1st Round 2007-2008

First Round Exam

1- A child , 2 years old came to the reception room
with difficult breathing. There was noise present
during inspiration.
i- What is the medical term for this condition and
what are the possible causes?
ii- How to save this patient life?
2- A male patient , 28 years old had bilateral nasal
obstruction.
On examination , multiple , masses were seen filling
both nasal cavities.
i- What is the diagnosis of this case?
ii- Mention the other symptoms he will suffer from
due to his bilateral nasal obstruction.
3- Causes of epistaxix.
MCQ
1- The commonest cause of sleep apnea in children
is:
i- Choanal atresia.
ii- Acute rhinitis.
iii- Enlarged tonsils and adenoids.
iv- Rhinoscleroma.
v- Nasal foreign body.
2- Reactionary haemorrhage after adeoidectomy is
treated by:

i- Ligation.
ii- Anterior nasal packing.
iii- Posterior nasal packing.
iv- Chemical cauterisation.
v- Electric cauterisation.
3- Lateral displacement of the eye ball is due to:
i- Sphenoidal sinus lesions.
ii- Ethmoidal sinus lesions.
iii- Maxillary sinus lesions.
iv- Frontal sinus lesions.
4- Lower motor neurone facial paralysis affects:
i- The upper part of the face.
ii- The lower part of the face.
iii- The whole side of the face.
iv- Eye muscles.
v- Muscles of the tongue
5- Cranial copmlications of otitis media include:
i- External otitis.
ii- Petrositis.
iii- Brain abcess.
iv- Extradural abcess.
v- Lateral sinus thrombosis.
6- Intracranial complications of O.M. include:
i- Facial paralysis.
ii- Mastoiditis.
iii- External otitis.
iv- Extradural abces

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2nd Round 2007-2008
Cases:
1- A 12 years old male pt. had a history of Rt. ear
discharge for 2 yrs. eight days ago he started to
have fever & pain behind the Rt. ear. On
examination, there was a perforation in the tympanic
memb. located in pars flaccida. there was tenderness
over the mastoid tip with a swelling posterior to the
auricle.
a- full diagnosis of this case?
b-What is the D.D?
c-discribe the discharge coming from the rt. ear in
the previous 2 yrs.
d-what is the most imp. single diagnosis to do? How
does it help in reaching the proper diagnosis?

2-Achild 3 yrs old came to emergency after

swallowing of caustic potash 30 min. ago.
a-Clinial pic. on presentation.
b-how to tt?
c-Clinical pic. after 3 monthes.

d-What is the mst valuble investigation to do after 3

ms. before any interference?
Written:
First aid treatment of a case of epistaxis
MCQ
1-All are branches of the facial nerve EXCEPT:
a-chorda tympani.
b-Greater auricular nerve.
c-Nerve to stapedius muscle.
d-Greater superfacial petrosal nerve.
2-Unilateral watery nasal discharge occurs in cases
of:
a-Allergic rhinitis.
b-Cancer maxilla.
c-C.S.F rhinorrhoea.
d-Acute sinusitis.
3-Scleroma can affect the following sites EXCEPT:
a-Larynx.
b-Nose.
c-Bronchi.
d-Lacrimal system.
4-A paired cartilage of the larynx:

a-Thyroid cartilage.
b-Arytenoid cartilage.
c-Cricoid cartilage.
d-Epiglottis.
5-The commonest cause of sleep apnoea in children
is:
a-Redundant soft palate.
b-Enlarged tongue base.
c-Enlarged tonsils and adenoids.
d-Deviated nasal septum.

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3rd Round 2007-2008
cases
1- A male pt.aged 23 years. he was suffering from
bilateral intermittent mucopurulant ear discharge for
the last 4 yrs. three days ago he had an attack of
common cold.
On examination both drum showed cenral
perforations. the discharge comming was pulsating.
a-Cause of pulasting discharge in this case?
b-What do you advice this pt.?
c-Which ear to operate first? why?
2-A 30 yrs old female had an attack of acute

follicular tonsillitis for the last 4 days. On the fouth

day the pain in the throat started to localize to the
left tonsillar region.
the pain became throbbing and radiating to the left
ear.
a-what is the likely daignosis?
b-What are the other symptoms do you expect to
find?
c-what are the signs you shall find in the pt.?

Written:
-What are the indications of tracheostomy?
-what are the typesof nasal packing for epistaxis &
how to do each?
MCQ:
1-CSOM cause all of the following symptoms except:
-Discharge.
-Pain
-tinnitus
-deafness
2-Stridor is:
-difficult breathing.
-noisy breathing.

-change in voice.
-difficult noisy breathing.
-difficult breathing & swallowing.
3-acute mastoditis is treated by:
-radical mastoidectomy.
-cortical mastoidectomy.
-tympanoplasty.
-stapedectomy.
4-Laryngoscleroma affect:
-epiglottis.
-vocal cords.
-above vocal cords.
-below vocal cords

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4th Round 2007-2008
1-A male patient aged 16 years suffered from recurrent
attacks of Epistaxis.
Over a 2-years period he was admitted twice to hospital for
blood transfusion.
a-What is the most probable diagnosis? (2 marks)
b- How to investigate? (3 marks)
c- How to treat? (3 marks)
2- A five years old girl came suffering of diminution of
hearing in both

ears for the last 2 months. The condition followed an attack

of upper
respiratory tract infection. On examination, both ear drums
were intact but
retracted.
a- How to know that the drum is retracted? (2 marks)
b- What is the diagnosis? (2 marks)
e- What are the investigations needed? (3 marks)
d- How to treat? (3 marks)
3- Post operative complications of tracheostomy. (5 marks)
4- M.C.Q: (5 marks)
1- Meniere's disease is characterized by :
a- Conductive deafness, otorrhea and vertigo.
b- Sensor neural deafness, pain in the ear and tinnitus.
c- Sensorineural deafness, tinnitus and vertigo.
d- Conductive deafness, facial paralysis and vertigo.
2- One of the following laryngeal lesions is
precancerous:
a- Singer's nodule.
b- Laryngoscleroma
c- Multiple papilloma
d- Laryngeal web.
e- Single papilloma
3- All the following muscles are supplied by the
recurrent laryngeal
nerve except:
a- Throaryrenoid.
b- Posterior cricoarytenoid .
c- Thyrohyoid.
d- Lateral cricoarytenoid.

