INTRODUCTION TO OSPE

(ENT- STATIC STATIONS)

Dr. M. Saleem
1. MICROTIA (1)
2. 6 YEARS (1)
3. CAULIFLOWER EAR (1)
4. REPEATED TRAUMA (1)
 A
Nasal process
of maxilla
B
Lesser Alar
carlages
D
C

EXAMINE THE PICTURE CAREFULLY AND ANSWER THE FOLLOWING:

1. Label A? (1)
2. Label B? (1)
3. Label C? (1)
4. Label D? (1)

KEY:

1. Nasal Bone (1)

2. Lateral Car9lage (1)
3. Alar Car9lage (1)
4. Septal Car9lage (1)
 ENT OSPE
1. What is this X-RAY? (1)
2. What is the view of this X-ray? (1)
3. Label the X-Ray? (3)

done

KEY:

1. X-RAY PNS 45 degree.

2. Water’s View/ Occipitomental View of the sinuses
3. A  Frontal Sinus
B  Nasal Septum
C  Maxillary Sinus
 ENT OSPE

4 Year girl was brought in ENT OPD by the mother telling that she saw some
white shining thing in the le9 ear. The girl had no complaints .The girl had no
complaints. On examina:on there was a white shining plas:c like rounded
object lying close to the tympanic membrane. She otherwise is a very
coopera:ve child?

1. What is your Diagnosis? (1)

2. How will you remove this? (1)
3. What are two kinds of these? (1)
4. Which type this appears to be? (1)
5. If this type not removed immediately what will happen? (1)

KEY: done

1. Foreign Body Ear.

2. As child is coopera:ve syringing can be done.
3. Organic and Inorganic.
4. Inorganic.
5. Nothing serious will happen.
 1. What is this posi:on called? (1)
2. Explain this Posi:on? (1)
3. What are the advantages of this posi:on? (1)
4. What are the absolute indica:ons of tonsillectomy (any 2)? (2)

KEY:

1. Rose Posi:on
2. Neck extended by a cushion/sand bag under the shoulder and head
supported on a ring.
3. In this posi:on larynx lies at high posi:on than oral cavity so chances of
aspira:on minimized.
Excellent Exposure.
4. Malignancy
Tonsilli:s causing febrile seizures
Recurrent Peritonsillar abcess
Obstruc:ve symptoms.
A pt. came in the emergency with h/o roadside accident. He was giving h/o
complete obstruc:on. On examina:on nose was tender to touch, there was
fusiform swelling in the nose bilaterally. It was pinkish in color & pt.’s
temperature is normal.

a) What is the diagnosis? (1)

b) How would you treat it? (2)
c) What are the main complica:ons if not treated? (2)

KEY:

a) Septal Hematoma
b) Aspira:on
Incision and Drainage
Nasal Packs
An:bio:c cover
c) Septal Abcess
Perfora:on
Necrosis of septum
Depression of nose/saddle shaped deformity
A 15-year-old pale looking boy presents with history of severe nosebleed oB and
on for last 3 years. Bleeding is very profuse and at :mes life threatening.

1. What is the probable diagnosis? (1)

2. What Inves:ga:ons will you do to conCrm your diagnosis? (1)
3. What is the role of biopsy in diagnosis? (1)
4. What Inves:ga:ons will you do to know about the feeding vessel? (1)
5. What is the accepted treatment in this condi:on? (1)

KEY: done

1. AngioFibroma
2. CT Scan
3. Biopsy is contraindicated
4. Angiography
5. Surgical Excision
 ENT OSPE

A 5 year old Boy is brought by mother with recurrent episodes of nose bleed
there is no history of any bleeding disorder. On examina:on there is a dilated
vessel just behind the columella on both sides and fresh blood in both nasal
ves:bules.

1. Name the vessel involved? (1)

2. What is the commonest cause of nose bleed in children? (1)
3. How will you manage this child? (2)
4. How will you counsel the child/mother? (1)

KEY:

1. Retrocolumellar vein
2. Repeated nose picking
3. Cautery to the bleeding vessel
Applica:on of emmolients
4. No nose picking
 1. What does the arrow in X-RAY shows? (1)
2. What is it sugges:ve of ? (1)
3. What is the most important cause of inspiratory stridor in a newborn? (1)
4. What is the management of laryngomalacia? (2)

KEY:

1. Steeple Sign
2. Croup usually caused by paramyxo-virus
3. Laryngomalacia
4. Conserva:ve managent
Tracheostomy may be required for severe cases of respiratory obstruc:on
A 30 year old female developed sneezing nasal conges:on and watery nasal
discharge every year in months of march and april. She got shortness of breath
with dry cough during the same season.

