ENT-Comprehensive EXAM MCQs.pdf

👂 ENT EXAM 👃​ 1 What factors cause non-allergic rhinosinusitis? a. Hormonal changes b. Infectious agents c. Primary ciliary dyskinesia d. All Which...

👂 ENT EXAM 👃​ 1 What factors cause non-allergic rhinosinusitis? a. Hormonal changes b. Infectious agents c. Primary ciliary dyskinesia d. All Which of the following pathologies is not associated with allergic rhinosinusitis? a. Conjunctivitis b. Deviated nasal septum c. Bronchial asthma d. Nasal polyposis How is the sound loudness (intensity) measured in clinical praxis? a. Decibels b. Octaves c. Hertz d. Watts In which position are vocal folds placed during phonation? a. Abduction b. Adduction c. Para median d. Middle Which of these is not a criterion of acute rhinosinusitis? a. Cough b. Purulent secretions from the nose c. Difficulty breathing through the nose d. Headache Which one of the following would you recommend as an additional therapy for a patient with acute bacterial rhinosinusitis? a. Local decongestants b Topical corticosteroids c. NSAIDs d. All above What is the most common region of laryngeal carcinomas? a. Subglottic b. Supraglottic c. Glottic Which method of the treatment is the first choice for nasal polyposis? a. Surgical treatment b. Topical decongestants, vasoconstrictors  2 c. Topical H1 antihistamines d. Topical corticosteroids Which of these can't be a complication of acute rhinosinusitis? a. Meningitis b. All of them can be c. Orbital abscess d. Orbital cellulitis Which sinus becomes pneumatized after 7 years of age? a. Ethmoidal b. None of them c. Sphenoid d. Frontal Cochlea... a. Performs 2.5 turns around the modiolus b. Performs 1.5 turns around the modiolus c. Performs 3.5 turns around the modiolus d. Performs 4.5 turns around the modiolus Your tactics for patients with laryngeal stenosis and acrocianosis? a. Antibacterial therapy b. Tracheostomy c. Local applications of adrenaline d. i/v corticosteroids When we have rhinosinusitis in rhinoscopy we can see... a. Purulent discharge from the middle meatus b. Perforation of nasal septum c. Enlargement of the middle turbinates d. Osteomeatal complex obstruction on CT scan Which is the best treatment of diphtheria? a. Tracheostomy, diphtheria antitoxin b. Penicillin, diphtheria antitoxin, rehydratation c. Diphtheria antitoxin, nonsteroidal anti - inflammatory drugs d. Mechanical removal of diphtheria membrane, erythromycin, NSAID In a patient with one-sided serous otitis media and undisturbed sensorineural hearing performing in Weber's test… a. Sound in both ears will be heard equally good b. Sound will be heard only in the sick ear c. Sound will be heard in the healthy ear What factors can cause allergic rhinosinusitis? a. Changes of air temperature b. Gastroesophageal reflux disease c. None of these  3 d. Long-term use of vasoconstrictive drugs What are the clinical symptoms of laryngeal trauma? a. Haemoptysis, dyspnoea, dysphagia b. Pain on the anterior part of the neck, dysphonia c. Stridorous breathing, cough, ecchymosis d. All of the answers are correct Typical tracheostomy is done between which of the following structures? a. Cricoid cartilage and the 1st tracheal ring b. 3rd and 4th tracheal ring c. 2nd and 3rd tracheal ring d. 1st and 2nd tracheal ring What is the aim of tympanoplasty? a. Hearing improvement in the case of conductive hearing loss b. Hearing improvement in the case of otosclerosis c. Drainage of mastoid abscess d. Eradication of infection and hearing improvement What can you use to treat allergic rhinosinusitis? a. Patient education how to avoid the allergen b. Medication (pharmacological treatment) c. Allergen-specific immunotherapy d. All options of the above Where is the best place to do a paracentesis (myringotomy)? a. Posterior, inferior quadrant b. Posterior, superior quadrant c. Anterior, superior quadrant d. Anterior, inferior quadrant What is the first involved structure in case of laryngeal papillomatosis? a. False vocal cords b. Epiglottis c. Subglottis d. Vocal cords Rhinosinusitis is considered chronic, if persisting for more than… a. 4 weeks b. 4 months c. 3 weeks d. 3 months Reflex otalgia can be caused by, except… a. Acute otitis media b. Dental infection c. Maxillary sinus inflammation d. Peritonsillar abscess  4 Which one of the following is antibacterial treatment of the first choice for acute bacterial rhinosinusitis? a. Cefuroxime b. Clindamycin c. Doxycycline d. Amoxicillin Which are the most frequent eardrum perforation localization for acute otitis media? a. Centrally pars tensa part b. None of the above c. Marginal pars tensa part d. Pars flaccida part Which of these diseases can cause nose bleeding? a. Osler disease b. Influenza c. Juvenile nasopharyngeal angiofibroma d. All previous The ossicular labyrinth consists of… a. Vestibulum and three semicircular canals b. Cochlea c. 2 water aqueductus d. All of the above Which is the best treatment of acute catarrhal laryngitis? a. Preserve the voice, nonsteroidal anti-inflammatory drugs, rehydratation per os b. Inhalations of potato steam and chamomile c. Inhalations of ephedrine, nonsteroidal anti- inflammatory drugs d. Penicillin group antibiotics, rehydratation Between which vertebrae of the spine topographically is the larynx? a. Between 3 and 6 cervical vertebrae b. Between 4 and 7 cervical vertebrae c. Between 1 and 4 cervical vertebrae d. Between 1 and 3 cervical vertebrae What factors do not cause allergic rhinosinusitis? a. Pollen b. Physical activity c. Animal dander d. Dust Which microorganism usually doesn’t cause acute otitis media? a. Moraxella catarrhalis b. Streptococcus pneumoniae c. Haemophilus influenzae d. Pseudomonas aeruginosa  5 The most common microorganisms causing otitis media are, except... a. S. pyogenes b. H. influenzae c. Pseudomonas aeruginosa d. Streptococcus pneumonia Which are the most effective medication groups for allergic rhinosinusitis treatment? a. There are no effective treatment b. Both are identical effective c. Intranasal decongestants, peroral corticosteroids d. Peroral antihistamines, intranasal corticosteroids Choose the most believable indication for tonsillectomy in children… a. Recurrent laryngitis b. Sialadenitis c. Cervical lymphadenopathy d. Sleep apnoea Which of the following diseases of the larynx is a precancerous condition? a. Leukoplakia b. Eritroplakia c. Pachydermia d. All of the above In the internal ear canal (Meatus acusticus internus) are all structures, except? a. Chorda tympani nerve b. A. labyrinthi c. VII cranial nerve d. VIII cranial nerve Which is the most common infectious agent for malignant otitis externa? a. Otomicosis b. E.coli c. Pseudomonas aeruginosa d. Staphylococcus Which of these viruses cause laryngeal papillomatosis (recurrent respiratory papillomatosis)? a. HPV 6, 11, 16, 18 b. EBV c. HHV-3 d. HZV What should be done in case of hoarseness lasting longer than 2 weeks? a. Prolonged medical treatment b. Laryngoscopic examination c. Magnetic resonance imaging d. Computed tomography  6 Sore throat, foreign body sensation in throat, bleeding from mouth, changes in voice, palpable cervical lymph nodes are the features of… a. Adenocarcinoma base of tongue b. Exudative tonsillopharyngitis c. Gastroesophageal reflux disease d. Fish bone in soft palate Which is not the indication for tonsillectomy? a. Peritonsillar abscess b. Chronic tonsillitis c. Systemic lupus erythematosus d. IgA nephropathy Which is the best choice of treatment for acute exudative tonsillitis? a. Second-generation cephalosporins b. Penicillin group antibiotics c. Local throat rinsing with antiseptic fluids d. Macrolides Which of the following is not the indication of tracheostomy? a. Mechanical upper airway obstruction b. The protection of patient with the risk of aspiration pneumonia c. Mechanical lower airway obstruction d. For easier access for patients with complicated head and neck surgery Normal value of antistreptolysin-O in adults… a. Until 100 IU/ml b. Until 5 IU/ml c. Until 50 IU/ml d. Until 200 IU/ml How to treat patients with rhinitis medicamentosa? a. With new generation of decongestants b. Stop using topical decongestants and prescribe topical steroids c. Stop using nasal drops, prescribe oral antihistamines d. None of the above Which are the signs of juvenile nasopharyngeal angiofibroma? a. Adenoids, subfebrile temperature b. Stuffy nose, recurrent nose bleeding c. Nasal septum thickening, pale nasal mucosa d. Changes in soft palate, runny nose and shortness of breath What usually causes pseudocroup? a. S. pneumoniae b Viral infection c. Corynebacterium diphtheriae d. H.influenzae  7 Most commonly dizziness is associated with... a. Labyrinthitis b. Vestibular schwannoma c. Benign paroxysmal positional vertigo d. Meniere's disease For the pinna hematoma case… a. Just blood suction b. Blood evacuation and supportive binder c. Antibacterial therapy d. There is no need for treatment, because it will be absorbed spontaneously What causes croup? a. Viral infection b. Corynebacterium diphtheriae c. H.influenzae d. S. pneumoniae What are the clinical signs of the foreign body in the larynx? a. Cough, unilateral wheezing, unilateral weakened breathing b. Asphyxiation, voice hoarseness, aphonia c. Dyspnoe, asthma-like wheezing, without voice hoarseness and aphonia d. a,c Otogenic labyrinthitis symptoms are? a. Fever b. Vomit c. Nystagmus d. Severe dizziness e. All these Where the recessus piriformis is localized? a. In nasal meatus under inferior turbinate b. In both sides of laryngeal vestibulum, separated with aryepiglottic folds c. In the middle ear behind stapes d. In the region of glottis Which of these radiological methods are not used for rhinosinusitis diagnostics? a. Standard X-ray of the sinuses b. Angiography c. CT for the sinuses d. US for the sinuses The narrowest place of the larynx (for adults) is… a. Subglottis b. Supraglottis c. Glottis Which symptoms are not typical for acute rhinosinusitis?  