ENT and Ophthalmology Prometric Style Questions – 50 Cases with Answers

What this deck covers

ENT and Ophthalmology Prometric Style Questions in 50 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. A bulging drum at two
2. Ear pain in a well four-year-old
3. Glue behind both drums
4. Pus through a grommet
5. A swelling behind the ear
6. Treating the infected bone
7. Sore when the tragus is pressed
8. Five infections in a year
9. Two curves and a gap
10. Discharge that will not clear
11. Deaf from birth with no clues
12. Nosebleeds and an itchy nose
13. Bleeding after a ball to the face
14. Why children’s noses bleed
15. A lump in a baby’s nostril
16. Blue at the breast, pink when crying
17. Drooling with a stiff neck
18. A uvula pushed sideways
19. When to take them out
20. Why the operation is offered
21. Snoring with pauses
22. Fixing the obstruction
23. A midline lump that moves
24. A lump along the muscle edge
25. A lump that lights up
26. A node above the clavicle
27. A blue swelling under the tongue
28. Swelling that comes with meals
29. Both sides in front of the ears
30. Finding the nerve safely
31. Noisy since two weeks old
32. Wheeze on one side only
33. A swollen eye that will not move
34. Acting before sight is lost
35. One eye that turns in
36. A normal eye that cannot see
37. A drooping lid and a big pupil
38. A watering eye since birth
39. Itchy eyes every spring
40. A scratched eye after a twig
41. Chemical in the eye ten minutes ago
42. A white pupil in a photograph
43. A grey reflex at six months
44. Struggling to see the board
45. Blurred discs and morning headache
46. Painful loss of vision in one eye
47. A lid that has always drooped
48. A squint worse at close range
49. A red lump on the eyelid
50. Blood inside the eye after a ball

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Topical ciprofloxacin drops, Oral amoxicillin for seven days, Oral flucloxacillin for a week, Otitis media with effusion, Pack the nose immediately with ribbon gauze, Flexible bronchoscopy, Any child with large tonsils on examination, Adenotonsillectomy, It resolves spontaneously in most children, The parotid gland, Subglottic stenosis, Admit for intravenous antibiotics and urgent imaging, The fourth nerve, causing vertical diplopia, Acute glaucoma.

Clinical pearls from this deck

• A red drum is not a diagnosis. Crying reddens a drum; only bulging and loss of movement make it otitis media.
• Prescribe the analgesia as a regular dose, not as required. The pain is the illness; the antibiotic is an argument about the last day of it.
• Get an audiogram before you refer or reassure. The decision rests on measured hearing, not on how the drum looks.
• Discharge through a grommet is usually painless. Pain with discharge should make you look for something else, starting behind the ear.
• Look behind the ear of every child whose otitis media is not settling, and compare the two sides from behind. The lost crease is easier to see than the swelling.
• Check the facial nerve and the conscious level at every review. Those two examinations are what tell you the infection has left the bone.

This deck is open to everyone with no sign-in. Work through it once for recognition, then again a week later to test yourself.

More from this system: all ENT and ophthalmology case decks · pediatric reference values.