Management of bacterial rhinitis include the following

1. Systemic antibiotics T
2. Analgesic T
3. Nasal decongestants T
4. Nasal wash with normal saline F
5. Topical nasal steroids F

The management of allergic rhinitis includes

6. Systemic antihistamines T
7. Topical nasal decongestions T
8. Systemic steroids F
9. Topical nasal steroids T
10. Systemic antibiotics F

The following conditions may be possible causes of facial nerve palsy

11. Acute suppurative otitis media
12. Malignant otitis externa
13. Fracture of the temporal bone
14. Acute otitis interna (Labyrinthitis)
15. Acoustic neuroma

Some of the definitive treatments for nosebleed are:

16. Septal dermoplasty F
17. Anterior nasal packing T
18. Posterior nasal packing T
19. Nasal cauterization T
20. Ligation of Internal maxillary artery T

Quincy
21. It is usually bilateral, and commonly affects adolescent males
22. The tonsil is found pushed downwards and medially
23. Commonly used drugs are broad spectrum penicillin like ampicillin/amoxicillin
 24. It is only treated medically
25. Three (3) weeks after I & D, tonsillectomy is performed to prevent further recurrence

Indications for tonsillectomy:

26. Recurrent acute tonsillitis -more than 6 episodes/year or 3 episodes/year for more than years
27. Recurrent acute tonsillitis associated with other conditions like: Cardiovascular disease associated
with recurrent streptococcal tonsillitis. Recurrent febrile seizures
28. Chronic tonsillitis that is unresponsive to medical management and associated with halitosis,
persistent sore throat and cervical adenitis
29. Streptococcal carrier state unresponsive to medical treatment
30. Acute tonsillitis.

Manifestation of laryngeal disorders includes:

31. Drooling of saliva
32. Haemoptysis
33. Trismus
34. Snoring
35. Expiratory Stridor

In Epiglottitis
36. Is associated with development of excess sludge and crust in the airways
37. Is caused by the para influenza viruses
38. An antero-posterior X-Ray of the neck show the “steeple” sign
39. The epiglottis becomes beefy reddened on oral examination
40. Treatment requires admission into the hospital where alternative airways can be provided

Laryngotracheobronchitis (LTB)
41. Is frequent in children
42. Has H. Influenza as the primary causative organism
43. Is associated with cyanosis and circumoral pallor
44. Intubation or tracheostomy may be necessary in its treatment
45. Is uniformly fatal without antibiotic administration
46. Surgical Emphysema is a complication of Tracheostomy
In the young adult with conductive hearing loss and normal-appearing tympanic membrane following
are possible
47. Otitis Media
48. Meniere’s disease
49. Otosclerosis
50. Acoustic Neuroma
51. Otitis Media with effusion

The following pathologies are external ear causes of conductive hearing loss
52. Otitis externa
53. Tympanosclerosis
54. Hemotympanum
55. Impacted cerumen
56. Meatal stenosis

The following conditions are causes of sensorineural hearing loss in the child
57. Kern icterus
58. Convulsions
59. Otosclerosis
60. Mumps
61. Adenoids hypertrophy

Sensorineural hearing loss (SNHL)

62. Is commonly treated with hearing aids
63. In the youth is commonly caused by psesbyacusis
64. In Otoclerosis, it is noted by the dip at 2000H, and carhart notch on the andiograph
65. Occupational noise exposure and ototoxicity are minor causes
66. Is usually unilateral in ototxicity
Risk factors for neonatal hearing impairment include following
67. Low birth weight (<1500gm)
68. Low Apgar scores (<5 at 1min and <7 at 5mins)
69. Ramsay Hunt’s syndrome
70. Gradenigo’s syndrome
71. Prematurity
The following are possible causes of Eustachian tube dysfunction
72. Adenoid hypertrophy
73. Cleft palate
74. Tonsillar hypertrophy
75. Post nasal space carcinoma
76. Mucocilary disorder

Tonsillitis
77. This is caused by a micro-organisms like Beta -haemolytic Streptococcus
78. It presents with a reddened slough on the tonsillar surface
79. Can complicate into parapharyngeal abscess
80. Nasal decongestants are required in management
81. There can be submandibular lymphadenopathy

Tonsillectomy is indicated in the following

82. Acute tonsillitis
83. Infectious mononucleosis
84. Quincy
85. Recurrent tonsilitis for more than four times in the year
86. Leukaemia

Adenoid facies is characterized by the following

87. Malocclusion of the teeth
88. Vacant facial expression
89. Drooling of saliva
90. Cough
91. Stridor

Adenoids are a collection of lymphoid tissues

92. The adenoid normally enlarges during childhood between 3-4 years
93. A large adenoid causes nasal obstruction, mouth breathing, snoring and restless sleep
 94. X-ray skull antero-posterior view shows clearly the enlarged adenoid tissue causing narr the naso
pharyngeal airway
95. The features of adenoid faces include elongated face, pinched nostrils, open mouth, arched palate,
shortened upper lip and vacant expression
96. Tonsillectomy is the operation of choice for adenoid hypertrophy

