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Otolaryngology 2023

What are the symptoms characteristic of chronic otitis media with cholesteatoma

Recurrent ear leakage, mixed hearing loss, exudate in the tympanic cavity, marginal perforation of the tympanic membrane

Mixed or conductive hearing loss, recurrent ear leakage with bad smell, marginal perforation of the tympanic membrane

Fluid in the tympanic cavity, signs of bony destruction on CT scan,

Recurrent leakage from the ear with unpleasant smell, perforation in the flaccid part of the tympanic membrane, conductive or mixed hearing loss, signs of bone destruction on CT scan

recurrent leakage from the ear with unpleasant smell, central perforation in the tense part of the eardrum, conductive or mixed hearing loss, signs of bone destruction on CT scan

Features of acute otitis media, inflammatory infiltration behind the auricle, and protrusion of the auricle are characteristic symptoms of:

Subacute ottis media

intratemporal complication acute otitis media

Intracranial complication of acute otitis media

Mastoiditis

The correct answers are B and D

The newborn was born on time, with a birth weight of 3050g, Apgar 9, 10, 10. After delivery, symptoms of pneumonia developed and the child required a stay in the Intensive Care Unit (4 days), where he was treated with amikacin for 10 days and required mechanical ventilation for 3 days. After leaving the Intensive Care Unit, an acoustic otoemission test was performed as part of the Hearing Screening Program. The result of the test was normal. What should be the further management according to the recommendations of the program:

The child does not require further hearing diagnostics because the mechanical ventilation lasted 3 days.

The child does not require further hearing diagnosis because the stay in the Intensive Care Unit lasted 4 days.

The child does not require further hearing diagnosis because the screening test result was normal

The child requires retesting due to treatment with amikacin

The correct answers are A, B and C.

In pure tone audiometry, the hallmark of conductive hearing loss is

Air-bone gap between the bone and air conduction curves

The bone curve runs from 0 to 20dB

The bone curve runs at a level above 20dB

The air curve runs at a level below 20dB

The correct answers are A and B

Which of the symptoms listen belopp is not a symptom of the peripheral dysfunction of vestibular system:

sudden onset

Horisontorotary nystagmus

vertical nystagmus

hearing impairment

Autonomic symptoms

The most common etiology of the peripheral vertigo is:

Meniere's disease

BPPV

Cholesteatoma

Otosclerosis

Ramsey-Hunt's syndrome

What could be the cause of nasal obstruction In a one year-old child:

Foreign body in the nasal cavity

cancer of the nasopharynx

Meningocerebral hernia

Orbital abscess

Rhinitis

The surgical treatment of chronic sinusitis in a preschool child is:

Mini FESS

Sinus ballooning

Non-operative treatment

Adenoidectomy

Nasal

In the treatment of early glottis cancer, the method of choice is:

chemotherapy

Radiation or sparing surgery

Partial surgery followed by irradiation

Totallaryngeccomy

Surgical treatment only

A patient with a solid tumor of the neck on the left side in fields IV and V, in FNAB probabi, a metastasis of adenocarcinoma. The most likely primary focus is:

Hypopharynx

uterus

Kidney

the middle of the larynx

Parotid gland

Choose the correct answer:

The best treatment for T3 glottic cancer is laser surgery

T3 in glottic cancer means preeglottic involvement

T3 cancer of the glottis is classified as an early malignancy

In the treatment of T3 cancer of the glottis, we obtain similar results as in 12 caste

Radiochemotherapy may be used in T3 glottis cancer

Recurrent laryngeal nerve:

It is a sensory nerve

it comes from the cervical loop

it innervates almost all muscles of the larynx

its damage causes paralysis of the vocal fold in abduction

It runs in the parapharyngeal space

The most serious complication of esophageal perforation is:

Bleeding from the mucosa

Mediastinitis

Meningitis

Pneumothorax

Esophagitis

In a patient after tracheotomy, who also has a disorder of the protective function of the larynx, the most effective way to protect against aspiration is:

Chronic intubation

insertion of the tracheostomy tube with inner cannula

insertion of a nasogastric tube

Insertion of a tracheostomy tube with a sealing cuff

Continuous suction

CSF-rhinorrhea will not occur with:

Fractures of the pyramid of temporal bone

Frontobasal fractures

Maxillary sinus fractures

Fractures of the sphenoid bone

Cribriform plate fractures

The most common reason for changing a voice prosthesis in patients after total laryngectomy is:

Inflammation around the prosthesis

Leakage through the prosthesis (valve dysfunction)

Leakage around the prosthesis

Obstruction of the prosthesis

Spontaneous loss of the prosthesis

Which of the following paranasal sinuses opens into the middle meatus?