8 a. Epistaxis, otalgia, hyperthermia b. Nasal itching, sneezing, rhinorrhea c. Nasal obstruction, rhinorrhea, headache d. None of suggested Middle ear's medial wall consists of all, except… a. Oval and round window b. Eustachian tube c. Promontorium d Horizontal part of the n. facialis What is the main symptom of all laryngeal neoplasms? a. Dysphonia b. Stridor c. Hoarseness d. Pain Symptoms of rhinosinusitis are... a. Swelling and hyperemia of nasal mucosa b. Olfactory disorders c. All d. Purulent discharge from the nasal meatus The most important pathogenetic factor for otitis media is… a. Inheritance b. Eustachian tube's dysfunction c. Bacteria hematogenous spread in the middle ear d. Allergy What is wrong about laryngeal papillomatosis (recurrent respiratory papillomatosis)? a The disease manifests in persons in the third decade of life (adult-onset) b. Tumor is benign, but is considered precancerous lesion c. It is the most common tumor in the larynx for adults d. The disease manifests in children between 2 and 4 years of age (juvenile-onset) Tympanic membrane consists of… a. 2 equal parts, that are named pars tensa and pars flaccida b. Bigger upper segment (pars flaccida) and smaller lower part (pars tensa) c. Smaller upper part (pars flaccida) and bigger upper part (pars tensa) d. None of the above What is the differential diagnosis for juvenile nasopharyngeal angiofibroma? a. Hypertrophy of lingual tonsil b. Gastroesophageal reflux disease C. Chronic tonsillitis d. Adenoids Bacterial labyrinthitis can be a complication of… a. Toxicity of salicylates  9 b. Toxicity of streptomycin c. Cholesteatoma d. Otomicosis Where is the opening of the Eustachian tube located in the tympanic cavity? a. Posterior wall b. Inferior wall c. Superior wall d. Anterior wall Which are the most common causes of chronic laryngitis? a. Smoking b. The burnout of voice c. Gastroesophageal reflux disease d. Upper airways infections e. All the above mentioned f. None of the above mentioned What is the most common malignant tumor of the larynx? a. Verrucous carcinoma b. Sarcoma c. Adenocarcinoma d. Squamous cell carcinoma Partial removal of the pharyngeal tonsil is called… a. Adenotomy b. Adenoidectomy c. Tonsillotomy d. Tonsillectomy The most common cause of epiglottitis is… a. Staphylococcus species b. Streptococcus pneumoniae c. Haemophilus influenzae type B d. Respiratory syncytial virus What promotes the stenosis of the larynx? a. Endotracheal intubation b. All of the answers are correct c. Local infection d. Foreign bodies e. Gastroesophageal reflux disease Conductive hearing loss in children most often is caused by… a. Congenital fixated tympanic ossicles b. Cerumen plug c. Otitis media with effusion d. Otosclerosis  10 Promontorium on the middle ear's medial wall is… a. Cochlear basal turn b. Posterior semicircular duct c. Anterior semicircular duct d. All of the above Sensory cells in semicircular ducts are located… a. None of the mentioned locations b. On macula c. In Corti organ d. On the crista ampullaris Which sinuses are pneumatized in newborns? a. Maxillary and sphenoid b. Frontal and sphenoid c. Frontal and maxillary d. Maxillary and ethmoid Which is the most common infectious agent of ear furuncle? a. S. aureus b. Proteus c. Ps. aeruginosa d. E. coli Recommendations for acute sensorineural deafness treatment are… a. I/v or p/o steroids b. Pentoxifylline c. Hyperbaric oxygenation therapy d. All of the above What is the most comfortable way of evacuating an alive foreign body from the external ear? a. With tweezers b. Do nothing and wait until it falls out itself c. To make it immobile, using ear oil in the external ear canal and then evacuate foreign body d. With the little hook In which neck region lymph nodes can we find the metastases from larynx cancer? a. In submental lymph nodes b. In superficial neck lymph nodes c. In submandibular lymph nodes d. In deep neck lymph nodes e. In retropharyngeal lymph nodes The most common malignant tumor of the upper respiratory tract in adults is... a. Oral cancer b Throat cancer c. Nasopharyngeal cancer d. Laryngeal cancer  11 What is the most common way, how the infection gets into the middle ear? a. Through tuba auditiva b. Lymphogenous way c. After a trauma of tympanic membrane d. Haematogenous way What doesn't cause atrophic rhinosinusitis? a. Too aggressive nasal turbinate surgery b. Moraxella catarrhalis c. Klebsiella ozaenae d. Wegener's granulomatosis What does the upper border of the tympanic cavity demarcate with? a. Anterior cranial fossa b. Processus mastoideus c. Posterior cranial fossa d. Middle cranial fossa Which of the following is not the method of choice in the treatment of laryngeal cancer? a. Chemotherapy b. Surgical c. Radiotherapy Rhinitis medicamentosa is… a. Chronic rhinitis in people who work in medicine b. Nasal obstruction caused by overuse of topical decongestants c. Rhinitis controlled by systemic drugs d. None of the above Stapedectomy is the first surgical option for… a. Bell paralysis b. Otosclerosis c. Meniere's disease d. Cholesteatoma Symptoms of acute rhinosinusitis… a. Sleep disorders b. Headaches c. Hallucinations d. a,b In case of bilateral damage of recurrent laryngeal nerves the main complaint is… a. Dyspnoe b. Hoarseness c. There are no complaints The selection method of laryngeal cancer stages I and II is… a. Chemotherapy b. Total laryngectomy  12 c. Radiotherapy d. Tumor extirpation with CO laser Rhinosinusitis symptoms are not typical for… a. Deviation of nasal septum b. Wegener's granulomatosis c. Chronic pharyngitis d. Choanal atresia External ear (auricula) consists of… a. Fibrotic cartilage b. Hyaline cartilage c. None of the above d. Elastic cartilage Aerootitis is characterized by… a. Mucous - purulent discharge b. Central perforation c. Effusion in the middle ear d. Epitympanic perforation The duration of chronic rhinosinusitis is… a. 3 weeks b. 8 weeks c. 16 weeks d. 12 weeks The decision for surgical treatment of patients with chronic rhinosinusitis is based on... a. The patient's history b. The result of nasal endoscopic examination c. The data of CT scan d. The data of MRI scan e. a,b,c f. a,b,d The decision for surgical treatment of the patient with chronic rhinosinusitis is based on... a. The patient's survey about the severity of the complaints b. The results of nasal endoscopic examination c. The data of CT scan d. a,b,c e. a,b Which of these is not a criteria of acute rhinosinusitis? a. Headache b. Purulent secretions from the nose c. Difficulty breathing through the nose d. Cough The management of choice in acute bacterial rhinosinusitis is…  13 a. Early surgical intervention followed by antibiotics b. Early surgical intervention, analgesics, anti-inflammatory medication c. Appropriate antibiotics, decongestants when indicated, intranasal steroids d. Antihistamines, decongestants and humidification First choice of a/b in acute rhinosinusitis... a. Penicillins b. Macrolides c. 1st generation cephalosporins d. Tetracyclines Second choice of a/b in case of acute rhinosinusitis: a. Macrolides b. 3rd generation cephalosporins c. Tetracyclines d. Quinolones Which pathology is not related to allergic rhinosinusitis? a. Bronchial asthma b. Nasal polyps c. Immunodeficiency d. Conjunctivitis Which symptom could help to differentiate adenoiditis from rhinosinusitis? a. Fever b. Nasal discharge c. Cough d. Snoring What medications are best for decreasing sneezing and nose itching in allergic rhinitis? a. 1st generation antihistamines b. 2nd generation antihistamines c. Nasal decongestants d. Intranasal topical steroids By WHO data, how common is allergic rhinitis in society? a. 5% b. 5-12% c. 14-20% d. 20-25% The method of choice in the treatment of patients with persistent allergic rhinitis (mould, dust) unblocked