Foreign body in the nose may complicate into the following

97. Rhinoliths
98. Deviation of nasal sept
99. Nasal vestibulitis
100. Rhinosinusitis
101. Epistaxis

Epistaxis may be caused by the following conditions:

102. Warfarin administration
103. Leukemia
104. Oser- Weber- Rendu Syndrome
105. Angiofibroma
106. Allergic rhinitis

Sinusitis can be caused by:

107. Dental apical abscess
108. Maxillofacial trauma
109. Foreign body in nose
110. Barotraumas
111. Herbal preparation instilled in nose

The following investigations may be useful in managing sinusitis

112. Nasal swab for culture sensitivity
113. X-RAY Skull (lateral View)
114. Blood culture
115. Full blood count
116. Nasal smear for count
Allergic rhinitis
117. Is a Type lI hypersensitivity reaction
118. Dust is a common allergen
119. Histamine release is key process
120. Antibodies are released by immunoglobulin G
121. It occurs frequently during rainy season

The Kiesseltbach plexus is formed by the following arteries:

122. Anterior ethmoidal
123. Posterior ethmoidal
124. Sphenopalatine
125. Greater palatine
126. Superior labial
The following are some of the causes of “referred pain” in the ear
127. Acute tonsillitis
128. Quincy
129. Impacted molar tooth
130. Mixed parotid tumour
131. Temporo- mandibular joint arthralgia

Otitis externa
132. Is caused by staphylococcus aureus
133. Tragal tenderness is present
134. Nasal decongestant is required
135. Antibiotic/steroid wick pack is required
136. Systemic steroid is indicated

Malignant otitis externa:

137. This is a pre-cancerous lesion of the external auditory canal
138. It is common in HIV/AIDS patient
139. It can be transformed into a malignancy
140. It can complicate into meningitis
141. Pseudomonas auriginosa may be a causative agent
Acute suppurative otitis media
142. Its common in children than in adults
143. The tympanic membrane will be bulging
144. Topical nasal decongestant will be required
145. Antibiotic/steroidal wick pack would be inserted
146. Schwabach will be shortened in the patient

Complication of the acute suppurative otitis media includes:

147. Gradenigo’s syndrome
148. Panophthalmitis
149. Meningitis
150. Epistaxis
151. Ramsey-Hunt Syndrome

Chronic suppurative otitis media

152. There is always a perforated tympanic membrane
153. There is always muco-purulent discharge
154. There can be otalgia
155. There is always a formation of cholesteatoma
156. Antibiotic/steroidal wick pack must be inserted

Labyrinthitis
157. This is usually a complication of otitis media
158. It presents with vertigo
159. There can be vomiting
160. It presents with conductive hearing loss
161. It may be associated with cholesteatoma formation

The following drugs are Ototoxic

162. Quinine
163. Ketoconazole
164. Astimizole
165. Neomycin
 166. Tobramycin

The following conditions can cause mixed hearing loss

167. Acoustic neuroma
168. Ossicular fibrosis
169. Otosclerosis
170. Endolymphatic sac hydrops
171. Tympanosclerosis

Hearing loss
172. In sensorineural hearing loss, the weber test is lateralised to the problem ear
173. In sensorineural hearing loss, the Schwabach test is expected to be shortened in the exar
174. Rinne "negative" means air conduction is better than bone conduction
175. In conductive hearing loss the Rinne test is always negative
176. Otosclerosis presents with paracusis willisi

The following are some of the ENT manifestations in HIV/AIDS patients

177. Herpes zoster oticus
178. Fungal Sinusitis
179. Atrophic rhinitis
180. cholesteatoma formation
181. Retropharyngeal abscess

Facial nerve palsy

182. There may be ipsilateral dry eye when the lesion is after the geniculate ganglion
183. Bell's phenomenon is present when the supranuclear lesion
184. Can be caused by vestibular schwannoma
185. Systemic steroids may be useful
186. It may lead to hyperesthesia
Acute suppurative Otitis Media
187. The middle ear is usually infected by extension of nasopharyngitis
188. Strept. pneumonia can be a cause
189. Severe ear ache at the pre suppurative stage is due to retraction of the drumhead
190. Meningitis is an extra-cranial complication of this disease
191. Mastoiditis is an intra-cranial complication of this disease

Chronic Otitis Media

192. Is an infection of the middle ear more than two (2) weeks
193. If the eardrum has a permanent perforation
194. Perforations can be central or marginal
195. Marginal perforations are normally safe
196. Central perforations are dangerous

Meniere’s disease
197. Consist of the triad of symptoms; Tinnitus, Vertigo and Conductive Hearing loss
198. The Pathology is in the middle ear
199. Diurectics are useful in treatment
200. Potassium supplement should be given as part of treatment
201. There is no surgical management
Ototoxicity
202. It is a medication-induced injury to the middle ear
203. It results in Conductive hearing loss
204. It may be temporal or permanent
205. Furosemide is associated with Ototoxicity
206. The erectile dysfunction drug Viagra has been found to be Ototoxic

