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EENT Flashcards

7 cards from real PANCE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 EENT flashcards as text

  1. A 50-year-old presents with progressive bilateral conductive hearing loss. Audiometry shows a Carhart notch at 2000 Hz on bone conduction and an absent stapedial reflex. What is the most likely diagnosis?

    Answer: Otosclerosis

    Otosclerosis causes progressive conductive hearing loss from abnormal bony fixation of the stapes footplate; the Carhart notch at 2000 Hz and absent stapedial reflex are classic findings.

  2. A 10-year-old with recurrent otitis media now has a white pearly mass visible through the tympanic membrane with a foul-smelling discharge. CT shows erosion of the ossicles. What is the diagnosis?

    Answer: Cholesteatoma

    Cholesteatoma is a destructive accumulation of keratinizing squamous epithelium in the middle ear that erodes ossicles and can extend intracranially; surgical removal is required.

  3. A 2-year-old presents with sudden onset of choking followed by persistent unilateral wheezing and decreased breath sounds on the right. The child is now afebrile and in no respiratory distress. Chest X-ray shows right-sided hyperinflation. What is the next step?

    Answer: Rigid bronchoscopy for foreign body removal

    Aspirated foreign body in the airway presents with unilateral air trapping and requires rigid bronchoscopy for definitive removal under controlled conditions.

  4. A 40-year-old presents with unilateral progressive sensorineural hearing loss, high-frequency tinnitus, and unsteadiness. MRI with gadolinium shows an enhancing cerebellopontine angle mass. What is the most likely diagnosis?

    Answer: Vestibular schwannoma (acoustic neuroma)

    Vestibular schwannoma arises from the Schwann cells of CN VIII at the internal auditory canal, presenting with unilateral sensorineural hearing loss, tinnitus, and imbalance.

  5. A 25-year-old presents with painless, progressive bilateral sensorineural hearing loss since age 12. He has no family history of hearing loss. He is found to have hematuria on urinalysis. Renal biopsy shows thinning of the glomerular basement membrane with a split lamina densa. What syndrome is this?

    Answer: Alport syndrome

    Alport syndrome is an X-linked disorder of type IV collagen causing sensorineural hearing loss and nephritis with characteristic lamina densa splitting on electron microscopy.

  6. A 60-year-old diabetic male presents with severe left-sided otalgia, purulent otorrhea, and granulation tissue visible in the external auditory canal. He has facial nerve palsy. CT shows cortical bone erosion at the skull base. What is the most likely organism?

    Answer: Pseudomonas aeruginosa

    Malignant (necrotizing) external otitis in diabetics is almost exclusively caused by Pseudomonas aeruginosa; facial nerve palsy indicates skull base osteomyelitis requiring prolonged IV antipseudomonal therapy.

  7. A 35-year-old presents with episodic positional vertigo triggered when lying down or rolling over in bed. Episodes last less than 1 minute. Dix-Hallpike test elicits upbeat-torsional nystagmus with a latency of 5 seconds. What is the first-line treatment?

    Answer: Epley canalith repositioning maneuver

    The Epley canalith repositioning maneuver moves displaced otoliths out of the posterior semicircular canal and is the first-line treatment for posterior canal BPPV.