nose… a. Antihistamines b. Allergen avoidance c. Nasal decongestants d. Topical nasal steroids Atrophic rhinitis is most often associated with…  14 a. A and B hemolytic streptococci b. Smoking c. Adenovirus d. Klebsiella Which argument about vasomotor rhinitis is not correct? a. It’ temporary in pregnant women b. It's the case of endocrine and vegetative nerve system disturbance c. IgE titer is elevated in case of VR d. VR attacks can be caused by strong smell or stressful situations Endoscopic sinus surgery is not indicated… a. Chronic pansinusitis b. Non-invasive fungal sinusitis c. Nasal septum deviation d. Chronic rhinosinusitis with nasal polyps An indentation in the lateral wall of the sphenoid sinus most likely represents… a. Trigeminal nerve b. Cavernous sinus c. Carotid artery d. Optic nerve In which order are acute paranasal sinusitis more common? a. Maxillary, frontal, ethmoidal, sphenoidal b. Maxillary, ethmoidal, frontal, sphenoidal c. Ethmoidal, frontal, maxillary, sphenoidal d. Ethmoidal, frontal, sphenoidal, maxillary Diagnosis of acute sinusitis can be put if the typical symptoms are seen until… a. 1-2 week b. 2-3 weeks c. 3-4 weeks d. 4-5 weeks In which x-ray investigation you can see paranasal sinuses best by using Caldwell occipital frontal projection? a. Frontal and maxillary b. Frontal and sphenoid c. Ethmoidal and sphenoid d. All of them Which paranasal sinus can we see the best in X-ray by using Waters or occipitomental view? a. Frontal cavities b. Maxillary cavities c. Sphenoidal cavities d. Ethmoidal cavities Larynx tumour is most often localized in:  15 a. Supraglottic ligament level b. Glottis ligament level c. Epiglottis level d. All of them The first symptoms of laryngeal cancer: a. Breathing stridor b. Hoarseness c. Pain in in neck d. Dry cough What is not correct about laryngeal papillomatosis? a. There is an adult onset with peak after 20 years of age b. Lesions are benign, but malignant degeneration is possible c. There is a juvenile-onset with peak at age 2-4 years d. It is the most common benign tumor of the larynx in adults e. Inverted laryngeal papilloma, it is benign aggressive needs surgery Most common causes of chronic laryngitis… a. Smoking b. Abuse of voice c. Gastric acid reflux disease d. Bronchial asthma e. a,b,c f. a,b,c,d Acute laryngitis in most cases is caused by… a. Bacteria b. Acute abuse of voice c. Viruses d. Respiratory allergy Phlegmonous laryngitis is usually localized… a. True vocal cords b. False vocal cords c. Epiglottis and arytenoids d. Para laryngeal The risk of airway obstruction in children with laryngitis is predicted by… a. Incompetence of immune system b. Incomplete immunization c. Smaller airway d. Aggressive microorganisms What is the earliest symptom of laryngeal stenosis? a. Tachypnoea b. Biphasic stridor c. Retraction of supraclavicular space d. Lip and acrocianosis  16 Larynx is… a. Right side of oesophagus b. Left to oesophagus c. Behind oesophagus d. In front of oesophagus The conical laryngeal ligaments are localized: a. In between arytenoid cartilages b. In frontal laryngeal surface between thyroid and cricoid c. Between thyroid and hyoid bone d. Between cricoid and trachea To which laryngeal cartilages is base laryngeal cartilage connected with? a. Epiglottis b. Thyroid c. Cricoid d. Arytenoids Thyroid cartilage and cricoid cartilage are connected to each other… a. Close and immobilized b. With joint c. With muscles d. They are not joint together Lymph drainage from upper to lower larynx drains to… a. Occipital lymph nodes b. Submandibular lymph nodes c. Deep neck lymph nodes and v. jugularis d. Mediastinal lymph nodes Which of the following nerves innervate intrinsic muscles of the larynx? a. n.laryngeus posterior b. n.laryngeus superior c. n. laryngeus anterior d. n.laryngeus recurrens What are your recommendations for an adult patient with hoarseness for 3 weeks? a. CT examination b. MR examination c. Symptomatic therapy and observation d. To have laryngoscopy The position of vocal folds during the phonation... a. in abduction b. in adduction c. paramedian The vocal folds are formed by…  17 a. Musculus vocalis b. Ligamentum vocalis c. Mucosa d. a,b,c e. a,b False vocal cords are… a. Duplicate of mucus b. Muscular structures c. The true vocal cord continuation d. Cartilage structures The cause of Reinke's edema is… a. Bacterial infection b. Smoking, voice abuse c. Viral infection d. Allergy The glottis space is between... a. True vocal cords b. False vocal cords c. False real cords d. Arytenoids Nowadays methods of treating glottis papilloma are... a. Cryotherapy b. Mechanical debridement with scissors c. Micro electrical acoustics d. CO2 laser Name the function/s of epiglottis. a. Protection of the airway b. Respiratory c. Phonation d. a,b Epiglottis is... a. Hyaline b. Elastic c. Mixed d. Non-cartilaginous The prominence on the medial wall of the tympanic cavity is formed by… a. Canal of the facial nerve b. Vestibulum of the labyrinth c. Settlicicuiai callai d. Basal turn of cochlea Eustachian tube length in adults…  18 a. 50cm b. 1m c. 20cm d. 35mm Cavum tympani volume is… a. 3-4cm b. 1-2 cm c. 2-3cm d. 0,9-1cm The biggest distance between the tympanic membrane and medial part of the middle ear is… a. Central part of tympanic membrane b. Tympanic membrane anterior inferior part c. Superior posterior part d. Superior inferior part The oval window is closed by… a. Secondary membrane b. Stapes c. Malleus d. Chorda tympani V. jugularis borders with cavum tympani at… a. Upper wall b. Frontal wall c. Lower wall d. Behind Where does perforation of the tympanic membrane most often happen? a. In border of pars tensa b. Central part of pars tensa c. Pars flaccida d. None of the above The patient has arrived in the doctor's office with severe ear pain, conductive hearing loss, red, bulging tympanic membrane and fever 38.5º. Which should be the first step in the management of this patient? a. Pain killers, antiinflammatory medication b. Myringotomy c. Antibiotics 40 years old female patient with bilateral conductive type of hearing loss, normal tympanic membrane and Eustachian tube function. What is the possible diagnosis? a. Presbyakusis b. Otosclerosis c. Serous otitis media d. Cerumen  19 Outer ear length for grownups is… a. 2cm b. 1,5cm c. 2,5cm d. 3cm Tympanic membrane from outside to inside is in this order… a. Skin, mucus, CT b. Skin, CT, mucus c. CT, skin, CT d. CT, mucus, skin The most common causative microorganism of furunculus is… a. Staphylococcus aureus b. E.coli c. Pseudomonas aeruginosa d. H. influenzae If the furuncles are in the outer ear lower floor, other things can also become inflamed… a. Parotid gland b. Processus mastoideus c. N. Facialisotitis media d. Temporomandibular joint Risk factors for furuncle development in the outer ear are all, except… a. Cleaning outer ear with cottons sticks b. Diabetes c. Cerumen d. Oncological patients Outer ear eczema is not typical for… a. Hyperaemia without distinctive borders b. Skin thickening rash c. Crust with peeling of d. Inflammation with sharp borders By putting an aural speculum in the ear, the patient can cough because of… a. N. Trigeminus reflex b. N. Vagus reflex c. N. Glossophrayngeus reflex d. N. Facials reflex The Otolithic apparatus is located… a. Inner ear canal b. In cochlea c. The vestibule d. The semicircular canals Scala tympani is divided…  20 a. Spiral type bony arch b. Basal membrane c. Reissner's membrane from top d. Reissner's membrane from top, from lower part spiral type bony arch and basal membrane Body state changes in the room irritates… a. Corti organ b. Ampullary apparatus c. Otolithic apparatus d. Cortex Adenoidectomy contraindications are not… a. Cleft palate b. Sleep apnoea c. Haemophilia A d. Acute Bronchitis The antibiotic of choice in children with streptococcal tonsillitis is… a. Amoxicillin b. Penicillin c. Clindamycin d. Erythromycin Which diseases should be excluded in case of exudative tonsillitis? a. Infectious mononucleosis b. Acute leukosis c. Scarlet fever d. agranulocytosis e. a,c,d f. a,b,c,d The most remarkable hyperplasia of nasopharyngeal tonsil is found at age… a. 4-8 years b. 2-3 years c. 9-11 years The most common cause of conductive hearing loss in adults? a. Perforation of tympanic membrane b. Otosclerosis c. Cerumen d. Serous otitis media The treatment of sudden sensorineural hearing loss includes… a. Corticosteroids i/v or p/o b. Pentoxifylline c. Hyperbaric oxygenation d. Aspirin e. a,b,c f. b,d  21 Rinne test is: a. Negative if air conduction is better than bone conduction b. Negative if air conduction is worse than bone conduction c. Positive if ail conduction is worse than bone conduction d. Positive if vibration is better felt with worse hearing Which is the most appropriate hearing test for newborns… a. Tympanometry b. Otoacoustic emissions c. Pure tone audiometry