuation of the extra-vasated blood is essential to avoid complications

It is better to avoid ear wash for removal of 1- wax 2- animate foreign body 3- impacted vegetable foreign body 4- non of the above

Answer : 3 Vegetable FB will swell if ear wash fails to get it out which will cause more impaction

It is better to avoid ear wash for removal of 1- wax 2- animate foreign body 3-calculator battery 4- non of the above

Answer : 3 Dont wash if the FB is a calculator battery as this may lead to leak of acid and chemical burn of the skin

The causative organism in ear fruncle is 1- proteus 2- Pseudomonas 3- staph. Aeureus 4- E coli

Answer :3

The causative organism in malignant otitis externa 1- proteus 2-Pseudomonas 3-staph. Aeureus 4- morexella catarrhalis

Answer : 2

Malignant otitis externa is 1- a truly malignant disease eroding the external canal 2- is most commonly seen in elderly uncontrolled diabetics 3- staphylococcus aureus is the causative organism 4- non of the above

Answer : 2

In the adult, the Eustachian tube is approximately the following lehgth 1- 30 mm 2- 20 mm 3- 36 mm 4- 45 mm

Answer : 3

In Gradenigo syndrome diplopia is due to inflammation of the following cranial nerve 1- IV nerve 2- V nerve 3- III Nerve 4- VI nerve

Answer : 4 This syndrome is charecterized by: 1- otorrhoea 2-facial pain due to irritation of V cranial nerve 3-diplopia and squint due to irritation of VI cranial nerve in Dorello canal

Conductive deafness in longtudinal temporal bone fracture may be due to: 1- Rupture of the tympanic membrane 2- Ossicular disruption 3- Non of the above 4- Both 1 and 2

Answer : 4

Longtudinal temporal bone fracture : 1- is less common than the transverse type 2- is usually associated with sensori-neural hearing loss 3- facial nerve paralysis is a common association with this type 4- non of the above

Answer : 4

The following organisms are involved in acute otitis media except 1- streptococcus pneumonia 2-hemophilus influenza 3-Pseudomonas aeroginosa 4-morexella cararrhalis

Answer : 3

All of the following are diagnostic of tympanic membrane retraction except 1- fore-shortened handle of malleus 2- prominent lateral process of malleus 3- Schwartz sign 4- distorted cone of light

Answer : 3 Schwartz sign is a flamingo red tinge of the tympanic membrane due to increased vascularity of the promontory and indicates active otosclerosis

Throbbing and severe earach is present in the following stage of acute otitis media 1- stage of salpingitis 2- stage of catarrhal otitis media 3- stage of suppurative otitis media 4- stage of tympanic membrane perforation

Answer : 3

The tympanic membrane perforation in acute otitis media is 1- central in the pars tensa 2- marginal in the pars tensa 3- small in the pars flaccida 4- non of the above

Answer : 1

Type c tympanogram is consistent with 1- secretory otitis media 2- otosclerosis 3- Eustachian tube dysfunction 4- otosclerosis

Answer : 3In Type C there is Normal compliance but the peak of the tympanogram is at the negative side so it is consistent with ET dysfunction in which there is negative pressure in the middle ear

Answer: 2

By central drum perforation we mean 1- a perforation at the central part of the drum 2- a perforation in the pars tensa which is surrounded by a rim of tympanic membrane 3- a perforation of the pars flaccida 4- a perforation in the pars tensa which is not surrounded by a rim of tympanic membrane

Answer: 3

All of the following may be seen in the tubotympanic type of chronic suppurative otitis media except 1- mucopurulent otorrhoea 2- central tympanic membrane perforation 3- marginal tympanic membrane perforation 4- profuse otorrhoea

Answer: 2

Cholesteatoma is characterized by 1- continuous mucopurulent ear discharge 2-A foul smelling ear discharge 3- A central tympanic membrane perforation 4- non of the above

Answer: 3

A child with retraced drum and conductive deafness after inadequate treatment of acute suppurative otitis media is suffering from 1-chronic tubotympanic otitis media 2-chronic atticoantral otitis media 3- otitis media with effusion 4- all of the above 5-non of the above

The commonest cause of conductive deafness in children is: 1- wax 2-secretory otitis media 3-otomycosis 4- otosclerosis

Answer:2

The commonest cause of conductive deafness in adults is: 1- wax 2-secretory otitis media 3-otomycosis 4- otosclerosis

Answer:1

In a patient suffering from purulent otorrhoea and attic perforation 1- treatment is essentially surgical 2- medical treatment and follow up is sufficient 3- myringoplasty is the only needed treatment 4- non of the above

Answer :1

The presence of foul odour otorrhoea and attic perforation is diagnostic of cholesteatoma. Treatment of this case is essentially surgical by mastoidectomy operation ( radical or modified radical)

In a 45 years old female patient presenting with pulsating tinnitus and red mass behind the drum, all of the following are true except 1- glomus tumour is a possible diagnosis 2-more assessment is needed by CT scan or MRI 3- MRI angiography confirm the diagnosis 4-biopsy is essential to verify the pathological nature