Sphenoid sinus

Maxillary sinus

The anterior ethmoidal sinuses

The posterior ethmoidal sinuses

Frontal sinus

Remembering the EPOS criteria point the true sentence

Acute rhinosinusitis (RS) is a sudden onset of two or more of four cardinal svmptoms

More than 10 days of RS is common cold

RS lasting for more than 12 weeks is chronic (CRS)

Topical intranasal corticosteroids are effective in treatment of RS

Four cardinal symptoms of RS are discharge, obstruction, pain, cough

Which is not the sign of potential complications of rhinosinusitis:

Displaced globe

ophthalmoplegia

reduced vision

loss of smell and huge purulent nasal discharge

Severe unilateral frontal headache with swelling

Symptoms of chronic sinusitis in children include all the symptoms listed below except for:

Cough

Nasal discharge

Headaches

Trouble breathing through the nose

Neck pain

15 year old boy complaint on recurrent nose bleeding, left nasal cavity and Eustachian tube obstruction, posterior rhinoscopy reveals a tumor in nasopharynx. What do you recommend?

Follow-up endoscopy of the nasopharynx

Suspicion of Juvenile Nasopharyngeal Angiofibroma and taking open biopsy for histopathology

Immediate radiotherapy of JNA

Immediate adenoidectomy

Surgery after CT, MRI and Angiography

Which of these arteries is not a part of Kisselbach's plexus

Post Ethmoidal artery

Ant Ethmoidal artery

Superior labial artery

Greater Palatine artery

Sphenopalatine artery

Nose bleeds can't be caused by:

High blood preasure

Wegner's Granulomatosis

Trauma

Maxillary sinus tumor

Diabetes **

The most common source of nose bleeding is:

Sphenopalatinar artery

Maxillary artery

Carotid artery

Wudruffs plexus

Kiesselbach's plexus

A 30 year old male presents with acute tonsillitis, occurring about 3 times per year for the past 4 years. What would you recommend?

Antibiotic treatment in accordance with throat culture

A 30 day course of broad spectrum penicillin

Tonsillectomy

Tonsillotomy

Tonsillectomy and adenoidectomy

Peritonsillar abscess:

it can be a complication of untreated sinusitis

it can't cause lockjaw symptom

It is always situated on the anterior (glossopharyngeal) palatinar arch

Antybiotics are the only possible treatment

Surgical drainage should be preformed with each suspicion of a peritonsillar abscess

Symptoms of the enlarged adenoids (pharyngeal tonsil) doesn't include:

Snoring

Sleep Apnea

Blocked, stuffy nose

Otitis media with effusion

Nose bleeds

All of the following are features of chronic tonsillitis except:

Constant feeling of sore throat

Pus in crypts

Congestion of anterior pillar

Surgery brings poor benefit

Enlargement of jugulodigastric lymph nodes

Which sentence about the adult patient with hypertrophied adenoid mass is true:

The specimen for histopatology should be taken

Otitis media with effusion may coexist

The patient should be tested for HIV

Snoring is one of the typical symptoms

All of the above

The most common cause of sore throat is:

Group A Beta-haemolytic Streptococcus

Allergy

chronic mouth-breathing

viral infection

GERD

Possible tonsillectomy complications are:

Hemorrhage

Peritonsillar abscess

Velopharyngeal insufficiency

Upper Airway obstruction from edema

Dehydration

What about caustic ingestion is true

Alkalis - odorless and tasteless are easily swallowed and liquefaction necrosis makes deeper penetration into tissue

Acids - bitter taste and painful cause rapid expectoration

Liquid alkalis are odorless and tasteless - easily swallowed, but coagulation necrosis prevents deeper penetration

Alkalis - bitter taste and painful cause rapid expectoration and minimal exposure to esophagus, but liquefaction necrosis makes deeper penetration into tissue

Liquid acids are odorless and tasteless - easily swallowed, but coagulation necrosis prevents deeper penetration

What is the correct procedure after caustic ingestion

Water, analgetics, antibiotic, steroids, PPl

Water or milk and no medications

Immediate administering the neutralizing substance, analgesics , antibiotic, steroids

Immediate dilatation of esophagus

Endoscopy during 5 - 15 days post ingestion

The first priority in management of maxilofacial trauma is:

CT scan

Securing the airway

Removing foreign bodies

Broad spectrum antibiotics

Each answer is false

The cochlear implant is used for rehabilitation of:

Deafness of cochlear origin

Deafness of neural origin

condactive hearing loss

mixed hearing loss

each type of hearing loss

The proper management of severe laryngeal trauma with respiratory distress is:

Immediate intubation

Tracheotomy under local anesthesia

Cricothyroidectomy

intravenous steroids and antybiotic therapy

Methods of the objective hearing examination are:

pure tone audiometer, behavioral study, ABR

Tympanometry, OAE, ABR

Pure tone audiometer, speech audiometer, tympanometry

tympanometry, tuning fork tests, OAE

Speech audiometry, ABR

Patient with the right side conductive hearing loss during the Weber test:

hears the tuning fork symmetrically

Hears the sound in the right ear

hears the sound in the left ear

can't hear the sound

Hears the sound longer on the left side

The Eustachian tube:

