FMGE ENT Syllabus

ENT syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for ENT in FMGE, not a summary of it.

1. 1

   Anatomy and Physiology

   2 topics

   • Anatomy of the ear, nose, throat, and related structures
     • External ear
     • Middle ear
     • Inner ear
     • Nasal cavity
     • Paranasal sinuses
     • Pharynx
     • Larynx
     • Trachea
   • Physiology of hearing, balance, smell, taste, and speech production
2. 2

   Otology

   5 topics

   • Ear examination
     • Otoscopy
     • Tuning fork tests (Weber and Rinne tests)
     • Audiometry
   • Outer ear disorders
     • Otitis externa
     • Foreign body in the ear
     • Trauma to the external ear
   • Middle ear disorders
     • Acute otitis media
     • Chronic otitis media
     • Otosclerosis
     • Tympanic membrane perforation
   • Inner ear disorders
     • Meniere's disease
     • Vestibular neuritis
     • Labyrinthitis
   • Hearing loss
     • Conductive hearing loss
     • Sensorineural hearing loss
     • Mixed hearing loss
     • Evaluation and management
3. 3

   Rhinology

   4 topics

   • Nasal examination
     • Anterior rhinoscopy
     • Endoscopy
     • Imaging (CT scan, MRI)
   • Nasal obstruction
     • Deviated nasal septum
     • Nasal polyps
     • Allergic rhinitis
     • Nasal tumors
   • Sinusitis
     • Acute sinusitis
     • Chronic sinusitis
     • Fungal sinusitis
     • Complications of sinusitis
   • Epistaxis
     • Causes
     • Evaluation
     • Management of anterior and posterior epistaxis
4. 4

   Laryngology

   4 topics

   • Laryngeal examination
     • Indirect laryngoscopy
     • Direct laryngoscopy
     • Flexible laryngoscopy
   • Voice disorders
     • Hoarseness
     • Dysphonia
     • Vocal cord nodules
     • Vocal cord paralysis
     • Laryngeal tumors
   • Laryngopharyngeal reflux
     • Clinical features
     • Diagnosis
     • Management
   • Stridor
     • Causes of inspiratory and expiratory stridor
     • Evaluation
     • Management
5. 5

   Head and Neck Surgery

   4 topics

   • Neck masses
     • Evaluation and management of cervical lymphadenopathy
     • Evaluation and management of thyroid nodules
     • Evaluation and management of salivary gland tumors
   • Thyroid surgery
     • Thyroidectomy for benign and malignant thyroid disorders
     • Lobectomy for benign and malignant thyroid disorders
     • Isthmectomy for benign and malignant thyroid disorders
   • Parathyroid surgery
     • Parathyroidectomy for hyperparathyroidism
   • Head and neck cancer
     • Squamous cell carcinoma of the head and neck
     • Management principles
     • Surgical approaches
6. 6

   Pediatric Otorhinolaryngology

   3 topics

   • Pediatric ear disorders
     • Otitis media with effusion
     • Acute otitis media
     • Congenital hearing loss
   • Pediatric nasal and sinus disorders
     • Choanal atresia
     • Adenoid hypertrophy
     • Nasal foreign bodies
   • Pediatric airway disorders
     • Laryngomalacia
     • Tracheomalacia
     • Congenital laryngeal anomalies
7. 7

   Audiology and Vestibular Disorders

   3 topics

   • Audiological evaluation
     • Pure tone audiometry
     • Speech audiometry
     • Tympanometry
     • Auditory brainstem response (ABR)
   • Vertigo and dizziness
     • Benign paroxysmal positional vertigo (BPPV)
     • Vestibular neuritis
     • Meniere's disease
     • Vestibular migraine
   • Vestibular testing
     • Caloric testing
     • Vestibular evoked myogenic potentials (VEMP)
     • Rotary chair testing
8. 8

   Obstructive sleep apnea (OSA)

   3 topics

   • Clinical features
   • Diagnosis
     • Polysomnography
   • Management
     • Continuous positive airway pressure
     • Surgical options
9. 9

   Allergy and Immunology

   2 topics

   • Allergic rhinitis
     • Clinical features
     • Allergen testing
     • Management
   • Immunodeficiency disorders
     • Evaluation and management of primary and secondary immunodeficiencies affecting the upper respiratory tract
10. 10

    Emergency Otorhinolaryngology

    2 topics

    • Airway management
      • Assessment and management of upper airway obstruction
      • Foreign body aspiration
      • Epiglottitis
    • Facial trauma
      • Evaluation and management of facial fractures
      • Nasal fractures
      • Laryngeal trauma

ENT flashcards for FMGE

20 of 50 cards from the ENT deck — real questions with worked answers.

1. What are the three anatomical divisions of the ear, and what separates the outer from the middle ear?

   External (outer), middle, and inner ear. The tympanic membrane (eardrum) separates the external ear from the middle ear.

2. Name the three ossicles of the middle ear in order from the tympanic membrane to the oval window.

   Malleus, incus, and stapes. The stapes footplate fits into the oval window.

