1. Regarding cholesteatoma, which of the following is true?

A. It consists of squamous epithelium.

B. It is a malignant tumour.
C. It should be left untreated.
D. It may metastasise to distant sites.
E. It is mainly treated medically.

2. Tympanic membrane develops from: D

A. Ectoderm.
B. Endoderm.
C. Mesoderm.
D. A, B and C.
E. A and C.

3. Stapes footplate covers: B

A. Round window.
B. Oval window.
C. Sinus tympani.
D. Aditus ad antrum.
E. Choclear aqueduct.

4. The auricle attains 90-95% of adult size by: A

A. 5-6 years.
B. Birth.
C. 9-12 years.
D. 11-15 years.
E. 13-18 years.

5. Communication between middle ear and Eustachian tube is obliterated

surgically in: B
A. Cortical mastoidectomy.
B. Radical mastoidectomy.
C. Myrigoplasty.
D. Modified radical mastoidectomy.
E. Bondyʼs mastoidectomy.

6. Treatment of choice for glue ear which presented for 6 months is : C

A. Conservative.
B. Adenoidectomy.
C. Myringotomy with ventilation tube insertion.
D. Myringotomy with cold knife.
E. Myringotomy with diode laser.

7. The cough response caused while cleaning the ear canal is mediated by
Stimulation of: E
A. The 5th cranial nerve.
B. Innervation of external ear canal by C1 and C2.
C. Branches of the 7th cranial nerve.
D. The 8th cranial nerve.
E. The 10th cranial nerve.

8. Which of the following is a cause of sensorineural hearing loss: A

A. Prespyacusis.
B. Tympanosclerosis.
C. Otosclerosis.
D. Longitudinal fracture of the temporal bone.
E. Cholesteatoma.

9. Which is the investigation of choice in assessing hearing loss in neonates? D

A. Impedance audiometry.
B. Behavioral audiometry.
C. Free field audiometry.
D. Brain-stem evoked response audiometry.
E. Pure tone audiometry.

10. Use of Siegelʼs speculum during ear examination provides all except: D
A. Magnification.
B. Visualization.
C. Assessment of movement of the tympanic membrane.
D. Removal of foreign body.
E. As applicator for the powdered antibiotic to ear.

11. All are true for Gradenigoʼs syndrome except A

A. It is associated with conductive hearing loss.
B. It is seen in petrositis.
C. It leads to involvement of the 5th and 6th cranial nerves.
D. It is characterized by retro-orbital pain.
E. Otalgia.

12. In right middle ear pathology, Weberʼs test will be A

A. Lateralized to right side.
B. Positive.
C. Lateralized to left side.
D. Centralized.
E. Normal.

13. Which of the following is not a typical feature of malignant otitis externa? A
A. Mitotic figures are high.
B. Caused by Pseudomonas aeruginosa.
C. Patient are usually immune compromised.
D. Presence of granulation tissue.
E. Patients are usually old.

14. Otoacoustic emissions are produced by: D

A. Inner hair cells.
B. Basilar membrane.
C. Auditory nerve.
D. Outer hair cells.
E. Utricle

15. Speech frequencies include: A

A. 500 1000 2000 Hz.
B. 125 250 2000 Hz.
C. 250 500 1000 Hz.
D. 1000 2000 3000Hz.
E. 2000 3000 4000Hz.

16. Decreased bone conduction in an audiogram indicates: C

A. Glue ear.
B. Tympanic membrane perforation.
C. Damage to cochlea.
D. Ossicular dislocation.
E. Ossicular fixation.

17. Traumatic perforation differ from infective perforation of the ear drum in the: B
A. Size of perforation.
B. Shape of perforation.
C. Number of perforations.
D. Site of perforation.
E. None of the above.

18. Caloric test determines function of: D

A. Posterior semicircular canal.
B. Saccule.
C. Utricle.
D. Lateral semicircular canal.
E. Superior semicircular canal.

19. Treatment of dry traumatic rupture of tympanic membrane is: D

A. Antibiotic ear drops.
B. Ear pack soaked with antibiotic.
C. Myringoplasty.
D. Protection of ear against water.
E. Systemic antibiotics.

20. All are true about ear wax except: D

A. pH is acidic in normal healthy canals.
B. Contains a bactericidal enzyme.
C. Is a combination of secretions of sebaceous and apocrine glands.
D. Needs to be removed periodically.
E. Secreted from outer third of external auditory canal.

21. Type B tympanogram is found in: D

A. Normal person.
B. Tympanosclerosis.
C. Otosclerosis.
D. Secretary otitis media.
E. Disconnection of the ossicles

22. Which of the following is not an extracranial complication of chronic : A

suppurative otitis media:
A. Sigmoid sinus thrombosis.
B. Facial nerve palsy.
C. Squamous cell carcinoma.
D. Labyrinthitis.
E. Hearing loss.

23. Unilateral referred otalgia is due to all of the following except: C

A. Peritonsillar abscess.
B. Ulcer oral tongue.
C. Allergic rhinitis.
D. Tempromandibular joint dysfunction.
E. Cancer of pyriform fossa.

24. Obliteration of postauricular sulcus is found in:- A

A. Acute mastoiditis.
B. Acute petrositis.
C. Malignant otitis externa.
D. Otomycosis.
E. Gradingoʼs syndrome.

25. The augmentation power of the sound wave by the tympanic membrane is:- A
A. 14 times.
B. 1.4 times.
C. 18 times.
D. 17 times.
E. 22 times.

26. Aim of mastoid surgery in CSOM which should receive first priority is: B
A. Making the ear dry.
B. Rendering the ear safe.
C. Improvement in hearing.
D. Preservation of hearing.
E. Eradication of infection.

