1.

56 years old present with vasomotor rhinitis

a) Local anti-histamine
b) Local decongestion
c) Local steroid
d) Systemic antibiotic.
 Antihistamines and oral decongestants.

2. 9 years old patient 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. A child was treated for otitis media with 3 different antibiotics for 6 weeks but without improvement.
Which antibiotic is the best treatment?
a) Amoxicillin
b) Penicillin
c) Cepahlosporin (ceprofloxacin)
d) Amoxicillin and Clavulonic acid
e) Erythromycin and sulfamethoxazol

5. best treatment for otitis media

a) Amoxcillin

6. Patient presented with 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.
 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.

7. Nasal decongestant (Vasoconstrictive) can cause:

a) Rhinitis sicca
b) Rebound phenomena
c) Nasal septal perforation
d) Vasomotor rhinitis

 Rhinitis medicamentosa is a condition of rebound nasal congestion

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8. Most common cause of otorrhea:
a) acute otitis media
b) cholesteatoma
c) leakage of cerumen
d) Eustachian tube dysfunction

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

10. 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

11. Patient with recurrent congested nose and conjunctivitis what would you give him.?
a) Antihistamine and oral decongestant

12. 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

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
c) Give anti-histamine
d) Decongestant

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

a) IQ test
b) Involuntary movement test
c) MEMORY score test
d) Hearing test

15. Young man came with nasal bleeding from posterior septum not known to have any medical disease
or bleeding disorder MANGEMENT is.
a) Tampon in posterior septum
b) Screen for blood and coagulation
c) Inject septum by vasoconstrictor
d) spray anaesthetic or 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. Epistaxis treatment:

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

19. A 45 years old lady was complaining of dizziness, sensory neural hearing loss on her left ear (8 th 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

20. 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

 Consult an ENT specialist if the object cannot be removed or if tympanic membrane perforation is
suspected.

21. 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

22. Most common cause of hearing loss in children:

a) Chronic serous otitis media
b) Eustachian tube dysfunction
c) Ototoxic drugs
 presbycusis the most sensorineural hearing loss in adult and otosclerosis commonest cause
of conductive hearing loss

23. Child with ear pain with positive pump test for tympanic membrane, treatment is:
a) Maryngiotomy
b) Amoxicillin/Potassium
 24. Treatment of cholesteatoma is
a) Antibiotic
b) Steroid
c) surgery
d) Grommet tube

25. child with unilateral nasal obstruct with bad odor (Fetid i.e: offensive odor)
a) unilateral adenoid hypertrophy
b) FB

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. most common site of malignancy in paranasal sinuses :

a) 90% Maxillary and ethmoid sinus

28. 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

29. First step in management of epistaxis:

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

30. The most common cause of cough in adults is

a) Asthma
b) Gerd
c) Postnasal drip

31. 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)
 32. Boy 3 day after flu symptom develop conjunctivitis with occipital and nick L.N enlarged so diagnosis is
a) adenoviruses
b) streptococcus
c) HSV

33. 50 years with uncontrolled diabetes, complain of black to brown nasal discharge. So diagnoses is
a) mycomyosis
b) aspirglosis
c) foreign body

 Mycomyosis (fungal infection caused by Mycorales, affect nasal sinus & lungs, characterized by
black nasal discharge, diagnosis by biopsy).

34. 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

35. MOST Prominent symptom of Acute otitis media

a) Pain
b) Hearing loss
c) Discharge
d) tinnitus

36. 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

37. 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.

38. 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
 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 and Thrombocytopeni
 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 topicaldecongestant.
Direct pressure should be applied continuously for at least five minutes and for up to 20 minutes. Tilting
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the head forward prevents blood from pooling in the posterior pharynx

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39. What is the commonest cause of otorrhea?
a) Otitis externa
b) CSF otorrhea
c) Liquefied eczema
d) Eustachian tube dysfunction

40. Regarding aphthous ulceration in the mouth 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

41. Patient had hoarseness of voice for 3 weeks, what is the next to do?
a) Throat swab
b) Laryngoscopy

42. 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”

43. 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 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 “The best if both drops”
 Topical aural medications typically include a mild acid, a corticosteroid (to decrease inflammation),
an antibacterial agent, and/or an antifungal agent

44. 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

45. Anosmia (unable to smell)

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

46. Patient 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
 Meniere Disease: Fluctuating hearing loss, sudden onset Vertigo, Roaring tinnitus and nausea/vomiting.
47. Patient with seasonal nasal discharge , watery , what is the first management:
a) Decongestant
b) Antihistamine
c) steroid

48. Patient 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)

49. 5 years 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

50. Right ear pain with plugging of tympanic membrane

a) Secretary otits media
 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

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

52. Fetal unilateral nasal discharge is feature of:

a) Adenoid
b) Choanal atresia
c) Foreign body
d) RT atrophy

53. the most common cause of epistaxis in children is:

a) polyps
b) Trauma (i.e. nose picking)
c) dry air
d) thrombocytopenia
 Epistaxis is more prevalent in dry climates and during cold weather.

