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1. after some days of nasal traume the complains of incrising dificoulty in nasal breathing continous pain and fewer developed. what is your first diagnosis:

Questions for final writing exemination
1. After some days of nasal trauma in breathing complaints of increasing difficulty, continuous pain and fever developed. What is your first diagnosis: 2. A three-year old child is inattentive, has recurrent sinusitis and sleeps with open mouth, snoring. What is your diagnosis: 3. A 55-year old patient has a gradually developed nasal obstruction. Recently he has had recurrent nasal bleeding and nasal discharge. What is your first diagnosis: 4. A 8-year old boy has recurrent sinusitis, nasal obstruction, eye itching and watery nasal discharge. What is your first diagnosis: 5. A 30-year old patient has a nasal obstruction, headache and sleeping disturbancy for a long time. His mouth gets dried up till morning.What is your first diagnosis: 6. A 10-day old infant has recurrent asphyxia-like attack during nutrition. What is your first diagnosis: 7. What is not a characteristic sign of allergic rhinitis in chilhood. 8. What is the characterstic X-ray sign of the malignant nasal tumor. A. inhomogen claudines over the sinus spreading towards the nasal cavity B. disappearing of the lateral nasal wall 9. What is to be done in a case of well situated nasal fracture. The patient has no complaint of nasal obstruction. There is no epistaxis and discharge. 10. A 38-year old woman has a complaint of pressing pain over the medial canthus and permanent purulent nasal discharge. What is your first diagnosis: 12. Which one is not a mucolytic agent? 13. The essence of functional endoscopic sinus surgery (FESS) is: A. to restore the function of the osteomeatal unit 14. A 5-year old child has put a glassball into his nasal cavity. How can you remove it? 15. What is to be done in case of nasal furuncle? D. strict observation and hospitalisation 16. The typical place of nasal bleeding in childhood is 17. A patient has not been able to smell for a year, he has pain over his right facial region, the right nasal cavity is obstructed and his hair is falling. C. nasal polyposis and maxillar sinusitis in the right side 18. The characteristic symptoms of deviated nasal septum are C. discharge on the posterior pharyngeal wall 19. Which diagnosis do you establish? The paitent,s main symptoms: fever, epileptiphorm fits, headache, nasal obstruction, purulent nasal discharge, pain over the facial region. C. pansinusitis + meningitis and encephalitis 20. A child has been treated for weeks with one sided purulent nasal discharge sinusitis and nasal obstruction. His status will not change. What is your next task? A. direct the patient to otolaryngologist for sinus irrigation B. direct the patient to otolaryngologist with suspition of chronic alien body in the nose. C. direct the patient to otolaryngologist with suspition of malignant nasal tumor 21. Choose the incorrect answer: the main symptoms of Meniere disease are: 22. The harmonic vestibular syndrom means: B. vestibular excitatory status is present C. the direction of spontaneous nystagmus is opposite to the direction of gait and pastpointing 23. The dysharmonic vestibular syndrom means: B. the direction of spontaneous nystagmus is the same as the that of the gait and pastpointing 24. An adult patient has sudden vertigo nausea and vomitus. Tuning fork tests are negative. Spontaneous III degree nystagmus towards the right side, pastpointing to the left. The patient can not stand in Romberg-position . What is your diagnosis? B. vestibular neuronitis in the left side C. otogen labyrinthitis in the right side 25. A 35-year old adult has complaints of one-sided tinnitus, hearing impairment and inbalance. Otolaryngological examination does not show alteration.What do you have to exclude first. 26. How should caloric vestibular test be performed in the case of chronic otitis. 27. List the spontaneous vestibular signs. 28. Besides intensive nausea, vomiting and vertigo what symptom indicates vestibular disease. 29. What is to be done in case of developed inbalance during Streptomycin treatment. A. stop the therapy, cochleovestibular examination B. continue the therapy with administration of vitamin-A and B. 30. After making a press over the tragus in a patient with chronic otitis sudden vertigo develops. What is your diagnosis? B. acute exacerbation of inflammatory process C. extended perforation of the tympanic membrane 31. What are the two main groups of audiological examination. 