d. Rinne test Which characteristics of the sound are measured in dB? a. The timbre b. The quality c. The loudness d. The frequency What medications are best for decreasing congested nose? a. 1st generation antihistamines b. 2nd generation antihistamines c. Nasal decongestants d. Intranasal topical steroids Which are the emergency situations in nasal bone fractures except… a. Rupture of the lacrimal duct b. CSF leakage c. Loss of vision d. Severe nose bleeding e. Lacerations of the palate Rhinoscleroma is a chronic granulomatous disease caused by… a. C. granulomatis b. S. aureus c. K. rhinoscleromatis d. T. pallidum Juvenile angiofibroma is… a. Malignant nasopharyngeal tumour which is most often in males b. Benign nasopharyngeal tumour which is most often in males c. Malignant nasopharyngeal tumour which is most often in females d. Benign nasopharyngeal tumor which is most often in females Juvenile angiofibroma is a common thing for… a. Stuffy nose and nose bleed b. Adenoids of sub febrile tissue c. Soft palate changes, runny nose, dyspnoea d. Septum thickening, pale nose mucosa, injected blood vessels in the nose  22 Oropharyngeal adenocarcinoma… a. Most common malignant tumour with many stages b. Malignant tumour that starts in salivary glands and most cases are found in uvula and upper palate c. Malignant tumour that is usually in the tonsils and base of the tongue. Usually found in new people, maybe with enlarged lymph nodes d. Benign tumour, metastases rarely, typical exophytic growing pattern In case of esophagus burn, the most important diagnosis and next step of treatment is… a. X-ray with barium b. X ray-without barium c. Endoscopy d. Physical examination Acute purulent mastoiditis is… a. Complication of conductive hearing loss b. Always a stage of acute otitis media c. A separate disease without otitis media d. Purulent inflammation of the mastoid antrum and air cells For diagnosis of pharyngeal syphilis the most important is… a. Serologic tests b. History c. Pharyngoscopy d. Palpation of submandibular and neck lymph nodes Which is not the complication of the deep neck infection? a. Mastoiditis b. Mediastinitis c. Airway obstruction d. Sepsis Which of the following factors is not related to atrophic rhinitis? a. Streptococcus aureus b. Klebsiella ozaenae c. Wegener's granulomatosis The most common complication of purulent ethmoidal sinusitis in children… a. Meningitis b. Orbital cellulitis c. Osteomyelitis of the frontal bone d. Cavernous sinus thrombosis Which one is the first and most common clinical presentation of nasopharyngeal cancer? a. Nasal obstruction b. Serous otitis media c. Nose bleeding d. Neck mass  23 Treatment of Reinke's edema is... a. Inhalations of steroids b. Reduction of vocal effort, quit smoking c. Microlaryngeal surgery The diagnosis of deep neck infection is based on... a. Laboratory data b. Endoscopic examination c. CT scan data d. MR scan data e. a,b,c f.a,b,c,d Which of the following factors can cause nonallergic rhinitis? a. Viruses b. Hormonal disbalance c. Nasal decongestants d. Aspirin e. All mentioned factors f. a,b,c Which symptoms could be in penetrating laryngeal trauma? a. Expectoration of blood b. Subcutaneous emphysema c. All the mentioned d. Voice changes e. Crepitation Which are the most common facial bone fractures? a. Nasal bone b. Maxillary bone c. Mandibular bone d. Frontal bone Ototoxic are all medications except... a. Betahistine b. Quinine c. streptomycin d. Gentamicin e. Rifampicin Which of the following factors is not related to functions of tonsils? a. Production of immunoglobulins b. Processing of allergens c. Migration of B cells to postcapillary venules d. Expansion of memory cells e. Processing of antigens  24 When eating a pink ice cream cone, which of the following cranial nerves provides the information necessary for the individual to recognize that it is "strawberry"? a. IX b. X c. I d. VII e. V Which symptom is not present in infectious mononucleosis? a. Enlargement of lymph nodes b. Increased Mo count in peripheral blood c. Airway obstruction d. Haematuria The tuberculosis of the nose is... a. Always a secondary disease b. Always a primary disease c. Predominantly secondary disease, in rare cases primary d. Predominantly primary disease, in rare cases secondary Patient with attack of vertigo, tinnitus and aural fullness, nausea and vomiting, sensorineural hearing loss. Which is appropriate management? a. Diazepam i b. Corticosteroids i/v c. Antiemetic medication i/v d. Bed rest without head movements The cause of Reinke's edema is... a. Bacterial infection b. Smoking, voice abuse c. Viral infection d. Allergy The involvement of the inner ear could be present in... a. Transverse fracture of the temporal bone b. Longitudinal fracture of the temporal bone c. Myringitis d. Otohematoma Trismus is not characteristic in... a. Chronic pharyngitis b. Tetanus c. Mandibular fracture d. Peritonsillar abscess e. Parapharyngeal abscess The most common causes of epistaxis are... a. Deficiency in factor XII, viral infections b. Foreign bodies in the nose, trauma, toxic or chemical irritation  25 c. Nasal trauma, cardiovascular diseases, platelet inhibiting medication d. Facial trauma, nasal septum deviation, liver diseases Rhinosinusitis is considered as chronic, if persisting for more than... a. 4 months b. 4 weeks c. 3 weeks d. 3 months Which of the following does not take part in sensory innervation of the external ear? a. Nervus trigeminus b. Nervus vagus c. Plexus cervicalis d. Nervus facialis Bell's palsy is idiopathic... a. n. facialis paralysis b. n. glossopharyngeus paralysis c. n. accessorius paralysis d. None of the above Which tumor looks like a mucosal ulcer with a necrotic base? a. Papilloma b. Hemangioma c. Basalioma d. Squamous cell carcinoma Which are the most common causing agents for acute rhinosinusitis? a. Streptococcus pneumonia, Haemophilus influenzae b. Branhamella catarrhalis, Staphylococcus aureus c. Staphylococcus aureus, Staphylococcus pyogenes d. Haemophilus influenzae and anaerobic bacteria Which one of the following is the first choice diagnostic method for patients with rhinosinusitis? a. CT scan b. Ultrasonography c. Roentgenography d. MRI Symptoms of acute mastoiditis are all, except... a. Hyperaemic, painful ear pinna b. Hearing loss C. Fever d. Ear pain with palpable or spontaneous pain over the mastoid process What has the main role the pathogenesis of pharyngeal candidomycosis? a. Frequent usage of antibacterial medicaments b. Frequent ARVIs c. Gastroesophageal reflux disease  26 d. Low mouth hygiene Which group of the patients is predisposed to nasal polyposis? a. Bronchial asthma b. The ones with NSAID intolerance c. Cystic fibrosis d. All above Which type of Human Papillomavirus (HPV) is responsible for laryngeal papillomatosis? a. HPV 1 and 3 b. HPV 6 and 16 c. 6 and 11 d. Could be any of them Which statement is true about the vocal cords? a The vocal cords receive their motor innervation from the superior laryngeal nerve b. The vocal cords are lined with columnar epithelium c. They are stretch between the vocal process of the arytenoid cartilage and the inner surface of the thyroid cartilage d. All is true Which statement is wrong about the unilateral vocal cord paralysis? a. This is always a life-threatening condition requiring an urgent tracheostomy b. Could be iatrogenic after the surgery of the thyroid gland c. The patient is usually in good condition, shortness of the breath is not typical Which of the following factors can not cause allergic rhinitis? a. Recurrent virus infections b. Pollens c. Frequent use of the nasal drops d. High-stress level e. a,c,d f. a,b,c Methods of the laryngeal examination are... a. Indirect laryngoscopy b. The Weber's test c. Stroboscopy d. Electronystagmography e. a,c f. The ultrasound of the thyroid gland Which of the tonsils is called “adenoids” when it becomes hyperplased? a. Torus tubarius tonsil b. Pharyngeal tonsil c. Palatal tonsil d. Lingual tonsil Which is not the indication for tonsillectomy?  