ENT Examination 2017 (Rotation 3 Group 3)

Single Best Answer (SBA)

Q1. In acute epiglottitis, the following are true EXCEPT

A. It is commonly caused by Staph aureus

B. Seen mainly in children
C. Stridor is present
D. Thumb sign is seen on lateral neck X ray
E. -
Sabrina has high fever, severe body ache and nasal discharge with fresh
Q2. epistaxis. She also has a rash over her chest that blanches on pressure. Her
platelet count is grossly low. She has
A. Viral rhinitis
B. Influenza
C. Dengue fever
D. Acute leukaemia
E. -
Mr Lim a 50 years old diabetic presents with giddiness, earache and mild
Q3. hearing loss. Your examination reveals a facial nerve palsy and few
vesicles in the ipsilateral external auditory canal. Mr Lim has
A. Bell’s palsy
B. Cholesteatoma of middle ear
C. Otitis Media Effusion (OME)
D. Herpes zoster oticus
E. -
A child develops sudden earache in the right ear with fever. Rinne’s test is
Q4. negative in right ear and positive in the left ear. Weber lateralizes to the right
ear. The child should be treated with antibiotics,
A. Antihistamines, analgesics and nasal decongestants
B. Antihistamines and analgesics
C. Antihistamines, analgesics and ear toilet
D. Antihistamines, analgesics and myringotomy
E. -

Q5. Cleft palate most associated with which condition

A. Acute Suppurative Otitis Media

B. Choric Suppurative Otitis Media
C. Acute necrotizing otitis media
D. Secretory Otitis Media
E. -
 A patient with ear infection treat with antibiotics. Few days later patient develop
Q6.
pain n vesicles in the ear

A. Insert a wick into the ear

B. Stop eardrop
C. Oral antiviral
D. Oral antibiotic
E. -

Q7. Choleastoma ear disease is

A. Usually at mesotympanum
B. Associated with intermittent & copious ear discharge
C. Associated with osteitis & bony erosion
D. Treat conservatively
E. -

Q8. Sensory neural hearing loss investigate for

A. Prebycusis
B. Otosclerosis
C. Labyrinthinitis
D. Cerebello pontine tumor
E. -

Q9. Nasal Septum

A. all septum deviation must be corrected

B. septum deviation will cause headache
C. septum deviation is confined to cartilaginous part
D. sinus is associated?
E. -

A 1-year old child presents with a single polyp in her left nasal fossa. It is
Q10.
important to exclude the following

A. Allergic polyp
B. Antrochoanal polyp
C. Meningoencephalocele
D. Inverted papilloma
E. -
Q11. Patient had posterior nasal bleeding. What is the initial treatment?

A. Posterior packing
B. Posterior&Anterior packing
C. Cauterization of the bleeder
D. Ligation of sphenopalatine artery
E. -

Salina has an allergic rhinitis episode. Few days later, she develops pain on
Q12.
her cheek and bilateral nasal discharge. How will you treat this?

A. Antibiotic, antihistamine, nasal decongestant

B. Antibiotic, topical steroid, antihistamine
C. Antibiotic, antihistamine, antral washout
D. Antibiotic, antihistamine, (?)
E. -

Q13. The most common salivary gland tumor is...

A. Warthins tumor
B. Ocycystoma
C. Lymphangioma
D. Pleomorphic adenoma
E. -

Q14. Functional aphonia

A. seen normally in children

B. loss of voice progress slowly
C. harsh and rough voice
D. cough is normal
E. -

Q15. A battery disc was found in the mid esophagus, what is the management?

A. Wait for it to expel anally

B. Removed promptly
C. Removed by fibre optic endoscopic
D. Thoracostomy
E. -
Q16. The most critical period for acquisition of speech is

A. Birth to 3 years
B. 3 to 5 years
C. 5 to 7 years
D. Above 7 years
E. -

Q17. Median rhomboid glossitis

A. Fungal infection
B. Bacterial infection
C. Is a developmental anomaly
D. Is premalignant
E. -

A child with unilateral foul, blood stained nasal discharge should be

Q18.
investigated for

A. Unilateral sinusitis
B. Nasal polyps
C. Nasal septum deviation
D. Foreign body
E. -

Ali has mild nasal obstruction that alternate to the opposite side every 3 to 4
Q19.
hours and left septal spur. Ali should be advised

A. This is normal nasal cycle and left alone

B. To undergo septoplasty
C. To undergo bilateral inferior turbinectomy
D. To undergo cautery of turbinates
E. -
A young man sustained blunt injury over his nasal bridge. He presents with
Q20. severe oedema and tenderness over his nose and surrounding soft tissue.
There is also crepitus over the area.
A. An X ray should be done and fracture corrected immediately
B. Reviewed after 3 weeks and fracture corrected if indicated
C. Reviewed after 1 week and fracture corrected
D. Reviewed after 1 week and fracture with deformity corrected
E. -
OSCE
EXHIBIT 1
PICTURE: OTITIS MEDIA EFFUSION