4- The commonest cause of sleep apnea in children is:

a- Bilateral nasal polyp
b- Deviated nasal septum.
c- Adenotonsillar hypertrophy.
d- Large uvula and soft palate.
5- Traumatic perforation of the drum is characterized by
all of the
followings except:
a- Irregular edges.
b- Marginal.
c- In pars tensa
d- May heal spontaneously.

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1st Round 2009
1.A child 7 year old presented with sore throat and fever
for 3 days. Now
the pain is localized to the right side, throbbing and
referred to the right
ear. The child cannot open his mouth. Externally, only the
jugulodigastric
lymph nodes are felt.
(2 marks) What is the possible diagnosis?
What are other signs to search for? (3 marks)
How to treat? (5marks)
2. Acute otitis media in children: Aetiological causes,
clinical picture and
treatment (5 marks)

3. Compare between different types of papillomas of the

larynx? (5 marks)
4-Mcqs (10 marks)
1- The commonest cause of epistaxis in children is:
a- Adenoids.
b- Nasopharyngeal fibroma.
c- Idiopathic.
d- Foreign body
2- In achalasia of the cardia dysphgia is :
a- Not present.
b- More to solids.
c- More to fluids.
d- Equal for both.
3- In upper motor neurone faciaL paralysis:
a- All muscles of the face are affected.
b- Hypertonia of the muscles is present.
e- lost expressions
d- Muscles are wasted.
4- C.S.F. rhinorrhoea is:
a- Bilateral.
b- Unilateral.
c- Mucoid.
d- Pulsattng.
5- All are symptoms of chronic suppurative otitis media
Except:
a- Discharge.
b- Pain.
c- Deafness.

d- TInnitus.

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2nd Round 2009
1- 54 years old man presented with hoarseness for last 3
weeks condition
was stationary inspite of medical ttt.
indirect laryngoscopy revealed a paralysed left vocal cord.
the remainder of otolaryngyological examination was normal.
he gave no history of truama nor operation prior to the onset
of hoarseness.
a) how does a paralysed cord appear?
b)what are the possiple causes in this particular case?
c) how to know the definite cause?
2-Enumerate causes of dysphagia.
3-Causes and medical ttt of vertigo.

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3rd Round 2009
Answer the following questions:
1. A male patient 55 years old presented with diminution of
hearing in his
right ear for the last 2 months. He felt a sensation of fluid In
his right ear.

On examination the right ear drum was opaque and

retracted. Weber's test
showed lateralization to the right ear .
a) What is the diagnosis of such a case? (1 Mark)
b) What are the full investigations needed for this elderly
male patient?(4
Marks)
c) How to treat? (2 Marks)
2. A male patient aged 24 years received a trauma to his
head. Immediately
following this trauma he noticed a clear watery fluid coming
from his left
nostril .
a) What do you need to know more about the characters of
this
discharge? (2 Marks)
b) What are the investigations needed for such a case? (2
Marks)
c) What do you advise him to do & not to do? (2 Marks)
d) How to treat? (1 Mark)
3. What are the symptoms, signs and management of
ingestion of a
corrosive :
a) Immediately after ingestion. (3 marks)
b) Two months following the ingestion. (3 Marks)
4. M.C.Q. (10 Marks)
1. EAC :
a. 36 cm
b. Lined by skin
c. Responsible for preception of hearing
d. Formed of cartilage

2. Olfactory epithelium lines :

a. Most of nasal passage
b. Roof of nasal passage
c. Floor of nasal passage
3. Commenest cause of sleep apnea in children is:
a. Bilateral nasal poly
b. Deviated nasal septum.
c. Adenotonsillar hypertrophy
d. Large uvula and soft palate
4. Syphilis of the nose affects
a. Anterior part of the septum
b. Posterior part of the septum
c. Middle turbinate
d. Inferioe turbinate
5. Laryngoscleroma affect:
a. epiglottis.
b. vocal cords.
c. below vocal cords
d. above vocal cord

Round cases answers questions :

1st Round 2009 >> The diagnosis is "Quinsy" .
throbbing pain localized to one side.
2nd round 2009 >> the answers are from the
book 3ady.. Causes of left cord paralysis , w el
position w el investigations

3rd round 2009 >> 1st case >> Secretory Otitis

Media
>> 2nd case >> CSF rhinorrhea ( 7at2ool
ba2eet el characteristics beta3et el discharge >
salty taste, doesn't stiffen handkerchief, increase
by straining and coughing ...... w b3deen el
investigations w el ttt mel nazary 3ady)
4th Round 2009 >> Msh 3ndy el exam aslan,
I'm Sorry..
NASOPHARYNGEAL CARCINOMA SOM


UNILATERAL SOM IN OLD MALE= NASOPHARYNGEAL
CARCINOMA.