ENT

Question 1

What are the key symptoms of viral sinusitis?

Answer 1

Self-limited congestion, clear nasal discharge, and improvement within 10 days.

Question 2

How is bacterial sinusitis differentiated from viral sinusitis?

Answer 2

Bacterial sinusitis lasts >10 days, has purulent nasal discharge, and sometimes facial pain.

Question 3

What is the first-line antibiotic for bacterial sinusitis?

Answer 3

Amoxicillin-clavulanate.

Question 4

How is benign paroxysmal positional vertigo (BPPV) diagnosed?

Answer 4

Positive Dix-Hallpike maneuver.

Question 5

How does vestibular neuritis differ from BPPV?

Answer 5

Vestibular neuritis causes continuous vertigo, whereas BPPV is episodic and positional.

Question 6

What is the first-line treatment for BPPV?

Answer 6

Epley maneuver.

Question 7

What are the key symptoms of allergic rhinitis?

Answer 7

Sneezing, nasal congestion, clear rhinorrhea, and nasal itching.

Question 8

What is the first-line treatment for allergic rhinitis?

Answer 8

Intranasal corticosteroids (e.g., fluticasone).

Question 9

How does allergic rhinitis differ from upper respiratory infections?

Answer 9

Allergic rhinitis is persistent, seasonal, and not associated with fever.

Question 10

What is considered sudden sensorineural hearing loss?

Answer 10

Hearing loss of at least 30 dB over three contiguous frequencies within 72 hours.

Question 11

What is the first-line treatment of sudden sensorineural hearing loss?

Answer 11

High-dose oral corticosteroids as soon as possible.

Question 12

What is the key diagnostic test should be performed first in the evaluation of sudden sensorineural hearing loss?

Answer 12

Formal audiogram, then a MRI to rule out acoustic neuroma.

Question 13

What are the most serious causes of an acute red eye?

Answer 13

Acute angle-closure glaucoma, endophthalmitis, scleritis, and uveitis.

Question 14

How does conjunctivitis differ from more serious causes of red eye?

Answer 14

Conjunctivitis is typically painless, with normal vision and no pupillary abnormalities.

Question 15

When should a patient with acute red eye be referred to ophthalmology?

Answer 15

If there is severe pain, vision changes, corneal involvement, or signs of intraocular pathology.

Question 16

What are the two major types of tinnitus?

Answer 16

Subjective (perceived only by the patient) and objective (caused by vascular or muscular pathology and heard by others).

Question 17

What are the common causes of subjective tinnitus?

Answer 17

Noise-induced hearing loss, presbycusis, ototoxic medications, and Meniere’s disease.

Question 18

When should a patient with tinnitus be referred for further evaluation?

Answer 18

If unilateral, pulsatile, or associated with neurologic symptoms, as this may indicate a tumor (e.g., acoustic neuroma).

Question 19

What are the most common pathogens causing acute otitis media?

Answer 19

Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.

Question 20

How does acute otitis media present differently in adults compared to children?

Answer 20

Adults may have more pronounced ear pain, hearing loss, and systemic symptoms like fever, whereas children often present with irritability and tugging at the ear.

Question 21

What is the first-line antibiotic for adult acute otitis media?

Answer 21

Amoxicillin + Clavulanic Acid; if allergic, alternatives include cefdinir.

Question 22

What is otitis media with effusion (OME)?

Answer 22

The presence of non-infected fluid in the middle ear, often following AOM or due to Eustachian tube dysfunction.

Question 23

How is OME differentiated from acute otitis media?

Answer 23

OME lacks signs of infection (e.g., no fever, no bulging tympanic membrane).

Question 24

When should tympanostomy tubes be considered for OME?

Answer 24

If effusion persists for >3 months with significant hearing loss or speech delay.

Question 25

What are the common pathogens causing otitis externa?

Answer 25

Pseudomonas aeruginosa and Staphylococcus aureus.

Question 26

How is otitis externa diagnosed clinically?

Answer 26

Ear pain, tenderness with tragal manipulation, and otoscopic findings of an erythematous, swollen ear canal with debris.

Question 27

What is the treatment for mild-to-moderate otitis externa?

Answer 27

Topical fluoroquinolone or aminoglycoside drops (e.g., ciprofloxacin or neomycin).

Question 28

What are the common causes of thyroid nodules?

Answer 28

Benign adenomas, multinodular goiter, thyroid cysts, and thyroid malignancies.

Question 29

How is a thyroid nodule initially evaluated?

Answer 29

TSH levels and ultrasound; fine-needle aspiration (FNA) biopsy if suspicious.

Question 30

What ultrasound features suggest malignancy in a thyroid nodule?

Answer 30

Hypoechogenicity, irregular borders, microcalcifications, and increased vascularity.

Question 31

What are the key symptoms of viral pharyngitis?

Answer 31

Cough, rhinorrhea, conjunctivitis, and mild throat pain.

Question 32

How does bacterial pharyngitis (GAS) differ from viral pharyngitis?

Answer 32

GAS pharyngitis presents with fever, anterior cervical lymphadenopathy, tonsillar exudates, and no cough.

Question 33

When is antibiotic treatment indicated for pharyngitis?

Answer 33

If the Centor score is ≥3 and a rapid strep test is positive; treat with penicillin or amoxicillin.

Question 34

What is the classic presentation of epiglottitis?

