NExT ENT and Ophthalmology (Regional Specialties) Syllabus

ENT and Ophthalmology (Regional Specialties) syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for ENT and Ophthalmology (Regional Specialties) in NExT, not a summary of it.

1. 1

   Diseases of the Ear

   4 topics

   • Hearing Assessment and Deafness
     • Conductive vs sensorineural; tuning fork and audiometry
   • Diseases of the External and Middle Ear
     • Otitis externa, ASOM, CSOM, cholesteatoma
   • Otosclerosis and Inner Ear Disorders
     • Meniere disease, vertigo, tinnitus
   • Facial Nerve Disorders and Complications of Ear Disease
2. 2

   Diseases of the Nose and Paranasal Sinuses

   4 topics

   • Nasal Obstruction and DNS
   • Rhinitis and Sinusitis
     • Allergic rhinitis, acute and chronic sinusitis
   • Epistaxis and Nasal Trauma
   • Nasal Polyps and Sinonasal Tumors
3. 3

   Diseases of the Throat, Larynx and Head-Neck

   5 topics

   • Tonsil and Adenoid Disorders
   • Laryngeal Disorders and Stridor
     • Hoarseness, vocal cord palsy, laryngeal carcinoma
   • Pharyngeal Diseases and Dysphagia
   • Head and Neck Tumors and Neck Masses
   • Tracheostomy and Airway Emergencies
4. 4

   Basic Ophthalmology and Anterior Segment

   5 topics

   • Disorders of the Conjunctiva and Cornea
     • Conjunctivitis, trachoma, corneal ulcer
   • Cataract
     • Types, evaluation, surgical management
   • Glaucoma
     • Open-angle, angle-closure, management
   • Uveitis and Scleral Disorders
   • Refractive Errors and Optics
     • Myopia, hypermetropia, astigmatism, presbyopia
5. 5

   Posterior Segment, Neuro-ophthalmology and Community Eye Health

   5 topics

   • Retinal Disorders
     • Diabetic and hypertensive retinopathy, retinal detachment
   • Optic Nerve and Visual Pathway Disorders
     • Optic neuritis, papilledema, field defects
   • Squint and Ocular Motility
   • Ocular Trauma and Emergencies
   • Preventable Blindness and National Programs
     • NPCB, cataract and refractive error control

ENT and Ophthalmology (Regional Specialties) flashcards for NExT

25 of 51 cards from the ENT and Ophthalmology (Regional Specialties) deck — real questions with worked answers.

1. In pure tone audiometry, what defines a conductive hearing loss?

   Air conduction (AC) thresholds are elevated (worse) while bone conduction (BC) thresholds are normal, producing an air-bone gap (AC worse than BC by >10 dB).

2. How do Rinne and Weber tests localize a unilateral conductive hearing loss?

   Rinne is negative (BC > AC) in the affected ear; Weber lateralizes to the affected (poorer-hearing) ear.

3. How do Rinne and Weber tests present in unilateral sensorineural hearing loss?

   Rinne is positive (AC > BC) in both ears; Weber lateralizes to the normal (better-hearing) ear.

4. What audiometric finding is characteristic of noise-induced hearing loss?

   A sensorineural notch at 4000 Hz (4 kHz dip) on the audiogram.

5. What is the most common cause of chronic suppurative otitis media (CSOM) safe type, and which structures does the unsafe type endanger?

   Safe (tubotympanic) type: central tympanic perforation with mucosal disease. Unsafe (atticoantral) type: cholesteatoma/attic perforation that erodes bone and can cause intracranial complications.

6. What is a cholesteatoma?

   Keratinizing stratified squamous epithelium trapped within the middle ear/mastoid that accumulates keratin debris and erodes bone; it is locally destructive but not a true tumor.

7. What is the most common organism causing acute otitis media in children?

   Streptococcus pneumoniae (followed by Haemophilus influenzae and Moraxella catarrhalis).