Opens when one yawns

Opens when one smiles

Opens when one blinks

It is alvays open

Never opens

Bithermal caloric test is highly sensitive in identifying:

Sensorineural hearing loss

Otosclerosis

Bilateral vestibular diseases

Unilateral vestibular diseases

BPPV

After pouring hot water (44C) into the right ear of a healthy person we will observe nystagmus with fast component directed

To the left ear

to the right ear

In both directions

Vertical

None of the above

Statistics have shown that:

60% of parotid tumors are benign and 50% of the submandibular tumors are malignant

50% of parotid and submandibular tumors are benign

80% of parotid and submandibular tumors are benign

80% of parotid tumors are benign and 50% of submandibular tumors are malignant

Acinic cell carcinomas of the parotid usually are located in the deep lobe

The symptoms of laryngeal cancer depend on the size and location of the tumor. Symptoms may include following

Hoarseness or other voice changes

A sore throat or feeling that something is stuck in the throat

Earache ("referred")

Stridor - a high pitched wheezing sound indicative of a narrowed or obstructed airway

All symptoms listed above can indicate laryngeal cancer

Cancer of the palatine tonsil:

Most common type is squamous cell carcinoma

Can be asymptomatic in early stages

The tumors frequently present as edvanced stages, and around 70% of patients present with metastasis to the cervical lymph. nodes

Can cause dysphagia

All are true

Type of laser which is useful for laryngeal surgery is:

Argon

Nd: YAG

CO2

All of the above

None of the above

Selective neck dissection pertains to:

Radical neck dissection with preservation of spinal accessory nerve, sternocleidomastoid muscle and internal jugular vein.

Radical neck dissection when nodes are palpable.

Radical neck dissection for No neck.

Modified radical neck dissection with preservation of sternocleidomastoid muscle.

Removal of some lymph node groups while sparing the others.

According to American Joint Committee on Cancer classification a T2 glottic carcinoma means:

Tumor involving both vocal cords.

Tumor of vocal cord extending to false cord

Tumor of vocal cord with cord fixity.

Tumor of vocal cord with extension to anterior commissure

Tumor ofvocal cord with extension to anteror commisure and invasion the thyroid cartilage

Which sentence describing simple chronic otitis media is correct (COM):

COM may lead to serious intracranial complications

COM is characterised by mesotympanal perforation and previous history of acute otitis media

Chronic discharge from the ear with headache is characteristic for COM

Central perforation of tympanic membrane is not typical for COM

All sentences are false

The most frequently encountered malignant tumor of the nose and paranasal sinuses is:

Adenoid cystic carcinoma

squamous cell carcinoma

Melanoma

Esthesioneuroblastoma

Juvenile angiofibroma

Intratemporal comolications of otitis media are:

Brain abscess, labirythitis, extradural abscess, meningitis

Extradural abscess, meningitis, petrositis, focal encephalitis,

Meningitis, lateral sinus thrombosis, otitic hydrocephalus, subdural empyema

Extradural abscess, subdural empyema, periostal abscess, facial nerve paralysis

Labirthitis, petrositis, mastoiditis, facial nerve paralysis

Facial paralysis (FN) as complication of otitis media - select correct sentence:

in acute otitis media treatment is conservative (corticosteroids), surgical facial nerve decompression tis generally not indicated in these cases

FN paralysis is complication of chronic otitis media requires surgical intervention

iatrogenic injury of FN during surgery should be immediately repaired

All sentences are correct

All sentences are false

Patient with acute dyspnoea is brought in ER by ambulance. What is the first procedure that should be performed

intubation

Cricothyrotomy

tracheostomy

Laryngoscopy

Heimlich maneuver

Which pathologies can cause severe laryngeal dyspnoea?

Laryngeal tumours

Foreign body aspiration

Epiglotic abscess

Unilateral vocal cord paralysis

Angioneurotic oedema

True statements concerning tracheotomy are:

Tracheotomy should be performed between thyroid cartilage and cricoid cartilage

Tracheotomy should be performed between cricoid cartilage and sternum

Opening in the trachea should be done on the level of first tracheal ring

Tracheotomy should always be done inferiorly to the isthmus of thyroid gland

Tracheotomy is the fastest surgical approach to the airways

Complications of auricular hematoma are:

auricular perichondritis

Auricular cartilage necrosis

Sensorineural hearing loss

Cauliflower ear deformity

facial nerve paresis

To perform aural syringing the temperature of water used should be:

70 degree centigrade

50 degree centigrade

At body temperature

30 degree centigrade

44 degree centigrade

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