27 a. Chronic tonsillitis b. Diphtheria C. Peritonsillar abscess d. Sleep apnea The most common cause of conductive hearing loss in adults is... a. Serous otitis media b. Impaction of cerumen in external ear canal c. Otosclerosis d. Perforation of tympanic membrane Which diseases can cause symptoms of acute tonsillitis? a. Infectious mononucleosis b. Otitis media with effusion c. Scarlet fever d. Agranulocytosis e. a,c,d f. a,b,c,d Which is not a symptom of chronic rhinosinusitis? a Nasal cavity filled with nasal polyps b. Vertigo c. Impaired olfaction d. The pain/pressure in the head, teeth The following structures are involved in speaking, except… a. The vocal cords b. The lips c. The oesophagus d. The teeth e. The tongue Which of the following is not the indication for tonsillectomy? a. Peritonsillar abscess b. 5 and more episodes of acute tonsillitis in 2 following years c. 3 or more episodes of acute tonsillitis per one year d. 3 and more episodes of acute tonsillitis in 3 following years Formation of cholesteatoma is related to... a. Chronic otitis media with central tympanic membrane perforation b. Chronic otitis media with marginal tympanic membrane perforation c. Serous otitis media d. Otosclerosis The symptoms of tonsillar hypertrophy are all except... a. Difficulty breathing through the nose b. Snoring C. Sleep apnea d. Painful swallowing of food  28 Which of the following factors is not related to medicamentous rhinitis? a. Patient's age b. Use of Cocaine c. Overuse of decongestant's nasal drops Which symptoms are present in the case of longitudinal fracture of the temporal bone? a. Rupture of the tympanic membrane b. Sensorineural hearing loss c. Vertigo and nystagmus d. CSF leakage from the ear canal e. a,d f. b,c In case of obstructive indications preferred surgery is following... a. Tonsillotomy b. Tonsillectomy Which of the following is not the emergency situation in case of craniofacial trauma? a. Loss of vision b. Cerebrospinal fluid (CSF) leakage c. Severe nasal bleeding d. Deformation of the nasal bone e. Unconsciousness The following symptoms suggest bacterial tonsillopharyngitis, except... a. Fever >38.0 C b. A cough c. Pharyngo-tonsillar exudate d. Cervical lymphadenopathy e. Painful swallowing The most common indication for tonsillar surgery in children is... a. Recurrent laryngitis b. Chronic rhinosinusitis C. Severe hearing loss d. Sleep apnoea The risk of airway obstruction in a child with acute laryngitis is predicted by... a. The deficit of the vitamin D b. Passive smoking c. The smaller diameter of the larynx d. High fever First and second choice antibiotics for treatment of acute tonsillitis are following, except... a. Penicillin b. Amoxicillin c. Ceftriaxone d. Erythromycin  29 The correct treatment the chronic otitis media with cholesteatoma requires is… a. Topical and systemic steroids, long-term antibiotic use b. Observation and repetitive MRI with the specific cholesteatoma programme c. Hearing aid d. Surgery for the cholesteatoma removal and reconstruction of the middle ear The most important type of immunoglobulins produced by palatine tonsils… a. IgM b. IgD C. IgA d. IgG The most common localization of the rhabdomyosarcoma in the head and neck region… a. Oral cavity b. Orbit c. Middle ear d. Larynx At what age begins the involution of adenoids? a. Around puberty (12 years) b. From 8 to 10 years of age c. There is no involution of adenoids, only surgery can reduce them d. From 2 to 4 years of age e. From 3 to 6 years of age Which is the main factor in the pathogenesis of middle ear disease? a. Inheritance b. Allergy c. Upper respiratory tract infections d. Passive smoking e. Eustachian tube dysfunction Which is not an important factor in the pathogenesis of rhinosinusitis? a. Hypoplasia of the paranasal sinus b. Mucosal oedema in and around the sinus ostium c. Alteration in sinus secretion d. Decreased ciliary function Which are the most common microorganisms in the case of acute bacterial rhinosinusitis? a. Rhinobacterium, Bacteroides, Staphylococcus aureus b. Moraxella catarrhalis, Haemophilus influenzae, Streptococcus pneumoniae c. E. Coli, H.influenza, Staphylococcus aureus, Streptococcus pyogenes d. Herpes virus, mycobacterium ovis In the case of laryngeal stenosis, which of the following symptoms is always present? a. Pain in the throat b. Foul smell from the mouth c. A cough  30 d. Hoarseness For what kind of illness diagnostics CENTOR scale is used? a. Nasopharyngeal carcinoma b. Laryngitis c. Tonsillitis d. Lymphoma e. Rhinosinusitis The first choice antibiotic in the case of acute exudative tonsillitis is… a. Erythromycin b. Clindamycin c. Gentamicin d. Penicillin High frequency sounds are percepted in the inner ear at the... a. Helicotrema b. Apical part of the cochlea C. Basal part of the cochlea d. Medial part of the cochlea e. Different parts of the cochlea Functional endoscopic sinus surgery is not indicated in patients with... a. Chronic rhinosinusitis with nasal polyps b. Chronic rhinosinusitis not responding to medical therapy c. Anatomical narrowing of the osteomeatal complex d. Nasal septum perforation All the muscles of the larynx are innervated by the recurrent laryngeal nerve except... a. Posterior cricoarytenoid b. Cricothyroid c. Thyroarytenoid How loud should the sound be at work to cause professional hearing loss? a. 60 dB b. 70 dB c. 80 dB d. >80 dB Which statement is true about the Eustachian tube? a. Provides the ventilation of the tympanic cavity and mastoid air cells b. Provides the ventilation of ethmoidal cells c. Is related to the function of the soft palate d. a,c The most common microbe causing acute otitis media is… a. Pseudomona aeruginosa b. Staphylococcus aureus C. Str. pneumoniae  31 d. Mycobacterium tuberculosis The following anatomical structure is not a component of the temporal bone... a. Mastoid process b. Medial pterygoid plate c. Styloid process d. Zygomatic process The most common cause of epistaxis from the following is… a. Nasal septum deviation b. Deficiency in coagulation factor XII c. Toxic or chemical irritation in the working environment d. Nasal trauma What could be possible causes of chronic laryngitis? a. Smoking b. Voice abuse c. Gastro-oesophageal reflux d. The blunt trauma of the neck e. Laryngeal cancer f. a,b,c g. All the mentioned The nasal cycle is… a. The physiological alteration of the vascular congestion and decongestion of the turbinates and nasal mucosa, which is provided by the autonomic nervous system. b. The cycle with exacerbation and remissions of the chronic sinusitis C. The period between two episodes of an acute virus rhinitis. The Ramsay-Hunt syndrome is… a. Herpes zoster infection of the nasal cavity and sinuses b. Herpes zoster infection of the tonsils and oral cavity c. Herpes zoster infection of the external and middle ear d. Herpes zoster infection of the larynx causing papillomatosis Acute laryngitis in childhood in most cases is caused by… a. Laryngopharyngeal reflux b. URI viruses and/or bacterias c. Acute abuse of voice d. Respiratory allergy What is necessary to differentiate laryngeal tuberculosis from laryngeal cancer? a. History of smoking and alcohol abuse b. Hoarseness and disturbed swallowing C. Biopsy from the affected mucosa d. Mantoux test e. CT scan of the larynx What is the transmission route for Human Papillomavirus (HPV)?  32 a. Alimentary b. Airborne c. Vertical route d. Sexual transmission e. b,d f. c,d Which symptom is not present in case of infectious mononucleosis? a. Enlargement of lymph nodes b. Gingival ulcerations and bleeding c. Tonsillar enlargement d. Increased atypical lymphocytes in peripheral blood count Benign, well-vascularized mass in nasopharynx which in almost 100% cases occurs in male… a. Hemangioma b. Papilloma c. Nasopharyngeal carcinoma d. Juvenile angiofibroma Which statement is correct about inverted sinonasal papilloma? a. Benign, but locally aggressive tumour, should be removed surgically b. Malignant tumour of the nose; gives distal metastases in the early stage of the disease, requires aggressive radiation therapy additionally to the surgery c. Benign, nonaggressive tumour of the nasal vestibulum; does not require specific therapy In a pediatric population which is not recommended for the treatment of an acute pharyngitis? a. NSAIDs, for example, aspirin b. Local anaesthetics c. Rehydration therapy d. Home rest Which muscle is related to the opening of the Eustachian tube? a. Levator palatini b. Tensor palatini c. Salpingopharyngeus d. Buccinator The diagnosis of chronic rhinosinusitis is made when nasal symptoms persist longer than… a. 3 weeks b. 8 weeks c. 12 weeks d. 16 weeks Which of the following microorganisms is causing infectious mononucleosis… a. Cytomegalovirus b. Epstein-Barr virus c. Herpes simplex d. a,c e. All of them  33 The damage to the inner ear could be present in… a. Longitudinal fracture of the temporal bone b. Longitudinal fracture of the maxillary bone c. Transverse fracture of the temporal bone d. Nasal fracture with epistaxis Bacterial tonsillitis is most commonly caused by… a. H. influenzae b. M. pneumoniae c. Str. pneumoniae d. AGBHS (A group B- haemolytic Streptococcus) Diagnostic methods used for juvenile angiofibroma are the following, except… a. Contrast-enhanced CT b. Contrast-enhanced MRI c. Endoscopy d. Biopsy e. Diagnostic angiography Poorly controlled diabetes is one of the predisposing factors for… a. Cerumen of the external ear canal b. Otosclerosis c. Malignant otitis externa d. Chronic rhinosinusitis Possible complications of adenotomy are following, except… a. Atlantoaxial subluxation b. Postoperative bleeding c. Temporomandibular joint dysfunction d. Acute otitis media