Free FMGE ENT questions

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A negative Rinne test means bone conduction exceeds air conduction and suggests conductive hearing loss. In normal hearing and sensorineural loss, Rinne remains positive.

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In unilateral sensorineural hearing loss, Weber lateralizes to the better-hearing ear. In conductive loss it usually lateralizes toward the affected ear.

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Otitis externa involves the external auditory canal, and tragal or pinna movement often causes marked pain. Acute otitis media is centered behind the tympanic membrane.

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Bulging of the tympanic membrane with middle-ear inflammation is characteristic of acute otitis media. Reduced mobility supports the presence of middle-ear effusion.

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Cholesteatoma consists of keratinizing squamous epithelium within the middle ear and commonly arises in the attic or pars flaccida. It can erode ossicles and adjacent bone.

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Otosclerosis commonly causes progressive conductive hearing loss due to fixation of the stapes footplate. The tympanic membrane is often normal on examination.

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Ménière disease classically presents with recurrent episodic vertigo, fluctuating sensorineural hearing loss, tinnitus, and aural fullness. Symptoms are usually unilateral initially.

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BPPV is characterized by short episodes of positional vertigo. The Dix-Hallpike maneuver is used to provoke posterior-canal BPPV.

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The Epley canalith-repositioning maneuver moves displaced otoconia out of the posterior semicircular canal. It is a first-line mechanical treatment for posterior-canal BPPV.

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Focal neurological signs, severe gait ataxia, or other brainstem/cerebellar findings raise concern for central vertigo. Such patients need urgent neurological evaluation.

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Most anterior nosebleeds arise from the vascular plexus on the anterior nasal septum known as Kiesselbach or Little area. Direct pressure is an important initial measure.

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Posterior epistaxis often arises from branches of the sphenopalatine artery and can cause heavy bleeding into the pharynx. It is more difficult to control than typical anterior epistaxis.

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Quinsy or peritonsillar abscess produces unilateral swelling, trismus, muffled voice, and uvular deviation. Drainage plus antimicrobial therapy is usually required.

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Acute epiglottitis can rapidly obstruct the airway. Airway stabilization takes priority, and agitating throat examination should be avoided when significant obstruction is suspected.

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Viral croup causes subglottic narrowing that may produce the steeple sign on anteroposterior neck radiography. The thumb sign is associated with epiglottitis.

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Sudden coughing or choking followed by unilateral wheeze or reduced air entry strongly suggests airway foreign body aspiration. Rigid bronchoscopy may be required for diagnosis and removal.

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The recurrent laryngeal nerve supplies most intrinsic muscles of the larynx and is vulnerable during thyroid surgery. Unilateral injury commonly causes hoarseness.

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Even small glottic lesions can alter vocal-cord vibration and produce persistent hoarseness. This may lead to earlier presentation compared with some supraglottic tumors.

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Nasopharyngeal carcinoma can obstruct the Eustachian tube, causing unilateral middle-ear effusion, and often metastasizes early to cervical nodes. Adult unilateral effusion warrants nasopharyngeal evaluation.

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Neonates are preferential nasal breathers, so bilateral choanal atresia can cause respiratory distress and cyclical cyanosis relieved by crying. Airway support and definitive repair are required.