Answer :4 Biopsy is contraindicated as it will lead to profuse bleeding

Bezold abscess is a collection of pus 1- above and in front of the auricle 2-behind the auricle 3-in the upper part of the neck deep to the sternomastoid 4- in the peritonsillar space

Answer : 3

During ear examination the reservoir sign is diagnostic of 1- acute otitis media 2- mastoiditis 3- petrositis 4- cholesteatoma

Answer :2

An early and diagnostic sign of mastoiditis is 1- reservoir sign 2-sagging of the posterosuperior part of the bony canal 3-perforated tympanic membrane 4- postauricular mastoid abscess

Answer : 2 Sagging means bulging downwards of the posterosuperior part of the bony external canal and is due to periostitis of the bone overlying the mastoid antrum. It is an early and diagnostic sign of mastoiditis

Answer : 2 Vertigo and nystagmus induced by pressure on the tragus is diagnostic of 1- serous labyrinthitis 2- circumscribed per- labyrintserous 3 suppurative labyrinthitishitis 4- all of the above

Answer : 2

In a case of cholesteatoma, sever spontaneous vertigo with Nausea and vomiting is suspicious of 1- circumscribed peri-labyrinthitis 2- diffuse serous labyrinthitis 3- extradural abscess 4- petrositis

In a patient having acute suppurative otitis media with bulging drum, myringotomy is benificial to 1-drain the middle ear 2- avoid rupture of the tympanic membrane 3-avoid complications 4-all of the above

Answer : 4

The most common complication of myringotomy operation is 1- injury of facial nerve 2-dislocation of the incus 3-injury of the jagular bulb 4- residual perforation

Answer : 4

In myringotomy operation the posterosuperior quadrant of the tympanic membrane must be avoided 1- to avoid injury of dehiscent jagular bulb 2- to avoid injury of the ossicles 3- non of the above 4- both 1 & 2

Answer : 2

The combination of unilateral otorrhoea, severe facial pain and diplopia is known as 1- Piere Robin syndrome 2- Gradenigos syndrome 3- Kartagner syndrome 4- Ramsay Hunt sundrome

Answer : 2

A child with an attic drum perforation who developed nausea, projrctile vomiting and fever of 40 degree is suspicious to have got 1- otogenic meningitis 2- otogenic labyrinthitis 3- petrositis 4- mastoiditis

Answer : 1

The first line of treatment in a child who develops lower motor neurone facial paralysis after acute otitis media is 1- antibiotics and corticosteroids 2- decompression of facial nerve 3- exploration of facial nerve 4- myringotomy

Answer : 4

Intermittent fever with rigors and headach in a patient with cholesteatma may be due to 1-otogenic meningitis 2-otogenic brain abscess 3- lateral sinus thrombophlebitis 4-extradural abscess

Answer : 3

A positive Kernig sign means 1-reflex flexion of the hips and knees when the neck is flexed 2- inability to extend the knee completely when the hip is flexed on the abdomen 3- inability to do rapid ulternating movement 4- non of the above

Answer : 2

A positive Brudzniski sign means 1-reflex flexion of the hips and knees when the neck is flexed 2- inability to extend the knee completely when the hip is flexed on the abdomen 3- inability to do rapid ulternating movement 4- non of the above

Answer : 1

Answer : 3 in mastoiditis there is profuse mucopurulent or purulent otorrhoea which recurs rapidly after remova ( a diagnostic sign called reservoir sign)

A persistent profuse ear discharge after acute otitis media is 1- cholesteatoma 2- secretory otitis media 3-mastoiditis 4- diffuse otitis externa

In otitic barotrauma, the following statements are correct except 1-occurs during airplane ascent 2- occurs during airplane rapid descent 3- can cause rupture of the tympanic membrane 4- occurs during diving

Answer :1

The commonest cause of vertigo is 1- menieres disease 2-labyrinthitis 3-benign paroxysmal positional vertigo 4-ototoxicity

Answer : 3

Most cases of extradural abscess of the temporal lobe 1- are asymptomatic and discovered accidentally during mastoidectomy 2- present with persistent ipsilateral temporal headach 3- present with vertigo 4- present with pulsating discharge,hearing loss and tinnitus

Answer : 1

The type of hearing loss in otosclerosis may be 1- conductive 2- sensorineural 3-mixed 4-all of the above

Answer :4 In stapedial otosclerosis hearing loss is conductive In cochlear type the hearing loss is sensorineural In combined otosclerosis the hearing loss is mixed

The commonest cause of bilateral sensorineural hearing loss in elderly individuals is 1- cochlear otosclerosis 2- presbyacusis 3- diabetes milltus 4- ototoxicity

Answer : 2

A 30 years old patient with recurrent attacks of vertigo, hearing loss and tinnitus associated with nausea and vomiting has 1- benign paroxysmal positional vertigo 2-vestibular neuronitis 3-Menieres disease 4-acoustic neuroma

Answer: 3 1- In benign paroxysmal

positional vertigo there isrecurrent attacks of vertigo for seconds which occurs when the patient assumes certain head position

