SURVIVING ENT

(so not writing the other name)

DEALING WITH PROFESSIONAL EXAM

As ENT is a clinical subject, you will only be given clinical scenarios in the exam. You will be tested on:
 Making Differential diagnosis
 Making a provisional diagnosis
 Investigations
 Treatment
As for the MCQs, sadly there are no past papers for them. The first and last time you will see them is in the
professional exam. REMEMBER to stay calm if you find them confusing and think.

How To Study A Topic

ENT is not like eye at all. The syllabus is longer and more difficult. You will actually need to spend some time
on it. Take it SERIOUSLY!

While studying any topic, you need to focus on it clinically with following headings in your mind:
 Definition
 Clinical Features
o Symptoms
o Signs
 Differential diagnosis
 Examination and Investigations
 Treatment
Clinical features will help you in making the differentials and a final diagnosis.
The most important part of any disease is its treatment. You will be asked about it in MCQs, written exam (in
every SEQ), and in viva.
 How To Attempt THE SEQS

When the Q says write management, you are supposed to write

 History points( i have never been able to figure out what)
 Signs/symptoms
 Examinations
 Investigations
 Then treatment
Dont Jump straight to treatment

For an Example of Antrochoanal Polyp

Q: Child with unilateral obstruction/mass that hangs in nasopharynx

Management:
1 History Points
2 Sign/Symptoms
 Nasal Obstruction
 Voice Change
 Nasal Discharge
3 Examinations
 Ant and Post Rhinoscopy
 Nasal Endoscopy
4 Investigations
 X ray Neck and Paranasal Sinuses
 Non Contrast CT Nose and Paranasal Sinuses
5 Treatment
 Surgery:
For new polyp: Endoscopic Sinus Surgery No 1 choice or Nasal/Oral Polypectomy by avulsion
(Old method)
For recurent cases: Caldwell Luc Op
 Medical (steroids) usually no effect
 Topics That Appeared Multiple Times In Past Ppr
EAR
 Tympanometry
 Tympanoplasty and its types
 Presbycusis
 Nystagmus
 Benign paroxysmal positional vertigo (BPPV)
 Furuncle of ear
 Otomycosis
 Malignant Otitis externa
 Foreign body and Ear wax management
 Middle ear disorders (Specially Otitis media with effusion)
 Cholesteatoma and CSOM
 Otosclerosis
 Referred causes of Otalgia
NOSE
 Furuncle of nose
 DNS
 Spetal abscess
 Septal haematoma
 Atrophic rhinitis
 CSF Rhinorrhea
 Nasal polyps
 Epistaxis
 Allergic fungal rhinosinusitis
THROAT
 DDs of Oral ulcers (Table)
 Adenoids
 Nasopharyngeal angiofibroma
 Nasopharyngeal cancer
 Acute and Chronic tonsillitis
 Faucial diphtheria
 Peritonsillar abscess
 Acute epiglottitis
 Stridor causes and management
 Carcinoma Larynx
 Tracheostomy
 Post cricoid carcinoma
 Dysphagia causes + management
SURGERIES
 Septoplasty
 SMR
 Types of mastoid surgeries
 Tonsillectomy
 Adenoidectomy
 DDs of conductive hearing loss and sensorineural hearing loss
 DDs of unilateral and bilateral nasal obstruction
 DISCLAIMER
I have included more topics than necessary in the guide to cover all the bases. You probably don’t need to them
all. So prioritize the ones marked Essential, IMP, Past Ppr Q and in bold

Also sometimes different editions have different chapter no. or page no. although I have tried my best to avoid
this but if you still encounter any such problem take a deep breath and turn over some pages. You will surely
find these topics. I BELIEVE IN YOU!! (It’s not like they are going to change the disease names any time
soon).