Answer 34

Rapid onset of fever, dysphagia, drooling, and stridor in a toxic-appearing patient.

Question 35

What is the first-line imaging study for suspected epiglottitis?

Answer 35

Lateral neck X-ray showing the “thumbprint sign.”

Question 36

What is the emergency management for epiglottitis?

Answer 36

Airway protection, IV antibiotics (ceftriaxone + vancomycin), and possible intubation.

Question 37

What are the key features of central vertigo?

Answer 37

Gradual onset, no positional component, neurological deficits (e.g., diplopia, dysarthria), and no improvement with head maneuvers.

Question 38

How is peripheral vertigo differentiated from central vertigo?

Answer 38

Peripheral vertigo is sudden, positional, and associated with nystagmus that improves with fixation.

Question 39

What conditions are common causes of central vertigo?

Answer 39

Stroke, multiple sclerosis, vestibular migraine, and brainstem tumors.

Question 40

What are the symptoms of a common upper respiratory infection (URI)?

Answer 40

Nasal congestion, sore throat, mild fever, and cough, typically resolving in 7-10 days.

Question 41

How does allergic rhinitis differ from a viral URI?

Answer 41

Allergic rhinitis has persistent symptoms, nasal pruritus, clear rhinorrhea, and seasonal occurrence.

Question 42

What is the preferred long-term treatment for allergic rhinitis?

Answer 42

Intranasal corticosteroids (e.g., fluticasone) and antihistamines.

Question 43

What are the symptoms of Eustachian tube dysfunction?

Answer 43

Ear fullness, intermittent popping, and difficulty equalizing ear pressure.

Question 44

What are the most common causes of Eustachian tube dysfunction?

Answer 44

Allergies, upper respiratory infections, and barotrauma.

Question 45

What treatments are available for chronic Eustachian tube dysfunction?

Answer 45

Decongestants, nasal corticosteroids, autoinflation, and in severe cases, tympanostomy tubes.

Question 46

What are the hallmark symptoms of a peritonsillar abscess?

Answer 46

Severe unilateral sore throat, uvular deviation, muffled “hot potato” voice, trismus, and difficulty swallowing.

Question 47

How is a peritonsillar abscess differentiated from severe tonsillitis?

Answer 47

PTA causes asymmetric swelling and deviation of the uvula, whereas tonsillitis presents with bilateral tonsillar inflammation.

Question 48

What is the preferred treatment for a peritonsillar abscess?

Answer 48

Needle aspiration or incision and drainage, IV antibiotics (ampicillin-sulbactam or clindamycin), and pain control.

Question 49

What is the most common site for anterior epistaxis?

Answer 49

Kiesselbach’s plexus in the anterior nasal septum.

Question 50

How should a patient be instructed to manage an acute nosebleed at home?

Answer 50

Lean forward, pinch the nostrils for 10-15 minutes, apply ice to the bridge of the nose, and avoid nose blowing.

Question 51

When should posterior epistaxis be suspected, and how is it managed?

Answer 51

Suspect in recurrent, heavy, or bilateral bleeding; treatment may require nasal packing, cauterization, or ENT intervention.

Question 52

What are the common triggers for aphthous ulcers?

Answer 52

Stress, trauma, acidic foods, vitamin deficiencies (B12, folate, iron), and immune conditions.

Question 53

How does an aphthous ulcer differ from herpetic stomatitis?

Answer 53

Aphthous ulcers are non-vesicular, round, and found on non-keratinized mucosa, while herpetic stomatitis presents with clustered vesicles on keratinized surfaces.

Question 54

What are effective treatments for recurrent aphthous ulcers?

Answer 54

Topical corticosteroids (triamcinolone in Orabase), pain relief (lidocaine gel), and vitamin supplementation if deficiency is suspected.

Question 55

What are the characteristic findings of oral candidiasis?

Answer 55

White, curd-like plaques on the oral mucosa that can be scraped off, leaving a red base.

Question 56

What populations are at higher risk for oral candidiasis?

Answer 56

Immunocompromised individuals (HIV, diabetes, chemotherapy patients), those on inhaled corticosteroids, and recent antibiotic users.

Question 57

What is the treatment for oral candidiasis?

Answer 57

Oral antifungals such as nystatin suspension or fluconazole for more severe cases.

Question 58

What are the symptoms of acute bacterial sialadenitis?

Answer 58

Painful swelling of the salivary gland, erythema, purulent discharge from the duct, and fever.

Question 59

What is the most common causative organism of bacterial sialadenitis?

Answer 59

Staphylococcus aureus.

Question 60

What is the treatment for bacterial sialadenitis?

Answer 60

Hydration, warm compresses, sialogogues (lemon drops), massage, and antibiotics (clindamycin or dicloxacillin).

Question 61

What are the common causes of reactive lymphadenopathy?

Answer 61

Viral infections (EBV, CMV, HIV), bacterial infections, inflammatory conditions, and recent vaccinations.

Question 62

How can benign reactive lymphadenopathy be distinguished from malignancy?

Answer 62

Benign nodes are soft, mobile, and tender; malignant nodes are hard, fixed, and painless.

Question 63

When should lymph node biopsy be considered in a patient with lymphadenopathy?

Answer 63

If the lymph node is >2 cm, persistent for >4 weeks, associated with systemic symptoms (fever, weight loss, night sweats), or has concerning characteristics on imaging.