23-

in vestibular neuronitis in Menieres disease

there is sudden severe vertigo for dayes but bo hearing loss

4- In Acoustic neuroma there is unilateral persistent tinnitus and gradually progressive hearing loss but vertigo is uncommon

recurrent attacks of vertigo, hearing loss and tinnitus associated with nausea and vomiting and the patient is free between attacks

Before tympanoplasty in a 30 years old patient, the following is required 1- audiogram 2- ensure dry perforation 3-treatment of any underlying nasal or paranasal sinus infection 4-all of the above 5- non of the above

Answer : 4

The XI, X and XI cranial nerves may be involved in all of the following except 1-acoustic neuroma 2-transverse temporal bone fracture 3-malignant otitis externa 4- squamous cell carcinoma of the middle ear

Answer : 2 in transverse temporal bone fracture the involved nerves are VII & VIII

In lower motor neurone facial paralysis with intact taste sensation at the anterior 2/3 of the tongue, the level of the lesion is 1- in the internal auditory canal 2-in the horizontal tympanic part 3- in the vertical part above the stapes 4- in the stylomastoid foramen

Answer : 4

Failure to close the eye voluntarily is a symptom of 1- paralysis of the trigeminal nerve 2- upper motor neurone facial paralysis 3- lower motor neurone facial paralysis 4- non of the above

Answer : 3

Uncontrolled diabetes in elderly patient may predispose to 1- cholesteatoma 2- malignant otitis externa 3- presbyacusis 4- vestibular neuronitis

Answer : 2

A large near total perforation following acute necrotizing otitis media must be followed up for fear of 1- recurrent middle ear infection 2- secondary acquired cholesteatoma 3-retraction pocket 4-tympanosclerosis

Answer : 2

By modified radical mastoidectomy we mean 1- removal of mastoid air cells and all middle ear contents 2- removal of diseased mastoid air cells 3- removal of mastoid air cells and all middle ear contents with preservation of healthy remnants of tympanic membrane and ossicles

Answer : 3

4- non of the above

By radical mastoidectomy operation we mean 1- removal of mastoid air cells and all middle ear contents except stapes 2- removal of diseased mastoid air cells 3- removal of mastoid air cells and all middle ear contents with preservation of healthy remnants of tympanic membrane and ossicles

Answer : 1

4- non of the above

Extensive cholesteatoma is best treated by 1- cortical mastoidectomy 2- radical mastoidectomy 3- modified reducal mastoidectomy 4- myringotomy wiyh insertion of T tube

Answer : 2

Which of the following statements is false concerning Cochlear implant 1-postlingually deaf get far better benefit than prelingually deaf 2-it is indicated in total sensory hearing loss 3-the auditory nerve should be intact 4- After the operation speech discrimination is good and lip reading is not needed

Answer :4

Which of the following statements is wrong concerning myringotomy Operation 1- it is indicated in acute suppurative otitis media with bulging drum 2- it is indicated in secretory otitis media after failure of medical Treatment 3- it is better done in the postero superior quadrant of the tympanic membrane 4-residual perforation of the tympanic membrane is one of its complications

Answer : 3

.

Etiology for pulsatile tinnitus includes the followings except: a) Arteriovenous malformation of neck. b) Otosclerosis. c) Glomus jugulare tumors. d) Hyperthyroidism. e) Atherosclerosis.

Answer :b

b) c) d) e) f)

Which of the following drugs are known to cause tinnitus? Salicylates. Loop Diuretics. Aminoglycosides. NSAID. All of the above

Answer :e

Which of the following is associated with objective tinnitus b) Menire's disease. c) Ear wax impaction. d) Acoustic neuroma. e) Palatal myoclonus. f) Middle ear effusion

Answer :d

The following have an ototoxic effect except 1- gentamycin 2- frusemide 3- streptomycin 4- amoxicilline 5- quinine

Answer :4

The following Paranasal sinuses drain into the Ostiomeatal complex except 1- posterior ethmoid sinuses 2- frontal sinus 3-maxillary sinus 4-anterior ethmoid sinuses

Answer :1

Posterior ethmoid sinus drain into 1- middle meatus 2-inferior meatus 3- superior meatus 4-sphenoethmoidal recess

Answer :3

Cacosmia means 1-complete loss of smell 2-diminution of the sense of smell 3-smelling bad odour due to the presence of noxious substance in the nose 4- smelling of non existing odor

Answer : 3

The lacrimal sac drains into 1- middle meatus 2-inferior meatus 3- superior meatus 4-sphenoethmoidal recess

Answer: 2

The external carotid artery gives blood supply to the nose through the following branches except 1- sphenopalatine artery 2-greater palatine artery 3- superior labial artery 4-anterior ehmoidal artery

Answer : 4

In a patient presenting to the emergency room with fractured nose associated with edema 1- postpone reduction for one week 2- immediate reduction of the nasal fracture is needed 3- patient should be prepared for immediate septorhinoplasty 4- postpone for one month before reduction