PS: If you happen to find any sarcasm. Ignore it! It’s not easy making this!
 SECTION 1 EAR

Chapter 1 Anatomy of Ear

 Overview of Ext and middle Ear for Viva and MCQs (plus blood and nerve supply)
 Mastoid Air Cells Names Past Ppr Q

Chapter 2 Physiology
 Semicircular Canal for viva
 Motion sickness

Chapter 3 Audiology
For MCQs mainly aaand viva

Chapter 4 Assesment of Hearing

 Types of Hearing Loss IMP
 Tuning Fork Test All 6 of them esp. the Negative Rinne
 Uses of Audiogram
 Roll over phenomenon pg. 26 IMP
 Tympanometry wave types V.IMP
 Acoustic Reflex
 Recruitment Phenomenon IMP
 BERA wave types pg. 29
 OAEs

Chapter 5 Hearing Loss
 Characteristics of both Conductive and SN hearing Loss
 Avg Hearing Loss Db values for MCQs
 Tympanoplasty Complete V.IMP Past Ppr Q
 Conductive Hearing Loss DDs Table 5.1 + 2 Past Ppr Q
 Myringoplasty
 Acquired SN Hearing loss causes
 Labrynthitis
 Ototoxic Drugs
 Presbycusis V.IMP Past Ppr Q

Chapter 6 Assesment of Vestibular Function

 Nystagmus with types IMP
 Fistula Test Past Ppr Q
 Peripheral vs Central Nystagmus Table 6.2 IMP Past Ppr Q
 Dix Hallpike Test IMP
 Caloric Test overview (REMEMBER it’s for lateral Semicircular canal - MCQS)
Chapter 7 Disorders of Vestibular Systems
 BPPV Past Ppr Q
Tip: Patient has vertigo only in some positions of head movement = BPPV 100%
For diagnosis Do Dix Hallpike Manoeuvre
For Treatment Do Epley Manoeuvre aur bs
Is ke illawa Diagnosis ya treatment ke lie apne pass se koi bhi cutting edge options ijaad krne ki
bilkul bhi koi zarurat nahi ha.
 Vestibular Neuronitis Viva
 Causes of Vestibular Disorders Table 7.1 Past Ppr Q

Chapter 8 Diseases of Ext Ear

 Hematoma of the Auricle
 Furuncle IMP Past Ppr Q
Tip: See Recurrent Furunculosis - Fav Viva Q
 Otomycosis IMP Past Ppr Q
 Malignant Otitis Externa is V.IMP in SEQ Viva MCQs and any other thing u can think of DONT
 SKIP THIS
Tip: Elderly diabetic with ear pain (+/- granulations or Facial Nerve prob) think MOE
 Impacted Wax down to the last line (and yes that includes the composition of soda bicarb) is a
FAV viva Q
 Removal of foreign bodies
 Keratosis Obturan Past Ppr Q
 Rupture of Tympanic Membrane Past Ppr Q
 Tympanosclerosis

Chapter 9 Eustachian Tube

 Anatomy + Table 9.1 for MCQs
 Patulous Eustachian Tube

Chapter 10 Middle Ear COMPLETE is ESENTIAL

 Otitis media All types are the 2nd Most IMP topic in ENT (Jise ye nahi ata us ne pass nahi hona)
 Stages of ASOM V.V.IMP Recurrent Past Ppr Q
 The treatment Options
 OME diagnostic features (sometimes only hear loss) IMP
 Complications of OME
Tip: The diagnostic test for OME is impedance audiometry= shows flat curve

Chapter 11 Chronic Otitis Media COMPLETE is ESENTIAL

 Cholesteatoma Theories V.IMP Past Ppr Q
 CSOM Types + Differences Table 11.1
 Alternative Classification
 Treatment for Atticoantral CSOM V.IMP Recurrent Past Ppr Q ( Don’t just write down canal wall
 up and down there are sub procedures written within them) + the table
 TB and syphilis are probably not going to be asked
Tip: Cholesteatoma Theories with Atticoantral treatment has appeared nearly every year without any
statement change.
Chapter 12 Complications of CSOM
 Classification
 Overview Mastoiditis, Labrynthitis, Meningitis, Otogenic Brain Abscess, Sigmoid Sinus
 thrombophlebitis
 Bezold Abscess pg 87 Past Ppr Q

Chapter 13 Otosclerosis COMPLETE is ESENTIAL

 Do everything esp the DD
Tip: 20-30 Yr old Pregnant Female with bilateral conductive loss

Chapter 14 Facial Nerve Disorders

 The anatomy is a FAV viva Q
 Surgical landmarks Past Ppr Q
 Bells palsy IMP
 Ramsay Hunt Syndrome IMP
 See Fracture of Temporal Bone Table 14.2
 Topodiagnostic Test Past Ppr Q
 Crocodile Tear + Frey Syndrome IMP
 Surgery of Facial Nerve Past Ppr Q