27. Most common cause for bilateral conductive deafness in a child is: A
A. Otitis media with effusion.
B. Otosclerosis.
C. Acute otitis media.
D. Congenital cholesteatoma.
E. Chronic suppurative otitis media.

28. A child aged 3 years presented with severe sensorineural deafness, he was
prescribed hearing aids but showed no improvement. What is the next line of
management? C
A. Fenestration.
B. Stapes mobilization.
C. Cochlear implant.
D. Conservative.
E. Mastoidectomy.

29. The most common cause of peripheral episodic vertigo is: A

A. Benign paroxysmal positional vertigo.
B. Meniereʼs disease.
C. Acoustic neuroma.
D. Vascular occlusion of labyrinthine artery.
E. Labyrinthitis.

30. A fifty year old male diabetic patient has developed itching in his ears. On
otoscopy there is debris with black specks in external auditory canal. The
treatment of choice in this case is:- D
A. Otosporin ear drops.
B. Gentamicin ear drops.
C. Salicylic acid in spirit drops.
D. Repeated suction toilet with antifungal drops.
E. Oral anti-fungal drugs.

31. Adenoidectomy is indicated in all of the following conditions except: C

A. Otitis media with effusion.
B. Nasal obstruction due to adenoidal hyperplasia.
C. Allergic rhinitis in children.
D. Recurrent otitis media in children.
E. Sleep apnea syndrome.

32. Complications of mumps include all except: C

A. Unilateral sensorineural hearing loss.
B. Pancreatitis.
C. Palatal paralysis.
D. Orchitis.
E. Bilateral sensorineural hearing loss.

33. External auditory canal extends from …… to tympanic membrane. D

A. Attic.
B. Lobule.
C. Isthmus.
D. Concha.
E. Umbo.

34. All of the following regarding pure tone audiometry is true except: A
A. Is an objective test.
B. It uses specific tones to give place specific responses.
C. Is used to determine the type of deafness.
D. Is used to determine the severity of deafness.
E. Is used to determine the side of deafness.

35. Tympanic membrane moves with respiration in: A

A. Patulous Eustachian tube.
B. Eustachian tube dysfunction.
C. Otosclerosis.
D. Secretary otitis media.
E. Disconnection of the ossicles.

36. Loss of stapedial reflex indicates all of the following except: C

A. Severe sensorineural hearing loss.
B. Profound sensorineural hearing loss.
C. Mild sensorineural hearing loss.
D. Facial nerve paralysis.
E. Conductive hearing loss.

37. External auditory canal has……constriction/s: C

A. 1.
B. 3.
C. 2.
D. 4.
E. No constriction.

38. Ototoxic drugs involves all of the following except: D

A. Gentamicin.
B. Aspirin.
C. Fruesamide.
D. Paracetamol.
E. Cisplatin.

39. A 50 year old male patient presented with otalgia, on examination both external
auditory canal and tympanic membrane are normal, all of the following might
be the sites of origin of his pain except: C
A. Neck.
B. Pharynx.
C. Brain.
D. Eye.
E. Nose

40. A nine months old baby has put a plastic bead in his ear. On otoscopy, it is
 present in deeper portion of meatus and totally occluding the meatus. The best
way to remove this bead is: E
A. Remove it with foreign body hook.
B. Remove it with crocodile forceps.
C. Remove it with suction.
D. Remove it with ear syringing.
E. Remove it under general anesthesia using microscope.

41. A two year child is very slow in developing language. On otoscopy he has dull
ear drum. Investigation of choice is: C
A. Pure tone audiogram.
B. X-ray mastoids.
C. Tympanogram.
D. Serum bilirubin.
E. Nystagmogram.

42. A 10 year old boy has had ear problems for many years. He has a fever and you
also notice that his mastoid bone is warm and tender to touch. Which of the
following is the best course of action? E
A. Refer routinely to ENT.
B. Prescribe topical eardrops.
C. Reassure.
D. Prescribe antibiotics.
E. Refer urgently to ENT.

43. If the patient can hear a whispered voice 30 cm away from the ear, the patient
has: A
A. Normal hearing.
B. Sensorineural hearing loss.
C. Conductive hearing loss.
D. Congenital hearing loss.
E. Mixed hearing loss.

44. All of the following tuning fork tests are used to detect organic hearing loss
except: A
A. Stenger test.
B. Weber test.
C. ABC test.
D. Rinne test.
E. Modified ABC test.

45. Fistula test is positive in: C

A. Acute mastoiditis.
B. Erosion in the basal turn of cochlea.
C. Erosion of the lateral canal.
D. Acute petrositis.
E. Adhesive otitis media.

46. Before bone conduction audiometry masking is done: A

A. To prevent cross hearing.
B. To diminish hearing acuity.
C. To increase hearing acuity.
D. To assess speech discrimination.
E. To prevent hair sensation.

47. A blue drum is seen in: D

A. Cochlear otosclerosis.
B. Prespyacusis.
C. Vestibular schwannoma.
D. High jugular bulb.
E. Glue ear.

48. The cone of light in the tympanic membrane points: C

A. Posteroinferiorly.
B. Superiorly.
C. Anteroinferiorly.
D. Posteriorly.
E. Centrally

49. Ear syringing is contraindicated in patients with: C

A. Impacted wax.
B. Otomycosis.
C. Previous history suggesting skull fracture.
D. Presence of foreign body.
E. None of the above.

50. Keratosis obturans is commonly associated with: A

A. Bronchiectasis.
B. Appendicitis.
C. Dextrocardia.
D. Renal failure.
E. Diabetes mellitus