Answer :2

in a patient presenting with severe throbbing pain in the nasal vestibule 1- the likely diagnosis is vestibulitis 2- squeezing pus from the swelling is recommended 3- the causative organism is streptococcus hemolyticus 4- checking the blood sugar in recurrent cases is recommended

Answer : 4

A four years old child presented with left nasal offensive nasal Answer : 3 discharge. You should suspect 1- choanal atresia 2- adenoid 3- foreign body impaction 4- rhinosinusitis

In a patient presenting with right watery clear nasal discharge that increases with straining, the following statements are correct except 1-cerebrospinal rhinorrhoea is suspected 2-CT scan with intrathecal dye injection is necessary 3-biochemical analysis of the nasal discharge should be done 4- nasal drops and packing are helpful to the patient 5- patient should avoid nose blowing and leaning forewards

Answer : 4

A 19 years old female presented with anosmia and crusty nose. Her mother described bad odour of her daughters nose. The most likely diagnosis is 1- rhinoscleroma 2- foreign body in the nose 3- chronic sinusitis 4-atrophic rhinitis

Answer : 4

In atrophic rhinitis the following signs are seen except 1- reddish non ulcerating firm nodules at the mucocutaneous junction 2-roomy nose 3-greenish offensive crusts 4-pale and atrophic mucosa

Answer : 1

One of the following statements is not correct concerning rhinosclerma 1- it is the commonest specific infective granuloma in Egypt 2- the disease is endemic in Kalyobeyah 3- biopsy is needed to confirm diagnosis 4- the causative organism is klebsiella ozynae

Answer : 4

The histopathological picture of scleroma includes the following except 1- Muklicz cells 2- Russels bodies 3- plasma cells and lymphocytes 4- neutophils

Answer : 4

The causative organism in common cold is 1234influenza virus type A Rhinovirus streptococcus pneumonia Moraxella catarrhalis

Answer : 2

The causative organism in influenza is 1- Haemophilus influenza 2- influenza virus type A, B, C 3-Rhinovirus 4- non of the above

Answer : 2

The following antibiotics are effective in rhinoscleroma except

1- rifampicin 2-quinolones 3- ampicillin 4- 3rd generation cephalosporins

Answer : 3

The organism involved in the pathogenesis of atrophic rhinitis is 1- klebsiella rhinoscleromatis 2-klebsiella ozynae 3-non of the above 4- all of the above

Answer : 2

The following statements are correct concerning lupus vulgaris except 1- I t is caused by attenuated tubercle bacilli 2- reddish ulcerating nodules at the mucocutaneous junction are seen 3-perforation of the hard palate is characteristic sign 4- perforation of cartilagenous part of the septum may occur 5- tuberculin test is positive

Answer : 3

Syphilis of the nose causes 1- bony septal perforation 2- palatal perforation 3-saddle nose deformity 4-all of the above

Answer : 4

40 years old male presented with left nasal obstruction and fleshy reddish nasal mass. There is a history of recuurence after previous surgery 2 years ago 1- the likely diagnosis is nasopharyngeal angiofibroma 2- inverted papilloma is suspected 3- allergic nasal polypi is a possible diagnosis 4- non of the above

Answer : 2

In a teenager presented with unilateral nasal obstruction with single pale grayish glistenibg soft pedunculated mass. The most likely diagnosis is: 1- nasopharyngeal angiofibroma 2-inverted papilloma 3- antrochoanal polyp 4-non of the above

Answer : 3

A patient with a Cshaped deviated nasal septum may suffer from all of the following symptoms except 1- epistaxis 2- unilateral nasal obstruction 3- facial pain 4- parosmia

Answer : 4

A patient presented with bilateral nasal obstruction after nasal trauma. The patient temperature is 38 There is throbbing nasal pain. Your diagnosis is 1- nasal frunculosis 2- septal hematoma 3-septal abscess 4- non of the above

Answer : 3

The commonest cause of septal perforation is 1- septal abscess 2- lupus vulgaris 3- septal operations 4-habitual nose picking

Answer : 3

The criteria of early congenital syphilis are 1- persistent rhinorrhoea, vestibulitis with fissuribg of the upper lip 2- notching of the upper central incisors with keratitis 3-peforation of the nasal septum 4- non of the above

Answer : 1

All of the following comprise Hatchinsons triade except 1- notching of the upper central incisor 2- interstitial keratitis 3-septal perforation 4-sensorineural hearing loss

Answer : 3

All of the following statements are correct concerning septal perforation except 1- it is commonly asymptomatic 2-epistaxis may occur on separation of crusts 3-the commonest cause is habitual nose picking 4- surgical closure is not successful in most cases

Answer : 3 the commonest cause is septal operations

Fracture of the middle third of the face that runs transversly through the floor of the maxillary sinus and nasal cavity is known as 1- Le Forte 1 fracture 2- Le Forte 2 fracture 3- Le Forte 3 fracture 4- non of the above

