ENT_OSCE_From IOM

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 OSCE_2072_Day I_IOM

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 Station No. 1
• Name the procedure
being carried out .

• Name 5 structures
seen during this
procedure.

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• Indirect laryngoscopy

• 1) Posterior 1/3rd of tongue

2) Valleculae
3) Epiglottis
4) Aryepiglottic fold & arytenoids
5) True and false vocal cords

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Station No.2
• Identify the
structure shown.

• Write down its

landmarks.

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• Tympanic membrane

• 1) Lateral process of malleous

2) Handle of malleous
3) Anterior & posterior malleolar fold
4) Umbo
5) Cone of light
6) Tympanic annulus
7) Pars flaccida & pars tensa
8) Shadow of long process of Incus

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 Station No. 3
• Picture shows enlarged
congested tonsil with
white patches.

• Write down the most

common condition.

• Mention two differential

diagnosis of the condition
shown in this picture.

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• Acute membranous tonsillitis

• 1) Diphtheria
2) Vincent angina
3) Agranulocytosis
4) Leukemia
5) Aphthous ulcers
6) Tonsillar malignancy
7) Candidal infection of tonsil

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Station No. 4

• Name the disease

condition.

• Mention its two

treatment options.

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• Ludwig’s angina/ Angina ludovici

• 1) Hospitalization & intravenous antibiotics

2) Tracheostomy if airway compromised
3) Drainage of serous fluid-rare

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 Station No. 5
• Define adenoids.

• Name two diseases

related with the
adenoids.

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• Adenoid/ Pharyngeal tonsil/ Luschka’s tonsil:
- a lobulated mass of lymphoid tissue found in the
superior and posterior walls of the nasopharynx

• 1) Adenoid hyperplasia
2) Chronic adenoid infection

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 Station No. 6
• This is a finding of
nasal endoscopy.
Identify the disease.

• What investigation
would you like to do
to know the extent
of the disease?
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• Nasal polyp

• CT- scan

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 Station No. 7
•Describe the finding
of this audiogram.

•In what condition

do
you get this type of
audiogram?
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• High frequency sensorineural hearing loss

• Age related/ senile hearing loss

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 Station No. 8
• Write down the
finding of this
tympanogram.

• In what condition do
you get this type of
curve?

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 • Type B tympanogram

• Fluid in the middle ear (eg. OME, acute otitis

media)

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Station No. 9

• Name the instrument.

• Write down the name of procedure in

which
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we use this instrument.
ENT_OSCE_Compiled_Binit_naihs4139 19
 • Laryngeal mirror

• Indirect laryngoscopy

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 Station No.10
• Name this
instrument .

• Name the surgery

in which this
instrument is used .

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• Cutting burr of the electric mastoid drill

• Mastoidectomy ( cortical/simple, radical &

modified radical)

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 Station No.11
• Name this
instrument .

• What are the two

therapeutic
indications for the
procedure where this
instrument is used ?
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 • Rigid laryngoscope

• 1) Excision of small lesions like vocal nodule,

polyp, retension cyst, papillomas etc.
2) Removal of foreign body

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 Station No.12
• Name this X- ray .

• What is the finding

in this X-ray ?

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• Plain x-ray nasal bone – lateral view

• Simple fracture of nasal bone

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 Station No.13
This is a plain x-ray of
a 3 year old child brought
to the emergency with
H/O ingestion of
something.
• Describe the x-ray.
•How do you treat this
patient?
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• Plain x-ray neck- lateral view showing a opaque
(probably a foreign body) shadow in the
oesophagus

• Removal of foreign body using rigid

oesophagoscope under general anesthesia

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Station No.14
Myringoplasty
• Name the surgical approaches for
myringoplasty.

• Mention the most common graft

material for myringoplasty

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• 1) Post-aural
2) Endaural
3) Permeatal

• 1) Temporalis fascia (most common)

2) Tragal perichondrium
3) Areolar fascia overlying temporal fascia
4) Cartilage
5) Vein
6) Periosteum

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 Station No. 15
•What procedure has
been done in the
neck ?

•What are common

three problems for
which this procedure
is performed ?
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• Tracheostomy

• 1) Epiglottitis
2) Foreign body in airway
3) Total Laryngectomy
4) Severe Ludwig’s angina
5) Positive pressure ventilation for more than 72
hours

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 OSCE_2072_Day II_IOM

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Station No. 1
• This is an
endoscopic
picture of larynx.
What is the
finding in the left
vocal cord?

