Título em Otorrinolaringologia Practice Questions - Título de Especialista em Otorrinolaringologia e Cirurgia Cérvico-Facial (ABORL-CCF AMB) Exam - Título em Otorrinolaringologia Practice Questions - Título de Especialista em Otorrinolaringologia e Cirurgia Cérvico-Facial (ABORL-CCF AMB) Exam

Question 1

A 34-year-old woman presents with progressive bilateral hearing loss, more pronounced in the left ear, and low-pitched tinnitus for the past two years. She notes that her hearing noticeably deteriorated during her recent pregnancy. Otoscopic examination is normal, with a faint pinkish vascular hue visible over the promontory through a translucent tympanic membrane (Schwartze sign). Pure-tone audiometry demonstrates a bilateral conductive hearing loss with an air-bone gap of 35 dB in the speech frequencies and a distinct dip in bone-conduction thresholds at 2000 Hz (Carhart notch). Tympanometry reveals type As curves bilaterally with absent acoustic stapedial reflexes. What is the definitive pathophysiological mechanism and primary surgical treatment of choice for this condition?

Incus necrosis from chronic Eustachian tube dysfunction treated with partial ossicular replacement prosthesis (PORP) Abnormal fibro-osseous remodeling of the otic capsule causing stapedio-vestibular ankylosis treated with stapedotomy Endolymphatic hydrops of the cochlear duct treated with endolymphatic sac decompression Autoimmune resorption of the malleus handle treated with total ossicular replacement prosthesis (TORP)

Correct Answer:

Abnormal fibro-osseous remodeling of the otic capsule causing stapedio-vestibular ankylosis treated with stapedotomy

Question 2

A 42-year-old man presents with chronic, foul-smelling, purulent left otorrhea refractory to topical fluoroquinolones, along with progressive hearing loss. Otoscopy reveals a retraction pocket in the pars flaccida containing keratin debris and erosion of the lateral epitympanic wall (scutum). High-resolution temporal bone CT demonstrates soft tissue filling the Prussak space with blunting of the scutum and partial erosion of the incus long process. Which of the following is the most appropriate surgical management according to ABORL-CCF otology consensus?

Myringotomy with grommet ventilation tube insertion and topical antibiotic drops Tympanomastoidectomy with complete cholesteatoma eradication and ossicular reconstruction Endolymphatic mastoid shunt surgery combined with systemic steroid therapy Laser myringoplasty with autologous fascia temporalis under local anesthesia

Correct Answer:

Tympanomastoidectomy with complete cholesteatoma eradication and ossicular reconstruction

Question 3

A 52-year-old woman presents to the emergency room with severe episodic vertigo lasting 30 to 45 seconds triggered whenever she turns her head to the right while in bed or looks up to reach a high shelf. There is no associated tinnitus, hearing loss, or spontaneous nystagmus. A right Dix-Hallpike maneuver induces a 5-second latent onset of mixed torsional (counterclockwise, top pole beating toward the down ear) and upbeating nystagmus with intense vertigo lasting 25 seconds, which fatigues upon repeated testing. What is the most appropriate next step in management?

Prescribe oral betahistine 24 mg twice daily and recommend strict bed rest for 5 days Perform an immediate right-sided Epley canalith repositioning maneuver Administer intravenous methylprednisolone 1 g for acute vestibular neuritis Perform a Lempert (360-degree barbecue roll) repositioning maneuver

Correct Answer:

Perform an immediate right-sided Epley canalith repositioning maneuver

Question 4

A 48-year-old male with a 4-year history of episodic true spinning vertigo lasting 2 to 4 hours, accompanied by fluctuating left-sided low-frequency hearing loss, roaring tinnitus, and ipsilateral aural fullness, presents for evaluation. Electrocochleography demonstrates an elevated Summating Potential to Action Potential ratio (SP/AP > 0.45). According to international and ABORL-CCF diagnostic criteria, which first-line medical maintenance strategy is recommended to reduce episode frequency and preserve hearing in this disorder?

Dietary sodium restriction (<2 g/day), caffeine/alcohol avoidance, and thiazide diuretic or betahistine maintenance therapy Prophylactic long-term daily intratympanic gentamicin injections High-dose lifelong oral carbamazepine or pregabalin Immediate surgical translabyrinthine vestibular nerve section

Correct Answer:

Dietary sodium restriction (<2 g/day), caffeine/alcohol avoidance, and thiazide diuretic or betahistine maintenance therapy

Question 5

A 38-year-old man presents with sudden hearing loss in his right ear upon waking 24 hours ago. He denies prior otologic surgery or trauma. Otoscopy is entirely normal bilaterally. Pure-tone audiometry confirms an acute right sensorineural hearing loss of 55 dB across 500 Hz, 1000 Hz, and 2000 Hz with a normal left ear. Speech discrimination in the right ear is 48%. According to national and international sudden sensorineural hearing loss (SSNHL) guidelines, which intervention is the cornerstone of initial emergency management within the early therapeutic window?

Immediate oral high-dose corticosteroid therapy (e.g., Prednisone 1 mg/kg/day for 10–14 days with taper) Immediate exploratory tympanotomy for suspected perilymphatic fistula Prescription of oral acyclovir 800 mg 5 times daily alone without corticosteroids Observation for 4 weeks with repeat audiogram, as spontaneous recovery rates exceed 90%

Correct Answer:

Immediate oral high-dose corticosteroid therapy (e.g., Prednisone 1 mg/kg/day for 10–14 days with taper)

Question 1

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Prepare with the Título em Otorrinolaringologia Practice Questions - Título de Especialista em Otorrinolaringologia e Cirurgia Cérvico-Facial (ABORL-CCF AMB) Exam practice quiz. This question bank includes 100 questions covering year-old, presents, right, hearing, and loss. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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Título em Otorrinolaringologia Practice Questions - Título de Especialista em Otorrinolaringologia e Cirurgia Cérvico-Facial (ABORL-CCF AMB) Exam

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Título em Otorrinolaringologia Practice Questions - Título de Especialista em Otorrinolaringologia e Cirurgia Cérvico-Facial (ABORL-CCF AMB) Exam

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