ENT MCQ

Question 1

You are working as a PA in a GP surgery. An 85 year old gentleman comes to see you complaining of left ear discomfort, hearing loss and ringing in that ear. All observations are normal. On otoscopic exam you find a large amount of wax, obscuring the tympanic membrane on the left.What is the first line treatment for this patient?
A. irrigation & microsuction
B. olive oil ear dops
C. give systemic antibiotics
D. give topical antibiotics
E. use cotton buds to take out the ear wax

Answer 1

B. olive oil ear dops

Question 2

You are working as a PA in a GP surgery. A 2 month old boy is brought to see you. His mother tells you he has had a runny nose for 3 days but today is very irritable and refusing to feed. He has vomited twice. She has noticed he feels hot and has given him some calpol (oral paracetamol). On examination he is crying and has a temperature of 38.7 ̊C. His right tympanic membrane is bulging and cloudy. What would be your first action?
A. admit the patient to hospital
B. prescribe antibiotic ear drops
C. prescribe oral antibiotics
D. send patient home with analgesics
E. send patient home & reassure the patient

Answer 2

A. admit the patient to hospital

Question 3

You are a PA working in a GP surgery. A 36 year old, diabetic, lady comes to see you complaining of facial pain, for 7 days. She describes the pain as a pressure above the eyebrows and over the cheek bones. She has also noticed that she can’t smell her coffee in the morning and her nose feels blocked. She feels generally unwell and her temperature is 37.9 ̊C.What is the most likely diagnosis?
A. allergic rhinitis
B. acute sinusitis
C. acute laryngitis
D. acute pharyngitis
E. nasal tumor

Answer 3

B. acute sinusitis

Question 4

You are working as a PA in the Emergency Department of a large hospital. You review a 75 year old man with epistaxis. You note he is taking regular aspirin. The bleeding started 45 minutes ago. He has been pinching his nose but is starting to feel light headed.What will be your first course of action?
A. assess ABCDE
B. call the ENT registrar
C. insert a nasal tampon
D. take a full history
E. take bloods for coagulation including FBC, group & save

Answer 4

A. assess ABCDE

Question 5

You are working as a PA in an Emergency Department. A 19 year old man comes in with a sore throat. The pain is on the left side only and 9/10 severity. The pain is worse on swallowing and he is drooling saliva. He feels generally unwell, has a headache and ear ache on the left. On examination he has difficulty opening his mouth and his breath has a foul odour. There is a large swelling superior and lateral to the left tonsil and the uvula is displaced to the right. His temperature is 39.2 ̊C. What is the most likely diagnosis?
A. epiglottitis
B. acute pharyngitis
C. acute laryngitis
D. quinsy (peritonsillar abscess)
E. acute tonsillitis

Answer 5

D. quinsy (peritonsillar abscess)

Question 6

You are a PA working in a GP surgery. A 5 year old boy came in with fever and occasional non productive cough noted 2 days ago. On examination, you notice the patient to be sitting forward with hands on his knees. He appears to be drooling, in respiratory distress and appears very unwell. His observations are as follows: HR= 120/min; RR= 37/min temp=39.6’cWhat is the most likely diagnosis?
A. allergic rhinitis
B. acute sinusitis
C. acute laryngitis
D. acute pharyngitis
E. acute epiglottitis

Answer 6

E. acute epiglottitis

Question 7

You are a PA working in a GP surgery. A 10 year old boy together with his parents came in because fever and ‘sore throat’ noted 2 days ago. No other associated signs & symptoms noted like hoarse voice or difficulty swallowing. On examination, you notice some inflammation involving his palatine tonsils but no exudates. He appears conscious & coherent with the following vitals signs: HR= 90/min; RR= 16/min temp=38.1’cWhat is the most likely diagnosis?
A. allergic rhinitis
B. acute sinusitis
C. acute laryngitis
D. acute tonsillitis
E. acute epiglottitis

Answer 7

D. acute tonsillitis