Chapter 15 Meniere Disease COMPLETE is ESENTIAL

 Do everything
Tip: Mostly male with episodic unilateral Hearing loss + vertigo and ear fullness

Chapter 16 Tumours Ext Ear

 Osteoma vs Exostosis pg 118
Chapter 17 Tumour Middle Ear and Mastoid
 Glomus Tumour

Chapter 18 Acoustic Neuroma

 Overview and diff from Meniere is IMP

Chapter 19 Deaf Child

Skip everything except the 3 Obj test in assesment of hearing Past Ppr Q (will only come if u
have really really bad luck)

Chapter 20 Rehabilitation
 Components of Cochlear Implant Past Ppr Q

Chapter 21 Otalgia
 Causes esp Referred is a Past Ppr Q

Chapter 22 Tinnitus
Read
 SECTION 2 NOSE
Chapter 23 Anatomy of Nose
 Read for MCQs or not it’s very hard to retain any of it but do read The turbinates and meatuses
 Nerve Supply Fig 23.9

Chapter 24 Physiology
 Humidification for MCQs

Chapter 25 Diseases of Ext Ear

 Saddle, Hump and Crooked Nose
 Types of Dermoid Fig 25.3 Heading
 Furuncle IMP Past Ppr Q
 Vestibulitis

Chapter 26 Nasal Septum COMPLETE is ESENTIAL

 Types of Fracture
 DNS types IMP
 Septal Hematoma (trauma history and soft fluctuant) vs Septal Abscess (fever pain lymph
 nodes) are Past Ppr Q
 Complications of Septal Abscess
 Causes of Perforation (Most common surgery - pls dont say cocaine)

Chapter 27 Acute Chronic Rhinitis

 Atrophic Rhinitis Complete V.IMP Past Ppr Q

Chapter 28 Granulomatous Diseases

 Aspergillosis, Mucor and Wegners
 Mucor is a Past Ppr Q
Tip: Black necrotic patches in nose = Mucor

Chapter 29 Misc Disorders

 Foreign Body and Rhinolith are V.IMP
 Read the rest
 CSF Rhinorrhoea IMP Past Ppr Q
 Diff vs nasal secretions Table 29.1

Chapter 30 Allergic Rhinitis

 Is not imp just Read or even skip
 But see ARIA Table 30.1

Chapter 31 Vasomotor Rhinitis

 Read esp the other forms of allergic rhinitis
Chapter 32 Nasal Polyp COMPLETE is ESENTIAL
 The parts of Antrochonal Polyp IMP Past Q
 The DDs for Unilateral and Bilateral Nasal Obstructions Table IMP RECURRENT PAST PPR Q
 Causes of Ethmoidal Polyp
 Differences Table 32.3 IMP
Tip:
Investigation of Choice is Non Contrast CT Nose and Paranasal sinuses
Ethmoidal polyp is bilateral and causes bony erosion, broadening of nose and intercanthal
distance for diagnosis. Also the age diff and laterality of the 2 polyps.

Chapter 33 Epistaxis COMPLETE is ESENTIAL

 For SEQ MCQs and esp Viva

Chapter 34 Trauma to Face

 Types of Nasal Fractures Depressed and Angulated pg 204
 Open and Closed reduction
Were both the most Fav VIVA Q in our Prof
 The 3 Fractures of Maxilla
 Fracture or Mandible Fig 34.8 CABS
 Oroantral Fistula Just an idea (Hint: it’s a fistula - thnk me later)

Chapter 35 Paranasal Sinus

 Ethmoid Air cell Names
 The time at which each sinus appears in life

Chapter 36 Acute Rhinosinusitis

 Classification
 Frontal sinusitis Past Ppr Q
Tip: Patient with Office headache(happens in mid-day)
 Complication of Ethmoid Sinusitis Past Ppr Q

Chapter 37 Chronic RhinoSinusitis

 Read Both types
 Fungal Infection V.IMP Past Ppr Q
 Bent and Cuhn Criteria for fungal infections i.e:
Chapter 38 Complications of Sinusitis
 Pott Puffy Tumour (single Line in osteomyelitis)
 Complications Table 38.1 Past Ppr Q
 Cavernous sinus Thrombosis Past Ppr Q
 Route of Infection Table 38.2 ( Sir Nukhbat doesn’t accept the route for Nose and Danger area of
 face)