Answer : 1

The commonest cause of oro-antral fistula is 1- nasal syphilis 2- cancer of the maxilla 3-osteomyelitis of the maxilla 4- extraction of 2nd premolar and first molar tooth

Answer : 4

A 25 years old patient with fever, mucopurulent nasal discharge and pain over the cheeks is suffering from 1- Frontal sinusitis 2- Acute maxillary sinusitis 3- Ethmoidal sinusitis 4- Chronic maxillary sinusitis

Answer : 2

Uncontrolled diabetic patient was diagnosed as having acute sinusitis. His general condition deteriorated rapidly. Nasal examination revealed blackish crusts, the most likely diagnosis is 1- mycetoma 2- acute fulminating fungal sinusitis 3- allergic fungal sinusitis 4- chronic indolent fungal sinusitis

Answer : 2

1234-

An atopic 35 years old patient presented with unilateral nasal obstruction. Examination revealed unilateral multiple nasal polypi and CT scan revealed unilateral sinus opacity with hyperdense spots . what is your diagnosis? allergic nasal polypi acute fulminating fungal sinusitis allergic fungal sinusitis chronic indolent fungal sinusitis

Answer : 2

The commonest benign tumor of the paranasal sinuses is 1- inverted papilloma 2-osteoma 3-nasopharyngeal angiofibroma 4- non of the above

Answer : 2

The following are causes of unilateral offensive nasal discharge except 1- nasal malignancy 2- nasal foreign body 3- nasal allergy 4- allergic fungal sinusitis

Answer : 3

A 3 years old male child with recurrent epistaxis, subcutaneous hematoma and swollen joints after minor trauma is probably suffering from 1- thrombocytopenic purpura 2- hemophilia 3- leukemia 4- rheumatic fever

Answer : 2

12345-

All of the follpwing arteries share in Keisselbachs plexus except anterior ethmoidal artery posterior ethmoidal artery greater palatine artery superior labial artery sphenopalatine artery

Answer : 2

Parosmia means 1- smelling of bad odour due to the presence of noxious substance in the patient nose 2- smelling of non existing odor 3-complete loss of the sense of smell 4-diminution of the sense of smell

Answer : 2

All of the following are charecteristic of rhinolalia clausa except 1- it is caused by bilateral nasal obstruction 2- there is decreased nasal resonance 3- it affects the letters m& n 4- it is a manifestation of cleft palate

Answer :4

Keisselbachs plexus accounts for the following percentage of epistaxis 1- 50% 2-60% 3-70% 4-80% 5-90%

Answer : 5

To define the offending allergen in allergic rhinitis the following is done 1- microscopic examination of a nasal smear 2- skin sensitivity test 3- blood examination for IgE level 4- all of the above 5- non of the above

Answer : 2

A septal abscess must be drained immediately for fear of 1-frontal lobe abscess 2- cavernous sinus thrombophlebitis 3- nasal deformity 4- orbital cellulitis

Answer : 2

A rhinolith is caused by 1-neglected foreign body in the nose 2- precipitation of calcium salts on a blood clot or inspissated mucus 3 all of the above 4- non of the above

Answer : 3

Which of the following nasal foreign bodies is irritating and cause inflammatory reaction 1- bean 2- button 3- bead 4- a piece of plastic

Answer : 1Vegetable FB are irritating and cause inflammatory reaction because of fatty acids

Cerebrospinal rhinorrhoea is characterized by all of the following except 1- watery and salty 2- does not stiffen handkerchief 3-increase on straining 4- bilateral

Answer : 4

Of the nasal foreign bodies one of the following may cause nasal septal perforation 1- metallic foreign body 2- vegetable foreign body 3- calculator battery 4- rhinolith

Answer : 3 This is due to leakage of chemicals from the battery

Deviated nasal septum can be associated with 1- unilateral nasal obstruction 2- bilateral nasal obstruction 3- epistaxis 4- all of the above

Answer : 4

Which of the following is wrong concerning submucous resection septal operation 1- it is contraindicated before the age of 18 2- it can be done under local anaesthesia 3- the incidence of septal perforation is less than septoplasty operation 4- the incidence of septal hematoma is more common than septoplasty operation

Answer :3

The nasopharynx takes its sensory nerve supply from 1- trigeminal nerve 2- glossopharyngeal nerve 3- vagus nerve 4- non of the above

Answer : 1

The oropharynx takes its sensory nerve supply from 1- trigeminal nerve 2glossopharyngeal nerve 3- vagus nerve 4- non of the above

Answer : 2

The hypopharynx takes its sensory nerve supply from 1- trigeminal nerve 2- glossopharyngeal nerve 3- vagus nerve 4- non of the above

Answer : 3

The Eustachian tube 1- opens in the lateral wall of the oropharynx 2- is opened by the levator palati muscle 3- wider in the adult than in infants 4- non of the above 5- all of the above

Answer : 4

The part of the pharynx that lies in front of the 3rd to 6th cervical vertebra is 1- oropharynx 2- nasopharynx 3- hypopharynx 4- the whole pharynx

