A 60-year-old man was planned for total pharyngolaryngectomy with gastric pull up reconstruction for post cricoid squamous cell carcinoma T4aNoMo. Which statement best describes the perioperative indication of blood transfusion in an asymptomatic patient?

A 56-year-old patient with type 2 diabetes mellitus presents with reduced hearing and tinnitus. He was diagnosed with right inactive otitis media and was electively admitted for right myringoplasty under general anaesthesia. He has no other comorbidities and was compliant to oral hypoglycaemic agents. Which statement best describes the preoperative care of this patient?

Which statement best describes the key objective in perioperative management of a diabetic patient?

A 60-year-old Malay gentleman with a background of hypertension, diabetes and chronic renal failure presents with one week history of a painful right sided neck swelling. On examination, he was alert, dehydrated, temperature was 38 degrees Celcius, blood pressure 100/55mmHg, pulse rate 101 beats/min, respiratory rate 12 breaths/min and capillary blood sugar was 15.0 mmol/L. The right side of the neck was swollen, tender and indurated with a small necrotic patch seen at right level 2 measuring 1x2 cm associated with crepitus. Computed tomography of the neck showed a gas forming collection on the right side of the neck. Which treatment best correlates with improved survival in this patient?

An 80-year-old gentleman presents to the otorhinolaryngology clinic 2 months following cerebrovascular accident with dysphagia associated with post swallow cough. He was advised for exclusive Ryle tube feeding and swallowing rehabilitation. Which endoscopic feature best predicts low risk of aspiration in this patient?

A 42-year-old smoker presents to the otorhinolaryngology clinic with persistent hoarseness of 2 months’ duration with no other associated symptoms. Examination showed a comfortable patient, well hydrated with overall dysphonia grade 3 and good cough. No neck mass palpable and 70 degree scope showed a fungating mass confined to the anterior commisure with normal vocal fold mobility. He was planned for direct laryngoscopy and biopsy of the mass under general anaesthesia. How would you secure the airway during the surgery?

A 45-year-old smoker presents to the emergency department with acute, unprovoked epistaxis which failed to arrest following Trotter maneuver. He was otherwise pink but anxious with blood pressure 160/80 mmHg, pulse rate 110 beats/min, respiratory rate 16 breaths/min and oxygen saturation 99% under room air. He was having profuse anterior and posterior epistaxis. What is the next step in managing this condition?

A 52-year-old patient was electively admitted for superficial parotidectomy following a diagnosis of pleomorphic adenoma arising from the tail of the parotid gland. Iatrogenic facial nerve injury is a complication following this procedure. Which statement best describes the operative precautions taken to reduce this complication?

A 2-year-old girl presents to the emergency department with 3 days history of unilateral purulent nasal discharge associated with epistaxis. Examination showed a fretful child who was otherwise active. Temperature was 37 degrees Celcius, blood pressure 90/50mmHg, pulse rate 120 beats/min, respiratory rate 16 breaths/min and oxygen saturation was 99% under room air. There was reduced air flow on the right nostril with purulent discharge seen on tip test. The left nostril, eye, facial and neck examination was otherwise normal. What is the most likely diagnosis?

An 8-year-old obese boy presents with snoring and hyperactivity for the past 1 year. Mother reports gradual weight gain over the past few years and occasional apneic spells associated with enuresis. Examination revealed an obese boy with BMI of 32kg/m2. He had acanthosis nigricans, palmar erythema and was breathing through his mouth. Examination revealed significant adenotonsillar hypertrophy associated with bilateral middle ear effusion. What is the next step in management of this boy?

Which statement best describes the key objective in perioperative management of a diabetic patient?

A 75-year-old lady underwent excision biopsy of a skin lesion under local anaesthesia with lignocaine 2%. She was also given IV midazolam for sedation. 30 minutes into the procedure she developed innitus, restlessness, nystagmus and facial muscle tremors.

What is the most likely cause for the above condition?

A 50-year-old lady is undergoing total thyroidectomy for follicular thyroid carcinoma. Intraoperatively, there is bleeding from the inferior thyroid artery.

What is the best way to secure hemostasis?

A 12-year-old boy presented with history of frequent rhinorrhoea and intermittent unilateral epistaxis past 3 months. The epistaxis sometimes stopped spontaneously but at times he experienced vomiting small ammount of blood clots. The most appropriate management in he clinic is

A 60-year-old man complained of persistent otorrhoea past 4 months associated with intermittent blood stained dischage. Otoscopic examination revealed an irregular mass on the external ear canal. The most likely diagnosis is

A 5-year-old girl presented with a painful neck swelling associated with fever for 2 days. She had history of similar episodes with intermittent discharge for the past 2 years. Examination revealed toxic looking child with inflamed, tender and fluctuant left lateral upper neck swelling.

What is the most appropriate treatment at this moment?

A 10-months-old baby, previously well was brought to the casualty with acute onset of persistent cough and noisy breathing after playing with siblings at home. However, the mother was not sure of any foreign body ingestion. Examination revealed baby was pink under room air, afebrile and expiratory stridor heard.

What is the definitive management for this case?

A 40-year-old male complained of right facial asymmetry that occured on waking up in the morning. He has background history of diabetes but well controlled. He presented to the ENT clinic one week after the onset of facial asymmetry. Physical examination revealed attic retraction of tympanic membrane with granulation tissue seen. The facial assessment showed HB Grade 4 facial nerve palsy. What is the confirmatory investigation?

A 1-year-old baby is diagnosed with bilateral canal atresia and microtia. Which investigation is most appropriate at this moment?