Chapter 39 Neoplasm of Nasal Cavity

 Inverted papilloma
 Esthesioneuroblastoma

Chapter 40 Neoplasm Of Paranasal Sinus

 Officially you are supposed to know the classification of Maxillary CA but it’s impossible so you
can skip it
 Incision Fig 40.9

Chapter 41 Proptosis
 Causes Table 41.1
 And the Last paragraph of the Chapter for MCQs
 SECTION 3: ORAL CAVITY
Chapter 43 Common Disorders
 DD for oral Ulcer Table 43.1 has appeared so many times in Past Ppr I have lost count
 Vincent Infection
 Apthous Ulcer
 Behcet Syndrome
 Lichen planus
 Ankyloglossia
 Submucous Fibrosis (is not going to come unless u have really bad luck)

Chapter 45 Non Neoplastic Disorders of Salivary Gland

 Read Definitions
Chapter 46 Neoplams of Salivary Gland
 Just read them you will cover them in patho:
 Pleomorphic AdenoCA
 Mucoepidermoid CA
 Adenoid cystis CA
 SECTION 4: PHARYNX
Chapter 47 Anatomy
 Nasopharynx Boundary is a Fav Viva Q
 For the rest read for MCQs
Chapter 48 Adenoids COMPLETE is ESENTIAL
 Adeniods are nearly as IMP as Tonsilitis
 Blood/Nerve supply
 The symptoms esp Adenoid facies
 Skip Nasopharyngitis
 The def of the Thornwaldt Disease is enough
 Tip: If it’s a child with dull look bilateral hearing loss mouth breathing - its adeniods 100%

Chapter 49 Tumour of Nasopharynx COMPLETE is ESENTIAL

 For Angiofibroma
 Its Location is IMP
 And the age group/gender is V.V.IMP
 Holman Miller sign (Fav Viva Q) IMP
 Surgical Treatment Just Names of the operations i.e. all 8 Past Ppr Q
 Options for recurrent Tumour
 Tip: 10-20 Male with spontaneous/recurrent epistaxis= Angiofibroma 100%. Investigation of
choice is CT with Contrast (Don’t forget the contrast)
 For Nasopharngeal CA
 Types Table 49.3
 Cervical Mode Mets IMP
 Treatment (opp. of angiofibroma)
 Ho Triangle Fig 49.6 Heading
 TNM in Table 49.4 (if u can manage to do it - no one can btw)

Chapter 51 Tonsillitis COMPLETE is ESENTIAL

 Is the Single Most IMP chapter in ENT (Jise ye na ayea us ne nahi pass hona)
 Bed of Tonsil (see figure for visual aid)
 Blood/Nerve Supply V.V.IMP Recurrent Past Q
 The Types of acute tonsilitis wth their features IMP
 Complications IMP
 Vincent angina
 Chronic Tonsillitis Defintion (3-4 attacks of acute tonsilitis in a year for consec 2 years)
 Irvin Moore Sign (Google)
 The 3 main complications for Chronic: cyst abscess stone
Tip: The diagnosis of acute and chronic cases are diff so be careful plus it could present with a
complication
 The DDs for membrane over tonsils have come in Past Ppr
Chapter 52 Head and Neck space Infections
 Ludwig Angina IMP
 Quinsy V.IMP Past Ppr Q Sooooo Many Times
 Prevertebral Abscess Past Ppr Q
 Parapharnygeal abscess Feature and Complication have appeared in Past Ppr

Chapter 53 Tumour of Oropharynx

 Styalgia

Chapter 54 Tumour of Hypopharynx

 Postcricoid CA V.IMP Past Ppr Q
Tip: Female with iron def. and dysphagia
 Pharyngeal Pouch for Viva

Chapter 55 Snoring and Sleep Apnoea

 Causes
 Section 5 LARYNX AND TRACHEA
Chapter 56 Anatomy
 For MCQs and Viva

Chapter 58 Acute and Chronic Inflammations

 Acute Epiglottis V.IMP Past Ppr Q
TIP: Child with drooling, protruding tongue and in tripod position
 Laryngotracheobronchitis
REMEMBER the age group and the cause.
 The diagnostic sign are: Age seal bark cough Steeple sign on Radiology(see Table 58.1)
 Treatment Options esp. the Hospitalization part
REMEMBER intubation is Done before Tracheostomy
 Reinke Edema esp. the boundaries for viva

