Otorhinolaryngology Quiz

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Questions and Answers

Which of the following is the MOST common source of bleeding in Rendu-Osler disease?

  • Paranasal sinuses
  • Oropharynx
  • Nasopharynx (correct)
  • Locus Kiesselbachi

Which diagnostic method is NOT used to investigate nystagmus?

  • Electronystagmography (ENG)
  • Videonystagmography (VNG)
  • Electroencephalography (EEG)
  • Electrocardiography (EKG) (correct)

Which of the following statements regarding oral cavity inflammation is TRUE?

  • Oral candidiasis is common in children under 1 year.
  • Herpetic aphthous gingivostomatitis is caused by human herpesvirus HSV-2.
  • Recurrent inflammation is usually not a result of cobalamin deficiencies
  • Oral mucositis is a common side effect of radiotherapy and chemotherapy. (correct)

Which of the following best describes Neuronitis vestibularis?

<p>It is an acute unilateral peripheral vestibular disorder. (C)</p> Signup and view all the answers

What is the PRIMARY goal of surgical treatment in chronic otitis media?

<p>To improve hearing. (C)</p> Signup and view all the answers

Which of these conditions is an indication for performing a mastoidectomy?

<p>Acute otitis media with facial nerve palsy (C)</p> Signup and view all the answers

What is a typical finding in audiometric examination in vestibular schwannoma?

<p>BERA indicating a supracochlear disorder (C)</p> Signup and view all the answers

Which of the following statements is TRUE regarding vocal cord paresis?

<p>Bilateral paresis of vocal cords requires immediate airway management. (D)</p> Signup and view all the answers

Which of the following is a primary use of laryngostroboscopy?

<p>Examining the oscillation of the vocal cords. (C)</p> Signup and view all the answers

What primary function is NOT investigated with acoustic reflex testing?

<p>Function of the sacculus. (A)</p> Signup and view all the answers

Which of the following is a possible cause of tinnitus?

<p>Vascular anomalies. (B)</p> Signup and view all the answers

Which of these is the most likely diagnosis for an 8-year-old child with bilateral conductive hearing loss?

<p>Serous otitis media (D)</p> Signup and view all the answers

What is a key function of the Valsalva maneuver?

<p>To examine the function of the Eustachian tube. (C)</p> Signup and view all the answers

Which of the following is a characteristic of laryngeal papillomatosis?

<p>The etiological agent is HPV type 6 or 11. (A)</p> Signup and view all the answers

Which of the following is a typical characteristic of inverted papilloma?

<p>It is treated surgically, radically. (D)</p> Signup and view all the answers

What is a typical finding during otoscopic examination in a patient with barotrauma during a plane flight?

<p>Retraction of the tympanic membrane with transudate. (A)</p> Signup and view all the answers

What is the most frequently isolated pathogen in acute pharyngitis and tonsilitis?

<p>Group A B-hemolytic streptococci (D)</p> Signup and view all the answers

Which of the following is NOT a typical symptom of serous otitis media?

<p>Elevated body temperature (A)</p> Signup and view all the answers

Which of the following is NOT a typical finding in the clinical appearance of unilateral hypoglossal palsy?

<p>Asymmetry of oropharyngeal isthmus (A)</p> Signup and view all the answers

What is the most common localization of squamous cell carcinoma (SCC) of the oral cavity?

<p>The edge of the body of the tongue (A)</p> Signup and view all the answers

Which of the following is NOT a complication of transnasal transphenoidal endoscopic approach?

<p>Bleeding from the internal carotid artery (A)</p> Signup and view all the answers

Which of the following statements about foreign bodies in the airway is INCORRECT?

<p>Foreign bodies are rarely found in the larynx and trachea (B)</p> Signup and view all the answers

Which of the following is NOT a typical symptom of mastoiditis?

<p>Rotational vertigo (B)</p> Signup and view all the answers

Which of the following statements about chronic rhinosinusitis is CORRECT?

<p>It is characterized by symptoms lasting more than 12 weeks (A)</p> Signup and view all the answers

What is the most common symptom of acute suppurative otitis media?

<p>Throbbing ear pain (D)</p> Signup and view all the answers

What is the primary purpose of the head impulse test?

<p>To assess the stability of the eyes during head motion (C)</p> Signup and view all the answers

Which of the following is NOT a type of evoked potential used in audiometry?