32. Choose the subjective audiological test. 33. What is the result of Weber-test in person with normal hearing. C. sound is lateralised in the normal side D. sound is lateralised in the affected side 34. What is the result of Rinne-test in person with normal hearing. D. Rinne is lateralised towards the affected side E. Rinne is lateralised towards the normal side 35. What is the result of tuning fork tests in case of one-sided conductive loss of hearing. C. Weber lateralised towards the affected side D. Weber lateralised towards the normal side E. Rinne positive in the normal side and negative in the affected side 36. What is the stimulus in pure tone audiometry? 37. What types of abnormal audiogram can be detected with pure tone audiometry? A. the bone and air conductive treshold run together. B. the bone conductive threshold is normal but between the two lines there is an air-bone gap C. the air conductive threshold is lower than the bone conductive threshold D. the bone air conductive threshold has risen and between the two lines there is on air-bone gap 38. What is the early sign of chronic noise trauma in pure tone audiometry A. dominant deep tone loss, rising curve D. high tone loss, apicocochlear type audiogram E. raised air conductive treshold at every frequency, pancochlear type of loss of hearing 39. What is to be do ne in case of a sudden loss of hearing? A. otoscopy, if there is obstructing wax, remove it 40. What is the possible method to detect recruitment phenomenon? 41. Put grades of the effects of noise in the organ of hearing in proper order. 42. What are the methods of objective audiometry? D. tests performed above the hearing threshold 43. Which is the best test for quick screening of the hearing of a newborn child? A. noise, caused by the outer hair cells B. noise, caused by the vibration of Reisner's membrane C. noise, caused by the movement of ossicular chain B. to reveal the fluid whithin the tympanic cavity C. the measure of the pressure within the tympanic cavity E. the reveal of disconnection of ossicular chain 46. At what age should children with damaged hearing be provided with aids? C. at the begining of learning how to speak E. immediately ofter revealing the hearing impairment 47. A young adult has fever, tonsillitis, lymph node are swollen in the neck, hepato- splenomegaly. What is the diagnosis? 49. What is the recruitment? 50. What kind of disturbance causes recruitment? 51. The first choice antibiotic in case of acute follicular tonsillitis, except. 52. The patient has one sided fur on the tonsil. What kind of diagnosis can you exclude? 53. What is the diagnosis: pain irradiates towards the ear, one sided odinophagia, trismus, painful swellings of the regional lymp nodes. 54. Give a list of systemic complications of chronic tonsillitis. 55. Which one is the incorrect answer! The absulute indications of tonsillectomy are: 56. We set up the diagnosis of chronic tonsillitis according to the case history, local and general symptoms. Give some characteristic signs. 57. What are the lower and upper age limit of tonsillectomy? 58. All of the following are indications of tonsillo-adenotomy in childhood, except: B. tonsillar hyperplasy without complaint 59. After 5 days of tonsillectomy there is white fur in the tonsillar bed. What is the task? A. since it is a purulent inflammation immediate antibiotics administration should be started C. nothing, it is a normal sign of healing 60. After tonsillectomy the child has otalgia. What is the cause? A. acute otitis media as complication after operation B. irradiating otalgia in the territory of glossopharyngeal innervation C. Estachian tube inflammation, paracentesis should be performed? 61. What are the primary paranasal sinuses? 62. Which ones are the secondary paranasal sinuses? 63. What are the criteria of classifying the paranasal sinuses into so called primary and secondary groups? C. whether they are pre- or postnatal formations 64. The patient has a headache, increased discharge from the nose and nasal bleeding. The diagnosis can be: 65. Enlist at least 4 factors which inreasingly cause paranasal sinus inflammation in childhood! 66. In which cases you do not give local steroids? (nasal spray) 67. The patient has periorbital edema. What kind of paranasal sinus is first of all inflamed? 68. Which one is the absolutely serosus salivary gland? 69. Which one is the mixed sero-mucinous salivary gland? 70. In which salivary gland does sialolyth mainly occur? 71. What are the main signs of the sialolythiasis? A. stone palpable through the skin of the neck B. pain in the territory of gland associated with meal C. swelling in the territory of gland independently of meal D. swelling in the territory of gland mainly during meal 72. A cranial nerve is paralised due to a malignant tumor of a salivary gland. What is the name of the gland and the nerve? 73. The patient has facial nerve paralysis but the motion of forehead is intact. Do you think of malignant tumor of the parotid gland? A. yes,because the tumor can cause partial nerve destruction, too B. no, because it is the sign of the central paralysis 74.You palpate tumor within the parotid gland. What can the cause be? A. only parotid neoplasm B. metastatic process, because there are many lymph nodes within the gland 75. In which salivary gland are lymph nodes. 