[HAADENT] HAAD ENT DOH
Licensureination for ENT Certification Exam
Guide
**Question 1.** Which of the following is the most common causative organism of acute otitis
media in children?
A) Staphylococcus aureus
B) Streptococcus pneumoniae
C) Pseudomonas aeruginosa
D) Haemophilus influenzae
Answer: B
Explanation: Streptococcus pneumoniae accounts for approximately 30‑40 % of acute otitis
media cases, making it the leading bacterial pathogen in pediatric patients.
**Question 2.** A 45‑year‑old patient presents with conductive hearing loss and a positive
Carhart’s notch on audiometry. The most likely diagnosis is:
A) Otosclerosis
B) Chronic suppurative otitis media
C) Cholesteatoma
D) Meniere’s disease
Answer: A
Explanation: Otosclerosis causes a characteristic dip at 2 kHz (Carhart’s notch) due to stapedial
footplate fixation, producing conductive loss.
**Question 3.** In the Epley maneuver for posterior canal BPPV, the patient’s head is turned to
the affected side by 45°. What is the next position after the first movement?
A) Head turned 45° to the opposite side
B) Patient rolled onto the unaffected side
C) Patient remains supine for 2 minutes
, [HAADENT] HAAD ENT DOH
Licensureination for ENT Certification Exam
Guide
D) Head extended 30° backward
Answer: A
Explanation: The Epley sequence proceeds by rotating the head 45° to the opposite side while
maintaining neck extension, to move otoconia out of the posterior canal.
**Question 4.** Which of the following is the first‑line medical therapy for Meniere’s disease?
A) Intratympanic steroids
B) Systemic antibiotics
C) Low‑salt diet and diuretics
D) High‑dose corticosteroids
Answer: C
Explanation: Lifestyle modification with a low‑salt diet and diuretics reduces endolymphatic
hydrops, forming the cornerstone of initial Meniere’s management.
**Question 5.** The House‑Brackmann grading system assesses facial nerve function. A
grade IV indicates:
A) Normal function
B) Slight weakness, barely noticeable
C) Moderately severe dysfunction, obvious asymmetry
D) Complete paralysis
Answer: C
Explanation: Grade IV denotes moderately severe dysfunction with obvious asymmetry, but
some movement at the mouth corner is still possible.
, [HAADENT] HAAD ENT DOH
Licensureination for ENT Certification Exam
Guide
**Question 6.** Which of the following is the most common cause of otitis externa
(“swimmer’s ear”)?
A) Staphylococcus epidermidis
B) Pseudomonas aeruginosa
C) Candida albicans
D) Streptococcus pyogenes
Answer: B
Explanation: Pseudomonas aeruginosa thrives in moist environments and is the predominant
pathogen in acute otitis externa.
**Question 7.** A patient with chronic suppurative otitis media (CSOM) develops a painless,
foul‑smelling ear discharge. The most appropriate next step is:
A) Immediate mastoidectomy
B) Topical antibiotic ear drops
C) Systemic corticosteroids
D) Myringotomy with tube placement
Answer: B
Explanation: Topical antibiotics are first‑line for CSOM with mucopurulent discharge; surgery is
reserved for complications or refractory disease.
**Question 8.** In cholesteatoma surgery, which structure is most at risk for injury during canal
wall down mastoidectomy?
A) Facial nerve canal
B) Stapedial tendon
C) Cochlear nerve
, [HAADENT] HAAD ENT DOH
Licensureination for ENT Certification Exam
Guide
D) Internal carotid artery
Answer: A
Explanation: The facial nerve runs in the fallopian canal close to the posterior ear canal; careful
dissection is required to avoid injury during mastoidectomy.
**Question 9.** Which audiometric pattern is typical for sensorineural hearing loss due to
presbycusis?
A) Flat loss across all frequencies
B) Downward sloping loss, greater at high frequencies
C) Upward sloping loss, greater at low frequencies
D) Notch at 4 kHz
Answer: B
Explanation: Presbycusis typically presents as a high‑frequency descending (sloping)
sensorineural loss.
**Question 10.** A 60‑year‑old man presents with unilateral pulsatile tinnitus, hearing loss,
and a blue‑red mass behind the tympanic membrane. The most likely diagnosis is:
A) Glomus tympanicum tumor
B) Cholesteatoma
C) Otosclerosis
D) Acute otitis media
Answer: A
Explanation: Glomus tympanicum (paraganglioma) presents as a vascular, pulsatile mass in the
middle ear with associated tinnitus and conductive loss.