8. What is otitis externa malignant (necrotizing) type, and which patients and organism are typically involved?

   Aggressive osteomyelitis of the skull base, typically in elderly diabetics or immunocompromised patients, caused by Pseudomonas aeruginosa.

9. What is the classic clinical triad of otosclerosis?

   Progressive conductive hearing loss (often bilateral), tinnitus, and a pinkish hue over the promontory seen through the drum (Schwartze sign) in active disease.

10. What is paracusis willisii, seen in otosclerosis?

    The phenomenon where the patient hears better in noisy surroundings, characteristic of conductive hearing loss in otosclerosis.

11. What is the audiometric Carhart's notch in otosclerosis?

    A dip in the bone conduction threshold at 2000 Hz (2 kHz), an artefactual notch that improves after successful stapedectomy.

12. What is the classic triad/symptom complex of Meniere's disease?

    Episodic rotational vertigo, fluctuating sensorineural hearing loss (low frequency), and tinnitus, with a sensation of aural fullness; due to endolymphatic hydrops.

13. What is the most common cause of recurrent positional vertigo, and how is it diagnosed and treated?

    Benign paroxysmal positional vertigo (BPPV); diagnosed with the Dix-Hallpike maneuver and treated with the Epley repositioning maneuver.

14. Through which segment of the facial nerve does the lesion lie in Bell's palsy, and what is its presentation?

    Idiopathic lower motor neuron facial palsy involving the intratemporal (often labyrinthine/geniculate) segment; presents with sudden unilateral whole-face weakness including the forehead.

15. How do you clinically distinguish an upper motor neuron from a lower motor neuron facial palsy?

    UMN palsy spares the forehead (bilateral cortical supply to upper face); LMN palsy involves the whole half of the face including the forehead.

16. What is Ramsay Hunt syndrome?

    Herpes zoster oticus: facial palsy with vesicles in the external auditory canal/pinna, otalgia, and often sensorineural hearing loss and vertigo, caused by varicella-zoster reactivation in the geniculate ganglion.

17. Name the major intracranial complications of unsafe CSOM/cholesteatoma.

    Meningitis, extradural/subdural abscess, brain abscess (temporal lobe or cerebellar), lateral sinus thrombophlebitis, and otitic hydrocephalus.

18. What is the most common cause of nasal obstruction due to a structural deviation, and what is DNS?

    Deviated nasal septum (DNS): deviation of the bony/cartilaginous nasal septum causing unilateral or alternating nasal obstruction; corrected by septoplasty or SMR.

19. Differentiate allergic rhinitis from vasomotor rhinitis.

    Allergic rhinitis is IgE-mediated with sneezing, watery rhinorrhea, itching, eosinophilia and identifiable allergens; vasomotor rhinitis is non-allergic, non-eosinophilic autonomic imbalance triggered by temperature/odors, with mainly nasal blockage and rhinorrhea.

20. What is rhinitis medicamentosa?

    Rebound nasal congestion caused by prolonged use (>5-7 days) of topical decongestant nasal drops/sprays (e.g., oxymetazoline).

21. Which sinus is most commonly involved in acute bacterial sinusitis in adults, and what are the common organisms?

    The maxillary sinus; organisms are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.

22. What is the danger of frontal/ethmoid sinusitis spreading, and name a serious orbital complication.

    Spread can cause orbital cellulitis or orbital/subperiosteal abscess (most often from ethmoid sinusitis) and cavernous sinus thrombosis.

23. Where is the most common site of anterior epistaxis?

    Little's area (Kiesselbach's plexus) on the anteroinferior nasal septum.

24. Which artery supplies the posterior nasal cavity and is the usual source of posterior epistaxis?

    The sphenopalatine artery (a branch of the maxillary artery).

25. What is a CSF rhinorrhea, and which simple bedside test helps confirm it?

    Leakage of cerebrospinal fluid from the nose due to a skull-base/cribriform plate defect; the halo (double ring) sign on tissue and beta-2 transferrin assay confirm it (glucose testing is unreliable).

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