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

55. All are normal in association with teething EXCEPT:

a) Rhinorrhea
b) Diarrhea
c) Fever > 39 C
d) Irritability
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56. 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.

57. All features of tonsillar abscess except :

a) Deviation of uvula to affected side

58. 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.

59. 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

60. child fall from stairs came with mild injury to the nose, no bleeding and edema in the nasal sputum
, treatment:
a) Nasal packing
b) Reassure
c) Analgesia
d) Refer to ENT (he will give analgesia)

61. 16 years old female become deaf suddenly. Her mother become deaf when she was 30, diagnosis:
a) Otosclerosis
b) acostic neuroma
c) tympanic perforation
 It is an autosomal dominant, conductive HL, stapesi footplate

62. Regarding barret esophagitis which correct?

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

63. 35 year old smoker, on examination shown white patch on the tongue, what is the management?
a) Antibiotics
b) No treatment
c) Close observation
d) Excision biopsy
 biopsy if it pre-cancer then do excision biopsy

64. acute otitis media criteria

a) Not should be with effusion
b) rapid sign and symptom
65. 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.

66. Patient after swimming pool (clear Dx of otitis externa) treatment is:
b) nothing
c) amphotericin B
d) steroid
e) ciprofloxacin drops

67. Post-partum female with recurrent attack of hearing loss , which diagnosed as conductive hearing loss ,
on CT the is adhesion in the of semicircular canal diagnosis is
a) Otosclerosis
b) miner's
c) Tuberous sclerosis.

68. Purulent discharge from middle ear how to treat him

a) systemic AB
b) local AB
c) steroid

69. 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) Augmantine
b) azythromycin
c) ciprofloxacin/steroid

70. Waking up from sleep. Can’t talk, no fever, can cough, normal vocal cord, what is the diagnosis?
a) Functional aphonia “loss of speech without attributable cause”

71. 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

72. URTI with meningiococcus type A treatment is

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

73. URTI with streptococcus type A, treatment is

a) Penicilline for 10 days
 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

74. Patient has snoring in sleeping and on exam there is large tensile, what u will do for him?
a) Weight reduction
b) Adenoidectomy
75. 5 years 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

76. 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

77. Child right ear pain and tenderness on pulling ear , no fever , O/E inflamed edematous rt ear canal with
yellow discharge, diagnosis
a) Otitis media
b) Otitis externa
c) Cholesteatoma

78. 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

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

80. 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

81. patient with URTIs , she said , I saw flash when I sneeze why :
a) Mechanical irritation
b) Chemical irritation
82. One of them causes conductive hearing loss :
a) Acute ottis media
b) Syphillis
c) Meneria disease

83. Patient develop nasal discharge with frontal headache

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

84. 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

85. Old patient presented with Ear pain ,headache , hem paresis, most likely cause:
a) Epidural abscess
b) Spinal abscess
c) Subd Subdural hematoma

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

a) Pharyngitis
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

87. 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 deafness
d) Hereditary hearing loss

88. 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
 acute epiglottitis If the was stable : ICU
 If patient is unstable ; Airway must be secured Use of steroid is controversial

89. Most common site of malignancy in paranasal sinuses :

a) Maxillary sinus
90. Patient find perforated tympanic membrane with foul whitish discharge dX?
 Otoseclerosis
 Otitis externa
 Cholesteatoma

91. Young male had pharyngitis, then cough and fever, what is the most likely organism?
a) Staph aureus
b) Streptococcus pneumonia

92. 7 years old child coming with SOB and wheezing he was sitting in bed, leaning forward, with drooling &
strider, what is diagnosis?
a) Epiglottits
b) Bronchial asthma

93. Child with epiglotitis will present with all of the following EXCEPT:
a) Fever
b) Dysphagia
c) like to lie in supine position
d) Stridor
 Epiglottitis usually presents abruptly and rapidly with fever, sore throat, dysphagia, respiratory
distress, drooling, and anxiety.
 Physical: Patients tend to appear seriously ill and apprehensive. Characteristically, patients have a "hot
potato" muffled voice and may have stridor. Usually children will assume the "sniffing position" with
their nose pointed superiorly to maintain an adequate airway.