*for illustration purpose only

a. Name 3 possible causes of this condition

b. What will be the tuning fork test show i. Rinne (right and left) ii. Weber
c. Interpret the tuning fork finding

EXHIBIT 2
PICTURE: RIGHT FACIAL NERVE PALSY

*for illustration purpose only

a. What is your diagnosis?

b. List 2 infective conditions of the ear that can cause this (excluding Bell’s palsy)
c. How you treat Bell’s palsy
EXHIBIT 3
PICTURE: NASAL OBSTRUCTION

*for illustration purpose only

a. Give 2 differential diagnosis that may presents this way

b. List the medical treatment of one condition in your differential diagnosis
c. If medicated treatment fails name the surgical problem indicated

EXHIBIT 4
PICTURE: INFECTED PREAURICULAR SINUS SWELLING

*for illustration purpose only

a. What is the diagnosis?

b. How will you treat this condition?
c. What advised will you give once patient is improved?
EXHIBIT 5
PICTURE: RIGHT PANSINUSITIS ON CT SCAN

*for illustration purpose only

a. What is your diagnosis?

b. How will you treat this condition?
c. Will you examine the oral cavity and why?
d. Give 2 complications of this condition.
 OPT Examination 2017 (Rotation 3 Group 3)
Single Best Answer (SBA)
A young 23-year-old black man presents with a hyphema in the right eye after
Q1.
blunt injury. All the following are acceptable initial treatments except?
A. sleep with the head elevated
B. prednisolone steroid eye drops
C. cyclopentolate dilating drops
D. carbonic anhydrase inhibitor pressure drops
E. -
7-year-old boy presents with swelling of his right eyelid. His mother cannot think
Q2. of anything that could have caused it. What finding is more characteristic of
orbital cellulitis?
A. Chemosis
B. Warmth and erythema of the eyelid
C. Physically tight eyelid
D. Proptosis
E. -

Q3. Aqueous is found in which chamber?

A. Anterior chamber
B. Posterior chamber
C. Vitreous chamber
D. trabecular chamber
E. -

Q4. The commonest painless lid swelling is

A. stye
B. cyst of moll
C. cyst of zeis
D. internal hordeolum
E. chalazion

Q5. What is glaucoma?

A. Retinal damage from high intraocular pressure

B. Optic nerve death caused by mechanical stretching forces
C. Ischemic nerve damage from decreased blood perfusion gradients
D. None of the above
E. -
 Which condition would result in an inaccurate high reading with applanation
Q6.
pressure measurement?
A. Thin cornea
B. Thick cornea
C. Edematous cornea
D. Keratoconus
E. -
32 years old white man with hx of type 1 diabetes presents to you with
complaint of reduce vision in both eyes. He has not been able to see an eye
Q7. doctor in years. On examination, you find numerous dot-blot haemorrhage,
hard exudates and areas of abnormal vessels on the retina. Pan retinal
haemorrhage is done for this patient to:
A. Kill ischemic retina
B. Tamponade retinal tears
C. Ablate peripheral blood vessels
D. Seal off leaking blood vessels
E. -

Q8. Risk factor of retinal detachment

A. Black
B. Male
C. Age
D. Myopia
E. Presbyopia

Q9. Schirmer’s test is used for diagnosing:

A. Dry eye
B. Infective keratitis
C. Watering eyes
D. Horner’s syndrome
E. -
What antibiotic would you use in a newborn with suspected chlamydial
Q10.
conjunctivitis?
A. Topical ciprofloxacin
B. Topical amoxicillin
C. Oral Doxycycline
D. Topical and oral erythromycin
E. -
 The mother of a 1 ½ year old child gives hx of a white reflex from one eye for 1
Q11. month. On CT scan of the orbit there is calcification seen within the globe. The
most likely diagnosis is?
A. Congenital cataract
B. Retinoblostoma
C. Endopthalmitis
D. Coat’s disease
E. -

Q12. In human corneal transplantation, the donor tissue is from:

A. Synthetic polymer
B. Donated human cadaver eye
C. Donated eye from human being
D. Monkey eye
E. -
A 50-year-old patient came after 3 day of cataract surgery with history of
Q13.
increasing pain and diminished vision ........
A. Endophthalmitis
B. After cataract
C. Missed
D. Retinal displacement
E. -

Q14. All the following signs ...... within the right cavernous sinus infection except?

