Formative

A 54 male diabetes had severe left otalgia for 1 weeks and develop
left facial palsy for 1 days. The otoscopic finding show mass at proximal
of ear canal. What is the most proper management?

• Mastoidectomy

• Oral steroid

• Biopsy mass

• MRI temporal bone

A 10 years old boy presents with midline neck mass. Physical
examination show fluctuance mass 2 cm, not tender and moving when
tongue is protruded. What is the most correct about this patient?

• The diagnosis is branchial cleft cyst

• Given oral antibiotic

• Core needle biopsy for definite diagnosis

• Sistrunk procedure is the standard surgical treatment

A 60 years old male presents with progressive dyspnea for 3 days
and develops hoarseness for 3 months. Physical examination detects
biphasic stridor and right cervical lymphadenopathy. He had history of
heavy alcoholic and smoking. What is the most proper initial
management?

• Cricothyroidotomy

• Endotracheal intubation

• Tracheostomy

• CT larynx include neck

4. A 56 years old female develops brief vertigo trigger by change of
   head position. Her hearing is normal and no history of headache or
   weakness. What is the proper investigation?

• Dix-Hallpike test

• Epley maneuver

• General laboratory blood test

• CT temporal bone

5. A 3 years boys presents with choking and sudden cough during play
   toys for 30 minutes. Physical examination show wheezing on right. CXR
   PA reveal hyperinflation right side. What is the proper management?
   

• Endotracheal intubation

• Tracheostomy

• Rigid bronchoscopy

• CT larynx include neck

7. A Thai boxer, 25-year-old, male patient presented with right ear pain for 2 days.

Physical examination showed as picture below.

• Amoxicillin

• Ceftriaxone

• Ciprofloxacin

• Dicloxacillin

A 78-year-old man presented for health check-up. He is able to perform ADL by

himself. His son fears that he is getting Alzheimer’s disease because he has trouble

with understanding what family members say.

Physical examination: BP 130/80 mmHg, no impact cerumen, otherwise normal.

What is the most appropriate next management?

• TMSE test

• Geriatric depression test

• Audiometry

• CT brain

A 60-year-old female presents with left side epistaxis twice a day for 3 days.

Physical examination: PR 80/min, RR 16/min, BP 120/70 mmHg, blood oozing after nasal compressian

from left anterior nasal septum, normal nasal mucosa, no nasal discharge.

What is the most appropriate management?

• Topical decongestant

• Antibiotic ointment

• Cauterization

• Anterior nasal packing

A 12-year-old girl was presented with left nasal obstruction and mucoid discharge for

2 months. Anterior rhinoscopy showed no masses. Posterior rhinoscopy showed a

glistening mass fully obstructing area with discharge. Valsalva maneuver does not

change the size of mass. What is the diagnosis?

• Foreign body

• Meningocele

• Antrochoanal polyp

• Dermoid cyst

A 50-year-old woman with history of DM presents with facial pain.

X-ray: increased opacity of maxillary antrum.

Physical examination: pale nasal mucosa, nasal obstruction, and purulent discharge.

What is the most appropriate next step management?

• Irrigation

• Nasal swab culture

• CT

• MRI