Chapter 59 Congenital Lesions and Stridor

 Laryngomalacia IMP Paat Ppr Q
 TIP: Stridor increases on crying but stops in prone position with cry being normal
 Larngeal Web has weak Cry
 Stridor Types + Causes IMP Past Ppr Q

Chapter 60 Laryngeal Paralysis

 IMP for both MCQs and Viva

Chapter 61 Benign Tumours

 Vocal Nodule IMP are bilateral
 Vocal Polyp is typically unilateral
 Juvenile Papillomatosis IMP Past Ppr Q

Chapter 62 Laryngeal CA COMPLETE is ESENTIAL

 Incidence in Male 40-79 Years IMP
 Risk Factors
 Table 62.2 TNM (if u can)
 Remember each type presents differently: The glottic CA is the only one with early hoarseness and also
the Most IMP
 Diagnosis of CA Past Ppr Q
 Treatment Options IMP
 T2N0 Cancer in Fig 62.7 (Fav Viva Q)
 Method of communication Table 62.3
TIP: Male smoker within danger age group presents with hoarseness for last 6 months = Larynx CA
(This has appeared soooo many times in Past Ppr -They don’t even change the scenario)

Chapter 63 Voice and Speech

 Read these
 Table 63.1 Causes of Hoarseness
 Stuttering
  Rhinolalia
 Phonasthenia

Chapter 64 Tracheomstomy COMPLETE is ESENTIAL

 Tracheostomy vs. Tracheotomy
 Functions for Tracheostomy and Types
 Indication for High Tracheostomy
 Table 64.1 Indications V.IMP ( Add 2 more Resp. failure and Resp. Paralysis so total 5 Rs -
 courtesy Sir Nukhbat)
 PostOp Care Past Ppr Q
 Complications V.IMP Recurrent Past Ppr Q
 Procedures for immediate Airway management has appeared once in past ppr somewhere
 Tracheostomy Tubes in The Chapter titled Instruments pg 524

Chapter 65 Foreign Bodies

 Vegetal Bronchitis

SECTION 6 THYROID
Skip Yayyyyyyy

SECTION 7 ESOPHAGUS
Chapter 67 Anatomy
 MCQs and Viva
Chapter 68 Disorders
 Corrosive Burn Management IMP Past Ppr Q
 Stricture Treatment IMP Past Ppr Q
 Plummer Vinson syndrome IMP
 You can read the motility disorders

Chapter 69 Dysphagia
 Esophageal Causes have appeared mannny times in Past Pprs
 Investigations

Chapter 70 Foreign Bodies

 The 5 sites IMP
 Investigations
 Rigid vs flexible esophagoscopy
 Complications Past Ppr Q
 Disc Battery
 SECTION 8 RECENT ADVANCES
Is not IMP at all because duhh they are recent and we are in a 160+ Yr. old institution we don’t do that here.
You can either burn it, tear it, throw it or all of them but probably not in that order.
 SECTION 9 CLINICAL METHODS AND NECK MASSES
Chapter 76 Clinical methods
 Read this or watch Selfless medicose vids
HINT: The vids are better
 The 7 Lvls of lymph Nodes Table 76.1 pg 441 IMP
 Neck Dissection Types and Incisions is a Past Ppr and Viva Q

Chapter 77 Neck Masses

 The names of Ant and Lateral Masses in fig 77.1 + 2 Past Ppr Q
 Branchial Sinus/Fistula Past Ppr Q
 Plunging Ranula
 Carotid Body Tumour Past Ppr Q
 Cystic Hygroma Definition

SECTION 10 OPERATIONS
Chapters you need to do ESSENTIALLY COMPLETE:
 SMR
 Septoplasty
 Tonsillectomy
 Adenoidectomy
Only Complicatons and Indications of the Following:
 Myringotomy
 All 3 Mastoidectomy(plus Definitions) IMP Past Ppr Q
 Myringoplasty(also see underlay overlay)
 Caldwell Luc
 Endoscopic Sinus Surgery

 Incisions In Chapter 79 Ear Surgery Approaches

 Proof Puncture, Bronchoscopy, Esophagoscopy have appeared once in Past ppr they are probably never
going to come again

Chapter 96 Imaging Techniques

 V.IMP For Viva
 Water and Caldwell Luc view for Paranasal Sinus
 X ray Views for Nasal Fracture
(Bonus Points if you know the reference)