CM ENTO Final Revision

What are the main symptoms of allergic rhinitis (Bi Qiu 鼻鼽)？

I. Sneezing

II. Runny nose with clear nasal discharge

III. Nasal congestion

IV. Broadened nasal cavity

• I and II only

• III and IV only

• I, II and III only

• II, III and IV only

Which are the structures of the middle ear?

I. Ossicles

II. Eustachian tube

III. Semicircular canals

IV. Cochlea

• I and II only

• III and IV only

• I, II and III only

• II, III and IV only

What is the bony projection with mucous membrane lining in the nose, which provide additional surface area to the air that we breath?

• Nasal septum

• Nasal turbinate

• Nasal meatus

• Nasal cilia

'Swimmers ear' is another name of:

• Otitis externa

• Otitis media

• Ear eczema

• Vertigo

Rinne test (-): Bone conduction is better than air conduction (BC > AC).

What does this indicate?

• Normal hearing

• Sensorineural hearing loss

• Conductive hearing loss

• Both sensorineural and conductive hearing loss

How many extraocular muscle are there?

• 5

• 4

• 8

• 6

A 65-year-old patient complains of slow progression blurry and distorted areas in the center of his vision for 6 months. Upon fundus examination, the are yellow deposits under the retina, as shown in picture.

What is the MOST likely diagnosis?

• Retinal vein occlusion

• Retinal artery occlusion

• Retinitis pigmentosa

• Age-related macular degeneration

Itchiness of eyes, burning sensation with mild pain, white stringy eye discharge, presence of pebble like papillae all over the palpebral conjunctiva. Pale red tongue with thin white coating, floating rapid pulse.

Which herbal formula is MOST suitable for this condition?

• Si Wu Tang modification 四物汤加减

• Xiao Feng San modification 消风散加减

• Pu Ji Xiao Du Yin modification 普济消毒饮加减

• Xian Fang Huo Ming Yin modification 仙方活命饮加减

a)State TWO (2) similarities of chalazion and hordeolum in terms of their characteristics.

b)State THREE (3) differences between chalazion and hordeolum in terms of their characteristics.

Answer explanation

a) Both disease involve swelling on the eyelid (1 mark)

Chalazion and internal hordeolum involve the meibomian gland (1 mark)

b) Chalazion is painless/minimal pain. Hordeolum can have more severe pain.

Chalazion has minimal discolouration. Hordeolum can have more redness.

Chalazion does not form pus. Hordeolum often forms pus.

Chalazion is non-infectious. Hordeolum is infectious.

Chalazion is slow-growing/ has a chronic onset.  Hordeolum has an acute/recurrent onset.

Any 3, 1 mark each.

A 17 year-old male patient come in with swelling on his eyelid for 3 days. There is localized swelling and boil growth on his left upper eyelid, itchiness and slight pain of the area, red tongue-tip with thin yellow coating, floating and rapid pulse.

Physical examination: The boil appears at the lid margin, about 1mm in size, with mild redness, swelling and visible pus.

a.State the disease diagnosis in the aspect of Western Medicine. (1 mark)

b.State the disease diagnosis in the aspect of Chinese Medicine. (1 mark)

c.State the syndrome diagnosis in the aspect of Chinese Medicine. (1 mark)

d.State TWO (2) treatment methods in the aspect of Chinese Medicine. (1 mark)

e.State the main herbal formula. List the main ingredients, TWO (2) additional ingredients and their respective dosage in raw herbs form. (6 marks)

Answer explanation

a)Hordeolum (1 mark)

b) Zhen Yan (1 mark)

c)Wind heat invading eyelid 风热客睑 (1 mark)

d)Dispel wind and clear heat, reduce swelling and break knots (any 2, 0.5 mark each)

e)Formula: Yin Qiao San modification 银翘散加减 (1 mark)
Main ingredients: JinYinHua 18g, LianQIao18g, JingJie 9g, Dan Dou Chi 9g, JieGeng 9g, BoHe 12g, NiuBangZi 9g, ZhuYe 9g, WeiGen 15g, ShengGanCao 6g (Any 8 with suitable dosage, 0.5 mark each)
Additional ingredients: JiLi 9g, JuHua 9g (with suitable dosage, 0.5 mark each)