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Question 1
A 45-year-old woman presents with a 12-month history of progressive left-sided sensorineural hearing loss and mild unsteadiness. Pure tone audiometry demonstrates a high-frequency sensorineural hearing loss on the left with a speech discrimination score of 40%. An MRI of the internal auditory meatuses (IAM) with gadolinium contrast reveals a 1.2 cm intensely enhancing lesion within the left internal auditory canal extending into the cerebellopontine angle without brainstem compression. What is the most appropriate initial management strategy?
Correct Answer:
Conservative management with MRI surveillance (watch and wait)
Question 2
A 32-year-old man presents with chronic left-sided foul-smelling otorrhea and progressive conductive hearing loss. Otoscopy shows a deep attic retraction pocket filled with keratinous debris and erosion of the scutum. High-resolution CT of the temporal bone confirms a soft tissue mass in the epitympanum with erosion of the incus body and scutum, but intact bony labyrinth and facial canal. What is the definitive management?
Correct Answer:
Mastoidectomy with complete excision of the cholesteatoma
Question 3
A 38-year-old woman presents with bilateral progressive hearing loss, worse in the right ear. She notes that her hearing improves slightly in noisy environments (paracusis Willisii). Otoscopy reveals normal tympanic membranes with a reddish hue visible through the right tympanic membrane (Schwartze sign). Pure tone audiometry shows a conductive hearing loss with a notch in bone conduction thresholds at 2 kHz (Carhart notch). What is the primary underlying pathological process?
Correct Answer:
Demineralization and bone remodeling of the otic capsule causing stapes fixation
Question 4
A 48-year-old man experiences recurrent episodes of severe vertigo lasting 2 to 4 hours, accompanied by nausea, left-sided low-frequency hearing loss, tinnitus, and a sensation of fullness in the left ear. Audiometry during an acute flare confirms a fluctuating low-frequency sensorineural hearing loss. Brain MRI rules out retrocochlear pathology. What is the recommended first-line medical management according to ENT UK guidelines?
Correct Answer:
Dietary salt restriction and betahistine or prophylactic diuretic therapy
Question 5
A 60-year-old woman presents with brief episodes of intense rotational vertigo lasting 20 seconds, triggered by rolling over in bed and tilting her head back. She has no hearing loss or tinnitus. Dix-Hallpike testing on the right side produces geotropic torsional and upbeating nystagmus after a 5-second latency, which fatigues after 30 seconds. What is the diagnosis and appropriate treatment?
Correct Answer:
Right posterior canal BPPV; treat with Epley maneuver
Question 1
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Prepare with the FRCS ORL-HNS Section 1 Practice Questions - Intercollegiate Specialty Fellowship Examination in Otolaryngology - Head and Neck Surgery (Section 1) Exam practice quiz. This question bank includes 100 questions covering year-old, presents, right, nasal, and reveals. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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FRCS ORL-HNS Section 1 Practice Questions - Intercollegiate Specialty Fellowship Examination in Otolaryngology - Head and Neck Surgery (Section 1) Exam

This practice set contains 100 questions from the matching question bank and focuses on year-old, presents, right, nasal, and reveals. Work through each question carefully, review the provided solutions, and revisit topics that need more study before your next attempt.

This is an independent study resource intended for practice and review; it is not an official examination or an endorsement by any organization named in the title.

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