OSCE exam for IMM & Part II

Prepared by Dr. Montasir Junaid

1
• Name the instrument shown.
• Enumerate its uses.

2
• Comment on the Ear drum
• Identify the numbered
structures in the figure
• Probable causes of
retracted drum.

3
• 30 years old female c/o:
Recurrent fractures of Metatarsal bones, hearing loss both ears - 8
years,No ear discharge.
• What is the most
likely diagnoses?
• What are the characteristic
features of the disease?
• What type of hearing loss
is shown in audio gram?
4
5 yr old child , excruciating pain in Rt ear -6hrs
Past h/o URTI-4 days. Otoscopy shows the
following:
• Diagnosis
• Various stages of this
disorder
• Treatment

5
• Why is the canal narrow?
• Enumerate differentials?
• What clinical problems pt. experience?
• How will you treat such condition ?

6
• Name the investigation?
• What is the likely
diagnosis?
• What other
investigations are
needed to reach to a
conclusion?
• What are the clinical
features of this disease?

7
• What is the investigation
shown?
• What is the likely
diagnosis?
• What is the
pathophysiology
of the disease?
• How will you treat it?
8
58 yr old female, c/o pulsatile
tinitus-3yr Rt. Ear, Decrease
hearing -2 years. Otoscopic
findings:

• Differential diagnosis?
• Probable diagnosis?
• Classic sign shown here?
• Possible clinical features
of this disease?
9
• What the investigation
showing?
• What is likely diagnosis?
• What is the
Pathophysiology of the
disease?
• How will you treat it?

10
• 55 yrs old male
h/o smoking, now with nasal
blocakge, epistaxis and anosmia.
• List differential diagnosis?
• How will you investigate
such case?
• What is the investigation
shown?

11
• Name each
Incision?
• Give at least 1
complication of
each type?

12
Premature 4month old brought
to E.R cyanosed, mother says it
worsens on crying.
• Likely diagnosis?
• Risk factors of this
disease?
• Complication arising secondary
to this
condition?
• How will you
manage such a case? 13
• Name the 5
investigation?
• Identify the
6
structures
numbered 1-6? 1
3

4
2

14
• What is likely
diagnosis?
• Enumarate
different
treatment option
available?

15
• What is the
investigation?
• Comment on the
findings?
• What is the sign
called?
• In which clinical
condition you will
find such a sign?
16
• What is the
investigation?
• Comment on the
findings?
• What is the sign
called?
• In which clinical
condition you will find
such a sign?
17
• Name the incision?
• What surgery could be performed
through this incision?
• What is the significance
of this area?

18
16 yrs old, came in E.R with
high grade fever and difficulty
opening mouth, he has
mufffled voice:

• What is the likely

diagnosis?
• How will treat such
patient?
• What is long term
management?
19
• What is the
investigation shown?
• Comment on the blue
aero?
• What is the likely
diagnosis?
• What other clinical
features are present in
such condition?
20
• What is the
investigation?
• Name the anatomical
structures arrows show?
• Give three differential
diagnosis?
• What other investigation
you would do to reach to
a definitive diagnosis?

21
• What is the
investigation shown?
• What is the likely
diagnosis?
• What are the clinical
features of this
condition?

22
• Name the
instrument
shown?
• Which surgery is it
commonly used ?
• Name the
advantages of
using this
instrument?
23
• Name this surgical
procedure?
• Name 4 indications of
this surgical
procedure?
• What is the most
common complication
of this procedure?

24
13 years old boy came
with c/o pain in the throat
(intense) 4 days Fever ++
• Describe this lesion.
• List Differential
diagnosis?
• What is the Likely
diagnosis?

25
• An 8 yrs old boy in ER
with breathing difficulty
• What is the investigation?
• What is the likely
diagnosis?
• How will you treat such
case?

26
• 14yrs old boy with nasal blockage
and epistaxis:
• What is the likely diagnosis?
• List investigations which will help in
diagnosis?
• What are the different treatment
options available.
• Name different surgical approaches.

27
• Name the given
approach?
• What are the
conditions in which
this approach can be
used?
• List Cons and Pros
for this approach?

28
• What Is the likely
diagnosis?
• What other
investigations helps
to support the
diagnosis?
• How will you treat
such a case?

29
32 yrs old male, h/o nasal
necrotic lesion.
• Enumerate
differentials?
• What investigations
will conclude
diagnosis?

30
• List the
deformities
shown

• What
techniques are 1
2
available to 4
3
correct such
deformity?
31
• What is the
investigation shown?
• What is anatomical area
arrow indicates?
• What is the likely
diagnosis?
• What is the name of
incision used to resect
such lesions?
32
• Adolacent male, h/o
trauma followed epistaxis
and nasal bloackage
• Likely diagnosis?
• How will you treat such
condition ?
• What will you do to
prevent such condition in
post-operatively?
33
• What is the investigation
shown?
• What are the
differentials?
• What is the likely
diagnosis?
• What are other clinical
findings will be there in
such a patient?
34
• What is dye called?
• Where is it used?
• What is the
concentration used
in ENT practice?
• What are the
complications
associated with it?

