Otolaryngology (68) Flashcards
ORL - 1
About the function of the outer hair cells we can get objective information on
A) tympanometry
B) BERA
C) otoacoustic emission
D) investigation of stapedial reflex
ANSWER
C) otoacoustic emission
EXPLANATION
The otoacoustic emission objectively registers the low intensity sounds at the external ear canal,that have been produced by the outer hair cells.
ORL - 2
The term “acoustic impedance” refers to the
A) pressure in the middle ear.
B) resonancy of the external ear.
C) hearing loss of inner ear origin.
D) acoustic resistance.
E) spatial hearing.
ANSWER
D) acoustic resistance.
EXPLANATION
The part of the middle ear (tympanic membrane and ossicular chain) create an acoustic resistance against the sound wave pressure.
ORL - 4
The patients has no ear pain in:
A) perichondritis of the ear
B) herpes zoster oticus
C) angina
D) otosclerosis
E) lymphadenitis of the neck
ANSWER
D) otosclerosis
EXPLANATION
In the case of otosclerosis, there is no pain but only hearing loss.
ORL - 5
Rinne’s test is informative in:
A) conductive hearing loss
B) sensorineural hearing loss
C) perforation of the tympanic membrane
D) sudden hearing loss
ANSWER
A) conductive hearing loss
EXPLANATION
In Rinne test the patient hears the transmitted sound better on the bone due to bone conductivity, rather than in the air. This indicates a conductive hearing loss
ORL - 7
Tenderness with pressure on the tragus or traction on the auricle is typical in:
A) othematoma
B) external otitis
C) mastoiditis
D) otosclerosis
ANSWER
B) external otitis
EXPLANATION
Tenderness with pressure on the tragus or traction on the auricle is characteristic in cases of external ear infections.
ORL - 9
The patient suffers from vertigo and unilateral hearing loss and tinnitus for 1 hour. The probable diagnosis is:
A) acoustic neurinoma
B) neuronitis vestibularis
C) vertebrobasilar insufficiency
D) Ménière’s disease
ANSWER
D) Ménière’s disease
EXPLANATION
The Ménière disease is characterized by a continues spinning vertigo, lasting for at least 1-2 hours, accompanied by tinnitus and unilateral hearing loss. In later phase the tinnitus and hearing loss can be permanent.
ORL - 10
The patient suffers from hearing loss on the right side. Weber test is lateralized to the right side. Probable cause of the hearing loss is:
A) otosclerosis on the left side
B) cerumen on the right side
C) Ménière’s disease on the right side
D) sensorineural hearing loss on the right side
ANSWER
B) cerumen on the right side
EXPLANATION
Weber test is heard louder to the affected side due to conductive hearing loss in the defective ear. The reason of conductive hearing loss most of the times is the existence of earwax.
ORL - 11
By the help of Valsalva maneuver we can
A) diagnose otosclerosis
B) ventilate the middle ear
C) detect nystagmus
D) exclude conductive hearing loss
E) evaluate the respiratory function of the nose
ANSWER
B) ventilate the middle ear
EXPLANATION
By applying the Valsalva maneuver, we can ventilate the ear. The air goes from the nostrils to the middle ear.
ORL - 12
Which part of the tympanic membrane should be preferred when doing a paracentesis?
A) antero-inferior quadrant
B) antero-superior quadrant
C) postero-superior quadrant
D) postero-inferior quadrant
ANSWER
A) antero-inferior quadrant
EXPLANATION
In paracentesis the preferred quadrant is the anterior inferior since there is no structure behind it that we can damage, and the fluid easily flows out from there.
ORL - 14
What can develop in the middle ear due to short-term obstruction of the Eustachian tube?
A) transsudate
B) haematoma
C) tympanosclerosis
D) acute inflammation
E) exudate
ANSWER
A) transsudate
EXPLANATION
Obstruction of the Eustachian tube frequently causes transudation in the tympanic cavity
ORL - 15
In adult patients with unilateral, recurring catarrh of the Eustachian tube you should exclude…
A) peritonsillar abscess.
B) adenoid hypertrophy.
C) malignant tumor in the epipharynx.
D) deviated septum.
ANSWER
C) malignant tumor in the epipharynx.
EXPLANATION
Adult patients with unilateral, recurring catarrhal inflammation of the Eustachian tube should be examined for epipharyngeal tumors that obstruct the opening of the tube
ORL - 16
Possible complications of mastoiditis do not include:
A) meningitis
B) subperiosteal abscess
C) cavernous sinus trombosis
D) Bezold-abscess
E) otogenic hidrocephalus
ANSWER
E) otogenic hidrocephalus
EXPLANATION
Mastoiditis can cause a variety of different complication, but otogenic hydrocephalus is not one of them.
ORL - 17
Adequate therapy of a confirmed otosclerosis is
A) mastoidectomy
B) paracentesis
C) transnasal Eustachian tube inflation
D) stapedectomy or stapedotomy
ANSWER
D) stapedectomy or stapedotomy
EXPLANATION
A choice of treatment in otosclerosis is removal of the sclerotic stapes and replacement by a prosthetic one: stapedectomy. Another type of operation is stapedotomy, when only the stapes superstructure is removed and replaced by a prosthesis.