<p>Electrocochleography (ECochG) (C)</p> Signup and view all the answers

What is the most common type of laryngeal carcinoma?

<p>Glottic carcinoma (A)</p> Signup and view all the answers

Which of these is a significant symptom for epiglottitis?

<p>Significant odynophagia to aphagia (B)</p> Signup and view all the answers

Which of the following examination methods are used to evaluate the vestibular apparatus?

<p>VEMP, BERA, Electrocochleography, Videonystagmography (VNG/ENG) (D)</p> Signup and view all the answers

What causes coagulation necrosis after caustic ingestion?

<p>Acids (B)</p> Signup and view all the answers

Which of the following is a typical symptom of acute otitis media (AOM) in young children?

<p>Fever (C)</p> Signup and view all the answers

What is the role of saliva in oral health?

<p>Saliva is important in the prevention of gum disease and dental caries. (B)</p> Signup and view all the answers

Which statement about Tornwaldt's cysts is correct?

<p>Tornwaldt's cysts are a blind sac in the nasal part of the pharynx. (B)</p> Signup and view all the answers

What is the most common cause of malignant external otitis?

<p>Pseudomonas aeruginosa (A)</p> Signup and view all the answers

What stimulates the semicircular canals?

<p>Angular acceleration (C)</p> Signup and view all the answers

Which of the following conditions does NOT result in the absence of the stapedial reflex?

<p>Conductive hearing loss (B)</p> Signup and view all the answers

What is a key characteristic of an esthesioneuroblastoma?

<p>It is a neurogenic tumor originating from the olfactory epithelium. (C)</p> Signup and view all the answers

Which statement is true regarding sudden sensorineural hearing loss (SSHL)?

<p>It is defined as a loss of at least 30 dB over three frequencies. (A)</p> Signup and view all the answers

What does the Rombert exam specifically assess?

<p>Vestibulospinal reflexes (D)</p> Signup and view all the answers

What indicates the presence of the stapedial reflex in otosclerosis?

<p>Absent (A)</p> Signup and view all the answers

Which of the following is NOT a consequence of a deviation of the nasal septum?

<p>Epistaxis (D)</p> Signup and view all the answers

Which treatment is considered most effective for tumors of the salivary glands?

<p>Surgical removal (B)</p> Signup and view all the answers

Which option indicates a possible application of cochlear implants?

<p>Severe sensorineural hearing loss (B)</p> Signup and view all the answers

What is a common complication related to vestibular schwannoma?

<p>Tinnitus (B)</p> Signup and view all the answers

What should never be used in cases of potential esophageal perforation?

<p>Barium for oral contrast examination (C)</p> Signup and view all the answers

Which statement about the head impulse test (HIT) is correct?

<p>It evaluates the function of the semicircular canals. (A)</p> Signup and view all the answers

What is a common treatment for sudden hearing loss?

<p>Steroids (A)</p> Signup and view all the answers

What is an indication that requires 24-hour pharyngeal pH monitoring?

<p>Understanding of extraesophageal manifestation of GERD (C)</p> Signup and view all the answers

What is a hallmark of harmonic vestibular syndrome?

<p>Spontaneous horizontal rotational nystagmus toward healthy side (D)</p> Signup and view all the answers

What is a critical component of the trachea's function?

<p>Contracts to decrease diameter (B)</p> Signup and view all the answers

Which statement about oral candidiasis is accurate?

<p>It can be a result of chemotherapy. (C)</p> Signup and view all the answers

Which option does NOT represent an otogenic intracranial complication?

<p>Sinusitis (B)</p> Signup and view all the answers

What would be a symptom of a ruptured tympanic membrane?

<p>Severe rotational vertigo (A)</p> Signup and view all the answers

Flashcards

Stapedial Reflex and Otosclerosis

The stapedial reflex is often absent in cases of otosclerosis.

Typical Symptoms of AOM in Children

Acute Otitis Media (AOM) in young children commonly presents with fever and vomiting.

Caustic Ingestion Injuries

Alkali ingestion causes severe injuries, while acids lead to coagulation necrosis.

Otoacoustic Emissions (OAE)

OAE are sounds produced by healthy hair cells in the cochlea, used for hearing screening.

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Malignant External Otitis

Malignant external otitis is characterized by skin ulcers, often in diabetic patients, and involves Pseudomonas aeruginosa.

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Rendu-Osler

A condition causing recurrent epistaxis, commonly from the nasopharynx.

