ENT Sendup solved Seqz- part 2

>> A 50 years old diabetic male for last 10 years is admitted in the medical ward for management of diabetic ketoacidosis. Black necrotic turbinate is noted in the right nostril along with right eye proptosis by the medical resident on call. The patient is sent to ENT department for consultation.
a. Diagnosis?(mucormycosis)
b. How will you prove your diagnosis?
c. Manage? (CPMC)

>> A young man has peculiar nasal obstruction that he can breathe in but cannot breathe out. On examination he has a mass in left nostril.
a. Diagnosis?(Antrochoanal poly)
b. Investigate?
c. treatment? (CPMC)

>> A 30 years old female complains of proptosis of the right eye, diminution of vision in the right eye, rhinorrhea and cough.
a. differential diagnosis?(C.A sinus,Orbital cellulitis)
b. what investigations will you prefer to confer or negate each of your diagnosis? (CPMC)

>> A 55 years old lady presents with right sided nasal obstruction, foul smelling blood stained discharge, right sided proptosis and pain in face. Examinsation aslso reveals a loose right upper molar tooth. How will you manage? (CMC)

>> Causes of unilateral nasal discharge. How will you treat rhinolith? (CMC)

>> Classify nasal polyp. How will you diagnose and treat case of Antrochoanal polyp. (CMC)

>> A 14 year old boy presented in ENT OPD with his mothers with compaints of bleeding from nose off and on for the last 8 months. His mother tells you that he is having nasal obstruction and his voice quality has also changed.
a. Diagnosis and which single examination procedure would you like to carry out to reach to a provisional diagnosis?Juvenile angiofibroma
b. manage? (AIMC)

>> A 40  year old diabetic, immunocompromised woman presented with nasal obstruction, headache and swelling of left eye. CT scan shows double density sign in paranasal sinuses.
a. Diagnosis?(fungal sinusitis,needs to b confirmed)
b. management plan? (AIMC)

>> A 40 years old patient has presented with history of attacks of profuse clear watery nasal discharge with transient obstruction. Laboratory finding show normal IgE levels
a. Diagnosis?VMR
b. what other important condition is to be excluded?
c. differentiating features in respect of cause, age of onset, complaints and lab findings in each? (WMC)

>> A 30 year old diabetic developed boil nose. He was seen by general physician and was given antibiotics and anti inflammatory drugs. 3 days later he developed high grade fever, swelling of eyes, prostration, headache and diplopia.
a. Diagnosis?COmplication of boil=cavernous sinus thrombosis
b. Investigate?
c. Manage? (WMC)

>> A man gets feeling of tightness in the face and cheeks followed by blood stained nasal discharge after air travel. Also complains of headache of dull nature.
a. diagnosis?Epistaxis due to decompression sickness
b. definition, etiology, pathology clinical features and management in this case
c. How can you prevent this condition? (WMC)

>> Enumerate tumors of nasopharynx. Discuss treatment of nasopharyngeal carcinoma. (QAMC)

A young boy presented history of nose trauma 244 hours back. On examination nose is blocked with blood clots, nasal bridge is swollen with deviation of nose. How will you manage the case? What complications can be associated? (QAMC)

>> A 35 years old diabetic male presented with fever headache and nasal obstruction since last night. On examination, there is tenderness over cheeks, vision is alright, nasal mucosa is congested with purulent discharge coming through middle meatus. What is the most probable diagnosis?(C.A.Max sinus,but not confirm) What complications can occur? (QAMC)

>> patients with red spot on her lips suffers from regular nose bleeds, she is also under treatment for gut lesions.
a. possibility?Hereditary Telangectesia
b. investigate?
c. treatment (FMH)

>> 14 year old boy has right side nasal obstruction that is progressive in nature and massive nasal bleeding off and on. On examination, a mass is present in right nostril and there is also swelling of right check.
a. diagnosis?Angiofibroma
b. Confirm your diagnosis?
c. if same mass extending into cheek, mention its route. (NSMC)

>> 47 yr male with bilateral nasal obstruction, headache and postnasal discharge. On examination his nasal cavities are filled with multiple whitish looking masses that are insensitive to touch.
a. diagnosis.Ethmoidal poly
b. surgical approaches and which one is best and why?
c. complications of surgery? (NSMC)

>> 27 years old school teacher with h/o nasal obstruction, watery nasal secretions and occasional sneezing specially at morning timings. She is in the habit of using a decongestant nasal spray. Her inferior turbinates were swollen and wet.
a. diagnosisVMR
b. how this differs from nasal allergy?
c. manage(NSMC)

>> 60 years old diabetic woman develops fever with b/l nasal congestion, orbital swelling of right side of face and facial pain for the last 6 days, endoscopy shows areas of congestion of nasal mucosa with black necrotic mucous on both sides
a. diagnosis.mucormycosis
b. investigation
c. treat? (RMC)

>> 15 year young girl with severe watery rhinorrhea bilaterally alongwith occasional nasal congestion. Dark circles under the eyes and pale boggy inferior turbinates.
a. diagnosis.Allergic Rhinitis
b. investigate
c. treatment(RMC)

>> 20 year old woman was using vasoconstrictor nasal drops on and off for reducing rhinosinusitis for 6 years. She gets attacks of nasal discharge sneezing and permanent nasal obstruction. She has grape like masses hanging in the nasal cavity.
a. diagnosis.Bilateral etmoidal polps 
b. medical treatment options?
c. best surgical procedure, enumerate complications also. (RMC)

>> various non traumatic causes of CSF rhinorhoea?
b. imp radiological investigations?
c. management? (SIMS)

>> Male child 14 years with recurrent epistaxis and right sided nasal obstruction for last 6 months. Mass in right nasal cavity and nasopharynx which is lobulated and pinkish in colour.
a.diagnosis?Anjiofibroma
b. investigations?
c. manage? (SIMS)

>> Management of a 20 years old motorcyclist who has sustained injuries on his facein a road traffic accident. (SIMS)

>> 22 years female with right sided nasal obstruction and foul smeling rhinorrhea for last 2 months. X-rays of paranasal sinuses showed opacity of right nasal cavity and maxillary sinus.
a. diagnosis.chronic max.sinusitis
b. treat? (SZMC)

>> 4 years old child with b/l nasal obstruction. h/o nasal trauma 2 days back. Anterior rhinoscopy revealed bilateral cystic swelling of septum.
a. diagnosis.septal hematoma
b. treat
c. complications(SZMC)

>> 30 years old female with c/o intermittent attacks of sneezing, nasal blockage and watery nasal discharge for last 5years. For the last 1 yeear, she states that her left sided nasal blockage has increased in intensity. Her nasal examnination showed septal deviation to right side with pearly white glistening multiple masses in left nasal cavity.
a. diagnosis.ethmoidal polyp
b. investigate and treat? (SZMC)

>> 3 year old female baby with mouth breathing, exclusive watering from mouth at right, nocturnal cough and occasional epistaxis. On anterior rhinoscopy, nothing abnormal is visible.
a. diagnosis?Adenoids
b. radiological investigations?
c. Treat? (IMC)

>> Boxer got sever injury to nose on day before and presented with epistaxis and almost complete blockage of nose. No external deformity of nose. Anterior rhinoscopy shows bilateral smooth reddish swellings. X-ray nasal bone shows no fracture.
a. diagnosis?Septal hematoma
b. treat?
c. complication? (IMC)

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