1. What is she suBering from? (1)

2. What Inves:ga:ons will you do? (2)
3. How will you treat her? (2)

KEY:

1. Seasonal Allergic Rhini:s with Asthma

2. Skin prick test
IgE levels
Nasal Smear
Nasal provoca:on test
3. An:histamines, Oral and topical steroids, Mast cell stabilizers, Nasal
decongestants, Bronchodilators.
 1. Explain the Cndings in the picture? (1)
2. What is the most common cause of middle congenital mass in neck?(1)
3. What is its management? (2)
4. What is the main complica:on if not properly excised? (1)

KEY:

1. A red, erythematous swelling in the midline of neck with signs of

inIamma:on present.
2. Thyroglossal duct/cyst.
3. Incision and drainage
An:bio:cs
Sistrunk procedure (Surgical resec:on/excision and removal of central
por:on of hyoid bone)
4. Recurrence
A Boxer developed a swelling of the pinna following a hit on ear, oblitera:ng all
the contours. The pinna is tender, red and swollen.

1. What is the diagnosis? (1)

2. Men:on two other condi:ons leading this clinical picture? (1)
3. How will you treat it? (1)
4. What medica:on is required in addi:on to what has been done? (1)
5. What is the main complica:on if treated inappropriately? (1)

KEY: done

1. Auricular Hematoma
2. Insect Bite
Spontaneous
3. Aspira:on with wide bore needle if small
Incision and drainage
Pressure applica:on
4. An:bio:cs and Analgesics
5. Deformity of Pinna (CauliIower ear)
 1. What is the view in the picture
and what do you see?
(1)
2. What does the arrow show? (1)

3. What are two varie:es of it? (1)

4. What is the treatment and what
type of anesthesia is required?
(1)
5. What is the anatomical loca:on
and in which age group it is seen
most commonly?
(1)

KEY:

1. So9 Tissue lateral view showing so9 :ssue mass.

2. Retropharangeal Abcess
3. Acute and Chronic
4. Incision and Drainage
Normally no Anesthesia is required
5. Prevertebral area on one side of midline
Under 2 years of age
 1. What is the diagnosis? (0.5)
2. Which Side is aBected? (0.5)
3. What are the two types according to
site of lesion? (1)
4. What are medical and Surgical
ENT OSPE
treatment op:ons in idiopathic type?
(2)

done

KEY:

1. Facial Nerve Paralysis

2. Right Side
3. Upper Motor Neuron Palsy
Lower Motor Neuron Palsy
4. Medical  Steroids , An:viral therapy, Physio therapy/ facial exercise
and protec:on of the eye
Surgical  Facial Nerve Decompression
 1. Name the
radiograph? (1)
2. Is there any posi:ve Cnding if yes what is it? (1)
3. Where are the normal constric:ons of esophagus located write with
vertebral levels? (1.5)
4. What is the treatment of cardia achalasia? (1.5)

Key:

1. Barium swallow
2. No posi:ve Cnding
3. Pharyngoesophageal junc:on 15cm from incisors – C6
At crossing of arch of aorta 25cm from incisors – T4
where it pierce diaphragm 40cm from incisors – T10
4. Heller’s Myotomy
Pneuma:c dila:on for unCt pa:ents
Iden:fy the Instruments and answer the following ques:ons?

1. Name the instrument

provided? (1)
2. Name two opera:ons in
which it is used? (1)
3. What is the aim of using
this instrument? (1)
4. Name the commonest
procedure done in
a:coantral type of
CSOM? (1)
5. Name one serious
complica:on of the canal wall down procedure? (1)

KEY:

1. Mollison mastoid retractor

2. Mastoidectomy, Cochlear Implant & opera:on on saccusendolypha:cus.
3. To retract so9 :ssues
4. ModiCed radical mastoidectomy
5. Facial Nerve palsy.
 1. Name The Instrument Provided? (1)
2. What are the indica:ons of it use? (1)
3. What is the aim of these side holes? (1)
4. What kind of anaesthesia is required for the procedure in rou:ne? (1)
5. At what vertebral level trachea starts? (1)

KEY:

1. Rigid Bronchoscope
2. Diagnos:c and Therapeu:c
3. For the ven:la:on of the contra lateral lung
4. General Anesthesia
5. At the lower border of 6th Cervical vertbral
A pt. is seen in ENT OPD he had ear discharge in past and complains of hearing
loss. On examina:on there is a dry central perfora:ons. Pure Tone audiometery
shows conduc:ve hearing loss.

