SBA ENT 15 Single Best Answer (SBA)
1. A 25-year-old woman presents with a one-week history of right-sided facial weakness. She cannot close her right eye and has drooping of the right side of her mouth. Which of the following is the most likely diagnosis?
Answer: A. Bell's palsy
Explanation: Bell's palsy is an acute, unilateral, lower motor neuron facial nerve paralysis causing inability to close the eye and drooping of the mouth.
2. A 40-year-old man complains of progressive hearing loss in his right ear and tinnitus. MRI reveals a mass at the cerebellopontine angle. What is the most likely diagnosis?
Answer: A. Acoustic neuroma (vestibular schwannoma)
Explanation: An acoustic neuroma is a benign tumour of the vestibulocochlear nerve at the cerebellopontine angle causing hearing loss and tinnitus.
3. A child presents with sore throat, fever, and muffled voice. On examination, there is trismus and deviation of the uvula. What is the most likely diagnosis?
Answer: A. Peritonsillar abscess (quinsy)
Explanation: Peritonsillar abscess presents with sore throat, fever, trismus, and uvula deviation due to swelling beside the tonsil.
4. A 50-year-old man presents with unilateral nasal obstruction and recurrent nosebleeds. Examination reveals a mass in the nasal cavity. What is the most likely diagnosis?
Answer: A. Nasal carcinoma
Explanation: Unilateral nasal obstruction with recurrent epistaxis in an older adult suggests nasal carcinoma.
5. A 35-year-old woman presents with vertigo, hearing loss, and tinnitus in the left ear. The episodes last for several hours. What is the most likely diagnosis?
Answer: A. Ménière's disease
Explanation: Ménière's disease is characterised by episodes of vertigo, sensorineural hearing loss, and tinnitus lasting hours.
6. A 60-year-old man complains of hoarseness for the past two months. He is a heavy smoker and drinker. What is the most likely diagnosis?
Answer: A. Laryngeal carcinoma
Explanation: Persistent hoarseness in a smoker raises suspicion for laryngeal carcinoma.
7. A 5-year-old boy has difficulty breathing through his nose, snores at night, and has recurrent ear infections. What is the most appropriate management?
Answer: A. Adenoidectomy with insertion of grommets
Explanation: Enlarged adenoids can cause nasal obstruction and otitis media; adenoidectomy and grommets can relieve symptoms.
8. A 30-year-old woman complains of a mass in her neck that moves upwards on swallowing. What is the most likely diagnosis?
Answer: A. Thyroid nodule
Explanation: Thyroid nodules move on swallowing because they are attached to the thyroid gland.
9. A patient presents with sudden onset of severe vertigo lasting several hours, nausea, and vomiting. There is no hearing loss or tinnitus. What is the most likely diagnosis?
Answer: A. Vestibular neuronitis
Explanation: Vestibular neuronitis presents with acute vertigo without auditory symptoms.
10. A 4-year-old child presents with high fever, dysphagia, drooling, and sitting in a tripod position. What is the most likely diagnosis?
Answer: A. Epiglottitis
Explanation: Epiglottitis is an emergency in children characterised by fever, drooling, and airway obstruction.
11. A 55-year-old man complains of a painless, progressively enlarging mass in his neck. He has a history of smoking and alcohol use. What is the most likely cause?
Answer: A. Squamous cell carcinoma of the head and neck
Explanation: Painless neck mass in a smoker may indicate metastatic lymph nodes from head and neck squamous cell carcinoma.
12. A patient presents with recurrent episodes of vertigo triggered by changes in head position, lasting less than a minute. What is the most appropriate management?
Answer: A. Epley manoeuvre
Explanation: BPPV is treated with particle repositioning manoeuvres like the Epley manoeuvre to relocate otoliths.
13. A 45-year-old man presents with unilateral facial pain, nasal obstruction, and blood-stained nasal discharge. What is the most likely diagnosis?
Answer: A. Sinonasal carcinoma
Explanation: Unilateral symptoms with blood-stained discharge suggest a neoplastic process like sinonasal carcinoma.
14. A teenager presents with painless, recurrent nosebleeds and nasal obstruction. What is the most likely diagnosis?
Answer: A. Juvenile nasopharyngeal angiofibroma
Explanation: This vascular tumour occurs in adolescent males causing recurrent epistaxis and nasal obstruction.
15. A 4-year-old child presents with fever, earache, and discharge from the right ear. Examination reveals a red, bulging tympanic membrane. What is the most likely diagnosis?
Answer: A. Acute otitis media
Explanation: Acute otitis media typically presents with fever, pain, and a bulging tympanic membrane due to inflammation in the middle ear.
Total Score: 0/15