Answer : 3

The part of the pharynx that lies in front of the 2nd and 3rd cervical vertebra is 1- oropharynx 2- nasopharynx 3- hypopharynx 4- laryngopharynx

Answer : 1

The voluntary stage of swallowing is 1- the oral phase 2- the pharyngeal phase 3- the esophageal phase 4- both 1 and 2

Answer : 1

Snoring is defined as 1- difficult noisy breathing due to partial obstruction of the larynx,trachea or bronchi 2-noisy breathing during sleep due to vibration of the hypotonic dynamic walls of the pharynx 3- both 1 and 2 are right 4- both 1 and 2 are wrong

Answer : 2

Dysphagia means 1- painful swallowing 2-difficult swallowing 3- sensation of the act of swallowing 4- all of the above

Answer : 4

A swelling may be felt in the neck which may gurgle on palpation, a sign known as 1-Boyce's sign. 2-Moures sign 3-Greisingers sign 4-kernig sign

Answer : 1

A middle aged female with gradually progressive dysphagia, koilonychia, hypochromic anaemia and glazed tongue is suffering from 1- Plummer Vinson syndrome 2- hypopharyngeal carcinoma 3- oesophageal carcinoma 4- achalasia

Answer : 1

The most common cause for pharyngeal and oral ulceration is 1- Behcet disease 2- aphthous ulcers 3- tuberculous ulcers 4- syphilitic ulcer

Answer : 2

In a teenager male with recurrent severe left epistaxis , pallor and conductive deafness of the left ear, you should suspect 1- antrochoanal polyp 2- inverted papilloma 3- nasopharyngeal angiofibroma 4- septal hemangioma

Answer : 3

The best investigation to confirm the diagnosis of nasopharyngeal angiofibroma is 1- biosy 2-CT scan 3-carotid angiography 4- non of the above

Answer : 3

Trotters triad consists of all of the following except 1-unilateral conductive hearing loss 2-ipsilateral earache and facial pain 3- ipsilateral proptosis 4- ipsilateral immobilization of the soft palate

Answer : 3

The commonest site of origin of nasopharyngeal carcinoma is 1-roof 2- the fossa of Rosenmuller 3-superior surface of the soft palate 4- Eustachian tube orifice

Answer : 2

In a child aging 3 years with Mouth breathing, hyponasality and Snoring of long duration, you suspect 1- bilateral choanal atresia 2- adenoid 3- acute rhinitis 4- non of the above Answer :2

The commonest cause of obstructive sleep apnea in adult is 1- allergic rhinitis 2-allergic nasal polypi 3-marked obesity 4-elongated uvula

Answer : 3

The commonest cause of obstructive sleep apnea in children is 1- bilateral choanal atresia 2- allergic nasal polypi 3- marked obesity 4- Adenoid

Answer : 4

A 4 years old child presented by his mother complaining of lack of attention, mouth breathing and hyponasality 1- secretory otitis media is suspected 2- adenoid is suspested 3-both 1 and 2 4- non of the above

Answer : 3

In diphtheria, the antitoxic serum is given 1- to neutralize the circulating exotoxin 2- to neutralize the fixed exotoxin 3- to kill the diphtheria bacilli 4- all of the above

Answer : 1

Adenoids can cause school retardation as a result of 1- excessive daytime sleepiness 2-impaired hearing 3- recurrent infection 4- all of the above

Answer : 4

True pharyngeal membrane occurs in 1- vincent angina 2-diphtheria 3- infectious mononucleasis 4- acute membranous tonsilitis

Answer : 4

The following are features consistent with postcricoid carcinoma except 1- dysphagia is more to fluids 2- rapid loss of weight 3- Moures sign can be detected 4- dysphagia is rapidly progressive , first to soilds then to solids and fluids

Answer : 1

Nasopharyngeal carcinoma can cause paralysis of the following nerves except 1- the vagus nerve 2-the facial nerve 3-the glossopharyngeal nerve 4-the abducent nerve

Answer : 2

Excessive tobacoo smoking and alcohol intake are predisposing factors to the following except 1- nasopharyngeal carcinoma 2- oropharyngeal carcinoma 3- hypopharyngeal carcinoma 4- oesophageal carcinoma

Answer : 1

The main arterial supply of the tonsil is from 1- ascending palatine artery 2- descending palatine artery 3- dorsalis linguae artery 4- tonsillar artery 5-ascending pharyngeal artery

Answer : 4

The commonest causative organism in acute tonsilitis is 1- staphylococcus aureus 2- haemophylus influenza 3- streptococcus haemolyticus 4- Morhexella catarrhalis

Answer : 3

Moures sign can be detected in 1- nasopharyngeal carcinoma 2- oropharyngeal carcino,a 3-postcricoid carcinoma 4- supraglottic carcinoma

Answer : 3 Moure;s sign means absence of laryngeal click which can be detected in normal individuals on moving the larynx from side to side