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Oral Mucositis

An inflammation of the oral cavity often seen as a side effect of chemotherapy and radiotherapy.

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Nystagmus Investigation

Clinical investigations for nystagmus include ENG and VNG.

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Neuronitis Vestibularis

A condition marked by sensorineural hearing loss and inflammation of the vestibular nerve, often from HSV-1.

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Mastoidectomy Indications

Mastoidectomy is indicated in acute otitis media with facial nerve palsy and secondary meningitis.

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Audiometric Findings in Schwannoma

Audiometric tests can show absent stapedial reflexes and unchanged word discrimination despite hearing loss.

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Vocal Cord Paresis

Paresis leads to difficulty breathing if vocal cords are abducted; acute bilateral paresis requires immediate coniotomy.

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Post-Stapedectomy Symptoms

Symptoms like tinnitus and fluctuating hearing loss may indicate perilymph fistula or Meniere's disease post-surgery.

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Laryngeal Endoscopy

A procedure to examine the larynx using rigid or flexible tubes.

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Acoustic Reflex Testing

A test to evaluate the reflexive action of the stapes muscle in the presence of loud sounds.

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Laryngeal Papillomatosis

Non-cancerous tumors of the larynx, often due to HPV, causing sore throat.

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Inverted Papilloma

A benign tumor in the nasal cavity that can grow bilaterally and requires surgical treatment.

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Transient-evoked OAEs

Tests that measure the echo of sounds in the inner ear to assess hearing ability.

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Barotrauma

Ear damage caused by sudden changes in atmospheric pressure during activities like flying.

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Tinnitus Management

Treatments for tinnitus include noise masking and, in some cases, surgical intervention.

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Rhinosinusitis in Children

Inflammation of sinuses, often caused by bacteria; X-rays are usually not required.

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24-hour pharyngeal pH monitoring

This test helps understand extraesophageal manifestations of GERD.

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Flexible Endoscopic Evaluation of Swallowing (FEES)

FEES is done under general anesthesia and uses real food to assess swallowing.

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Deviation of the nasal septum

Severe deviation may require surgery and can cause headaches and breathing issues.

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Cochlear implant

A cochlear implant is used for severe sensorineural and conductive hearing loss.

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Otogenic intracranial complications

These include extradural abscess, mastoiditis, and brain abscess.

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Harmonic vestibular syndrome

Characterized by nystagmus towards the healthy side, typical for central vestibular disorders.

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Dysharmonic vestibular syndrome

Nystagmus is distinct and usually negative in halmagyi's maneuver, with neurological symptoms present.

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Trachealis muscle

The trachealis muscle allows the trachea to contract and decrease its diameter.

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Pleomorphic adenoma

The most common benign tumor of the salivary glands, found in the parotid gland.

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Vestibular schwannoma

Occurs with symptoms like tinnitus, vertigo, and hearing impairments.

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Barium and esophageal perforation

Never use barium if there's a danger of esophageal perforation.

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Treatment of sudden hearing loss

Includes antibiotics and hyperbaric oxygen therapy.

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Head Impulse Test (HIT)

Investigates the function of the semicircular canals and vestibular system.

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Oral candidiasis in children

Oral candidiasis occurs exceptionally in children under 1 year old.

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Semicircular Canals

They detect angular velocity and acceleration in the body.

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Stapedial Reflex Absence

Absent in deafness, cochlear damage >65dB, or non-cooperation.

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Estezioneuroblastoma

A malignant neurogenic tumor in the nasal cavity from olfactory epithelium.

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Tracheal Injury Signs

Injuries show pain, swallowing difficulty, and hemoptysis.

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Sudden Sensorineural Hearing Loss

Hearing loss of 30dB or more over three frequencies, often idiopathic.

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Presbyacusis

Age-related hearing loss, gradual and often bilateral.

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Acute pharyngitis symptoms

Common symptom includes cough, treatable with penicillin.

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Otoliquorea

Cerebrospinal fluid leak from the ear or nasal cavity.

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Chronic rhinosinusitis

Inflammation with symptoms lasting over 12 weeks.

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Mastoiditis

Infection of the mastoid process, often stemming from untreated otitis media.

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Malignant lesions in oral cavity

Painless swelling or non-healing ulcers indicating possible cancer.

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Transnasal transphenoidal approach

Minimally invasive method for pituitary tumor surgery.

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Complications of transnasal surgeries

Potential risks include optic nerve damage and bleeding.

