Physician Assistant Eyes, Ears, Nose and Throat (EENT) 3

Question 1

A patient with chronic otitis media has painless foul-smelling otorrhea and a pearly white mass in the attic of the tympanic membrane. What is the diagnosis?

Accepted Answer

Cholesteatoma

Answer

Cholesteatoma is a keratinizing squamous epithelial growth that can erode the ossicles and requires surgical excision.

Question 2

An elderly man with poorly controlled diabetes has severe ear pain, granulation tissue in the external canal, and an elevated ESR. Which organism is most likely responsible?

Accepted Answer

Pseudomonas aeruginosa

Answer

Malignant (necrotizing) otitis externa is usually caused by Pseudomonas and can progress to skull base osteomyelitis.

Question 3

A patient has left-sided hearing loss. The Weber test lateralizes to the left ear, and Rinne testing on the left shows bone conduction greater than air conduction. What type of hearing loss is present?

Accepted Answer

Left conductive hearing loss

Answer

In conductive loss, Weber lateralizes to the affected ear and Rinne shows BC > AC on that side.

Question 4

A patient has episodic vertigo lasting hours, fluctuating low-frequency hearing loss, tinnitus, and aural fullness. What is the first-line management?

Accepted Answer

Low-sodium diet and diuretics

Answer

Ménière disease is initially managed with salt restriction and diuretics to reduce endolymphatic hydrops.

Question 5

A patient has brief episodes of vertigo lasting under a minute when rolling over in bed. Dix-Hallpike produces torsional upbeating nystagmus. What is the best treatment?

Accepted Answer

Canalith repositioning (Epley maneuver)

Answer

Posterior canal BPPV is treated by canalith repositioning, which moves otoconia out of the semicircular canal.

Physician Assistant Practice Test

Physician Assistant Practice Test

Physician Assistant Eyes, Ears, Nose and Throat (EENT) 3