The diagnostic manifestation of a Parapharyngeal abscess is

1- Trotters triad 2- Geisengers sign 3-Gradenigo triade 4- Boecks triade

Answer : 4

Un ulcer with undermined edge and yellow caseous floor is consistent with

Answer : 2

1- traumatic ulcer 2-tuberculous ulcer 3- syphilitic ulcer 4- malignant ulcer

Un ulcer with everted edge , necrotic floor and indurated base is consistent with 1- traumatic ulcer 2-tuberculous ulcer 3- syphilitic ulcer 4- malignant ulcer

Answer : 4

The palatine tonsil is different from the lymph node in that 1- the tonsil has only efferent lymph vessels 2- the tonsil has efferent and afferent lymph vessels 3- the tonsil has afferent lymphatics only 4- the tonsil is completely capsulated

Answer : 1

The earliest and commonest complication of diphtheria is 1- heart failure 2- palatal paralysis 3-laryngeal obstruction 4-acute nephritis

Answer : 4

The earliest and Commonest neurological complication of Diphtheria is 1- paralysis of occular muscles 2-paralysis of the diaphragm 3-palatal paralysis 4-laryngeal paralysis

Answer : 3

Tonsillectomy is not indicated in 1-chronic tonsillitis 2- history of peritonsillar abscess 3- diphtheria carrier resistant to penicilline therapy 4- acute tonsilitis

Answer : 4

All of the following are signs of chronic tonsillitis except 1- inequality of the size of both tonsils 2- irregularity of the surface of the tonsils 3- membrane on the tonsils 4- persistent enlargement of jagulodigastric lymph node

Answer : 3

Concerning contraindications of Tonsillectomy, which of the following statements is wrong 1- tonsillectomy is contraindicated in acute tonsilitis 2-rheumatic fever is a contraindication to avoid bacterial endocarditis 3- it is contraindicated in haemophilia 4- it is contraindicated in tuberculous cervical lymphadenopathy

Answer : 4

In a 3 years old child presenting with bleeding from the mouth 5 days after tonsillectomy 1- ligation of bleeding points should be carried out immediately 2- the cause of bleeding in this patient is slippage of a loose ligature 3- if conservative measures fail to stop bleeding consider packing the tonsillar bed with absorbable haemostatic material 4- non of the above

Answer : 3

Adenoidectomy operation is contraindicated in 1- acute upper respiratory tract infection and the operation is postponed for 3 weeks 2- cleft palate 3- hempophilia 4- all of the above

Answer : 4

Which of the following is not true concerning active immunization against diphtheria 1- it is compulsory and given at the age of 2,4 and 6 month 2-it is given to contacts of diphtheretic patients 3- it is given to diphtheria patients 4- booster doses are given at the age of 18 months and 5 years

Answer: 3

In achalasia of the cardia 1- dysphagia is more to solids than to fluids 2-there is irregular filling defect in barium swallow 3-hour glass appearance is a characteristic feature in barium swallow 4- barium swallow shows marked dilatation of the lower 2/3 of the esophagus with smooth tapering lower endAnswer: 4

Which of the following is not true concerning esophageal carcinoma 1- dysphagia is more to solids than to fluids 2- loss of weight is marked 3- it is more common in males than females 4- the esophagus is markedly dilated above the esophageal stenotic part

Answer: 4

Esophageal perforation may be associated with 1-surgical emphysema in the neck 2-pneumothorax 3- mediastinitis 4- all of the above

Answer: 4

The commonest esophageal foreign body is 1- fish bone 2-disc batteries 3- coins 4- pins

Answer: 3

the length of the adult esophagus is about 1-15 cm 2- 25 cm 3- 30 cm 4- 35 cm

Answer: 2

The esophagus is crossed by the left main bronchus and aortic arch at about: 1- 15 cm from the incisor teeth 2- 25 cm from the incisor teeth 3- 30 cm from the incisor 4- 40 cm from the incisor

Answer: 2

The gastro-esophageal sphincter lies at about 1- 15 from the incisor teeth 2- 25from the incisor teeth 3- 40 from the incisor teeth 4- 50 from the incisor teeth

Answer: 3

The crico-pharyngeal sphincter lies at about 1- 15 from the incisor teeth 2- 25 from the incisor teeth 3- 40 from the incisor teeth 4- 50 from the incisor teeth

Answer: 1

The crico-pharyngeal sphincter lies at 1- 15 cmfrom the incisor teeth 2- 6 inches from the incisor teeth 3- at the level of 6th cervical vertebra 4- all of the above 5- non of the above

Answer: 4

A teenager with left recurrent severe epistaxis and left nasal obstruction. Examination revealed left pink nasal mass which bleeds on touch You suspect:.. Two investigations to be done: 1 2-

Nasopharyngeal angiofibroma 1-CT scan 2-Angiography

A 35 years old lady develops hoarsness of voice after a neck surgery You suspect:Unilateral vocal cord paralysis Intubation granuloma

A 30 years old female presented with bilateral impairment of hearing

Otosclerosis

A 55 years old patient presented with unilateral tinnitus and progressive impairment of hearing of one year duration. Suggest 2 investigations You suspect.