1. What is the cause of central perfora:on and which type of disease? (1)
2. What is the cause of conduc:ve deafness? (1)
3. What is the name given to the other type of perfora:on? (1)
4. What will you do for the perfora:on? (1)
5. If surgical op:on is considered what kind of material is commonly used
for this purpose? (1)

KEY:

1. Chronic Suppori:ve O::s Media , Tubotympanic

2. Perfora:on of tympanic memberane
3. Maginal perfora:on
4. Myringoplasty/Tympanoplasty
5. Temporalis fascia
 1. What is A? (1)
2. What is B? (1)
3. What is it used for? (1)
4. Name the procedures in which it is used (any 4) ? (1)

A B

KEY:

1. Boyle Davis Mouth Gag

2. Tongue Blades
3. Opening mouth and retrac:ng the tongue anteriorly
4. Palate surgery
Tonsillectomy
Surgery of so9 palate
Pharyngoplasty
Adenoidectomy
Excision of angioCbroma
 1. What is the diagnosis? (1)
2. What is the most common age group at which this is encountered? (1)
3. What is the exact anatomical plane where the pus develops? (1)
4. What is the treatment? (2)

Key:

1. Peri Tonsillar abcess

2. Adults
3. Peritonsillar space between superior constrictor muscle and tonsil
4. I & D , An:bio:cs or alterna:vely Hot Tonsillectomy
 A B

C
D

EXAMINE THE PHOTOGRAPH CAREFULLY AND ANSWER FOLLOWING:

1. Name the procedure being performed? (1)

2. What is A? (0.5)

3. What is B? (0.5)

4. What is C? (0.5)

5. What is D? (0.5)

6. Write the treatment plan of T2N0M0 gloLs carcinoma with intact mobility of vocal
cords? (1)

KEY – Sta8on 6
1. IDL (1)
2. Vocal Cord (0.5)
3. EpigloLs (0.5)
4. Cuneiform Car8lage (0.5)
5. Corniculate Car8lage (0.5)
6. Radiotherapyif failsConserva8on laryngectomyif failsTotal laryngectomy (1)
 Date:22nd Nov 2018
AZIZ FATIMAH MEDICAL AND DENTAL COLLEGE
OTORHINOLARYNGOLOGY
rd
3 PROFESSIONAL EXAMINATION MBBS-ANNUAL 2018 – GROUP A
OBJECTIVELY STRUCTURED PRACTICAL/CLINICAL EXAMINATION (OSPE/OSCE)
CAREFULLY EXAMINE THE PICTURE AND ANSWER
FOLLOWING:

1. What is the diagnosis? (1)

2. How will you treat such paent? (2)
3. What advice will you give to this paent to prevent recurrence? (1)

KEY – STATION 5

1. Vocal Nodules (1)

2. Medical Voice Rest, Speech therapy, Steam Inhalaon, Analgesics
Surgical Surgical Excision (2)
3. Change Occupaon and Voice therapy (1)
 Date: 22nd Nov 2018
AZIZ FATIMAH MEDICAL AND DENTAL COLLEGE
OTORHINOLARYNGOLOGY
3rd PROFESSIONAL EXAMINATION MBBS-ANNUAL 2018– GROUP B
OBJECTIVELY STRUCTURED PRACTICAL/CLINICAL EXAMINATION (OSPE/OSCE)
2. Write the most common sites of epistaxis in children
and adults? (1)
3. Write the most common cause of epistaxis in children and adults? (1)
4. Write the brief management of epistaxis? (1)

KEY - STATION 3:

1. Posterior Nasal Packing (1)

2. ChildrenLi:le’s area(Kieselbach plexus)
AdultsWoodru=s plexus (1)
3. ChildrenFinger nail trauma(Nose picking)
AdultsHypertension (1)
4. Epistaxis Management (conserva3ve and surgical) (1)
 Date: 22nd Nov 2018
AZIZ FATIMAH MEDICAL AND DENTAL COLLEGE
OTORHINOLARYNGOLOGY
3rd PROFESSIONAL EXAMINATION MBBS-ANNUAL 2018– GROUP B
OBJECTIVELY STRUCTURED PRACTICAL/CLINICAL EXAMINATION (OSPE/OSCE)
STATION 6
CAREFULLY EXAMINE THE INSTRUMENTS AND ANSWER THE FOLLOWING:
1. What is A and what is it used for? (1)
2. What is B and what is it used for? (1)
3. What is C and what is it used for? (1)
4. What is D and what is it used for? (1)

