PAC FINAL EXAM QUESTIONS WITH COMPLETE
SOLUTIONS ACTUAL EXAM GUARANTEED PASS
2025/2026
Malignant otitis media
P. aeruginosa (common in elderly and diabetes) mastoiditis
inflammation of the mastoid bone --> post auricular swelling,
erythema, tenderness
-urgent and often surgical intervention by ENT
Bulbous Myringitis
Hemorrhagic painful vesicles on the TM
-urgent and often surgical intervention by ENT
GOLD STANDARD for measuring brain's response to sound
ABR
(tracks sound moving from ear to brain)
-tests cochlea, auditory nerve, lower brainstem; SLEEPING in younger,
awake in older
Ear foreign body
-Common in children ages 2-4
-otalgia, otorrhea, or decreased hearing
,-At times, symptoms may be nonspecific, such as irritability and crying
-Ear FBs can be removed by irrigation, suction, or instrumentation.
-Small inorganic objects can be removed from the EAC by irrigation.
Contraindication to irrigation includes:
-Perforated TM
-Vegetable matter — Irrigation causes swelling of the vegetable matter
which leads to further obstruction
-Alkaline (button) battery — Irrigation enhances leakage and potential
for liquefaction necrosis and severe alkaline burns conductive and
sensorineural phase
Conductive loss = problems with external or middle ear
-Noisy environments may help this
-causes: cerumen impaction, otosclerosis, cholesteatoma, TM
perforation
Sensorineural loss = problems with inner ear or nerve
-Trouble understanding speech that’s worse in noisy environments
-Presbycusis is most common cause of sensorineural hearing loss,
followed by noise-induced hearing loss should AC or BC be longer
in a normal ear?
AC > BC
Air Conduction:
,-First phase of hearing
-Sound through air and into cochlea
Bone Conduction:
-Bypasses the external & middle ear
T/F: Tuning fork tests DO NOT distinguish between bilateral
sensorineural hearing loss TRUE which meds can cause temporary
hearing loss
ASA, NSAIDs, quinidine & loop diuretics which meds
can cause permanent hearing loss
-aminoglycosides "-micin"
-chemo: cisplatin
Perceived sound with NO stimulus
tinnitus
Hearing loss + tinnitus + vertigo
Meniere's disease (unilateral + episodic)
Physiology of Nose & Sinuses
-Air enters nasal cavity --> passes into the vestibule --> nasopharynx
-Vestibule is lined with hair-bearing skin NOT mucosa
-Nasolacrimal duct drains into inferior meatus
-Turbinates function to clean, humidify & warm the air
-Only the frontal & maxillary sinuses are accessible on exam
, Examination of the Nose & Sinuses
1. Inspect
2. Palpate:
-Nares for potency
-Frontal sinuses and maxillary sinuses for tenderness
3. Speculum exam:
Mucosa: color, swelling, bleeding, exudate, ulcers, polyps
Septum: deviation, inflammation, perforation
4. Transillumination of the sinuses viral vs bacterial sinusitis
-viral: <7 days
-bacterial sinusitis persists > 7 days & accompanies facial/sinus
tenderness
Pale blue turbinates
allergic rhinitis
Wharton duct
submandibular duct
Stensen duct parotid
gland
Men > 50 yo, smokers and alcohol abusers are at highest risk for...
tongue/oral CA (squamous cell CA)
-Biopsy any nodule, leukoplakia, or erythroplakia
-Tobacco and alcohol account for 75% of these cancers
SOLUTIONS ACTUAL EXAM GUARANTEED PASS
2025/2026
Malignant otitis media
P. aeruginosa (common in elderly and diabetes) mastoiditis
inflammation of the mastoid bone --> post auricular swelling,
erythema, tenderness
-urgent and often surgical intervention by ENT
Bulbous Myringitis
Hemorrhagic painful vesicles on the TM
-urgent and often surgical intervention by ENT
GOLD STANDARD for measuring brain's response to sound
ABR
(tracks sound moving from ear to brain)
-tests cochlea, auditory nerve, lower brainstem; SLEEPING in younger,
awake in older
Ear foreign body
-Common in children ages 2-4
-otalgia, otorrhea, or decreased hearing
,-At times, symptoms may be nonspecific, such as irritability and crying
-Ear FBs can be removed by irrigation, suction, or instrumentation.
-Small inorganic objects can be removed from the EAC by irrigation.
Contraindication to irrigation includes:
-Perforated TM
-Vegetable matter — Irrigation causes swelling of the vegetable matter
which leads to further obstruction
-Alkaline (button) battery — Irrigation enhances leakage and potential
for liquefaction necrosis and severe alkaline burns conductive and
sensorineural phase
Conductive loss = problems with external or middle ear
-Noisy environments may help this
-causes: cerumen impaction, otosclerosis, cholesteatoma, TM
perforation
Sensorineural loss = problems with inner ear or nerve
-Trouble understanding speech that’s worse in noisy environments
-Presbycusis is most common cause of sensorineural hearing loss,
followed by noise-induced hearing loss should AC or BC be longer
in a normal ear?
AC > BC
Air Conduction:
,-First phase of hearing
-Sound through air and into cochlea
Bone Conduction:
-Bypasses the external & middle ear
T/F: Tuning fork tests DO NOT distinguish between bilateral
sensorineural hearing loss TRUE which meds can cause temporary
hearing loss
ASA, NSAIDs, quinidine & loop diuretics which meds
can cause permanent hearing loss
-aminoglycosides "-micin"
-chemo: cisplatin
Perceived sound with NO stimulus
tinnitus
Hearing loss + tinnitus + vertigo
Meniere's disease (unilateral + episodic)
Physiology of Nose & Sinuses
-Air enters nasal cavity --> passes into the vestibule --> nasopharynx
-Vestibule is lined with hair-bearing skin NOT mucosa
-Nasolacrimal duct drains into inferior meatus
-Turbinates function to clean, humidify & warm the air
-Only the frontal & maxillary sinuses are accessible on exam
, Examination of the Nose & Sinuses
1. Inspect
2. Palpate:
-Nares for potency
-Frontal sinuses and maxillary sinuses for tenderness
3. Speculum exam:
Mucosa: color, swelling, bleeding, exudate, ulcers, polyps
Septum: deviation, inflammation, perforation
4. Transillumination of the sinuses viral vs bacterial sinusitis
-viral: <7 days
-bacterial sinusitis persists > 7 days & accompanies facial/sinus
tenderness
Pale blue turbinates
allergic rhinitis
Wharton duct
submandibular duct
Stensen duct parotid
gland
Men > 50 yo, smokers and alcohol abusers are at highest risk for...
tongue/oral CA (squamous cell CA)
-Biopsy any nodule, leukoplakia, or erythroplakia
-Tobacco and alcohol account for 75% of these cancers