with effusion Which are the clinical signs of the juvenile angiofibroma? a Nasal obstruction, recurrent nose bleeding b. "Kissing" tonsils c. Thickening of nasal septum, cyanotic nasal mucosa d. Watery discharge from the nose, cough Which statement is true about the Maxillary sinus? a. Maxillary sinus borders the nasal cavity laterally b. Behind the maxillary sinus, there is the pterygopalatine fossa c. The floor of the maxillary sinus is related to the root of molar teeth d. The maxillary sinus is developed at the birth e. a,b,c What are the symptoms of nasopharyngeal carcinoma, which do not occur at an early stage of the disease? a. Epistaxis b. Nasal congestion  34 c. Dysfunction of the Eustachian tube d. Swallowing disturbances e. Taste changes f. d,e Which stage of the laryngeal stenosis is it if the patient has the hoarseness and stridor at rest, the involvement of additional breathing muscles, but has no acrocyanosis? a. Initial b. Compensatory c. Decompensatory d. Final stage of laryngeal stenosis Which are the most common causes of chronic laryngitis? a. Smoking b. Burnout of voice c. Gastroesophageal reflux disease d. Upper airways infections e. All the above mentioned f. None of the above mentioned Which of the following is not the indication of tracheostomy? a. Mechanical lower airway obstruction b. Mechanical upper airway obstruction c. For easier access for patients with complicated head and neck surgery d. The protection of patient with the risk of aspiration pneumonia Which microorganisms usually do not cause acute otitis media? a. Streptococcus pneumoniae b. Haemophilus influenzae c. Pseudomonas aeruginosa D. Moraxella catarrhalis Congested nose associates the most with… a. 1 generation antihistamines. b. 2nd generation antihistamines c. Nasal decongestants d. Intranasal topical steroids Adenoidectomy indications are not… a. Cleft palate b. Secretory middle meatus infection c. Sleep apnea d. Constant breathing problems. Semicircular canals adequate irritation is… a. Vibration b. Sounds c. Linear acceleration d. Centrifugal acceleration  35 Hearing of whispering is tested from this distance: 60cm Recidivist rhinosinusitis provoking factors are all, except… a. Osteomyelitis complex obstruction b. Nose polyps c. Chronic allergic rhinitis d. Trigeminal neuralgia In case of pyramid transverse fracture… a. The patient will be deaf in the affected area. b. The patient will have mixed complications with hearing in the affected area. c. The hearing function won't be affected. d. None of them N. Facialis damage in the horizontal part causes… a. Saliva secretion impairment in affected areas. b. Facial muscles paralysis on the opposite side of the affected area. c. Lacrimal gland secretion in the affected area. d. All mentioned Where perforation of tegmentum most often happens… a. In border of pars tensa b. Centrally pars tensa c. Pars flaccida d. None of them In case of a severe esophagus burn, as a transplant we use… a. Ileum because the diameter of it is very similar to esophagus. b. Ileum because it's longer than the colon and does not cause disturbances in the Gl system. c. We use colon because the peristalsis is better. d. Transplantation of the ileum is very new, before there was only colon interposition. In case of esophagus burn the most important diagnosis and next step of treatment is… a. X-ray with barium b. Without barium c. Endoscopy d. physical examination By doing otoscopy in kids we have to… a. Pull ear back and up b. back and down c. Do it before the kid starts crying d. a,c e. b,c Circle the correct statement. a. Outer ear outer third is made out of bones for adults. b. Ear wax glands are everywhere in the outer ear.  36 c. Outer ear furuncles may be only in the outer third. Outer ear upper roof is bordering with… a. Cranial anterior fossa b. Medial fossa c. Posterior d. Proc. Mastoideus Outer ear length for grown ups is: 2,5 cm The cartilage part of outer ear does not have: a. Sweat glands b. Fat glands c. Cerumen glands d. Hair follicles Posterior outer ear part is bordering with: Fossa cranii posterior etc By putting in the outer ear device the patient can… a. Cough because of n. Trigeminus reflex b. n vagus reflex c. n glossopharyngeus reflex d. n. Facialis reflex Tympanic membrane, from the outside is, in order… a. Skin, mucus, connective tissue b. Skin, connective tissue, mucus c. Connective tissue, skin, connective tissue d. Connective tissue, mucus, skin Vestibular bones are mostly concentrated in… a. Epitympanic part b. Mesotympanic part c. Hypotympanic part d. All parts The conical laryngeal ligaments are localised… a. In between arytenoid cartilages. b. In frontal laryngeal surface between thyroid and cricoidea c. Between thyroid and os hyoideum d. Between cricoidea and trachea The biggest lumen in the larynx is: supraglottic space Phlegmonous laryngitis complication isn't… a. Pneumonia b. Neck phlegmon c. Larynx stenosis d. Larynx edema  37 90% of laryngeal tumours are… a. Squamous cell b. Keratoma c. Salivary gland benign tumours d. Sarcoma The most common papillomavirus are… a. 16 and 18 b. 10 and 15 c. 1 and 2 d. 12 and 20 Choose the wrong statement about the singer's glands. a. It is a precancerous state b. These glands are usually benign on both vocal cords. c. Usually localised in the frontal or medial part of vocal cords. d. Usually happens to active and loud screaming kids. Speech frequency is: One of the frequencies within part of the audio range, that is used for the transmission of speech (180 Hz - 255 Hz) Indications for immediate CT for acute paranasal sinusitis are all, except… a. Diplopia for one day b. Congested nose and pain in the cheeks for 2 days c. Eyelid rash and edema for one day cellulitis expected d. Intense pain in frontal bone when bending forward and positive meningeal symptoms For healthy humans, nystagmus does not provoke… a. Caloric proof b. Pneumatic proof c. Rotation proof d. Head proof Atrophic rhinitis the most common triad is… a. Anosmia, serous secretion, difficulty breathing b. Anosmia, foul smell, atrophy c. Anosmia, Serous secretion, ryness in the nose d. Dryness in the nose, atrophy, serous secretion Labyrinthine fistula is presented by... a. Nystagmus after rotation in its own axis b. Nystagmus after caloric triad c. Nystagmus after inner and outer ear compression/decompression d. Spontaneous nystagmus Sound vibration conduction time from tympanic membrane to stapes is… a. Increased sound vibration amplitude, and the force increases. b. Vibration amplitude and force does not change.  38 c. The amplitude of vibration decreases but the force increases. d. Decreases both “When doing otoscopy, adults pull the ear up and back.” a. Yes b. No The sensory innervation of the external ear comes from… a. The greater auricular nerve b. Temporomandibular nerve c. Vestibulocochlear nerve d. Auriculotemporal nerve e. a,d f. a,b,d The most common complication of purulent ethmoidal sinusitis in childhood is… a. Orbital cellulitis b. Osteomyelitis of the frontal bone c. Meningitis d. Cavernous sinus thrombosis Which of the following factors can not cause allergic rhinitis? a. Recurrent virus infections b. Pollens c. Frequent use of the nasal drops d. High-stress level e. a,c,d f. a,b,c Methods of the laryngeal examination are… a. Indirect laryngoscopy b. The Weber's test c. Stroboscopy d. Electronystagmography e. a,c f. The ultrasound of the thyroid gland g. a,c,e Which is not a symptom of chronic rhinosinusitis? a. Nasal cavity filled with nasal polyps b. Vertigo c. Impaired olfaction d. The pain/pressure in the head, teeth The patient has arrived in the doctor's office with severe night pain in the ear, not responding to analgesics, conductive hearing loss, red, bulging tympanic membrane and fever 38.5º. Which should be the first step in the management of this patient? a. Application of the antibacterial ear drops into the external ear canal b. Nasal decongestants c. Myringotomy What is not the method of choice in treatment of the first stage of laryngeal cancer? a. Laser surgery b. Radiation therapy  39 c. Bilateral neck dissection Which statement is wrong about bilateral vocal cord paralysis? a. Could be a life-threatening condition requiring an urgent tracheostomy b. The patient usually is in good condition, shortness of breath is not typical c. Could be iatrogenic after the surgery on the thyroid gland Typical symptoms for an acute bacterial rhinosinusitis are... a. Nasal obstruction b. Epistaxis c. Purulent discharge from the nose d. Facial swelling e. Loss of smell f. a,c,e Which statements regarding the allergic rhinitis are true? a. lgE related type 1. Allergic reaction b. Usually, affects children in age group 2-4 y c. Develops due to prolonged application of topical intranasal steroids d. Allergic rhinitis could combine with ocular symptoms e. a,d f. a,b,d What are the clinical symptoms