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ENT medical question bank

Practise every ENT topic with explained SBAs.

Recall Engine has 550+ ENT questions across 40+ topics in 2 body systems. Every question explains each option.

questions
550+
topics
40+
topic notes
30+
clinical skills guides
10+
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ENT by body system

ENT has 40+ topics in 2 body systems. Each section shows how many questions it has and every topic it covers.

Nervous system

5 questions across 1 topic. It also has 1 topic note.

  • Bell palsy

Head, neck, and special senses

550+ questions across 40+ topics. It also has 30+ topic notes and 10+ clinical skills guides.

  • Acute otitis media in children
  • Acute rhinosinusitis
  • Bedside hearing examination
  • Chronic otitis media and cholesteatoma
  • Clinical nose examination
  • Dix-Hallpike test and Epley manoeuvre
  • Ear and nose conditions: otoscopy and endoscopy findings
  • Ear examination
  • Ear history taking
  • Ear, nose, oropharynx, facial nerve, and neck node examination
  • ENT emergencies: nose, airway, and throat
  • ENT history and examination
  • Fungal rhinosinusitis
  • Granulomatous nasal disease
  • Head and neck cancer
  • Hearing loss: communication support
  • Hearing loss: conductive and sensorineural
  • Hearing loss: Rinne and Weber tests
  • Language development and disorders
  • Nasal obstruction
  • Nasal presentations: epistaxis, rhinorrhoea, and polyps
  • Neck lumps
  • Nose examination
  • Nose history
  • Nose history taking
  • Oropharyngeal dysphagia
  • Oropharyngeal examination
  • Otalgia: ear and referred causes
  • Otitis externa: assessment and escalation
  • Otitis media complications
  • Otitis media with effusion
  • Otorrhoea
  • Otoscopy: incomplete views
  • Paediatric ENT: airway, nose, and foreign bodies
  • Pharynx and larynx examination
  • Rhinorrhoea
  • Salivary gland assessment
  • Salivary gland tumours
  • Snoring and obstructive sleep apnoea
  • Throat and voice: history and examination
  • Tinnitus
  • Tonsillitis
  • Unilateral nasal symptoms: history and examination
  • Vertigo
  • Vestibulocochlear nerve examination

ENT sample questions

These 5 are published ENT questions shown exactly as students see them. Open an answer to see why it is right and why every other option is wrong.

Question 1 · ENT, Clinical

A 31-year-old man has an attic cholesteatoma in his right ear with persistent offensive discharge and a 30 dB conductive loss. He has no vertigo, facial weakness, or headache. Two courses of ciprofloxacin drops after microsuction made the ear dry for only a few weeks each time. He asks whether more drops could cure it. Which plan is most appropriate?

  1. A. Microsuction clinic every three months as definitive care
  2. B. Myringoplasty to seal the drum over the pocket
  3. C. A ventilation tube to aerate the attic pocket
  4. D. Temporal bone CT, then mastoid surgery to remove it
  5. E. A three-month course of quinolone drops at home
Show the answer and explanation

Answer: D. Temporal bone CT, then mastoid surgery to remove it

Cholesteatoma is treated surgically: drops and suction may settle infection but never cure it, as his relapses show. CT of the temporal bone maps the extent of disease and bone erosion before surgery, then mastoidectomy removes the sac and the middle ear is reconstructed. Recurrent or residual disease is common, so long-term follow-up follows.

Why the other options are wrong

  • A. Microsuction clinic every three months as definitive care: Regular cleaning can keep a pocket tidy but does not stop an established cholesteatoma growing and eroding bone.
  • B. Myringoplasty to seal the drum over the pocket: Grafting over a cholesteatoma traps keratin behind the graft and hides continuing disease.
  • C. A ventilation tube to aerate the attic pocket: A tube treats middle ear effusion; it cannot remove an established keratin sac from the attic.
  • E. A three-month course of quinolone drops at home: Drops control infection on the surface but never remove the keratin sac, so the discharge returns and bone erosion continues.

Key point: Cholesteatoma needs surgical removal, planned with temporal bone CT; drops and microsuction only control infection and never cure it.

References

Question 2 · ENT, Clinical

A 29-year-old woman develops sharp right earache, a blocked feeling, and muffled hearing while descending on a recreational dive, after struggling to equalise. She has had nasal congestion from a cold for 3 days. She has no vertigo, fever, or discharge. Otoscopy shows a retracted, congested right tympanic membrane with dark fluid behind it; the canal is normal. Which diagnosis is most likely?

  1. A. Acute otitis media
  2. B. Perilymph fistula
  3. C. Swimmer's otitis externa
  4. D. Middle ear barotrauma
  5. E. Bullous myringitis
Show the answer and explanation

Answer: D. Middle ear barotrauma

Earache, fullness, and muffled hearing starting during descent, in someone whose congested nose stopped the Eustachian tube equalising, with a retracted, congested drum and fluid or blood behind it, is middle ear barotrauma. Treatment is analgesia, decongestant, and equalising manoeuvres; myringotomy is occasionally needed for severe pain. Vertigo or sensorineural loss would suggest inner ear injury and needs urgent ENT review.