3. Which nerve supplies general sensation to most of the tongue, and which supplies taste to its anterior two-thirds?

   General sensation to the anterior two-thirds is via the lingual nerve (V3); taste to the anterior two-thirds is via the chorda tympani (branch of facial nerve, CN VII). The posterior third gets both taste and sensation from the glossopharyngeal nerve (CN IX).

4. Describe the basic process of sound transduction in the cochlea.

   Sound vibrations move the ossicles, pushing the stapes on the oval window, creating fluid waves in the cochlea. These deflect the basilar membrane and stereocilia of hair cells in the organ of Corti, opening ion channels and generating action potentials in the cochlear nerve.

5. What is the tonotopic organization of the cochlea?

   The cochlea is frequency-mapped: the base detects high frequencies and the apex detects low frequencies.

6. Which structures of the inner ear sense rotational (angular) acceleration versus linear acceleration/gravity?

   The three semicircular canals (via cristae ampullaris) sense rotational/angular acceleration; the otolith organs (utricle and saccule, via maculae) sense linear acceleration and head position relative to gravity.

7. What is the difference between conductive and sensorineural hearing loss on Rinne and Weber tests?

   Conductive loss: Rinne negative (bone > air) in affected ear, Weber lateralizes TO the affected ear. Sensorineural loss: Rinne positive (air > bone), Weber lateralizes AWAY from the affected ear (to the better ear).

8. How is the Weber test performed and interpreted?

   A vibrating 512 Hz tuning fork is placed on the midline of the forehead/vertex. Normal: heard equally in both ears. Sound lateralizes to the affected ear in conductive loss and to the better ear in sensorineural loss.

9. What is otitis externa, and what is its most common bacterial cause?

   Inflammation/infection of the external auditory canal ('swimmer's ear'), presenting with ear pain, tragal tenderness, and discharge. Most common cause is Pseudomonas aeruginosa (also Staphylococcus aureus).

10. What organism causes malignant (necrotizing) otitis externa, and in which patients does it typically occur?

    Pseudomonas aeruginosa, typically in elderly diabetics or immunocompromised patients. It is an invasive osteomyelitis of the skull base and is potentially fatal.

11. What is acute otitis media, and what are its three most common bacterial pathogens?

    Acute suppurative infection of the middle ear, common in children. Top pathogens: Streptococcus pneumoniae, Haemophilus influenzae (non-typeable), and Moraxella catarrhalis.

12. What is otitis media with effusion (glue ear), and how does it differ from acute otitis media?

    Fluid in the middle ear without acute infection signs; causes conductive hearing loss with a retracted/dull immobile drum. Unlike AOM, there is no acute pain or systemic infection. Common cause of hearing loss in children.

13. What is a cholesteatoma and why is it dangerous?

    An abnormal collection of keratinizing squamous epithelium in the middle ear/mastoid. It is locally destructive, erodes ossicles and bone, and can cause hearing loss, facial palsy, labyrinthine fistula, and intracranial complications.

14. What is otosclerosis and how does it typically present?

    Abnormal bone remodeling around the stapes footplate fixing it to the oval window, causing progressive conductive hearing loss, often in young adults with a family history. Carhart's notch on audiogram and a pinkish promontory (Schwartze sign) may be seen.

15. What is the classic triad of Meniere's disease?

    Episodic vertigo (lasting minutes to hours), fluctuating sensorineural hearing loss (typically low-frequency), and tinnitus, often with aural fullness. Due to endolymphatic hydrops.

16. What characterizes benign paroxysmal positional vertigo (BPPV) and how is it diagnosed and treated?

    Brief (seconds) episodes of vertigo triggered by head position changes, due to otoconia in a semicircular canal (usually posterior). Diagnosed with the Dix-Hallpike maneuver; treated with the Epley repositioning maneuver.

17. What is a vestibular schwannoma (acoustic neuroma) and how does it present?

    A benign tumor of the vestibular portion of CN VIII (Schwann cells), classically causing unilateral sensorineural hearing loss, tinnitus, and imbalance. MRI with gadolinium is the investigation of choice. Bilateral tumors suggest neurofibromatosis type 2.

18. Differentiate central from peripheral vertigo based on nystagmus.

    Peripheral: horizontal/rotatory nystagmus, suppressed by visual fixation, with hearing symptoms; benign cause. Central: vertical/direction-changing nystagmus, NOT suppressed by fixation, with other neuro signs; suggests brainstem/cerebellar pathology.

19. What does the HINTS exam assess and what finding suggests a central cause of acute vertigo?

    HINTS = Head Impulse, Nystagmus, Test of Skew. A NORMAL head impulse test, direction-changing nystagmus, or skew deviation suggests a central (stroke) cause rather than peripheral vestibular neuritis.

20. What is a tympanogram, and what do Type A, B, and C curves indicate?

    Measures tympanic membrane mobility/middle-ear pressure. Type A = normal; Type B = flat (effusion or perforation); Type C = negative middle-ear pressure (Eustachian tube dysfunction).

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