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QBank EENT (Missed EENT for Qbank) Questions With Complete Solutions
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QBank EENT (Missed EENT for Qbank) Questions With Complete Solutions
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QBank EENT (Missed EENT for Qbank) Questions WithComplete Solutions
A 20-year-old pregnant woman is experiencing rapidly
progressive hearing loss. Several relatives in her family
developed deafness prior to age 25 years. Otoscopic
examination shows normal tympanic membranes bilaterally.
Hearing testing shows a conductive hearing loss, with one ear
being affected more severely than the other. Which of the
following diagnoses is most likely? Correct Answer This is
otosclerosis, an often hereditary (autosomal-dominant) disease
in which new, immature bone with abundant vascular channels
causes ankylosis of the stapedial foot plate. This causes
progressive conductive (and in severe cases, sensory) hearing
loss that may become clinically significant in the late teens to
early twenties. Although otosclerotic lesions occur in up to 10%
of Caucasian adults, significant hearing loss occurs in only about
10% of patients who have bony lesions. Pregnancy may cause
the condition to progress more rapidly. Many patients can be
managed with hearing aids; severe cases may respond to
removal of the stapes with implantation of a prosthesis. Hearing
loss is typically bilateral in this condition.
A 24-year-old woman presents to her health care provider with a
dilated right eye and complaint that she cannot read a lunch
menu with the same eye. Which of the following drugs is most
likely responsible for her symptoms? Correct Answer The
question is asking for a drug that dilates the pupil (mydriasis)
and prevents accommodation by paralyzing the ciliary muscle
(cycloplegia). Scopolamine would produce both of these actions
by blocking muscarinic acetylcholine receptors on the pupillary
,constrictor muscle (leading to mydriasis) and on the ciliary
muscle (producing cycloplegia). Scopolamine patches are used
to prevent motion sickness. A possible explanation for this
scenario is that the woman most likely applied the patch and
subsequently rubbed her eye.
A 39-year-old woman with a long history of sinus infections
consults a health care provider because one eye is extremely
sore. Her temperature is 39.5°C (103.1°F). Physical examination
demonstrates erythema and edema of the eyelids and
conjunctivae. The eyeball is protruding and the patient is unable
to move her eye in some directions. Which of the following is
the most likely diagnosis? Correct Answer This is orbital
cellulitis, a dangerous infection of the orbital tissues. Orbital
cellulitis can be seen as a complication of paranasal sinusitis,
eyelid trauma, or dental/oral infection. The presentation
described in the question stem is typical. Major complications
include potentially permanent visual loss secondary to optic
neuritis, meningitis secondary to spread of the infection to the
brain, and cavernous sinus thrombosis secondary to extension of
clots in orbital veins. Treatment is with antibiotics in oral or
intravenous form, depending upon the severity of infection.
Surgical drainage can help if suppuration is present.
A 45-year-old man comes to the clinic with a 2-cm, firm, non-
tender mass in front of his left ear. The mass has been present
for 4 months and has limited mobility, but it is not fixed to deep
tissues or to the overlying skin. The patient has normal function
of the facial nerve, and there are no enlarged lymph nodes in the
neck. A fine-needle aspiration is done, but the pathologist is
unable to provide a cytological diagnosis. The most appropriate
, next step in management would be which of the following?
Correct Answer Clinically this has to be assumed to be a parotid
tumor, and statistically it is most likely to be a pleomorphic
adenoma ("mixed tumor"). Only a formal parotidectomy can
provide complete removal with permanent cure and sparing of
the facial nerve. Whether a superficial or total parotidectomy is
done depends on the location of the tumor—superficial or deep
to the nerve. This formal operation serves as the biopsy.
A 50-year-old man presents with acute pain in his right ear
which occurred 3 days after he started to develop cold
symptoms. He denies drainage from the ear. He has not been
swimming. He has not been around anyone who has similar
symptoms. He denies sore throat or dysphagia. He denies eye
pain or itchiness. Physical examination reveals an afebrile male
who is nontoxic in appearance. Examination of the right ear
reveals the right tympanic membrane to be erythematous with
poor mobility on pneumatic otoscopy. The rest of the auditory
canal is unremarkable. If medical treatment is chosen, which of
the following is the treatment of choice? Correct Answer
Amoxicillin
A 50-year-old man presents with acute pain in his right ear
which occurred 3 days after he started to develop cold
symptoms. He denies drainage from the ear. He has not been
swimming. He has not been around anyone who has similar
symptoms. He denies sore throat or dysphagia. He denies eye
pain or itchiness. Physical examination reveals an afebrile male
who is nontoxic in appearance. Examination of the right ear
reveals the right tympanic membrane to be erythematous with
poor mobility on pneumatic otoscopy. The rest of the auditory
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