REPASO LECTURES OTORRINO

Which classification correctly identifies the main types of external ear injuries according to their causative factor? A. Mechanical, infectious, autoimmune and neoplastic injuries B. Mechanical, thermal, chemical, electrical and radiation-induced injuries C. Congenital, sensorineural, conductive and mixed injuries D. Vestibular, cochlear, retrocochlear and central injuries.

An elderly diabetic patient presents with severe persistent otalgia, otorrhoea and granulation tissue in the external auditory canal. Which statement is CORRECT? A. The most likely diagnosis is uncomplicated viral otitis externa, treated with observation alone. B. Malignant otitis externa is a benign neoplasm that usually requires chemotherapy. C. Necrotising otitis externa is commonly caused by Pseudomonas aeruginosa and requires prolonged systemic antipseudomonal treatment. D. Facial nerve paralysis is required to establish the diagnosis of malignant otitis externa.

A 5-year-old child has uncomplicated bilateral otitis media with effusion without important developmental risk factors. Which management strategy is generally appropriate initially? A. Immediate systemic antibiotics for every patient B. Observation for approximately three months, with ventilation tubes considered if persistent effusion causes significant hearing difficulties C. Immediate radical mastoidectomy D. Routine long-term antihistamines and oral corticosteroids.

Which combination is most characteristic of chronic suppurative otitis media? A. Sudden severe otalgia with an intact bulging tympanic membrane B. Recurrent painless otorrhoea, conductive hearing loss and tympanic membrane perforation C. Episodic vertigo with fluctuating sensorineural hearing loss and tinnitus D. Severe otalgia with vesicular eruption of the external ear and facial paralysis.

A patient develops acute prolonged vertigo, nausea, vomiting, nystagmus and unilateral sensorineural hearing loss. Which diagnosis best explains the clinical presentation? A. Vestibular neuritis without cochlear involvement B. Benign paroxysmal positional vertigo C. Labyrinthitis D. Otitis media with effusion.

Which statement about treatment of Ménière's disease is CORRECT? A. Labyrinthectomy is the preferred initial treatment in every patient because it preserves residual hearing. B. Short-term vestibular suppressants may be used during acute attacks, while intratympanic corticosteroids or gentamicin may be considered for selected persistent cases. C. Long-term vestibular suppressants are the definitive treatment for every patient. D. Vestibular rehabilitation is indicated primarily for stopping acute vertigo attacks immediately.

Which combination correctly matches the diagnostic test and first-line treatment for posterior canal benign paroxysmal positional vertigo? A. Weber test for diagnosis and antibiotics for treatment B. Dix–Hallpike manoeuvre for diagnosis and Epley manoeuvre for treatment C. MRI for diagnosis and labyrinthectomy in every patient D. Tympanometry for diagnosis and oral corticosteroids for treatment.

Which statement correctly classifies hearing loss according to anatomical localisation? A. Conductive hearing loss originates in the cochlea, while sensorineural hearing loss originates in the external auditory canal. B. Conductive hearing loss affects sound transmission through the external or middle ear; sensorineural hearing loss involves the cochlea or auditory nerve; mixed hearing loss combines both components. C. Mixed hearing loss occurs exclusively in the auditory cortex. D. All hearing loss is caused by damage to the vestibular system.

Which combination represents normal tuning fork test results in a healthy individual? A. Rinne negative bilaterally, Weber lateralised, Schwabach prolonged B. Rinne positive bilaterally, Weber central and Schwabach normal C. Rinne negative on one side, Weber central and Schwabach shortened D. Rinne positive bilaterally, Weber lateralised and Schwabach absent.

A patient presents with sudden unilateral sensorineural hearing loss. Which treatment strategy is consistent with the lecture? A. Delay all treatment for at least three months. B. Start routine antibiotics as the only treatment. C. Consider early corticosteroid therapy, ideally within two weeks, with intratympanic steroid salvage treatment for incomplete recovery within two to six weeks. D. Perform immediate total labyrinthectomy in every patient.

Which patient may benefit from a bone-anchored hearing aid (BAHA)? A. A patient with conductive hearing loss who cannot use a conventional air-conduction hearing aid B. A patient with normal hearing who wishes to prevent vertigo C. A patient with acute bacterial meningitis as a substitute for antibiotics D. A patient with isolated vocal-fold paralysis to improve speech production.

Which statement correctly describes videonystagmography (VNG)? A. It measures the integrity of the tympanic membrane using acoustic pressure. B. It records involuntary eye movements using infrared video goggles to assess vestibular function. C. It directly measures intracranial pressure. D. It replaces all neurological examinations in patients with dizziness.

