tuesday 13 th july 2011 toynbee club meeting st marys hospital

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FRCS ( ORL-HNS) Part one Tuesday 13 th July 2011 Toynbee Club Meeting St Mary’s Hospital

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Page 1: Tuesday 13 th July 2011 Toynbee Club Meeting St Marys Hospital

FRCS ( ORL-HNS)Part one

Tuesday 13th July 2011Toynbee Club Meeting

St Mary’s Hospital

Page 2: Tuesday 13 th July 2011 Toynbee Club Meeting St Marys Hospital

FormatSBA

Paper 1 [2 hours] Single Best Answer Paper (SBA) 110 Multiple Choice Questions(Single Best Answer Format; 1 from 5) )

Page 3: Tuesday 13 th July 2011 Toynbee Club Meeting St Marys Hospital

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 c-ANCAB Chest X-rayC Differential white cell countD Serum ACEE Urinalysis 

Page 4: Tuesday 13 th July 2011 Toynbee Club Meeting St Marys Hospital

In the investigation of allergic rhinitis, the radioallergoabsorbent test (RAST) is used to detect which of the following in the patients serum?

 A Immunoglobulin AB Immunoglobulin DC Immunoglobulin ED Immunoglobulin GE Immunoglobulin M

Page 5: Tuesday 13 th July 2011 Toynbee Club Meeting St Marys Hospital

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 Negative interstitial pressure within middle ear mucosaB Referred pain from a molar tooth due to trapped gas below a

fillingC Referred pain from an agger nasi cellD Referred pain from an ipsilateral concha bullosaE Referred pain from overstretching of stretch receptors in the

trachea   

Page 6: Tuesday 13 th July 2011 Toynbee Club Meeting St Marys Hospital

Which of the following statements regarding the cause of facial trauma is true?

 A Assault is the commonest cause of facial trauma in the UKB Facial injury in the home is the most common in the 30-50

age groupC In the UK, consumption of alcohol by the victim or the

assailant occur in less than 25% of casesD The design and construction of beer glasses has been shown

to have no effect on the incidence of maxillofacial injuriesE Worldwide, road traffic accidents play a small part in the

cause of maxillofacial injury 

Page 7: Tuesday 13 th July 2011 Toynbee Club Meeting St Marys Hospital

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 Careful follow up in the multidisciplinary outpatient clinicB Chemotherapy and radiotherapyC Radio-iodine therapyD Regular monitoring of calcitonin levelsE Total thyroidectomy and removal of any enlarged lymph nodes  

Page 8: Tuesday 13 th July 2011 Toynbee Club Meeting St Marys Hospital

Format EMIPaper 2: [2 hours 30 minutes] Extending Matching Item Paper (EMI) 135 Multiple Choice Questions (Extended Matching Item Format)

Page 9: Tuesday 13 th July 2011 Toynbee Club Meeting St Marys Hospital

SOLID TUMOURS A AdenocarcinomaB ChondrosarcomaC EsthesioneuroblastomaD GlioblastomaE Medullary cell carcinomaF MedulloblastomaG NephroblastomaH OsteosarcomaI ParagangliomaJ PlasmacytomaK RhabdomyosarcomaL Squamous cell carcinomaM 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.

Page 10: Tuesday 13 th July 2011 Toynbee Club Meeting St Marys Hospital

SOLID TUMOURS A AdenocarcinomaB ChondrosarcomaC EsthesioneuroblastomaD GlioblastomaE Medullary cell carcinomaF MedulloblastomaG NephroblastomaH OsteosarcomaI ParagangliomaJ PlasmacytomaK RhabdomyosarcomaL Squamous cell carcinomaM 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.

 

Page 11: Tuesday 13 th July 2011 Toynbee Club Meeting St Marys Hospital

SOLID TUMOURS A AdenocarcinomaB ChondrosarcomaC EsthesioneuroblastomaD GlioblastomaE Medullary cell carcinomaF MedulloblastomaG NephroblastomaH OsteosarcomaI ParagangliomaJ PlasmacytomaK RhabdomyosarcomaL Squamous cell carcinomaM 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.

  

Page 12: Tuesday 13 th July 2011 Toynbee Club Meeting St Marys Hospital

Structure 1. Paeds ( embryology & Syndromes)

2. Otol (including neuro-otol and audiology)3. Rhinology (including Facial plastic)4. Head and neck5. Medical jurisdiction (ie ethics, consent, GMC, DVLA ,data protection etc)6. Basic sciences (immuno, embryo, genetics pharmacol)7. Stats and screening8. ?Medicine relevant to ENT (rheumatol, CT diseases, microbiol), maybe this can be distributed between 1-4?)

Page 13: Tuesday 13 th July 2011 Toynbee Club Meeting St Marys Hospital

Recent FRCSClassification of questions

5 stat and screening ( simple)10 basics (anatomy ( 3 embryology))10 electrophysiology tests ( very hard)10 jurisdiction, consent, DVLA and ethical50 medicine and neurology related questions ( mostly about

neurology)50 otology and neuro-otology including audiology15 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)

Page 14: Tuesday 13 th July 2011 Toynbee Club Meeting St Marys Hospital

You have to answer

150 out 253 questions correctly

Page 15: Tuesday 13 th July 2011 Toynbee Club Meeting St Marys Hospital

Resources

£ 42 used £ 40 used £ 40 used £ 60 new

Page 16: Tuesday 13 th July 2011 Toynbee Club Meeting St Marys Hospital

Best book

£ 42 used 400 pages 3500 Q & AUp2date & Coves everything Hard to digestAmerican Style

Page 17: Tuesday 13 th July 2011 Toynbee Club Meeting St Marys Hospital

Courses

Page 18: Tuesday 13 th July 2011 Toynbee Club Meeting St Marys Hospital

Questions