Ear, Nose and Throat EMQs

Options For Questions 1 - 7

A. Thyroglossal cyst

B. Hodgkin’s lymphoma

C. Reactive lymph node

D. Branchial cyst

E. Squamous cell carcinoma

F. Lipoma

G. Cystic hygroma

 

Select the diagnosis that best matches the presentation:

1. 17 year old with a swollen, tender neck lump just below the angle of the mandible associated with a new sore throat

2. 4 year old with a midline neck lump that moves upwards when he sticks out his tongue

3. 19 year old with a round, soft, non-tender swelling below the angle of the mandible

4. 20 year old with an enlarged, non-tender, “rubbery” neck lump that becomes painful when drinking alcohol

5. Neonate with a left-sided, large, soft lump in the posterior triangle of the neck that will transilluminate with a pen torch

6. 70 year old with a subcutaneous, soft, non-tender, mobile lump on the back of their neck for the past five years

7. 64 year old smoker with a persistent, non-tender, hard, tethered neck lump

 

Options For Questions 8 - 14

A. Mumps

B. Streptococcus pneumoniae

C. Streptococcus pyogenes

D. Mycobacterium tuberculosis

E. Anaerobic bacteria

F. Epstein-Barr Virus

G. Pseudomonas aeruginosa

 

Match the most likely causative organism to the presentation:

8. Ear pain, fevers and a bulging, red, inflamed tympanic membrane in a 30 year old

9. Fever and bilateral severely inflamed tonsils with exudates in a 6 year old

10. Ear pain and discharge and an inflamed ear canal in a 28 year old keen swimmer

11. A soft, non-tender subcutaneous swelling in the posterior triangle of the neck associated with night sweats and weight loss in a 47 year old from Zambia

12. Bilateral swelling and tenderness of the parotid gland in a 24 year old

13. An intensely itchy maculopapular rash in response to amoxicillin in a 17 year old with a sore throat, swollen lymph nodes, fatigue and fevers

14. Rapid onset swollen, painful, bleeding gums in a 58 year old with poor oral hygiene

 

Options For Questions 15 - 22

A. Benign paroxysmal positional vertigo

B. Vestibular migraine

C. Acoustic neuroma

D. Ménière's disease

E. Vestibular neuronitis

F. Posterior circulation infarction

G. Multiple sclerosis

H. Labyrinthitis

 

Select the cause of vertigo that best matches the presentation:

15. 32 year old with acute onset vertigo and hearing loss after a recent viral upper respiratory tract infection

16. 35 year old with recurrent episodes of vertigo lasting several days associated with loss of vision in one eye

17. 70 year old with sudden onset vertigo, double vision and a wide-based and unsteady gait

18. 28 year old with acute onset vertigo and vomiting after a recent viral upper respiratory tract infection and no other symptoms

19. 78 year old with recurrent episodes of vertigo triggered by rolling over in bed

20. 40 year old with episodes of vertigo lasting several hours associated with experiencing flashing lights in both eyes

21. 50 year old with gradual onset and persistent vertigo, unilateral hearing loss, tinnitus and facial nerve palsy

22. Recurrent attacks of vertigo associated with unilateral hearing loss, tinnitus and a feeling of fullness in the ear

  1. 17 year old with a swollen, tender neck lump just below the angle of the mandible associated with a new sore throat. C. Reactive lymph node
  2. 4 year old with a midline neck lump that moves upwards when he sticks out his tongue. A. Thyroglossal cyst
  3. 19 year old with a round, soft, non-tender swelling between the angle of the mandible and the sternocleidomastoid muscle. D. Branchial cyst
  4. 20 year old with an enlarged, non-tender, “rubbery” neck lump that becomes painful when drinking alcohol. B. Hodgkin’s lymphoma
  5. Neonate with a left-sided, large, soft lump in the posterior triangle of the neck that will transilluminate with a pen torch. G. Cystic hygroma
  6. 70 year old with a subcutaneous, soft, non-tender, mobile lump on the back of their neck for the past five years. F. Lipoma
  7. 64 year old smoker with a persistent, non-tender, hard, tethered neck lump. E. Squamous cell carcinoma
  8. Ear pain, fevers and a bulging, red, inflamed tympanic membrane in a 30 year old. B. Streptococcus pneumoniae
  9. Fever and bilateral severely inflamed tonsils with exudates in a 6 year old. C. Streptococcus pyogenes
  10. Ear pain and discharge and an inflamed ear canal in a 28 year old keen swimmer. G. Pseudomonas aeruginosa
  11. A soft, non-tender subcutaneous swelling in the posterior triangle of the neck associated with night sweats and weight loss in a 47 year old from Zambia. D. Mycobacterium tuberculosis
  12. Bilateral swelling and tenderness of the parotid gland in a 24 year old. A. Mumps
  13. An intensely itchy maculopapular rash in response to amoxicillin in a 17 year old with a sore throat, lymphadenopathy, fatigue and fevers. F. Epstein-Barr Virus
  14. Rapid onset swollen, painful, bleeding gums in a 58 year old with poor oral hygiene. E. Anaerobic bacteria
  15. 32 year old with acute onset vertigo and hearing loss after a recent viral upper respiratory tract infection. H. Labyrinthitis
  16. 35 year old with recurrent episodes of vertigo lasting several days associated with loss of vision in one eye. G. Multiple sclerosis
  17. 70 year old with sudden onset vertigo, double vision and a wide-based and unsteady gait. F. Posterior circulation infarction
  18. 28 year old with acute onset vertigo and vomiting after a recent viral upper respiratory tract infection and no other symptoms. E. Vestibular neuronitis
  19. 78 year old with recurrent episodes of vertigo triggered by rolling over in bed. A. Benign paroxysmal positional vertigo
  20. 40 year old with episodes of vertigo lasting several hours associated with experiencing flashing lights in both eyes. B. Vestibular migraine
  21. 50 year old with gradual onset and persistent vertigo, unilateral hearing loss, tinnitus and facial nerve palsy. C. Acoustic neuroma
  22. Recurrent attacks of vertigo associated with unilateral hearing loss, tinnitus and a feeling of fullness in the ear. D. Ménière's disease

 

Maximum score = 22

Your % = your score x 4.55