Transcript FRCS ( ORL-HNS) Part one - ENT Tzar Ltd :: Educating

Tuesday 13th July 2011
Toynbee Club Meeting
St Mary’s Hospital
Format
SBA
 Paper 1 [2 hours]
 Single Best Answer Paper (SBA)
 110 Multiple Choice Questions
 (Single Best Answer Format; 1 from 5) )
Sample
A previously fit 38 year old woman is referred with an incomplete unilateral
facial palsy of two weeks duration. Apart from the left sided nasal obstruction,
crusting of recent onset and some wheezing, she has otherwise been well.
Examination reveals a left sided facial palsy of House Brackmann grade 2, some
granularity of the nasal septal mucosa and bilateral cervical lymphadenopathy.
A few sibilant rhonchi can be heard in the chest.
Which one of the following investigations would be most effective in establishing
a diagnosis?
A
B
C
D
E
c-ANCA
Chest X-ray
Differential white cell count
Serum ACE
Urinalysis
In the investigation of allergic rhinitis, the radioallergoabsorbent test
(RAST) is used to detect which of the following in the patients serum?
A
B
C
D
E
Immunoglobulin A
Immunoglobulin D
Immunoglobulin E
Immunoglobulin G
Immunoglobulin M
A 25 year old novice SCUBA diver dives to 30m. During the ascent he
experiences otalgia. Which of the following is the most likely cause?
A
B
C
D
E
Negative interstitial pressure within middle ear mucosa
Referred pain from a molar tooth due to trapped gas below a filling
Referred pain from an agger nasi cell
Referred pain from an ipsilateral concha bullosa
Referred pain from overstretching of stretch receptors in the trachea
Which of the following statements regarding the cause of facial
trauma is true?
A Assault is the commonest cause of facial trauma in the UK
B Facial injury in the home is the most common in the 30-50 age
group
C In the UK, consumption of alcohol by the victim or the assailant
occur in less than 25% of cases
D The design and construction of beer glasses has been shown to
have no effect on the incidence of maxillofacial injuries
E Worldwide, road traffic accidents play a small part in the cause
of maxillofacial injury
A 58 year old woman has undergone a thyroid lobectomy for what was
thought to be a solitary “cold” adenoma. Ten days later the histology
report confirms the diagnosis as a medullary carcinoma.
What is the best advice on future management?
A
B
C
D
E
Careful follow up in the multidisciplinary outpatient clinic
Chemotherapy and radiotherapy
Radio-iodine therapy
Regular monitoring of calcitonin levels
Total thyroidectomy and removal of any enlarged lymph nodes
Format
EMI
 Paper 2: [2 hours 30 minutes]
 Extending Matching Item Paper (EMI)
 135 Multiple Choice Questions
 (Extended Matching Item Format)
SOLID TUMOURS
A
B
C
D
E
F
G
H
I
J
K
L
M
Adenocarcinoma
Chondrosarcoma
Esthesioneuroblastoma
Glioblastoma
Medullary cell carcinoma
Medulloblastoma
Nephroblastoma
Osteosarcoma
Paraganglioma
Plasmacytoma
Rhabdomyosarcoma
Squamous cell carcinoma
Teratoma
From the options shown above, choose the single most likely diagnosis for each of the
scenarios below. Each option may be used once, more than once or not at all.
A 20 year old man complains of a sensation of blockage of his left nasal airway, reduced
sense of smell and epistaxis.
SOLID TUMOURS
A
B
C
D
E
F
G
H
I
J
K
L
M
Adenocarcinoma
Chondrosarcoma
Esthesioneuroblastoma
Glioblastoma
Medullary cell carcinoma
Medulloblastoma
Nephroblastoma
Osteosarcoma
Paraganglioma
Plasmacytoma
Rhabdomyosarcoma
Squamous cell carcinoma
Teratoma
From the options shown above, choose the single most likely diagnosis for each of the scenarios below. Each option may be
used once, more than once or not at all.
An 8 year old girl has left sided nasal obstruction, blood-stained discharge and swelling of the left cheek.
SOLID TUMOURS
A
B
C
D
E
F
G
H
I
J
K
L
M
Adenocarcinoma
Chondrosarcoma
Esthesioneuroblastoma
Glioblastoma
Medullary cell carcinoma
Medulloblastoma
Nephroblastoma
Osteosarcoma
Paraganglioma
Plasmacytoma
Rhabdomyosarcoma
Squamous cell carcinoma
Teratoma
From the options shown above, choose the single most likely diagnosis for each of the scenarios below. Each option may be
used once, more than once or not at all.
A 24 year old pregnant woman reaches term and is due to deliver imminently. An ultrasound scan of the baby shows a large
complex mass of the neck compressing the trachea.
Structure
 1. Paeds ( embryology & Syndromes)
2. Otol (including neuro-otol and audiology)
3. Rhinology (including Facial plastic)
4. Head and neck
5. Medical jurisdiction (ie ethics, consent, GMC, DVLA
,data protection etc)
6. Basic sciences (immuno, embryo, genetics pharmacol)
7. Stats and screening
8. ?Medicine relevant to ENT (rheumatol, CT diseases,
microbiol), maybe this can be distributed between 1-4?)
Recent FRCS
Classification of questions
 5 stat and screening ( simple)
 10 basics (anatomy ( 3 embryology))
 10 electrophysiology tests ( very hard)
 10 jurisdiction, consent, DVLA and ethical
 50 medicine and neurology related questions ( mostly about neurology)
 50 otology and neuro-otology including audiology
 15 head and neck (benign & oncology)
 20 rhinology ( 10 complications of FESS)
 10 paediatric ( audiology, airway and neck masses)
 50 mixed and common sense questions ( simple)
You have to answer
150 out 253 questions
correctly
Resources
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£ 40 used
£ 60 new
Best book
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400 pages
3500 Q & A
Up2date & Coves everything
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