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

95. Patient is post rhinoplasty, presented with brown discharge with foully odor from the wound, what
could be the management?
a) Debridement and antibiotic

96. 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

97. 4 years old ptatient comes with cystic swelling behind lower lib varying in size has bluish discoloration:
a) ranula “ ruptured salivary gland duct usually caused by local trauma”

98. Generalized skin rash associated with lymph node enlargement:

a) EBV

99. enlarger unilateral tonsils:

a) peripharangial abcses
100. 5 years old child with history of fever and swelling of the face ant to the both ears (parotid
gland enlargement) what is the most common complication
a) Orchitis.
b) encephalitis
c) mastoiditis
d) Meningitis.
 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

101. All features of tonsillar abscess except :

a) Deviation of uvula to affected side:
 Complication of tonsillitis and consists of a collection of pus beside the tonsil. Severe unilateralpain 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

102. Patient taking treatment for TB came with imbalance, hearing loss which drug?
a) INH- peripheral neuritis
b) Strept (8thnerve 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
 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

103. Old patient with abnormal ear sensation and fullness, history 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.
104. Patient 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
 Seborrhoeic dermatitis affecting the scalp, face, and torso. Typically, seborrheic dermatitis presents
with scaly, flaky, itchy and red skin
 Treatment: combines a dandruff shampoo, antifungal agent and topical steroid

105. Adult patient came with acute otitis media received amoxicillin for 1 week , follow up 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

106. What true about management of epistaxis?

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

107. 55 years old male presented with intermittent vertigo and tinnitus. He had history of progressive
hearing loss for 3 years. MRI of the brain will show:
a) Acoustic neuroma.
b) No abnormal changes.

108.Child with URTI, developed ear pain, diagnosed with acute otitis media. The best antibiotics for AOM:
a) Penicillin.
b) Amoxicillin.
c) Ceftriaxone.

109. Patient had seasonal runny nose, itching and nasal obstruction, treated many times with broad-
spectrum antibiotics. The most EFFECTIVE therapy is:
a) Antibiotics.
b) Nasal decongestant.
c) Antihistamines.
d) Topical Corticosteroids

110.Posterior epistaxis with unremarkable history what is next :

a) Post nasal tampon
b) blood coagulation studies

111.Undisplaced nose fracture, what is next step?

a) Refer to ENT surgeon
b) Ice and anageslcis
c) Anterior packing
112.Picture of base of mouth showing a white patch with sharply-demarcated edges. Patient is male, long-
term smoker and chews tobacco, presents with painless lesion in mouth. What is the next most
important step:
a) Topical Fluconazole
b) Biopsy
c) Wide surgical excision
 Diagnosis is leukoplakia
1) painless white plaque
2) associated with smoking
3) on the mucous membranes of the oral cavity, including the tongue, but also other areas of the gastro-
intestinal tract, urinary tract and the genitals
4) Tobacco, either smoked or chewed, is considered to be the main culprit in its development
5) 5% to 25% of leukoplakias are premalignant lesions; therefore, all leukoplakias should be treated
as premalignant lesions by dentists and physicians - they require histologic evaluation or biopsy

113.Most common cause of otitis media all ageis

a) Staphalococcus aurous
b) Streptococcus pnemonia

114.ulcer on the nose with averted edge

a) Basal cell carcinoma
b) Herpes simplx

115.Patient with meniere disease advised to take

a) Low salt no caffeine
b) Low salt high caffeine
c) High salt no caffeine
d) High salt low caffeine

116.Patient with pharyngo tonsilities he took antibiotic and improved in 2 days <the full course of antibiotic
should be for:
a) 5 days
b) 2-7 days
c) 14 days
d) 10 days

117.Tympanic membrane perforation in cases of cholesteotoma are commonly situated in :

a) anterior part of mem tensa
b) Centre of mem. tensa
c) posterior superior segment
d) posterior inferior segment of the tympanic membrane

118.Most common cause of recurrent tonsillitis is

a) Group a beta hemolytic streptococcus
b) parainfelunsa
c) Rhinovirus.

