AMC MCQ Ophthalmology and ENT 3

Question 1

A 5-year-old is found on routine screening to have best corrected visual acuity of 6/6 in the right eye and 6/60 in the left eye with no structural abnormality.
What is the most effective treatment for the left eye?

Accepted Answer

Patching the right (good) eye for several hours per day

Answer

Corrective lenses alone

Answer

Surgery on the left eye

Answer

Atropine drops to both eyes

Question 2

A 45-year-old presents with a drooping left upper eyelid, a constricted left pupil that reacts poorly in dim light, and reduced sweating on the left side of the face. What is the diagnosis?

Accepted Answer

Left Horner syndrome

Answer

Left third cranial nerve palsy

Answer

Myasthenia gravis

Answer

Left Bell's palsy

Question 3

A 52-year-old smoker presents with a firm, painless 3 cm neck mass that has been present for 8 weeks. Fine needle aspiration cytology reveals squamous cell carcinoma. What is the most important next investigative step?

Accepted Answer

Panendoscopy to identify the primary tumour

Answer

Immediate radical neck dissection

Answer

PET-CT scan only

Answer

Empirical radiotherapy to the neck

Question 4

A 61-year-old smoker presents with 8 weeks of progressive hoarseness. Flexible laryngoscopy reveals a lesion on the left true vocal cord with impaired mobility. What is the single most important next step in management?

Accepted Answer

Microlaryngoscopy and biopsy under general anaesthesia

Answer

Voice rest for 4 weeks and reassessment

Answer

Proton pump inhibitors for suspected laryngopharyngeal reflux

Answer

Antifungal therapy for presumed candidiasis

Question 5

A 35-year-old presents with recurrent anterior epistaxis originating from the Kiesselbach plexus (Little's area). The bleeding is moderate and the patient is haemodynamically stable. What is the correct initial management?

Accepted Answer

Firm pinching of the soft part of the nose for 10-15 minutes while leaning forward

Answer

Immediate anterior nasal packing with ribbon gauze

Answer

Posterior nasal packing

Answer

Urgent sphenopalatine artery ligation

Question 6

Parents of a 6-year-old ask about tonsillectomy after their child had 7 documented episodes of streptococcal tonsillitis in the past year, each requiring antibiotics. According to the Paradise criteria, is this child a candidate for tonsillectomy?

Accepted Answer

Yes — 7 episodes in one year meets the threshold for tonsillectomy consideration

Answer

No — requires 10 episodes in one year

Answer

No — tonsillectomy is not indicated before age 7

Answer

Yes — but only if adenoidectomy is performed simultaneously

Question 7

A 63-year-old heavy smoker and drinker presents with progressive hoarseness, odynophagia, referred otalgia, and a palpable neck mass. Laryngoscopy reveals a supraglottic mass. Which investigation is most important for staging?

Accepted Answer

CT scan of the neck, chest, and upper abdomen with contrast

Answer

Plain chest radiograph alone

Answer

MRI of the brain only

Answer

Ultrasound of the neck