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Epistaxis

Nosebleed often needing urgent care.

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Positive fistula sign

Indicates inner ear disorders like otosclerosis or cholesteatoma.

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Sign of Carhart notch

A dip in bone conduction threshold indicating conductive hearing loss.

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Neck diseases in adults

First thought should be viral infection if over 40 with lymphadenopathy.

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Chronic bacterial rhinosinusitis treatment

Targeted antibiotics based on microbiology results.

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Study Notes

ORL 2023 Questions

  • Weber's Test Lateralization: Weber's test lateralizes to the affected ear in unilateral conductive hearing loss
  • Rhinoliquor Location: Used to determine the location of rhinoliquor using rhinoendoscopic examination, rhinoendoscopic examination + intrathecal florescein, HRCT, CT cisternography, MRI cisternography
  • Nystagmus Types: Spontaneous nystagmus, after air irritation (24°C), after water irritation (37°C), after water irritation (44°C)
  • Chronic Otitis Characteristics: Characterized by opacity of the cell system, fluid behind the intact eardrum, or eardrum perforation
  • Otosclerosis Hearing Loss: Caused by dense sclerotic bone in the basal turn of the cochlea
  • Acoustic Reflex Testing: Investigates the function of the sacculus, cochlear nerve, and facial nerve and the defense mechanism against noise-induced hearing loss
  • Sialadenitis: The most common viral pathogen is the mumps virus. Generally, it does not respond well to medical management with antibiotics
  • Hypopharyngeal Carcinoma: Induction chemotherapy with radiotherapy and surgical treatment with radiotherapy have the same results
  • Etiological factor: Consumption of concentrated alcohol and tobacco. Smoking
  • Hypopharyngeal Carcinoma Symptoms: The most frequent symptoms are the sensation of a foreign body in the pharynx and dysphagia
  • Bullous Myringitis: Paracentesis is performed after which the patient has less pain. The disease is caused by herpes zoster virus or influenza virus
  • Malignant Otitis Externa: Usually caused by Streptococcus pyogenes or Pseudomonas aeruginosa
  • Laryngomalacia: Caused by the prolapse of tissue into the larynx during inspiration. Usually gets better after 3 to 4 months.
  • Head and Neck Cancers: PET-CT is superior to either PET or CT alone in evaluation. Intravenous contrast in CT has an importance in the neck
  • Salivary Glands: Saliva contains antimicrobial agents
  • Myringotomy in Acute Otitis Media (AOM): Performed when spontaneous perforation is present or when antibiotics have been administered and temperature continues to persist.
  • Vocal Cord Paresis: Adductor paresis results in the vocal cords being abducted, resulting in difficult breathing and resonant voice.
  • Acute Otitis Media With Facial Nerve Palsy: Audiometric examination in vestibular schwannoma shows stapedial reflexes missing and conductive hearing loss
  • Vestibulocochlear Nerve Neurinoma (n. VIII): Hearing loss with tinnitus and vertigo is present. Impaired innervation of the facial nerve (n. VII) may be present

Other Topics

  • Cystic Fibrosis: Characterized by nasal polyps in pediatric patients, often described as a "whiteout effect" on CT scans
  • Temporal Bone Fractures: The most prevalent kind involve transverse fractures
  • Chronic Bacterial Rhinosinusitis: CT is useful for diagnosis, and treatment involves targeted antibiotic therapy based on microbiological results
  • Laryngeal Carcinoma: Glottic, supraglottic, and subglottic carcinomas
  • Examination of the Pharynx: Clinical examination revealing unilateral hypoglossal palsy (tongue deviation) during protrusion.
  • Hearing Loss: Conductive and Sensorineural
  • Bezold Triad: The otoscope findings
  • Otitis Media and Intracranial Complications: Often spread by per continuitatem or hematogenous routes.
  • Imaging Methods: Methods including CT (computed tomography), MRI (magnetic resonance imaging) PET-CT, and potentially others, depending on the specific area being imaged
  • Glomus Tympanicum: Usually associated with pulsating tinnitus, sometimes manifesting as bleeding from the ear.
  • Cochlear Implant: Suitable for congenitally deaf children under 6 years, those with retrocochlear hearing loss, those using gesture language.
  • Foreign Body Aspirations: Often occur in the left main bronchus
  • Hearing Loss in Otosclerosis: A conductive hearing loss, with Weber testing lateralizing to the affected ear

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