Treatment of dry traumatic rupture of tympanic membrane is

207. Antibiotic ear drops
208. Myringoplasty
209. Protection of the ear against water
 210. Ear pack soaked with antibiotics
211. It may be associated with cholesteatoma

Ear Wax
212. PH is acidic in normal healthy canals
213. Needs to be removed periodically
214. Contains a bactericidal enzyme
215. Is a combination of secretions of sebaceous and apocrine glands
216. Is found in the inner 2/3 of the Extremal Auditory canal.
217. Treatment may include voice rest, increased fluid intake, steam inhalation and antibiotics
administration

In airway obstruction from foreign body aspiration:

218. Restlessness and agitation are indices of hypoxia as haemoptysis is an index of mucosa disruption,
trauma and cancers
219. Frequent in adolescent especially when sudden inspiration is taken when an object is mouth
220. Lack of posterior dentition, mental retardation, seizure disorders and abusive environmental are some
risk factors
221. Initial symptoms may be subtle but sudden onset at meals of cough with or without dys very
suggestive
222. A positive history must never be ignored, while a negative history may be misleading

Foreign body (FB) Aspiration

223. X-ray radiographs can be diagnostic
224. Inorganic objects aspirated are feared for both their instant obstruction effects and subse: FB reaction
225. Heimlich's manoeuvre is an important treatment option in the hospital
226. Tracheostomy can be a life saving measure until definitive treatment is available
227. can be complicated by lung collapse
Tracheostomy
228. Allows for the entry into the larynx
229. 1s classified by the level at which it is done into vertical and horizontal tracheostomies
230. Decreases the dead space in the airway by a one-third
231. It enables care-givers to instil medications into the lower airways
232. Has no contradictions
Tracheostomy
233. Rarely leads to aphonia
234. Can be a prophylactic and an elective surgical procedure
235. Can complicate into early and late tracheoesophageal fistula
236. May be indicated in the ICU for patients with prolong intubation
237. Is indicated in all patients with airway obstruction

Tracheostomy
238. The ideal site of Tracheostomy is 1" and 2nd trachea rings
239. The ideal site of Tracheostomy is 3" and 4h trachea rings
240. In a deeply comatose patient, Tracheostomy is done to prevent aspiration pneumonia
241. In severe head injury, tracheotomy is performed to assist ventilation

The following drugs lead to ototoxic hearing loss

242. Salicylates
243. Gentamycin
244. Erythromycin
245. Ciprofloxacin
246. Clindamycin

Intracranial complications of untreated Otitis Media are:

247. Mastoiditis
248. Cholesteatoma
249. Otitic hydrocephalus
250. Carvenous sinus thrombosis
251. Myringosclerosis

A patient with tracheostomy

252. May require mucolytics to facilitate expectoration
253. Requires observation for respiratory distress due to reactive tracheal secretion
254. May develop hoarseness of voice
 255. Stand to suffer anosmia
256. Loses the protective reflexes for the lower airways

Clinical features of epiglottitis include

257. Upright sitting position of the patient with the chin up and mouth opened
258. Difficulty in handling patient's own secretions
259. Circumoral pallor
260. Insidious clinical pallor
261. Irritability and respiratory distress that are rapidly progressive

In radiographic evaluation of airway disorders, lateral view, plain-film X-ray with neck extend identify
262. Adenoids hypertrophy
263. Epiglottitis
264. Atelectasis
265. Laryngomalacia
266. Deep space Infection

267. A male of sixty years presented with progressive visual deterioration with perception of halos
around light. Examination revealed IOP of 32 In Right Eye and 26 mm of Hg in Left Eye, open
angle and 'snow flakes' like material on the surface of the lens. The possible diagnosis in this case
would be:
a) Pigmentary glaucoma
b) Pigment dispersion syndrome
c) Essential Iris atrophy
d) Pseudo exfoliation glaucoma
e) Neovascular glaucoma

268. While playing with the child the mother sustained nail injury to the eye following which she
developed pain, redness and intense watering from that eye. What is the most probable diagnosis
of this case:
f) Lid injury
g) Conjunctival ulcer
h) Corneal ulcer
i) Uveitis
j) Blow out injury
269. A young male sustained head injury during a road traffic accident and a clot was removed from
the left temporal lobe leading to partial dysfunction of the corresponding areas. Which of the
following field defect is the characteristic for left temporal dysfunction:
k) Right upper temporal
l) Right lower temporal
m) Right upper nasal
n) Right lower nasal
o) Central vision

270. A baby age one month is brought to the ophthalmic clinic with findings of haziness and
slightly larger size cornea noted on both sides. What do you think is the probable diagnosis in
this infant?
p) Congenital rubella infection
q) Congenital Cataract
r) Congenital glaucoma
s) Light coloured Iris
t) Megalocornea

271. A young boy was presented in the eye clinic with blunt trauma to his left eye with a ball. There
was a superficial corneal ulcer involving the inferotemporal quadrant of the cornea. Which of the
following is the best management for this young boy:
u) Use of antibiotic eye drops
v) Use of antibiotic eye ointment
w) Bandaged contact lens
x) Use of antibiotic and eye patching
y) No management required and it will heal by itself