of recurrent laryngeal papillomatosis? a. Hoarseness, difficulty breathing, stridor b. Coughing, hoarseness, unpleasant smell from the mouth c. None of the above d. Feeling of a foreign body in the neck, trismus, elevated body temperature e. Difficulty in breathing, fever, throat pain Motor innervation of the masticatory muscles are supplied by… a. Facial nerve b. Mandibular nerve c. Parasympathetic fibers from pterygopalatine ganglion d. Maxillary nerve Contraindication of adenoidectomy is… a. b,d b. Cleft palate c. Acute otitis media d. Acute infection e. Hypertrophy of the palatine tonsils f. Dysfunction of the tympanostomy tube g. b,c,f Ototoxic drugs involved all of the following, except: a. Paracetamol b. Gentamicin c. Furosemide d. Cisplatin The auricle attains 90-95% of adult size by… a. 9-12y b. 11-15y c. Birth d. 5-6y  40 How to best retrieve a motionless foreign body from the external ear canal? a. With a conchotome b. Do not touch, will fall out on its one c. With a hook d. With forceps Otoacoustic emission is a phenomenon of… a. Basilar membrane b. Utricle c. Auditory nerve d. Inner hair cells e. Outer hair cells A child aged 3 years presented with severe sensorineural deafness, he was using hearing aids but showed no improvement. What is the next line of management? a. Fenestration b. Cochlear implant c. Mastoidectomy d. Stapes mobilization A patient has a severe bilateral sensorineural hearing loss. What would be the appropriate hearing rehabilitation method in this case? a. Tympanoplasty b. Sign language, lip reading c. Hearing aid d. BAHA implant e. Cochlear implant What is true about the lymphatic drainage of the vocal cords? a. It has poor lymphatic drainage b. It has no lymphatic drainage c. It has a lymphatic drainage only in the anterior half d. It has rich lymphatic drainage In case of an acute sensorineural hearing loss, the Rinne test is… a. Negative b. Positive Early post-tonsillectomy complications include all of the following, except… a. Epistaxis b. Referred otalgia c. Oedema of the uvula d. Secondary bleeding Which muscle is not involved in the opening of the eustachian tube? a. Tensor veli palatini b. Salpingopharyngeus c. Levator veli palatini d. Buccinator Where distal metastases of laryngeal cancer are found? a. Distal metastases are not characteristic to laryngeal cancer b. Liver c. Thyroid gland d. Lungs  41 e. Central nervous system What kind of treatment is currently available for a patient with laryngeal papillomatosis? a. Etiological b. Symptomatic c. Currently there is no treatment available d. Pathogenic Which one of the following pathologies is characterized by a non-homogenous opacity of one paranasal sinus on a CT scan, non-elevated inflammatory markers, sense of pressure or fullness on the paranasal sinus projection site, foul-smelling nasal discharge? a. Acute rhinosinusitis due to rhinovirus b. Acute bacterial rhinosinusitis c. Sinusitis due to fungal infection d. Posttraumatic sinusitis In case of an acute purulent otitis media, the Rinne test is… a. Negative b. Positive If a patient has a perforated tympanic membrane, he should avoid… a. Wind exposure b. Heat exposure c. Cold exposure d. Water exposure in the ear Indications of tracheostomy… a. In all cases of acute laryngitis b. Ludwig's angina c. In any intubated patient with in 3 days d. Unilateral choanal atresia In practical medicine sound frequency is measured in… a. Hertz b. Watt c. Decibel d. Octave Which of the statements is true regarding epistaxis? a. An application of a warm towel on the nose and head will help to stop the bleeding b. The first step to stop the bleeding is to press the nostrils together and bend the head forwards c. It is never a possible life threatening condition d. The first step to stop the bleeding is to press nostrils together and bend the head backwards In case of recurrent tonsillitis, preferred surgery is the following... a. Tonsillotomy b. Tonsillectomy Regarding the management of sinusitis, which of the following is false? a. Imaging either by Xray, CT or MRI is generally not recommended in acute sinusitis unless complications develop b. Nasal endoscopy is generally a completely painless procedure which takes between 5-10min to complete c. Acute sinusitis mostly treated by surgery d. For sinusitis lasting more than 12 weeks a CT scan is recommended e. Ab are not recommended for most cases  42 Which one of the following symptom complexes most precisely describe acute rhinosinusitis? a. Nasal congestion, external nasal deformation, periorbital hematoma b. Nasal congestion, rhinorrhea, headache c. Epistaxis, otalgia, fever d. Nasal itching, sneezing, rash lacrimation A blue ear drum is seen in… a. Cochlear otosclerosis b. High jugular bulb c. Acute otitis media d. Vestibular schwannoma e. Presbycusis All are causes of congenital stridor, except… a. Vascular anomaly b. Acute epiglottitis c. Laryngomalacia d. Laryngeal web e. Subglottic stenosis In which one of the following pathologies nasal polyps are not a characteristic finding? a. Cystic fibrosis b. Odontogenic rhinosinusitis c. Patient with NSAID intolerance d. Bronchial asthma in combination with allergic rhinitis The olfaction is mediated through… a. N. olfactorius b. N. trigeminus c. N. glossopharyngeus d. N. facialis e. a,b f. a,c g. a,d Round, smooth, soft, translucent, yellow or pale, a glistening structure which results from prolapsed lining of the ethmoid sinus and blocks the nose to variable degree depending on their size… a. Furunculosis b. Nasal turbinate c. Nasal polyp d. Inverted papilloma Diagnostic methods used to differentiate congenital lateral neck cyst are all, except… a. X-ray b. Neck ultrasound c. CT scan d. MRI e. Fine needle biopsy Which of the following pathologies is not characterised by nasal symptoms? a. Nasal septum deviation b. Wegener's granulomatosis c. Chronic pharyngitis d. Choanal atresia  43 Decreased bone conduction in an audiogram indicates… a. Glue ear b. Damage to cochlea c. Ossicular dislocation d. Tympanic membrane perforation e. Ossicular fixation Use of ear speculum during ear examination provides all, except… a. Access to foreign body b. Application of the local medication c. Magnification d. Visualization of the tympanic membrane and external ear canal Which one is the most common early complication after tonsillectomy? a. Velopharyngeal insufficiency b. Breathing impairment c. Bleeding d. Peritonsillar abscess Which is the narrowest portion of the larynx in children younger than 5 years? a. Glottis b. Subglottis c. Supraglottis Conservative treatment of dry traumatic rupture of tympanic membrane is… a. Myringoplasty b. Ab ear drops c. Ear pack soaked in ab d. Systemic ab e. Protection of ear against water Stapedoplasty is an operation of choice in… a. Cholesteatoma b. Bell's palsy c. Otosclerosis d. Meniere's disease Stapes footplate covers… a. Oval window b. Round window c. Sinus tympani D. Aditus ad antrum Which of the following could be a complication of an acute otitis media? a. All of the above b. Brain abscess c. Meningitis d. Labyrinthitis e. None of the above The B tympanogram is found in… a. Sensorineural hearing loss b. Healthy person c. Secretory otitis media d. Otosclerosis  44 All structures open in the middle meatus, except… a. Sphenoid sinus b. Anterior ethmoid air cells c. Maxillary sinus d. Frontal sinus All of the following cause ulceration, except… a. Diphtheria b. Vincent's angina c. Granulocytosis d. Papilloma Which ab would be appropriate for treating nasal furuncle? a. Ciprofloxacin b. Doxycycline c. Azithromycin d. Vancomycin e. Amoxicillin All is true about earwax, except… a. Contains bactericidal enzymes b. Needs to be removed regularly c. Secreted from outer third of external auditory canal d. In a healthy ear canal the pH outside is acidic e. Is a combination of secretion from sebaceous and apocrine glands Lymphoid tissue called Waldeyer's ring is situated in… a. Nasopharynx b. Hypopharynx c. Base of tongue d. Upper two parts of the pharynx e. Oropharynx Which disease of the following cannot cause symptoms of, or mimic an acute tonsillitis? a. Infection mononucleosis b. Otitis media with effusion c. Scarlet fever d. Acute lymphoblastic leukemia e. a,b,d f. a,d A 5 year old girl presented with pain between eyes, frontal headache, discharge form the nose, post nasal drip, and high fever. What is the provisional diagnosis? a. Acute ethmoidal sinusitis b. Sphenoid tumor c. Acute sphenoidal sinusitis d. Chronic ethmoidal sinusitis e. Acute frontal sinusitis An examination method of the middle ear that measures mobility of the tympanic membrane is… a. Myringoplasty b. Audiometry c. Rhinomanometry d. Tympanometry  45 What is the most common reason for the mechanical nasal blockage in adults? a. Allergic rhinitis b. Nasal septum deviation c. Foreign body in the nose d. Acute rhinosinusitis A patient