KEY – STATION 6
1. Tracheostomy tube with cu=; used to protect lower airway in airway
obstruc3on (1)
2. Tonsil holding forceps; used in tonsillectomy to hold and retract tonsils
medially (1)
3. Adenoid cure:e; used for adenoid cure:age in adenoidectomy (1)
4. Eve’s Tonsil snare; used for crushing and cuDng tonsillar pedicle in
tonsillectomy (1)
 Date:23rd Nov 2018
AZIZ FATIMAH MEDICAL AND DENTAL COLLEGE
OTORHINOLARYNGOLOGY
3rd PROFESSIONAL EXAMINATION MBBS-ANNUAL 2018– GROUP C
OBJECTIVELY STRUCTURED PRACTICAL/CLINICAL EXAMINATION (OSPE/OSCE)
3. Name the disease represented by curve “As”?
(1)
4. Name the condi!ons represented by curve B and C? (1)

KEY – STATION 5

1. Types of Tympanogram (1)

2. A Normal Tympanometry (1)
3. As  Otosclerosis (1)
4. BFluid in middle ear, CEustachian tube dysfunc!on (1)
 Date:23rd Nov 2018
AZIZ FATIMAH MEDICAL AND DENTAL COLLEGE
OTORHINOLARYNGOLOGY
rd
3 PROFESSIONAL EXAMINATION MBBS-ANNUAL 2018– GROUP C
OBJECTIVELY STRUCTURED PRACTICAL/CLINICAL EXAMINATION (OSPE/OSCE)

KEY – STATION 6
1. Direct Laryngoscope; Barking Dog (1)
2. Mollison mastoid retractor; mastoidectomy, Stapedectomy etc. (1)
3. Bronchoscope; Holes are for aera!on of contralateral lung (1)
4. Negus Artery Forceps; used to ligate bleeding point in tonsillectomy (1)
A 10 year old child presented in ENT OPD, his
mother complaints of him having recurrent sore
throat and also that a very bad smell comes from
his mouth and he snores a lot. The picture was
taken during the examination of his throat.
1. What is the diagnosis?
(1)
2. Name the different types of it?
(1)
3. Name the surgical procedure for its treatment
and write 4 absolute indications of the
procedure? (2)

1. Chronic Tonsillitis
2. Follicular, Parenchymatous, fibroid tonsillitis
3. Tonsillectomy
malignancy, causing febrile seizures, recurrent
infections, peritonsillar abscess, obstructive
symptoms
 C

A D

E
B
Examine the pictures carefully and answer the following: F
1. Name the procedure being performed in the picture?
(0.5)
G
2. LABEL THE PICTURE FROM A TO G ?
(0.5 EACH)
1. Posterior Rhinoscopy
2. AàPosterior ends of turbinate
Bà Opening of Eustachian tube
Cà Adenoids
Dà Posterior border of nasal septum
Eà Fossa of Rossenmuller
Fà Torus Tubularis
Gà Upper Surface of soft palate
A 50 year old lady presented in ENT OPD with complaints of hoarseness
of voice for 2 years. You being the house-officer were asked by the
consultant to examine the throat and perform indirect laryngoscopy.
Following the examination you were asked these following questions.

1. Name Various Un-Paired Laryngeal Cartilages? (1)

2. Which Structure acts as the only complete ring in the whole
tracheobronchial tree? (1)
3. Name the intrinsic muscle not innervated by recurrent laryngeal
nerve?
(1)
4. What is the “anterior meeting point of true vocal cords” is called? (1)

1. Epiglottis, thyroid, cricoid

2. Cricoid
3. Cricothyroid
4. Anterior commissure
EXAMINE THE RADIOGRAPHS CAREFULLY AND
ANSWER FOLLOWING:
1. Name the radiographs and what are the
views of them? (1)
2. Is there any positive finding if yes what is
it? (1)
3. How is it corrected and what type of
anesthesia is required? (1)
4. Write the indications of septoplasty?
(1)

1. X-Ray Nasal bone; Both lateral views

2. Fracture Nasal bone
3. Mobilization, Fracture reduction and Fixation;
Local Anesthesia.
4. Symptomatic Deviated Septum; As part of
Septo-Rhinoplasty; As an approach to
hypophysectomy; Septal Spur causing recurrent
epistaxis
A 23 year old male who had undergone septoplasty a
week ago presented in ENT OPD with complaints of nasal
obstruction and pain in the nose. On examination this
image was taken.

