Otolaryngology (ENT) Question Bank

54 CME Credits


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Course Benefits:

  • One-year access to over 1,400 otolaryngology [ENT] questions mapped to the ABO, OTE, and AOBOO exams
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  • Correct your answers as you go with evidence-based rationales for the correct answers

Clinician FeedBack

Each question is written in a board-style format and each answer offers a detailed review of key concepts. We've been waiting for this type of ENT review material to be available to us and it's finally here." Danny Soares, Otolaryngology/Plastics Fellow at Emory University

Danny Soares - Otolaryngology/Plastics Fellow at Emory University

Otolaryngology [ENT] Sample Questions:

Question 1

A 25 year old male presents with a progressively enlarging left mandibular mass, which he says has enlarged progressively over the past few years. Prior to seeing you, he had a biopsy from his oral surgeon and was told that the diagnosis was ameloblastoma. CT scan shows the following findings. What is the most appropriate treatment for this lesion?

A) Enucleation
B) Curettage
C) Aspiration of cystic contents
D) Segmental mandibulectomy with 1.15cm bony margins

Answer
D) Segmental mandibulectomy with 1.15cm bony margins


Explanation
Correct: (D) Segmental mandibulectomy with 1.15cm bony margins. Explanation: The radiologic appearance on this scan is consistent with that of ameloblastoma, showing a 'soap bubble' multiloculated mandibular lesion. This is the most common odontogenic tumor of the jaw. This lesion arises from tooth enamel precursor cells. In cases of multiloculated ameloblastoma with thinning/erosion of bone, surgical resection involving 1-1.5cm margins is advocated to reduce the recurrence risks.

Reference
KJ Lee, Essential Otolaryngology Head and Neck Surgery. 10th Edition Chapter 25- Cysts and tumors of the jaw. Image from: http://en.wikipedia.org/wiki/Ameloblastoma#mediaviewer/File:CT_Scan.JPG


Question 2

A 58 year old male with history of T3N2bM0 tongue base squamous cell carcinoma is treated with primary chemoradiation. A one year post-treatment PET/CT reveals no evidence of oropharyngeal carcinoma but a 2 cm FDG avid right thyroid nodule is discovered incidentally. What is the next best step in the management of this patient?

A) Close observation with ultrasound assessment in 6 months
B) Close observation with repeat PET/CT in 6 months
C) Fine-needle aspiration biopsy
D) Thyroid lobectomy
E) Total thyroidectomy

Answer
C) Fine-needle aspiration biopsy


Explanation
Correct: (C) Fine-needle aspiration biopsy. Explanation: Approximately 1-2% of positron emission tomography scans for other reasons reveal incidental thyroid nodules. The risk of malignancy in 18FDG-positive nodules is about 33% and the cancers have a tendency to be more aggressive. Standardized uptake values (SUV) are significantly higher in malignant nodules compares to benign nodules. Because of the tendency for this nodule to be malignant, observation is not appropriate. A repeat PET/CT is not necessary. Going straight to surgery without definitive diagnosis is too aggressive at this point. The nodule should be biopsied with fine-needle aspiration first.

Reference
Soelberg KK, Bonnema SJ, Brix TH, Hegudus L. Risk of malignancy in thyroid incidentalomas detected by 19F-flouorodeoxyglucose positron emission tomography: a systemic review. Thyroid. 2012. Sep;22(9): 918-25.

Questions taken from the BoardVitals Otolaryngology (ENT) Question Bank.

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