ORL - 18
Peripheral facial palsy cannot be caused by:
A) polyomyelitis
B) herpes zoster oticus
C) mastoiditis
D) chronic otitis media with cholesteatoma
E) otosclerosis
ANSWER
E) otosclerosis
EXPLANATION
Peripheral facial palsy cannot be caused by otosclerosis. Though it can be caused by poliomyelitis, Herpes Zoster oticus, mastoiditis, chronic otitis media with cholesteatoma
ORL - 19
The anatomic structure(s) opening into the middle nose cavity is/are:
A) nasofrontal and nasolacrimal ducts
B) sphenoidal sinus and Eustachian tube
C) maxillary sinus, frontal sinus and anterior and middle ethmoid cells
D) posterior ethmoid cells
E) only the maxillary sinus
ANSWER
C) maxillary sinus, frontal sinus and anterior and middle ethmoid cells
EXPLANATION
The middle nasal cavity includes the openings for the maxillary sinuses, frontal sinus and anterior and middle ethmoid cells.
ORL - 20
During the treatment of a nasal furuncle always avoid
A) hospitalization and bed rest
B) incision and pressing (squeezing) of the lesion
C) parenteral antibiotic therapy
D) application of warm compresses
ANSWER
B) incision and pressing (squeezing) of the lesion
EXPLANATION
Nasal furuncle should not be incised or squeezed. Aggressive treatment on it can cause thrombophlebitis and further infection. Recommended treatment is antibiotics.
ORL - 21
For the treatment of a simple rhinitis we recommend
A) nasal drops for 5 to 7 days
B) antibiotics
C) NSAIDs
D) corticosteroids
ANSWER
A) nasal drops for 5 to 7 days
EXPLANATION
The simple rhinitis is treatable with 5 to 7 days of nasal drop usage. Other treatment is unnecessary
ORL - 22
Most relevant therapy of allergic rhinitis consists of:
A) vasoconstrictor agents
B) antibiotics
C) NSAIDs
D) elimination of the allergen
ANSWER
D) elimination of the allergen
EXPLANATION
Most relevant therapy of allergic rhinitis is the elimination of the allergen.
ORL - 23
Oezena
A) is a form of atrophic rhinitis
B) involves foul-smelling lesion of the mucosa
C) has unknown etiology
D) becomes better with aging
E) is characterized by all the above statements
ANSWER
E) is characterized by all the above statements
EXPLANATION
Atrophic oezema is characterized by a foul smelling fluid, where it’s etiology is unknown and is shown to be improving with aging.
ORL - 24
An elder patient presents with unilateral sanguinous, purulent, foul-smelling nasal discharge. You think of:
A) frontal sinusitis
B) malignant tumor of the nose or a paranasal sinus
C) ozaena
D) infected dental cyst
E) angiofibroma
ANSWER
B) malignant tumor of the nose or a paranasal sinus
EXPLANATION
Unilateral sanguinous, purulent, foul-smelling nasal discharge indicates us to a possibility of malignant tumor in the nose or paranasal sinuses
ORL - 25
Most common location of nasal bleeding:
A) nasopharynx
B) middle turbinate
C) superior meatus
D) anterior part of nasal septum
E) posterior part of the nasal septum
ANSWER
D) anterior part of nasal septum
EXPLANATION
Most common location of nasal bleeding is the anterior part of the nasal cavity, most specifically at the Kisselbach area, whereas the mucosa is thinner and has a rich vascularity.
ORL - 26
In acute upper airway infection of an infant, one-sided swelling of the upper and lower eyelid appears. Which condition would you think of?
A) acute rhinitis
B) acute maxillary sinusitis
C) acute ethmoiditis
D) allergic reaction
ANSWER
C) acute ethmoiditis
EXPLANATION
In acute upper respiratory infection of an infant, one sided swelling of the upper and lower eyelid is an indication of an acute ethmoiditis. In this age the rest of the sinuses are either not fully developed or cannot cause eyelid swelling. In case of allergy, there is a symmetric swelling.
ORL - 27
Adenotomy is indicated in
A) chronic sinusitis
B) otitis media
C) sleep apnoe
D) adenoid hypertrophy
E) each of the above conditions
ANSWER
E) each of the above conditions
EXPLANATION
Adenotomy is indicated in chronic sinusitis, frequent otitis media, sleep apnoe, adenoid hypertrophy. In these cases, the nose breathing and the Eustachian tube function improve.
ORL - 29
The term “blow-out fracture” refers to a(n)
A) frontobasal fracture.
B) zygomatic fracture.
C) cheekbone fracture.
D) orbital floor fracture.
E) frontal bone fracture.
ANSWER
D) orbital floor fracture.
EXPLANATION
Blow-out fracture is a traumatic deformity of the orbital floor.
ORL - 30
Osteoma of a paranasal sinus
A) metastatizes to the bones
B) is a congenital lesion
C) most commonly affects swimmers
D) should be surgically removed
E) can be treated with radiotherapy
ANSWER
D) should be surgically removed
EXPLANATION
Paranasal sinus osteoma is removed after a surgical intervention. Pain, obstruction of the sinus openings and the aesthetic deformation is resolved.
ORL - 31
A middle-aged male patient has a painless, freely mobile mass of about 30 mm in one parotid gland for 5 years. Facial nerve funtion is intact. The probable diagnose is
A) osteoma in the external acoustic meatus
B) glomus caroticum tumor
C) pleomorph adenoma
D) salivary stone in the parotid gland
E) malignant tumor of the parotid gland
ANSWER
C) pleomorph adenoma
EXPLANATION
Pleiomorphic adenoma is the most frequent benign parotid tumor, accessible to remove surgically and does not give metastasis. The diagnosis is made by fine needle aspiration.
ORL - 32
Necrotic, coated lesion of the tonsils suggests a(n)
A) scarlatina-associated tonsillitis
B) mononucleosis
C) agranulocytic angina
D) tonsillitis follicularis
E) herpangina
ANSWER
C) agranulocytic angina
EXPLANATION
Necrotic, coated lesion of the tonsils suggest agranulocytic angina. Treatment of the haematological status is recommended.
