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FMGE ENT Syllabus

The ENT syllabus for FMGE in full: 10 chapters, 32 topics and 96 sub-topics, every one listed below, plus 50 ENT flashcards with answers.

10Chapters

32Topics

96Sub-topics

50Flashcards

ENT syllabus: all 10 chapters

Expand any chapter to see its topics and sub-topics.

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
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
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
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
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
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
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
Obstructive sleep apnea (OSA)
3 topics
- Clinical features
- Diagnosis
  - Polysomnography
- Management
  - Continuous positive airway pressure
  - Surgical options
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
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

FMGE ENT flashcards — 50 questions with answers

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.
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.
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).
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.
What is the tonotopic organization of the cochlea?
The cochlea is frequency-mapped: the base detects high frequencies and the apex detects low frequencies.
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.
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).
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.
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).
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).

Show the other 30 ENT flashcards

What is presbycusis?
Age-related, bilateral, symmetric, progressive sensorineural hearing loss, typically affecting high frequencies first due to loss of cochlear hair cells.
List common causes of conductive hearing loss.
Cerumen impaction, otitis externa, otitis media/effusion, tympanic membrane perforation, otosclerosis, ossicular discontinuity, and cholesteatoma.
What is allergic rhinitis and what is the classic mechanism?
IgE-mediated (type I hypersensitivity) inflammation of the nasal mucosa from allergen exposure, causing sneezing, rhinorrhea, nasal congestion, and itching. Mast cell degranulation releases histamine.
What is the first-line pharmacological treatment for moderate-to-severe allergic rhinitis?
Intranasal corticosteroids; oral/intranasal antihistamines are useful for milder or intermittent symptoms.
What are common causes of nasal obstruction in adults?
Deviated nasal septum, nasal polyps, allergic/non-allergic rhinitis, turbinate hypertrophy, chronic sinusitis, and (unilateral, especially with bleeding) nasal tumors.
What is the difference between acute and chronic rhinosinusitis by duration?
Acute rhinosinusitis lasts less than 4 weeks; subacute 4-12 weeks; chronic rhinosinusitis persists 12 weeks or longer.
What are the most common bacterial causes of acute bacterial sinusitis?
Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis (same as acute otitis media).
What features suggest bacterial rather than viral acute sinusitis?
Symptoms persisting beyond 10 days, severe symptoms (high fever, purulent discharge, facial pain) for 3-4 days, or 'double worsening' (initial improvement followed by deterioration).
Where do most cases of epistaxis arise anatomically?
Most (about 90%) are anterior, arising from Little's area (Kiesselbach's plexus) on the anterior nasal septum. Posterior bleeds (often from the sphenopalatine artery) are less common but more severe.
What is the initial management of acute anterior epistaxis?
Sit forward, pinch the soft (cartilaginous) part of the nose firmly for 10-15 minutes, breathe through the mouth. If it fails: topical vasoconstrictor, chemical/electrical cautery of the bleeding point, then anterior nasal packing.
What is laryngopharyngeal reflux (LPR) and how does it differ from GERD?
Retrograde flow of gastric contents to the larynx/pharynx causing hoarseness, throat clearing, globus, and chronic cough. Unlike GERD, heartburn is often absent ('silent reflux'). Managed with PPIs, dietary/lifestyle changes.
What is the most common cause of acute laryngitis and its hallmark symptom?
Viral upper respiratory infection. Hallmark is hoarseness/dysphonia, usually self-limiting; voice rest is advised.
What are vocal cord (vocal fold) nodules and who typically gets them?
Bilateral, symmetric benign callus-like lesions at the junction of anterior and middle thirds of the vocal folds, caused by vocal overuse/abuse ('singer's/screamer's nodules'). Treated primarily with voice therapy.
What is the significance of new-onset hoarseness lasting more than 2-3 weeks in a smoker?
It is a red flag for laryngeal carcinoma and warrants urgent laryngoscopy to rule out malignancy.
What is stridor and what does inspiratory vs expiratory stridor localize to?
A harsh, high-pitched sound from turbulent airflow through a narrowed airway. Inspiratory stridor suggests extrathoracic/supraglottic-glottic obstruction; expiratory suggests intrathoracic/lower airway; biphasic suggests subglottic/tracheal obstruction.