ABR MRI Acoustic neuroma

A diabetic patient well known to have left chronic ear discharge developed left facial pain and diplopia on looking to the left side

Petrositis Gradenigo syndrome

A 3 years old child whose mother noticed offensive right nasal discharge

right nasal foreign body

A 3 years old child with a history of common cold before a few days. He developed right facial paralysis. Examination revealed reddish drum. Diagnosis First step in treatment :Otitic facial paralysis Myringotomy

A patient attended the ENT clinic for ear wash. She felt pain during wash with water coming from her nose

Traumatic drum perforation

A patient presented with left facial paralysis discovered while he was shaving. No abnormality was seen at ENT examination. CT scan and MRI revealed no head and neck abnormality

Bells palsy

The mother of this child described inattention of her child You suspect Another investigation to be done?

Secretory otitis media Tympanometry

This man presented with dysphagia

Achalasia

60 years old man presented with dysphagia to solids more than fluids and loss of weight of 3 months duration. Three weeks ago he developed right painless neck swelling

Hypopharyngeal carcinoma with spread to cervical lymph nodes

A 35 years old patient presented with recurrent attacks of vertigo for seconds occurring when he assumes certain head position. His hearing was normal Diagnosis:

Benign paroxysmal positional vertigo

25 YEARS OLD PATIENT WHO HAD BURN IN HIS LIMB WAS ADMITTED IN A HOSPITAL FOR 10 DAYS FOR MANAGEMENT OF HIS BURN. AFTER DISCHARGE HE PRESENTED TO THE ENT CLINIC WITH BILATERAL HEARING LOSS. EXAMINATION REVEALED NORMAL TYMPANIC MEMBRANE.

SNHL following ototoxic drugs

A 23 years old patient has severe sore throat. Temperature is 39.5, after 2 days, he developed severe dysphagia, throbbing pain referred otalgia and drooling of saliva He is most probably suffering from:..

Peritonsillar abscess

A 23 years old patient has severe sore throat. After 3 days, he developed severe dysphagia, throbbing pain referred otalgia and drooling of saliva. Neck examination revealed a tender swelling in the right side of the neck

Right parapharyngeal abscess

A 24 year old male patient presented because of severe pain in the throat and the left ear that increased with swallowing of sudden onset and 2 days duration. He gave a history of sore throat and fever a few days prior to the condition. On examination, the patient looked very ill and has a thickened voice. The temperature was 39.5 C and the pulse 110/minute. The patient had fetor of the breath and was unable to open his mouth. There was marked edema of the palate concealing the left tonsil that was found injected. There was a painful hot swelling located below the left angle of the mandible. The left tympanic membrane was normal. Look at previous quiz

A 35 years old patient presentes with mild sore throat with painful limited neck movement. There is a history of admission in chest hospital. Examination revealed a midline swelling in the posterior pharyngeal wall Diagnosis Investigation

Chronic retropharyngeal abscess X ray or CT scan of the neck (shows widening of prevertebral space and destruction of cervical spines)

A 2.5 years old child presented by his parents who noticed sudden inability of the child to swallow and regurgitation of undigested food. Temperature was normal and clinical ENT examination was normal. You suspect.

Foreign body in the esophagus

An infant 3 months after birth develops inspiratory stridor which improves on lying on prone position. The infant cry was normal. Temperature was 37. You suspect..

laryngomalacia

A 3 month old infant presented with left persistent nasal obstruction and thick mucoid nasal discharge noticed since birth. You suspect . How to investigate

Unilateral choanal atresia CT scan or X-ray with instillation of lipidol

A newly born infant has difficult breathing with intermittent cyanosis. Examination revealed bilateral nasal mucoid discharge. A small catheter can not be passed through the nose to the pharynx. Laryngeal examination revealed no abnormality. You suspect

Bilateral choanal atresia

A 20 years old female presented with crusty nose and anosmia. Examination revealed roomy nose, greenish crusts and pale atrophic nasal mucosa

Atrophic rhinitis

A 25 years old female from Benha presented with chronic persistent nasal obstruction. Nasal examination revealed reddish non ulcerating firm nodules at the mucocutaneous junction. Biopsy was taken You suspect.

Rhinoscleroma

A 25 years old female from Benha presented with biphasic stridor and expectoration of greenish crusts. The patient has a history of chronic persistent nasal obstruction with crusty nasal discharge.

Sleroma of the nose and larynx

A 40 years old male presented with hoarsy weak voice and severe throat pain referred to the ear. There is a history of admission in a chest hospital. Examination revealed pale laryngeal mucosa with interarytenoid granulations

Tuberculous laryngitis

A 45 years old patient presented with pulsating tinnitus in his right ear. Examination: look at right image Diagnosis

Glomus jagulari

A 40 year old female has been complaining of nasal troubles of a long duration in the form of bilateral nasal obstruction, anosmia and nasal crustation. Two months ago she developed mild stridor that necessitated a tracheostomy later on. She received medical treatment for her condition, but 1 month later developed severe to profound hearing loss that necessitated the use of a hearing aid.

Rhinolaryngeo scleroma Ototoxicity