35
• Enumerate
differentials?
• What is the likely
diagnosis?
• Name the
investigations?
• What is the
treatment?

36
• What is the incision
name?
• Write surgical
landmarks for,
medial and Total
maxillectomy

37
 1 2 3 4

5
6 7 8

• What is the investigation shown?

• Enumerate likely diagnosis for each.

38
• What could be the
possible differential
diagnosis ?
• Name the clinical
tests you would do in
this patient ?
• List of investigations
that will help to
reach to a diagnosis?
39
• What is the investigation
shown?
• What is the likely
diagnosis?
• Why is the condition
most common in
submandibular gland?

40
• What is the likely
diagnosis?
• What causes this
condition?
• Name the
organism
involved?
• How will you
treat such a case?
41
• Name the incision?
• In which procedure it
is used?
• What is its
advantage?

42
• Name the muscle
shown?
• What are the
structures lying
just underneath
this muscle?

43
• Name the
structure shown?
• Where is it used?
• What are the
advantages?

44
62 yrs old man, smoker
with hoarseness.
• Likely diagnosis?
• How will you investigate?
• What is the staging of
this particular case?
• What treatment options
are available to treat
such a case?
45
• Name the
instrument shown
in picture.
• Write where it is
used?

46
• What are the complications
arising immediately after
shown surgery?
• How will you calculate the
serum Ca+2 deficit?
• How do you manage tetany?

47
• What is the
instrument name?
• Write down its
uses.

48
• Name the shown
instrument.
• What are its
uses?

49
• Name the instrument ?
• What are its uses?

50
• Name the instrument.
• Enumerate its uses.

51
• Identify the instrument.
• Enumerate its uses
52
23 yrs old primigravida,
complaints of hearing loss
• What is the disease
process shown in
histopath?
• What is the
pathophysiology?
• Write down the
treatment options
for the given disease?
53
Young boy c/o central neck
swelling moves on protruding the
tongue
• What is the most likely
diagnosis?
• How will you identify the
aberrant thyroid?
• Name the sites where
aberrant thyroid can be
found?
• How will you treat such a
case?
54
• 6 yrs girl, c/o hoarseness, and
breathing difficulty, h/o some
laryngeal surgery in the past.
• What are the differentials in
such a case?
• What is the likely diagnosis?
• What is etiology of this disease?
• What are the treatment options
available?
55
• What is the likely diagnosis?
• What is the pathpysiology
of the disaease?
• What are the hallmark of
the disease?
• How do you treat the
condition in its acute
phase?
• How is it treated in long
term? X=left, O=right

56
26 yrs old female has difficulty
swallowing, given are the
findings of tongue and lips

• What is the likely diagnosis?

• What are the sign and
symptoms of this disease?
• What investigations are
required to reach to a
diagnosis?

57
6yrs old boy with
unilateral nasal
bloackage and
discharge
• Write differentials?
• What is the
syndrome associated
with this disease?
• How do you treat
such a case?
58
A 6 yrs boy h/o snorring
& nasal bloackage, body
mass index >30 and
decrease hearing B/L
• What could be the
differentials
• What investigations
should be done to
reach to a conclusion?
59
• What does the post-
op picture show?
• What was the
surgery performed?
• Name complications
associated with such
a procedure?

60
• 39 yrs old beetle nut addict
comes with non healing ulcer
2x 1.5cm for 8 month and left
side level II single node
(approx 3cm )
• What is the likely diagnosis?
• How will you investigate such
a case?
• What is the TNM for the given
scenario?
61
• Name the instrument ?
• What procedure is it used in?
• Name the complications of such procedure? 62
42 yrs male, Alcoholic, h/o
recurrent red patch over
tongue.

• What are the

differentials?
• What is the likely
diagnosis?
• How will you treat such
a case?
63
• Identify the
instruments
• Name the
surgery in
which it is
used?
• What’s the
purpose of the
instrument?
64
• Identify the deformity?
• What complications arise
if not treated?
• What is the treatment?
• Name the instrument
used during its treatment?
• Name the complications
arising secondary to its
treatment?
65
14 yrs old boy, H/o copious ear
discharge, foul smelling, now
with post-auricular swelling.

• What is the diagnosis?

• What are routes of infection in

Ear?
• Name the Complications
arising from the given
condition if left untreated. 66
26 yr male, hemangioma left
lat border of tongue, advised
laser resection

• What laser works best on

hemangioma?
• Name other types of laser
used in ENT practice?
• What is the wavelength of
the laser used in this
specific case?
67
29 yrs old 8th post
thyroidectomy day pt. comes
with hoarseness. FODL shows
left cord paralysis.

• What other pertinent question

will you ask in history?
• Write the names of treatment
options are available?
• Write con and pros for each.
( 1 for every type)

68
• Name the Shown
maneuver?
• For which condition is it
performed for?
• What is the pathophysiology
of the disease?
• What treatment options are
available for the given
condition ?

69
• Enumerate and
classify different
reconstruction
options for such a
defect.

70
Thank you
and
Good Luck !

71