1. What is the diagnosis? (1)

2. How would you treat it? (2)
3. What are the main complications if not treated?
(1)

1. Septal Hematoma
2. Aspiration
Incision and Drainage
Nasal Packs
Antibiotic cover
3. Septal Abscess
Perforation
Necrosis of septum
Depression of nose/saddle shaped deformity
 C

A
D

E
B
F

Examine the pictures carefully and

answer the following:

1. Name the procedure being performed in the picture? (0.5)

LABEL THE FOLLOWING:
2. A? (0.5)

3. B? (0.5)

4. C? (0.5)

5. D? (0.5)

6. E? (0.5)

7. F? (0.5)

8. G? (0.5)

KEY – Station 6
1. Posterior Rhinoscopy
2. APosterior ends of turbinate
3. B Opening of Eustachian tube
4. C Adenoids
5. D Posterior border of nasal septum
6. E Fossa of Rossenmuller
7. F Torus Tubularis
8. G Upper Surface of soft palate
 This Patient of age 22 presented in
ENT OPD with complaints of
postnasal drip, recurrent throat
infections, decreased nasal patency
and external nasal deformity. On
Examination of his nose this
photograph was take and the above
sketch was drawn.

READ SCENARIO AND EXAMINE PHOTOGRAPH CAREFULLY TO ANSWER

FOLLOWING:

1. What is the diagnosis and what type is shown in the sketch? (1)

2. Enumerate other types of DNS? (1)

3. What is the ideal treatment for this patient? (1)

4. Write the indications of septoplasty? (1)

KEY – Station 4

1. DNSAnterior Dislocation

2. C shaped; S shaped; Spur; Thickening

3. Septo-Rhinoplasty

4. Symptomatic Deviated Septum; As part of Septo-Rhinoplasty; As an

approach to hypophysectomy; Septal Spur causing recurrent
epistaxis
EXAMINE THE PHOTOGRAPH CAREFULLY AND ANSWER FOLLOWING:

1. Explain the findings in the picture? (1)

2. Write the most common cause of middle congenital neck mass? (1)

3. What is its management? (1)

4. What is the main complication if not properly excised? (1)

KEY – Station 6:

1. A Swelling in the midline of neck that moves with the protrusion of

tongue.

2. Thyroglossal duct/cyst.

3. Cis-Trunk procedure (Surgical resection/excision and removal of

central portion of hyoid bone)

4. Recurrence
EXAMINE THE PHOTOGRAPH CAREFULLY AND ANSWER FOLLOWING:

1. What is shown in the photograph? (0.5)

2. Name the test shown collectively in A and B? (0.5)

3. Name the test shown in C? (0.5)

4. What is being tested in A? (0.5)

5. What is being tested in B? (0.5)

6. What is being tested in C? (0.5)

7. What is Rinne’s +ve? (0.5)

8. What does Weber Not Lateralized tells about hearing? (0.5)

KEY – Station 2
1. Tuning fork tests
2. Rinne’s Test
3. Weber Test
4. Air Conduction
5. Bone Conduction
6. Bone Conduction better in which ear
7. AC>BC; Normal
8. Normal hearing
 B

E
D
C
A
CAREFULLY EXAMINE THE PHOTOGRAPH AND ANSWER FOLLOWING:

1. What is area ‘A’ called? (0.5)

2. LABEL THE ARTERY B? (0.5)

3. LABEL THE ARTERY C? (0.5)

4. LABEL THE ARTERY D? (0.5)

5. LABEL THE ARTERY E? (0.5)

6. What is the significance of area A? (0.5)

7. What is the most common cause of anterior epistaxis? (0.5)

8. What is the most common cause of posterior epistaxis? (0.5)

KEY – Station 6
1. Kieselbach plexus/Little’s area
2. Anterior Ehtmoidal
3. Greater Palatine
4. Sphenopalatine
5. Septal branches of superior labial
6. Most common site of anterior epistaxis
7. Finger Nose trauma
8. Hypertension