A patient presents with severe otalgia, painful vesicles affecting the external ear and ipsilateral peripheral facial paralysis. Which diagnosis is most likely? A. Ménière's disease B. Ramsay Hunt syndrome C. Otosclerosis D. Benign paroxysmal positional vertigo.

Why is Ludwig's angina considered life-threatening? A. It causes immediate irreversible cochlear destruction in every patient. B. It causes swelling of the floor of the mouth, elevating and displacing the tongue posteriorly, potentially obstructing the airway. C. It produces only mild inflammation of the external auditory canal. D. It exclusively causes conductive hearing loss.

Which situation represents an accepted indication to consider tonsillectomy? A. A single episode of uncomplicated viral pharyngitis B. Documented recurrent tonsillitis meeting frequency criteria, obstructive sleep apnea associated with tonsillar hypertrophy or suspicious unilateral tonsillar enlargement C. Mild sneezing during pollen season D. Asymptomatic cerumen impaction.

Which combination contains recognised causes of obstruction of the ostiomeatal complex? A. Mucosal oedema, nasal polyps, septal deviation, concha bullosa, Haller cells, tumours and scarring B. Otosclerosis, presbycusis and vestibular neuritis C. Facial nerve paralysis and cochlear damage exclusively D. Submandibular stones and parotid gland cysts.

Which symptom combination is characteristic of acute rhinosinusitis? A. Nasal obstruction, anterior or posterior nasal discharge, facial pressure and reduced sense of smell B. Isolated severe sensorineural hearing loss without nasal symptoms C. Painful vesicles of the external ear with facial paralysis D. Progressive shoulder weakness without upper respiratory symptoms.

Which two surgical techniques are highlighted in the lecture for selected cases of chronic rhinosinusitis? A. Tympanoplasty and mastoidectomy B. Functional endoscopic sinus surgery and balloon sinuplasty C. Tonsillectomy and adenoidectomy exclusively D. Parotidectomy and neck dissection.

Which clinical presentation is most characteristic of mumps? A. Recurrent painless otorrhoea and conductive hearing loss B. Painful, often bilateral parotid swelling with fever, headache and malaise C. Acute isolated facial nerve paralysis without parotid swelling or systemic symptoms D. A slowly growing painless thyroid nodule.

Which statement about treatment of sialolithiasis is CORRECT? A. Antibiotics are indicated for every salivary stone, even without infection. B. All stones require immediate removal of the affected salivary gland. C. Management depends on stone size and location and may include conservative care, sialendoscopy, lithotripsy or surgery. D. Salivary stones are always treated with radiotherapy.

Which statement correctly describes the safest management of a foreign body in the external auditory canal? A. Blind insertion of instruments is recommended to remove the object rapidly. B. Irrigation is always safe, including for button batteries and organic materials. C. Removal under direct visualisation with appropriate instruments is preferred, while irrigation is contraindicated in selected circumstances. D. Every object should be pushed further into the canal before removal.

Where do aspirated airway foreign bodies most frequently lodge? A. Left main bronchus because it is longer and more horizontal B. Right main bronchus because it is wider, shorter and more vertical C. Both main bronchi are anatomically identical D. Exclusively within the laryngeal ventricles.

Which examination is particularly useful for assessing vocal-fold vibration, mucosal wave and glottic closure during phonation? A. Tympanometry B. Videostroboscopy C. Pure-tone audiometry D. Caloric vestibular testing.

A 2-year-old child presents with barking cough, inspiratory stridor and signs of subglottic oedema consistent with viral croup. Which treatment is appropriate? A. Immediate antibiotics for every patient B. Dexamethasone, with nebulised epinephrine for moderate to severe cases C. Routine total laryngectomy D. Antifungal therapy as first-line treatment.

Which of the following is a recognised complication of tracheotomy? A. Subcutaneous emphysema B. Tracheal stenosis C. Tracheoinnominate fistula D. All of the above.

Which symptom is particularly emphasised in the lecture as characteristic of laryngopharyngeal reflux disease (LPRD)? A. Conductive hearing loss B. Globus pharyngeus — sensation of a foreign body or lump in the throat C. Sudden peripheral facial paralysis D. Recurrent painful parotid swelling during meals.

Which combination represents the classic symptom triad of obstructive sleep apnoea syndrome (OSAS)? A. Hoarseness, otalgia and dysphagia B. Vertigo, tinnitus and sensorineural hearing loss C. Loud snoring, witnessed apnoeas and excessive daytime sleepiness D. Epistaxis, nasal obstruction and facial pain.