A. Constriction pupil to light

B. Engorgement of retinal tear
C. Ptosis
D. Ophthalmoplegia
E. -

Q15. Most common causative agent of dendritic corneal ulcer is

A. Staph aureus
B. Fungal
C. Herpes simplex
D. Herpes zoster
E. Mycobacterium
Q16. All are seen in 3rd nerve palsy except:

A. Ptosis
B. Diplopia
C. Miosis
D. Outwards eye deviation
E. -

Q17. Organism that can penetrate intact cornea

A. Strep pyogene
B. Staph aureus
C. Pseudomonas pyocaenae
D. Cornybacterium diphtheriae
E. -

Q18. Fifth cranial nerve palsy could cause

A. Ptosis
B. Proptosis
C. Neuropathic keratopathy
D. Lagopthalmos
E. -

Q19. The action of inferior oblique is:

A. Depression, extorsion, abduction

B. Depression, extorsion, adduction
C. Elevation, extorsion, adduction
D. Elevation, extorsion, abduction
E. -

Q20. The best treatment for amblyopia is:

A. Orthoptic exercises
B. Occlusion
C. Surgery
D. Best treat after age 10 years
E. -
Q21. Most common causes of unilateral ptosis

A. Thyroid orbitopathy
B. Metastasis
C. Lymphoma
D. Meningioma
E. -

Q21. Homogenous hemianopia. Lesion at

A. Optic tract
B. Optic nerve
C. Optic chiasma
D. Retina
E. Occipital cortex

Q23. In the absence of lens accommodation, a myopic eye focuses images:

A. in front of the lens

B. In front of the retina
C. behind the retina
D. Behind the cornea
E. -
After 48 hours of a cataract extraction operation, a patient complained of ocular
Q24. pain and visual loss. On examination, this eye looked red with ciliary injection,
corneal oedema and absent red reflex. The first suspicion must be:
A. Secondary glaucoma
B. Anterior uveitis
C. Bacterial endophthalmitis
D. Acute conjunctivitis
E. -

Q25. Best site where intraocular lens is fitted:

A. Capsular ligament
B. Endosulcus
C. Ciliary supported
D. Capsular bag
E. -
OSCE
Station 1:

*for illustration purpose only

This 57-year-old insulin dependent diabetic noticed blurred vision in this eye.
a. Classify the stages of Diabetic Retinopathy (DR) and mention the
recommended WHO plan for followup according to the stages. (2)
b. What stage of DR is shown here? (1)
c. What is your mx of this case? (2)

Station 2:

*for illustration purpose only

This child was noted to have an absent red reflex.

a. Name the sign that you observe. (1)

b. Name 3 differentials that may present with the above sign. (3)
c. Name 2 clinical signs that a child with Retinoblastoma may present with
besides the above. (1)
Station 3:

*for illustration purpose only

Observe the following picture of an ophthalmological instrument.

a. Name the instrument. (1)
b. What tests would you use it for in your clinical practice? (1)
c. Name 3 examples of instruments that are used for the same reason. (3)

Station 4:

*for illustration purpose only

25-year-old female presents with complaints of red eye, pain and reduced vision for
one day.
a. Mention 3 signs that you observe. (2)
b. Mention the test that have been done. (1)
c. What would your likely treatment be? (2)
Station 5:

*for illustration purpose only

15-year-old boy presents with redness and blurring of vision. He gives a hx of

playing badminton 2 days prior.
a. What is the clinical condition observed? (1)
b. What would your Rx be for this patient? (2)
c. Name 2 complications that may dev. from this condition. (1)

Station 6:

*for illustration purpose only

This picture is a 28 y/o female.

a. What nerve is likely involved? (1)
b. How would you manage this patient? (2)
c. Name 2 conditions that predispose the above? (1)
Station 7:

*for illustration purpose only

This picture is of a 40 y/o female

a. Name the signs that you observe. (1)
b. What symptoms that you expect from this patient? (2)
c. Name 3 blinding complications from thyroid eye disease. (2)

Station 8:

*for illustration purpose only

This is the fundus of a 60 y/o man with ischemic heart disease who dev. a sudden
loss of vision 4 hours ago.
a. What is the diagnosis? (1)
b. What is the immediate management? (2)
c. What is the visual prognosis? (1)
d. What are other vascular causes of sudden visual loss? (1)
 Forensic Examination 2017 (Rotation 3 Group 3)
Single Best Answer (SBA)

Q1. Hydrostatic test is done to

A. Lung in live birth

B. Pneumothorax
C. PM clot
D. Subendocardial haemorrhage
E. Intracerebral bleeding

Q2. Rigor mortis

A. Sets seen after 1-2hours after death

B. Seen in single group of voluntary muscle
C. Seen in excited or fear before death
D. Low level of ATP
E. Sets seen after 1-2hours after death