currently has a peritonsillar abscess and confirms episodes of recurrent tonsillitis in the past 5 years with repeated ab treatment. What would be correct? a. Conservative treatment, ab at hospital b. Surgical therapy, bilateral tonsillectomy c. Surgical therapy, unilateral tonsillectomy d. Conservative treatment, ab outpatient To minimize occupational hearing loss, worker exposure to noise should be controlled below… a. 60dB b. 70dB c. 85dB d. 80dB You have a trauma patient with multiple injuries of the soft tissue of the face, and suspicion about the facial bone fracture. What would be the appropriate examination regarding facial trauma? a. CT scan without contrast matter for facial bones b. CT scan with contrast matter c. Plan x-ray d. MRI The bony labyrinth consists of… a. Cochlea b. Two endolymphatic ducts c. a,b d. Vestibulum and three semicircular canals All could be the reason for the conductive hearing loss, except… a. Use of gentamicin recently b. Ear wax in the external ear canal c. Traumatic injury of the ossicles d. Acute purulent otitis media Which of the following is not an extracranial complication of chronic suppurative otitis media? a. Labyrinthitis b. Facial nerve palsy c. Sigmoid sinus thrombosis d. Hearing loss Which statement is incorrect regarding laryngeal papillomatosis? a. Disease has a juvenile flare in children between 2 and 4 years b. Lesion is benign, however it is considered premalignant state c. It is the most common laryngeal lesion in adults d. Disease an adult flare in the 3rd decade A three-year-old boy gets high fever associated with difficulty swallowing and strider. The child was sitting, unable to sleep, and drooling. The resident paediatrician asked for a lateral cervical X-ray and then asked your opinion about what looked like a thumb in front of the hypopharynx. Your diagnosis was… a. Acute epiglottitis b. Laryngo-tracheo-bronchitis  46 c. Acute pharyngitis d. Acute viral laryngitis What is included in the treatment of allergic rhinitis? a. Patient education, allergen avoidance b. Pharmacological treatment c. Specific immunotherapy d. All of the above Functions of the larynx include… a. Prevention of the lower airways from aspiration b. Respiration c. Humidification and warming of the inhaled air d. Production of the voice e. a,b,d f. All of the above are true What is a typical risk group patient for the development of malignant otitis externa? a. Alcoholic and smoker b. A young adult with HIV c. Elderly with diabetes d. Recurrent cleaner of the ear canal with a cotton bud What is not correct about acute epiglottitis? a. Systemic antibiotics is not a must to be started immediately b. Dyspnea may be progressing and alarming c. Age incidence is between 1-6 year old d. It is a special form of acute laryngitis, in which the inflammatory changes affect mainly the loosely attached mucosa of the epiglottis e. Constant supervision in hospital is mandatory Which is the most common malignant tumor of palatine tonsils… a. Adenocarcinoma b. Fibrosarcoma c. Hodgins lymphoma d. Squamous cell carcinoma Which is the most important factor in pathogenesis of rhinosinusitis? a. Decreased ciliary function b. Mucosal oedema in and around the sinus ostium c. Hypoplasia of the paranasal sinus d. Alteration in sinus secretion Which paranasal sinuses have clinical significance in newborns? a. Maxillary and sphenoid sinuses b. Maxillary sinuses and anterior ethmoidal cells c. Anterior and posterior ethmoidal cells d. Frontal and sphenoid sinuses e. Maxillary and frontal sinuses Which paranasal sinuses have clinical significance in newborns? a. Sphenoidal sinus only b. Maxillary and sphenoid sinuses c. Maxillary and frontal sinuses d. Frontal and sphenoid sinuses  47 e. Ethmoidal Cells Which diseases should be excluded in case of exudative tonsillitis? a. Infectious mononucleosis b. Acute leukosis c. Scarlet fever d. Agranulocytosis e. a,c,d f. a,b,c,d Which is the most appropriate hearing test in newborns? a. Tympanometry b. Otoacoustic emissions c. Pure tone audiometry d. Rinne test Which are the most common causative microorganisms of acute bacterial rhinosinusitis? a. S.pneumoniae, H.influenzae, S.aureus, S.pyogenes b. H.influenzae, E.coli c. Rhinobacterium, Bacteroides, S.aureus d. Moraxella catarrhalis, H.influenzae Moraxella The sensory cells in semicircular canals of the inner ear… a. In macula utriculi b. In the organ of Corti c. On the crista ampullaris What are the sound intensities of 8 hour duration, causing professional hearing loss? a. >80 dB b. 60 dB c. 80 dB d. 70 dB Rhinoscleroma is a chronic granulomatous disease caused by… a. C. granulomatis b. S. aureus c. K. rhinoscleromatis d. T. pallidum Which of these can’t be complications of acute rhinosinusitis? a. All of them can be b. Meningitis c. Orbital abscess d. Orbital cellulitis Which one of the following is the first choice diagnostic method for patients with rhinosinusitis? a. CT scan b. Ultrasonography c. Roentgenography d. MRI The most common cause of epiglottitis is… a. Streptococcus pneumoniae b. Haemophilus influenzae type B c. Respiratory syncytial virus d. Staphylococcus species  48 Maxillary sinus drains into… a. Inferior meatus b. Superior meatus c. Middle meatus d. Spheno-ethmoidal recess Complications of acute rhinosinusitis are all, except… a. Mediastinitis b. Meningitis c. Preseptal cellulitis d. Orbital cellulitis e. Intracranial abscess Most cases of external otitis should be managed with… a. Chemotherapy b. Surgical therapy c. Topical therapy d. Systemic therapy The most common suppurative complication of acute otitis media… a. Brain abscess b. Meningitis c. Labyrinthitis d. Mastoiditis What is the most common causative agent of acute bacterial laryngitis in the paediatric population? a. Herpes simplex b. E.coli c. Staphylococcus aureus d. H. influenza What is the most common iatrogenic reason for vocal cord paralysis? a. Nasal septum operation b. Thyroid gland operation c. Tracheal intubation d. Indirect laryngoscopy ​What is the best therapeutic tactic for a patient with bilateral hearing impairment of less than 40dB? a. Unilateral cochlear implantation b. Unilateral hearing aid c. Bilateral hearing aid d. Bilateral cochlear implantation e. Watchful waiting Which one of the following symptoms does not characterise BPPV? a. Hearing impairment b. Nystagmus c. Vomiting d. Vertigo Which one of the following is not an aetiological factor of the pharyngeal tumour? a. Recurrent bacterial tonsillitis b. Smoking  49 c. Excessive alcohol use d. Human Papillomavirus (HPV) infection Arteries that supply nasal septum are all, except… a. A. sphenopalatina b. A. labialis interior c. A. ethmoidalis anterior d. A. ethmoidalis posterior Which one is a typical early symptom of the laryngeal tumour? a. Neck pain b. Difficult breathing c. Hoarseness d. Malodorous breath What kind of hearing impairment develops in case of otitis media with effusion in a child? a. None b. Sensorineural type c. Conductive type d. Mixed type Which of the following is not a congenital neck malformation? a. Thyreoglossus cyst b. Branchial cleft cyst c. Lymph node clusters d. Lymphangioma e. Dermoid cyst Most common type of medial neck cyst? a. Dermoid cyst b. Hemangiomas c. None of them d. Teratomas e. Ductus thyreoglossus cysts f. Lymphangiomas Paired cartilages of the larynx are all, except… a. Cart. corniculata b. Cart. arytenoidea c. Cart. cricoidea d. Cart. cuneiforme Which laryngeal cartilages are unpaired? a. Thyreoidea b. All mentioned are unpaired c. Epiglottis d. Cricoidea e. All mentioned are paired Anatomical structure that is not a part of the larynx… a. Cart. thyroidea b. Os hyoideum c. Cart. cricoidea d. Cart. arytenoidea  50 Anterior wall of the tympanic cavity is also called… a. Carotid wall b. Jugular wall c. Mastoid wall d. Tegmental wall Hearing evaluation method that is used as new-born screening test… a. Behavioral audiometry b. Speech audiometry c. Pure tone audiometry d. Otoacoustic emissions Clinical forms of the tonsillitis are all, except… a. Interstitial b. Follicular c. Lacunar d. Ulcerative e. Membranous Fascia that is not a part of the deep cervical fascia (fascia cervicalis s. fascia colli)... a. Superficial fascia b. Prevertebral fascia c. Prevertebral fascia d. Pretracheal fascia ​Which pathogens of the following are the most common aetiological agents in the case of bacterial rhinosinusitis? a. Str. pneumoniae, M. catarrhalis, P. aeruginosa b. Str. pneumoniae, M. catarrhalis, H. influenzae c. Str. pneumoniae, M. catarrhalis, C. diphtheriae d. Str. pneumoniae, M. catarrhalis, S. epidermidis ​Battle’s sign is characteristic to: a. Fracture of the larynx b. Fracture of the nose c. Le Fort I fracture d. Fracture of the temporal bone Which one of the following reasons does not cause epistaxis? a.Trauma of the nose b.Warfarin overdose c.Adenoiditis d.Arterial hypertension