119. Patient with left tonsil enlargement and exudates:

a) Quinsy

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120. patient has fever and vesicular rash all over his palate and uvula , that later ulcerated and
became painful:
a) Herpangina

121. Regarding strep pharyngitis: same as q13 put choices are complete:
a) No treatment should be given until strep infection is proven.
b) Treatment has no effect on rapidity of solution of infection
c) Treatment prevents post-strep glomerulonephritis
d) Treatment can be postponed for 9 days
e) Clindamycin is the drug of choice

122. A young healthy male complain of sleep apnea on examination there is only enlarged
tonsils mangment:
a) Adenoidectomy
b) Reduce weight

123. Patient came with sore throat, ear pain and cough. On examination, tympanic membrane is inflamed
with hemorrhagic vesicles. What is the organism?
a) strep pyogenes
b) pseudomonas
c) mycoplasma

124. Young patient with decreased hearing and family history of hearing loss, ear examination was
normal Rene and Weber test revealed that bone conduction is more than air conduction, what would
you do?
a) Tell him it's only temporary and it will go back to normal.
b) Tell him there is no treatment for his condition.
c) Refer to audiometry.
d) Refer to otolaryngeologist

125. Patient with epiglottitis what in the next step

a) Nasopharyngeal intubation
b) Endotracheal intubation
c) Tracheostomy

126. Patient with hx of acute otitis media , came with cloudy discharge from his left ear you should manage
him by :
a) topical antibiotic
b) systemic antibiotic
c) steriods

127. Young patient with pharyngitis, inflammation of oral mucosa and lips that has whitish cover and
erythmatous base, febrile, splenomegaly.
a) more common in children less than 14 yrs
b) EBV
c) HZV

128. Patient febrile 38.5, ear ache, discharge, parasthesia and hemiparesis on the same side
a) HZV
b) epidural abscess
c) subdural hematoma
129. Patient with seasonal watery nasal discharge, sneezing and nasal block. What should you give him as a
treatment:
a) Topical steroid
b) Decongestants
c) Antihistamines
d) Systemic Steriods

130. Child presented with decreased hearing for 1 year, on exam. there is fluid behind the ear drum
and adenoid hypertrophy. In addition to adenoidectomy what will you do:
a) Myringotomy.
b) Gromet tube insertion.
c) Antibiotics.

131. Patient with perforated tympanic membrane ttt:

a) Topical ABX
b) Topical steroid
c) Systemic ABX
d) Systemic steroid

132. 25 years old female came complaining of difficult hearing , she mentioned that their a family history of
early onset hearing loss ( her grandmother) Oto. Exam was normal .. Weber and rinne tests result in
( bone conduction is greater than air conduction ) ... Next action is :
a) Refer her for aid hearing
b) Tell her there is no avalible ttt
c) Refer her to otolaryngologist

133. patient with nasal congestion, watery nasal discharge and conjunctivitis, ttt:
a) oral antihistamine
b) Na cromoglycate
c) Topical steroid

134. Common cause of AOM in all age groups:

a) H influenza
b) St. pneumonae

135. 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
c) dental abscess
d) chronic atrophic rhinitis
e) chronic sinusitis

136. 28 years 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

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137. Patient with seasonal watery nasal discharge, sneezing and nasal block. What should you give him as a
treatment:
a) Topical steroid
b) Decongestants
c) Antihistamines
d) Systemic Steriods

138. Submandublar swelling & pain during eating what best investing
a) X-ray
b) US
c) CT
d) MRI
 Diagnosis is usually made by characteristic history and physical examination. Diagnosis can be
confirmed by x-ray (80% of salivary gland calculi are visible on x-ray), or by sialogram or ultrasound.
 CT scans are 10 times more sensitive than x-ray

139. all are speech disorders except:

a) Stuttering
b) Mumbling
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

140. Child with recureent otitis media was going to have tonsillectomy, what can u do else to improve
his condition?
a) Myringotomy
b) Grommet insertion

141. Male fell from 10 stairs, on examination contusion over the nose. Your action will be.
a) CT scan
b) referred to ENT

142. Patient present with submandibular swelling with eating, relieved after eating , Dx :
a) Submandibular gland stone

143. Long scenario, patient with greenish nasal discharge , sinus pressure last 4 month , He ttt with broad
spectrum antibiotics with no response , (chronic sinusitis not response to antibiotics) , what is the
management now ;
a) antihistamine
b) local decongestion
c) antibiotic
d) observation

 A case of chronic sinusitis; systemic antibiotics may be tried along with steroid, decongestants, and
vasoconstrictors

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 c) retinoid

145. Indication to give prophylactic antibiotic to recurrent sapurative otitis media in

children:

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

147. A lady patient otherwise healthy complaint a hissing sound in her ears at
night during sleeping; her bedroom is sound proof and no noise coming
from outside. Diagnosis?
a) Migraine
b) Otosclerosis
c) otitis media with effusion tinnitus

148. 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.
c) could be zincker diverticulum