Why the other options are wrong

  • A. Acute otitis media: Acute otitis media gives a bulging drum with fever; her drum is retracted, she is afebrile, and pain began on descent.
  • B. Perilymph fistula: An inner ear fistula causes vertigo and sensorineural loss; she has no vertigo and her findings are in the middle ear.
  • C. Swimmer's otitis externa: Otitis externa causes a swollen, tender canal with discharge over days; her canal is normal and the pain began suddenly on descent.
  • E. Bullous myringitis: Bullous myringitis shows blisters on the drum during an ear infection and has no link to a pressure change; this drum is retracted with fluid behind it after a dive.

Key point: Earache with fullness and conductive hearing loss starting during flight descent or diving, especially with a blocked nose, and a retracted drum with effusion or haemotympanum indicates middle ear barotrauma.

References

Question 3 · ENT, Clinical

A man has a hard, painful, unilateral swelling of a salivary gland. Which mechanism explains it?

  1. A. A stone in the duct causing backlog and pressure
  2. B. Mumps virus infection
  3. C. Malignant change in a pleomorphic adenoma
  4. D. Infection or inflammation of the gland
  5. E. A long-term autoimmune condition
Show the answer and explanation

Answer: A. A stone in the duct causing backlog and pressure

Sialolithiasis is a stone in the duct causing backlog and pressure, giving a hard, painful, unilateral swelling.

Why the other options are wrong

  • B. Mumps virus infection: Mumps virus causes bilateral, diffuse, soft swelling.
  • C. Malignant change in a pleomorphic adenoma: Pleomorphic adenoma has potential for malignant change, and malignant parotid lesions can show facial nerve palsy and overlying erythema or ulceration.
  • D. Infection or inflammation of the gland: Sialadenitis is infection or inflammation of the salivary glands, with diffuse, soft, unilateral swelling.
  • E. A long-term autoimmune condition: Sjogren's syndrome is a long-term autoimmune condition with bilateral, diffuse, painless swelling.

Key point: Sialolithiasis is a stone in the duct causing backlog and pressure, with hard, painful, unilateral swelling.

References

Question 4 · ENT, Clinical

A man with diabetes has fever and an indurated, severely tender submandibular swelling that fluctuates, with trismus. An infected second mandibular molar tooth is found. Which treatment is given?

  1. A. Preoperative injection of sclerosing material then surgical excision
  2. B. Surgical evacuation of haematoma and postoperative physiotherapy
  3. C. Surgical excision (marsupialization)
  4. D. Surgical excision
  5. E. Systemic antibiotics plus drainage
Show the answer and explanation

Answer: E. Systemic antibiotics plus drainage

Cellulitis and suppuration in the submandibular space arising from an infected second or third mandibular molar is Ludwig's angina, which is more common in diabetics. Fever, an indurated severely tender submandibular swelling, fluctuation indicating suppuration, and trismus fit it. Treatment is systemic antibiotics plus drainage.

Why the other options are wrong

  • A. Preoperative injection of sclerosing material then surgical excision: Preoperative injection of sclerosing material then surgical excision is the treatment of cystic hygroma.
  • B. Surgical evacuation of haematoma and postoperative physiotherapy: Surgical evacuation of haematoma and postoperative physiotherapy is the treatment of sternomastoid muscle tumour.
  • C. Surgical excision (marsupialization): Surgical excision (marsupialization) is the treatment of ranula.
  • D. Surgical excision: Surgical excision is the treatment of branchial cyst, thyroglossal cyst, laryngocele, and subhyoid bursa.

Key point: Ludwig's angina is treated with systemic antibiotics plus drainage.

References

Question 5 · ENT, Clinical

A 34-year-old man has a painless, slowly growing parotid swelling. The excised tumour is smooth, multilobular, and encapsulated. Microscopy shows both epithelial and mesenchymal-like elements, with myoepithelial cells in the stromal areas. Which tumour is this?

  1. A. Pleomorphic adenoma
  2. B. Adenoid cystic carcinoma
  3. C. Warthin tumour
  4. D. Acinic cell tumour
  5. E. Mucoepidermoid carcinoma
Show the answer and explanation

Answer: A. Pleomorphic adenoma

Pleomorphic adenoma is painless and slowly growing, and it is smooth, multilobular, and encapsulated on gross evaluation. Its characteristic microscopic feature is morphologic diversity, with epithelial and mesenchymal-like elements, and the myoepithelial cells make up the stromal areas. It is the commonest benign salivary gland tumour.

Why the other options are wrong

  • B. Adenoid cystic carcinoma: Microscopically, adenoid cystic carcinomas consist of basaloid epithelial elements forming cylindrical structures, and they are usually nonencapsulated.
  • C. Warthin tumour: Warthin tumours show multiple papillae projecting into cystic spaces on microscopy.
  • D. Acinic cell tumour: Acinic cell tumours are formed of serous cells.
  • E. Mucoepidermoid carcinoma: Mucoepidermoid carcinomas contain mucous and epidermoid cells, and the grade depends on their relative proportion.

Key point: Pleomorphic adenoma is the commonest benign salivary gland tumour and is smooth, multilobular, and encapsulated.

References

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