Licensureination for ENT Certification Exam
Guide
**Question 1.** Which of the following is the most common causative organism of acute otitis
media in children?
A) Staphylococcus aureus
B) Streptococcus pneumoniae
C) Pseudomonas aeruginosa
D) Haemophilus influenzae
Answer: B
Explanation: Streptococcus pneumoniae accounts for approximately 30‑40 % of acute otitis
media cases, making it the leading bacterial pathogen in pediatric patients.
**Question 2.** A 45‑year‑old patient presents with conductive hearing loss and a positive
Carhart’s notch on audiometry. The most likely diagnosis is:
A) Otosclerosis
B) Chronic suppurative otitis media
C) Cholesteatoma
D) Meniere’s disease
Answer: A
Explanation: Otosclerosis causes a characteristic dip at 2 kHz (Carhart’s notch) due to stapedial
footplate fixation, producing conductive loss.
**Question 3.** In the Epley maneuver for posterior canal BPPV, the patient’s head is turned to
the affected side by 45°. What is the next position after the first movement?
A) Head turned 45° to the opposite side
B) Patient rolled onto the unaffected side
C) Patient remains supine for 2 minutes
, [HAADENT] HAAD ENT DOH
Licensureination for ENT Certification Exam
Guide
D) Head extended 30° backward
Answer: A
Explanation: The Epley sequence proceeds by rotating the head 45° to the opposite side while
maintaining neck extension, to move otoconia out of the posterior canal.
**Question 4.** Which of the following is the first‑line medical therapy for Meniere’s disease?
A) Intratympanic steroids
B) Systemic antibiotics
C) Low‑salt diet and diuretics
D) High‑dose corticosteroids
Answer: C
Explanation: Lifestyle modification with a low‑salt diet and diuretics reduces endolymphatic
hydrops, forming the cornerstone of initial Meniere’s management.
**Question 5.** The House‑Brackmann grading system assesses facial nerve function. A
grade IV indicates:
A) Normal function
B) Slight weakness, barely noticeable
C) Moderately severe dysfunction, obvious asymmetry
D) Complete paralysis
Answer: C
Explanation: Grade IV denotes moderately severe dysfunction with obvious asymmetry, but
some movement at the mouth corner is still possible.
, [HAADENT] HAAD ENT DOH
Licensureination for ENT Certification Exam
Guide
**Question 6.** Which of the following is the most common cause of otitis externa
(“swimmer’s ear”)?
A) Staphylococcus epidermidis
B) Pseudomonas aeruginosa
C) Candida albicans
D) Streptococcus pyogenes
Answer: B
Explanation: Pseudomonas aeruginosa thrives in moist environments and is the predominant
pathogen in acute otitis externa.
**Question 7.** A patient with chronic suppurative otitis media (CSOM) develops a painless,
foul‑smelling ear discharge. The most appropriate next step is:
A) Immediate mastoidectomy
B) Topical antibiotic ear drops
C) Systemic corticosteroids
D) Myringotomy with tube placement
Answer: B
Explanation: Topical antibiotics are first‑line for CSOM with mucopurulent discharge; surgery is
reserved for complications or refractory disease.
**Question 8.** In cholesteatoma surgery, which structure is most at risk for injury during canal
wall down mastoidectomy?
A) Facial nerve canal
B) Stapedial tendon
C) Cochlear nerve
, [HAADENT] HAAD ENT DOH
Licensureination for ENT Certification Exam
Guide
D) Internal carotid artery
Answer: A
Explanation: The facial nerve runs in the fallopian canal close to the posterior ear canal; careful
dissection is required to avoid injury during mastoidectomy.
**Question 9.** Which audiometric pattern is typical for sensorineural hearing loss due to
presbycusis?
A) Flat loss across all frequencies
B) Downward sloping loss, greater at high frequencies
C) Upward sloping loss, greater at low frequencies
D) Notch at 4 kHz
Answer: B
Explanation: Presbycusis typically presents as a high‑frequency descending (sloping)
sensorineural loss.
**Question 10.** A 60‑year‑old man presents with unilateral pulsatile tinnitus, hearing loss,
and a blue‑red mass behind the tympanic membrane. The most likely diagnosis is:
A) Glomus tympanicum tumor
B) Cholesteatoma
C) Otosclerosis
D) Acute otitis media
Answer: A
Explanation: Glomus tympanicum (paraganglioma) presents as a vascular, pulsatile mass in the
middle ear with associated tinnitus and conductive loss.