• How do you treat

this condition ?
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• Vocal cord polyp

• Microlaryngoscopy and excision

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Station No. 2
A patient presented with
painful right pinna for
last 3 days, however
there is no history of ear
injury.

• What are the findings in

the right

• Write down THREE causes

causing this condition.

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• Red, swollen, tense, shiny upeer 2/3rd of right
auricle

• 1) Secondary infection following trauma, surgery

2) Extension of infection from diffuse otitis
externa, furuncle of meatus
3) Frost bite, burn

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 Station No. 3
• Name the
procedure.

• What are the 4

anatomical
structures seen
during this
procedure?

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• Anterior rhinoscopy

• 1) Nasal septum
2) Middle and inferior turbinates
3) middle and inferior meatuses
4) Nasal mucosa

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 Station No. 4
A 14 year old boy
presented with history of
progressive right nasal
obstruction with ecurrent
profuse nasal bleeding for
the last one year.

•What is your provisional

diagnosis?
•What investigation do you
advise to see the extent of
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the disease?
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• Nasopharyngeal angiofibroma

• CT-scan or MRI

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 Station No. 5

•Name the equipment.

•In what surgical procedure is this

equipment is used?
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• 0° nasal telescope

• 1) Functional Endoscopic Sinus Surgery (FESS)

2) Endoscopic DCR ( Dacrocystorhinostomy)
3) Endoscopic CSF rhinorrhea repair

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 Station No. 6
A 7 year old boy
presented with sorethroat,
fever and drooling of saliva.
This was the examination
finding of oropharynx.

• Describe the findings seen in

this picture.

• Write down THREE differential

diagnosis.

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• Acute membranous tonsillitis

• 1) Diphtheria
2) Vincent Angina
3) Aphthous ulcer
4) Agranulocytosis
5) Leukoplakia
6) Infectious mononucleosis

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Station No. 7
• Identify the
instrument.

• Name any TWO

tests done using
this instrument.

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• Tuning fork

• 1) Rinne test
2) Weber test
3) Absolute bone conduction test

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 Station No.8
• Name the procedure
done here.

• Mention TWO
conditions in which this
procedure is done.

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• Anterior nasal packing

• 1) Intraoperatively during nasal and sinus surgeries

2) uncontrolled profuse epistaxis

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 Station No.9
• What is the type of
hearing loss shown in this
audiogram?

• Name TWO conditions

giving rise to such
audiogram.

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• moderate conductive hearing loss

• 1) Wax ear
2) Chronic otitis media, mucosal & squamosal type
3) OME & AOM

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 Station No.10
• What kind of
tympanogram curve is
this?

• Name ONE clinical

condition in which we
get such kind of
curve.

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• Ad type tympanogram

• Ossicular discontinuity

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 Station No.11
• What is the abnormality
seen in the X-ray?

• Name TWO differential

diagnosis.

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• A totally opaque left maxillary sinus on plain x-ray
PNS- OM/ Water’s view

• 1) Chronic maxillary sinusitis, left

2) Blunt trauma with blood in sinus
3) Malignancy in maxillary sinus

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Station No.12
• Name the
instrument.

• Mention its TWO

uses.

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• Mollison’s self retaining hemostatic mastoid
retractor

• 1) retraction of soft tissue after skin incision in

mastoidectomy & myringoplasty
2) also helps in hemostasis at the same time

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Station No.13
• Name the site and
view of this x-ray.

• What is the
advantage of this
view?

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• Plain x-ray mastoids – Towne’s view showing
translucent mastoid air cells on both sides

• In one view both the temporal bone can be seen &

compared to each other

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Station No. 14

A five year old child

complains of a painless
anterior neck swelling of 6
months duration. On
examination the finding is as
seen in the illustration.

• What is your provisional

diagnosis?

• What is the definite surgical

treatment for this condition?
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• Thyroglossal cyst

• Sistrunk’s operation ( excision of cyst tracing upto

the base of tongue & excision of central portion of
body of hyoid bone)

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 Station No. 15
• Name the procedure.

• In what TWO
conditions is this
procedure done?

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• Tympanostomy ( myringotomy & ventilation tube/
grommet insertion)

• 1) OME
2) unresolved AOM ( before perforation)

• Complications:
1) Tympanosclerosis
2) Persistent perforation after extrusion of VT
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 OSCE_2072_Day III_IOM

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 Slide No. 1

•How do you examine

nasal vestibule?
• What normal structures
do you see ?
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 • Best examined by gently lifting the tip of nose by
the left thumb

• 1) lining skin
2) hair (vibrissae)

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 Slide No. 2
A lady complains of severe
itching and fullness in the
right ear.
Examination of external
auditory canal is shown.

