Clinical Med II: EENT Practice Exam
(Physician Assistant) PANCE Questions
with verified correct detailed answers
latest update 2025
A 16-year-old boy presents with a history of injury to his left pinna
while competing at a wrestling match. The superior outer portion of
the pinna is edematous and fluctuant to palpation. There is minimal
tenderness to palpation, and the patient is diagnosed with cauliflower
ear. Which of the following management decisions is most
appropriate?
A. refer the patient for incision and drainage (I&D) and pressure
dressing
B. have the patient return only if he develops a fever
C. apply a soft, bulky, and loose-fitting dressing to protect the pinna
D. prescribe a 10-day course of amoxicillin and schedule for a clinic
follow-up
E. perform an I&D only if the pinna becomes red and tender --- correct
answer ---A. refer the patient for incision and drainage (I&D) and
pressure dressing
,A 65-year-old male with a history of diabetes mellitus presents with
an acute episode of left facial paralysis. He is still able to wrinkle and
elevate both sides of his forehead. He denies recent viral illness or ear
pain. His diabetes has been well controlled. Examination of the TMs
and the external pinnae are normal. The Weber and Rinne tuning fork
assessments are normal. Visual acuity, extraocular movements, and
pupillary responses are all normal and equal bilaterally. Which of the
following is the most likely diagnosis?
A. Bell palsy
B. Ramsay-Hunt syndrome
C. Cerebrovascular accident
D. peripheral facial nerve palsy
E. diabetic neuropathy --- correct answer ---C. Cerebrovascular
accident
A patient presents with a 3-day history of vertigo associated with
turning over in his bed, which lasts for several minutes. There are no
other symptoms of the ear. Dix-Hallpike testing shows rotary
nystagmus, which diminishes with repeated testing. Which of the
following is the most likely diagnosis?
,A. central nervous system (CNS) lesion
B. positional vertigo
C. labyrinthitis
D. Meniere disease
E. vestibular neuronitis --- correct answer ---B. positional vertigo
A 33-year-old female presents with episodes of vertigo lasting about
20 minutes and associated with fluctuating hearing loss and a low-
frequency nonpulsatile tinnitus in the affected ear. After these
episodes of vertigo, the patient states that her hearing improves and
the tinnitus resolves. Which of the following illnesses is suggested by
these symptoms?
A. Meniere disease
B. Eustachian tube dysfunction
C. vestibular neuronitis
D. paroxysmal positional vertigo
E. none of the above --- correct answer ---A. Meniere disease
A 35-year-old male presents with a 1-week history of a marked
decrease of hearing in his right ear. He denies trauma, otorrhea, or
vertigo. The physical examination appears to be normal except for his
, tuning fork tests. The Weber test lateralizes to the better ear and the
Rinne test shows air conduction to be better than bone conduction in
both ears. After confirmation of your findings with an audiometric
evaluation, what would be the most appropriate treatment?
A. broad-spectrum antibiotic
B. nasal steroids
C. decongestant
D. oral steroids
E. antihistamines --- correct answer ---D. oral steroids
A 60-year-old female presents with an acute onset of left facial nerve
paralysis. She has severe pain. You notice that she has vesicles on the
pinna. What is the name of this syndrome?
A. Bell palsy
B. Ramsay-Hunt
C. Mobius
D. Millard-Gubler
E. Melkersson-Rosenthal --- correct answer ---B. Ramsay-Hunt
(Physician Assistant) PANCE Questions
with verified correct detailed answers
latest update 2025
A 16-year-old boy presents with a history of injury to his left pinna
while competing at a wrestling match. The superior outer portion of
the pinna is edematous and fluctuant to palpation. There is minimal
tenderness to palpation, and the patient is diagnosed with cauliflower
ear. Which of the following management decisions is most
appropriate?
A. refer the patient for incision and drainage (I&D) and pressure
dressing
B. have the patient return only if he develops a fever
C. apply a soft, bulky, and loose-fitting dressing to protect the pinna
D. prescribe a 10-day course of amoxicillin and schedule for a clinic
follow-up
E. perform an I&D only if the pinna becomes red and tender --- correct
answer ---A. refer the patient for incision and drainage (I&D) and
pressure dressing
,A 65-year-old male with a history of diabetes mellitus presents with
an acute episode of left facial paralysis. He is still able to wrinkle and
elevate both sides of his forehead. He denies recent viral illness or ear
pain. His diabetes has been well controlled. Examination of the TMs
and the external pinnae are normal. The Weber and Rinne tuning fork
assessments are normal. Visual acuity, extraocular movements, and
pupillary responses are all normal and equal bilaterally. Which of the
following is the most likely diagnosis?
A. Bell palsy
B. Ramsay-Hunt syndrome
C. Cerebrovascular accident
D. peripheral facial nerve palsy
E. diabetic neuropathy --- correct answer ---C. Cerebrovascular
accident
A patient presents with a 3-day history of vertigo associated with
turning over in his bed, which lasts for several minutes. There are no
other symptoms of the ear. Dix-Hallpike testing shows rotary
nystagmus, which diminishes with repeated testing. Which of the
following is the most likely diagnosis?
,A. central nervous system (CNS) lesion
B. positional vertigo
C. labyrinthitis
D. Meniere disease
E. vestibular neuronitis --- correct answer ---B. positional vertigo
A 33-year-old female presents with episodes of vertigo lasting about
20 minutes and associated with fluctuating hearing loss and a low-
frequency nonpulsatile tinnitus in the affected ear. After these
episodes of vertigo, the patient states that her hearing improves and
the tinnitus resolves. Which of the following illnesses is suggested by
these symptoms?
A. Meniere disease
B. Eustachian tube dysfunction
C. vestibular neuronitis
D. paroxysmal positional vertigo
E. none of the above --- correct answer ---A. Meniere disease
A 35-year-old male presents with a 1-week history of a marked
decrease of hearing in his right ear. He denies trauma, otorrhea, or
vertigo. The physical examination appears to be normal except for his
, tuning fork tests. The Weber test lateralizes to the better ear and the
Rinne test shows air conduction to be better than bone conduction in
both ears. After confirmation of your findings with an audiometric
evaluation, what would be the most appropriate treatment?
A. broad-spectrum antibiotic
B. nasal steroids
C. decongestant
D. oral steroids
E. antihistamines --- correct answer ---D. oral steroids
A 60-year-old female presents with an acute onset of left facial nerve
paralysis. She has severe pain. You notice that she has vesicles on the
pinna. What is the name of this syndrome?
A. Bell palsy
B. Ramsay-Hunt
C. Mobius
D. Millard-Gubler
E. Melkersson-Rosenthal --- correct answer ---B. Ramsay-Hunt