Q3. Regarding an inquest :

A. An open hearing court for public

B. Ordered by police officer
C. Held in all form of natural death
D. Missed
E. Followed by a court sentence

Q4. changes seen in lungs of the live birth

A. sharp margin
B. frothy blood exudes on section
C. whole lung sinks in water
D. soft, spongy and crepitus
E. volume is large and covers the heart

Q5. Self-inflicted wounds are

A. Mostly incised wounds

B. Commonly seen on eyes
C. Made to charge an enemy with assault or attempted murder
D. Done by women to bring a charge of rape against an individual
E. Produced by another person under duress
 The following features are seen in the lungs of a man died due to fresh water
Q6.
drowning
A. Ballooned and heavy
B. Pale pink in color
C. Shape is retained and do not collapse
D. Crepitus is heard during sectioning
E. Soft and jelly-like consistency

Q7. Match the following

A. Cunnilingus.... Buccal coitus

B. Voyeurism.... Peeping Tom
C. Masochism.... Intercourse with lower animals
D. Sodomy.... Anal intercourse
E. Fetishism.... Objects for sexual gratification

Q8. Regarding Battered-child syndrome

A. Non-accidental physical injuries on a child produced by unknown person

B. There is always delay between the injury and medical attention
C. The victims are usually less than 3-years of age
D. These victims often have a history of family disharmony
E. They can present with skull fracture

Q9. Regarding rape victim

A. It is examined by outpatient clinic

B. Done by Gynecologist
C. Consent is necessary
D. Not to have female chaperone
E. Investigating officer is mandatory before examination

Q10. Following are the features of Post-Mortem wound

A. Don't have gap

B. No blood clot
C. Absence of enzyme activity in histochemistry
D. Missed
E. Missed
Q11. Exhumation

A. Examination on buried body

B. Permissible in civil and criminal cases.
C. Need written consent by coroner
D. 2nd autopsy is not valid after exhumation.
E. Soil surrounding sample is useful for suspected poisoning cases.

Q12. A doctor is NOT under negligence,

A. if he cares and treated skillfully

B. if he fails to obtain informed consent from the patient
C. if he fails to give proper instruction to the patient
D. if he fails to maintain professional confidentiality
E. when patient fails to take treatment given

Q13. The Coroner

A. Has the power to charge contempt of court

B. Gives the verdict in court
C. Is a magistrate by profession
D. Is an appointee of the police
E. Issues a subpoena

Q14. Regarding colour of bruises

A. at first - red
B. few hours to 3 days - blue
C. 4th day - black to brown
D. 7 -12 days - green
E. 2 weeks - yellow

Q15. If rape, the consent is not valid if the women

A. impersonate the husband

B. sound mind and body
C. above 16-year-old
D. under threat
E. information /facts are withheld
Single Best Answer (SBA)

Q1. Female homosexuality is known as

A. Sodomy
B. Fetishism
C. Exhibitionism
D. Tribadism
E. Missed

Q2. In exit bullet wound,

A. the edges are inverted

B. there is presence of grease collar
C. there is blackening
D. there is no lead ring on radiological examination
E. is smaller than the diameter of the bullet

Q3. 3rd molar rupture

A. 17-25
B. 12-14
C. 11-12
D. 10-12
E. 7-11

Q4. Spalding sign is seen in

A. Live birth
B. Still birth
C. Dead born
D. Premature baby
E. Missed

Q5. Diatom

A. Virus particle
B. Bacteria cell wall
C. Algae
D. Haemoparasite
E. Coal particle
OSPE
OSPE Q1

*for illustration purpose only (exact)

Picture of Tache Noire:

1. Describe the eye lesion
2. Explain the mechanism of the pm change

OSPE Q2

*for illustration purpose only (exact)

Name the instruments and state the usage/indication.

1. Type of weapon used
2. Describe the injury
OSPE Q3

*for illustration purpose only (exact)

Postmortem specimen
1. Identify the organ
2. Briefly describe the finding in the organ
3. Mention ONE cause of this injury
4. Mention ONE complication of the above condition which could have lead to death of
the individual.

OSPE 4

*for illustration purpose only (not exact)

Picture of a pair of bruise marks on the buttock of a child.

1. Describe the lesion.

2. Explain the most likely cause of this condition.
OSPE 5

*for illustration purpose only

1. Name the sexual offence

2. describe the sexual offence

*P/S:
This is the sum up of Ear, Nose, and Throat, Ophthalmology, and Forensic Examination for
Group 3.
Thank you everyone for contributing into the compilation. There are some missing answers,
but hopefully it would help other groups in their rotation. Apologies regarded for
undocumented questions.

“The value of experience is not seeing much, but in seeing

wisely.”

~William Osler