•What is your diagnosis ?

•How do you treat it?

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 • Fungal otitis externa (otomycosis)

• 1) Thorough cleaning of fungoid mass and

discharge of EAC by mopping, suction or syringing

2) Broad spectrum topical antifungal drug (3

drops of clotrimazole, 3 drops thrice daily for 10
days)

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 Slide No. 3
This is a laryngoscopic
picture of a recurrent
respiratory papillomatosis
in a 5 year –old child.
• Write two common
presenting symptom of this
child.
• What is the usual surgical
treatment for this
condition ?

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 • 1) Hoarseness of voice or aphonia
2) Respiratory difficulty or even stridor

• Microlaryngoscopy & CO2 laser excision avoiding

injury to the vocal ligament

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 Slide No. 4
• What type of curve
do you see in this
Tympanogram?

• Name the clinical

condition where we
find this type of
curve.

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 • Type C tympanogram

• Eustachian tube dysfunction

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 Slide No.5
Cortical ( Simple ) Mastoidectomy
• Write down any two common indications of cortical
(Simple) mastoidectomy ?

• How does cortical (Simple) mastoidectomy differ from

modified radical mastoidectomy?

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 • 1) Acute otitis media that doesn’t respond to
medical treatment after 48 hours

2) Mastoid abscess due to AOM

• Canal wall up mastoidectomy while MRM is canal

wall down mastoidectomy

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 Slide No. 6
•What
abnormality do
you see in the
anterior neck ?

• Mentio any TWO

common
differential
diagnosis ?

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 • Thyroglossal cyst

• 1) Sublingual dermoid cyst

2) Pretracheal & prelaryngeal lymph nodes

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 Slide No. 7
• Name the
instrument.

• Mention its TWO

uses.

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 • Lack’s tongue depressor

• 1) Aids in posterior rhinoscopy

2) In surgeries along with Boyle’s Davis Mouth

Gag- palatal ( palatoplasty), oral cavity
(tonsillectomy), nasopharynx (adenoidectomy)

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 Slide No. 8
• Name the
instrument.
• Mention any TWO
common surgeries
in which this
instrument is used.

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 • Luc’s Forceps

• 1) Septal surgeries ( septoplasty & submucosal

resection)

2) Caldwell- Luc’s operation

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 Slide No. 9
• What is the type of
hearing loss shown
in the illustration?

• Name any two

common
conditions found in
such an audiogram.

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 • High frequency sensorineural hearing loss

• 1) Senile/ age related hearing loss

2) Noise induced hearing loss

3) Barotrauma

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 Slide No 10
• Identify the device .

• Write down any two

common
complications using
this device .

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 • Tracheostomy tube

• 1) Dislodgement/displacement of tube

2) Infection

3) Blockage of the tube

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Slide No. 11
Posterior Rhinoscopy

• Write down any four instruments/

equipment required to perform
posterior rhinoscopy?

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 1) Posterior rhinoscopy mirror

2) Lack’s tongue depressor

3) Spirit lamp

4) Bull’s eye lamp with head mirror

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 Slide No. 12
• Write down any two
differential diagnosis of this
neck swelling.

• Mention any four common

investigations done in such
cases.

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 • 1) Thyroid swelling
2) Thyroglossal cyst
3) Laryngeal malignancy
4) Cystic hygroma

• 1) plain x-ray soft tissue neck- AP, Lateral view

2) USG

3) FNAC

4) TFT

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 Slide No. 13
• Mention the site &
view of this x-ray.

• Write down any

two abnormal
findings.

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 • Plain x-ray soft tissue neck – lateral view

• 1) Radioopaque shadow (probably FB) in the

esophagus

2)

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 Slide No. 14
FESS
• What is the full form of FESS?

• Mention its TWO common indications.

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 • Functional Endoscopic Sinus Surgery

• 1) Chronic rhinosinusitis including fungal rhinosinusitis

2) Nasal polyps- both ethmoid & antrochoanal polyps

3) Frontoethmoid mucocele

4) Septoplasty

5) Cauterization or ligation of sphenopalatine artey- in

refractory posterior epistaxis

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 Slide No. 15
• Mention the site and
view of the X-ray.

• Name two common

conditions giving rise
to these findings.

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 • Plain x-ray PNS - OM/Water’s view showing air fluid
level on both sides maxillar sinus

• 1) Chronic maxillary sinusitis

2) Blunt trauma with blood in sinuses

3) Malignancy of maxillary sinuses

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OSCE_2072_Day IV_IOM + Extra

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