What is the most common cause of chronic stridor in infants?
Laryngomalacia - collapse of soft supraglottic structures on inspiration, causing inspiratory stridor that worsens when supine/feeding and usually resolves by 12-18 months.
What is acute epiglottitis, its classic causative organism, and a key management caution?
Life-threatening supraglottic inflammation, classically from Haemophilus influenzae type B. Presents with the '4 Ds' (drooling, dysphagia, dysphonia, distress) and tripod posture. Do NOT examine the throat with a tongue depressor; secure the airway first.
What is croup (laryngotracheobronchitis), its cause, and hallmark features?
Viral (most often parainfluenza) subglottic inflammation in young children, causing a barking/seal-like cough, inspiratory stridor, and hoarseness. X-ray shows the 'steeple sign'. Treated with corticosteroids and nebulized adrenaline if severe.
What is the most common cause of an anterior midline neck mass that moves with swallowing and tongue protrusion?
A thyroglossal duct cyst - moves upward with tongue protrusion and swallowing because of its connection to the foramen cecum at the tongue base.
Give a differential for a lateral neck mass in an adult.
Reactive/infective lymphadenopathy, metastatic lymph node (especially squamous cell carcinoma in older smokers), lymphoma, branchial cleft cyst (younger patients), and salivary gland tumors.
What is the most common type of head and neck cancer and its major risk factors?
Squamous cell carcinoma. Major risk factors are tobacco and alcohol (synergistic); HPV (type 16) is increasingly important, especially for oropharyngeal cancer and carries a better prognosis.
What is the most common type of thyroid cancer and how does it typically spread?
Papillary thyroid carcinoma (most common, ~80%). It spreads via lymphatics to cervical nodes and generally has an excellent prognosis.
What two important structures are at risk during thyroid surgery, and what does injury to each cause?
The recurrent laryngeal nerve (injury causes hoarseness/vocal fold paralysis; bilateral injury can cause airway obstruction) and the parathyroid glands (injury/removal causes hypocalcemia).
What is the classic biochemistry of primary hyperparathyroidism, and what is the usual cause?
High serum calcium with high (or inappropriately normal) PTH and low phosphate. Usually caused by a single parathyroid adenoma; treated surgically by parathyroidectomy.
What are the early symptoms of postoperative hypocalcemia after thyroid/parathyroid surgery, and what are the classic clinical signs?
Perioral and digital paresthesia, muscle cramps, and tetany. Classic signs: Chvostek's sign (facial twitch on tapping the facial nerve) and Trousseau's sign (carpal spasm with BP cuff inflation).
What is the structured 'ABCDE' priority in airway management of a critically ill patient?
Airway (with cervical spine control), Breathing, Circulation, Disability, Exposure - assessed and treated in that order, with the airway always addressed first.
What is the definition and components of a primary immunodeficiency that should be suspected with recurrent ENT infections?
An inherited defect in the immune system. Suspect it with recurrent/severe/persistent ENT and sinopulmonary infections (e.g., recurrent otitis media/sinusitis), failure to thrive, or unusual organisms. Examples include selective IgA deficiency and common variable immunodeficiency.
In nasal/midface (facial) trauma, what must be excluded after nasal injury, and why is it urgent?
A septal hematoma - a collection of blood between the septal cartilage and perichondrium. It must be drained urgently because untreated it causes cartilage necrosis (avascular) leading to a saddle-nose deformity or abscess.
What is a Le Fort fracture classification of the midface?
Le Fort I: horizontal fracture above the maxillary teeth (floating palate). Le Fort II: pyramidal fracture through the nasal bridge and maxilla (floating maxilla). Le Fort III: craniofacial disjunction separating the midface from the skull base.
What is a 'CSF rhinorrhea' sign and how can it be confirmed after head/facial trauma?
Leakage of cerebrospinal fluid from the nose due to a skull base (cribriform plate) fracture. Confirmed by testing the fluid for beta-2 transferrin (specific for CSF), or the 'halo/ring sign' on tissue.

Same ENT syllabus in other exams

The ENT outline above is identical in these 3 exams:

FMGE ENT FAQ

What is in the FMGE ENT syllabus?

FMGE ENT is split into 10 chapters: Anatomy and Physiology, Otology, Rhinology, Laryngology, Head and Neck Surgery, Pediatric Otorhinolaryngology, Audiology and Vestibular Disorders, Obstructive sleep apnea (OSA), Allergy and Immunology and Emergency Otorhinolaryngology. Together they contain 32 topics and 96 sub-topics.

How many chapters are in FMGE ENT?

10 chapters, containing 32 topics and 96 sub-topics. The largest chapter is Otology, with 5 topics.

Are there flashcards for FMGE ENT?

Yes — a 50-card ENT deck, printed in full in the flashcards section of this page and available in the Examius app with spaced repetition. The free plan covers one exam of your choice, including its flashcards; Examius Pro, a one-time purchase, unlocks every other exam and deck.