76. What can the diagnosis be? Pain in the neck, difficulty in swallowing, during meal or after malodorous food regurgitation occurs. C. oesophageal stricture after corrosive injury 77. What is the most frequent place of the bronchial alien body? 78. The alien body mainly occurs in the right main bronchus. Why? B. its direction is deeper than that of the left one C. it rises from a higher part of trachea than the left one 79. What is the main danger of the floating alien body? can get into one of the bronchi any time B. after stopping directly the carina of the trachea, it can close both bronchi D. permanent irritation of tracheal mucosa can cause severe bleeding 80. Alien body is suspected in the lower respiratory tract in child. What is to be done in this case? A. the patient may go home. If there should be any complaint, he is to show up at a check-up examination B. after X-ray film a check-up examination is needed C. the child is referred to hospital, the alien body should be excluded with a possibly 81. Out of the symptoms listed below which ones are those of Meniere’s disease: A. tinnitus B. pancochlear loss of hearing C. feeling fullness in the ear D. sudden onset E. all of them 82. Obligatory symptoms of otosclerosis: A. mixed type loss of hearing B. tinnitus C. painless onset D. all of them E. none of them A. viral infection B. cerumen in the external auditory canal C. acoustic neurinoma D. ischaemia of the inner ear E. cervical spondylosis A. true: 1,2,3 B. true: 1,2,3,4,5 C. true: 1,2,3,4 D. true: 1,4 E. true: 1,3,4,5 84. Above what noise level is damping (earplugs or muffs) advisable? A. above 40 dB B. above 60 dB C. above 80 dB D. above 100 dB E. independent of the noise level, because the inner ear is most sensitive to the noise at a 85. It is characteristic of Lyme-disease: A. Lyme described it in the last century as a sensory-neural loss of hearing B. caused by a spirochaeta (Borrelia burgdorferi) C. steroid therapy is advisable D. specific test for diagnosis is given by ELISA A. true: 1,2,3 B. true: 2 C. true: 1 D. true: 1,4 86. The Gelle-probe (tuning fork test) is positive in: A. otosclerosis B. cholesteatoma of the middle ear C. disfunction of the Eustachian tube D. fistula of the labyrinth 87. When does the patient not have an ear-ache? A. perichondritis of the auricle B. herpes zoster oticus C. angina D. otosclerosis E. lymphadenitis colli 88. The Rinne-test is used to diagnose: A. conductive loss of hearing B. perceptive loss of hearing C. perforation of the tympanic membrane D. disfunction of the Eustachian tube E. sudden deafness 89. Ear-wash is not advisable in case of: A. acute otitis media B. alien body in the external ear canal C. chronic otitis media D. cerumen 90. If the patient feels pain during tragus-pressing or auricle-pulling, the diagnosis could be: A. othaematoma B. furuncule or inflammation of the external ear canal C. mastoiditis D. otosclerosis 91. When do you think of mastoiditis, if the patient has had acute otitis media without making any progress for: A. 2 days B. 6 days C. 10 days D. 3 weeks 92. The patient has had vertigo, loss of hearing and tinnitus for one hour. What is your diagnosis? A. acoustic neurinoma B. vestibular neuritis C. vertebrobasilar insufficiency D. Meniere’s disease 93. The patient has loss of hearing in the right side, and lateralizes the Weber's test to the right side. What is your diagnosis? A. otosclerosis in the left side B. cerumen in the ear canal in the right side C. Meniere's disease in the right side D. neural loss of hearing in the left side 94. Valsalva manoeuvre is used for testing: A. otosclerosis B. to inflate the middle ear C. to detect nystagmus D. to exclude conductive hearing loss E. to detect the obstruction of the nose 95. What is the typical place for paracentezis? A. anterior-inferior quadrant B. anterior-posterior quadrant C. superior-posterior quadrant D. superior-anterior quadrant A. Meniere’s disease B. otosclerosis C. commotion labyrinth D. cholesteatoma of the middle ear E. chronic suppuration of mucosa 97. What does short term Eustachian tube occlusion cause in the middle ear? A. exsudate B. hematoma C. tympanic membrane adhesions D. acute inflammation E. transudate 98. A patient had acute peripheral vestibular lesion half a year ago. His walking is still unstable, after a sudden motion vertigo occurs. What is the therapy? A. to increase the dosis of Daedalon B. to give sedatives continuously C. active moving-therapy for evoking compensation with less amount of sedatives A. Chloramphenicol B. Streptomycin C. Tetracyclin D. Gentamycin E. Kanamycin A. true: 1,2,3 B. true: 2,3,4 C. true: 1,4,5 D. true: 1,3,5 E. true: 2,4,5 100. Peripheral facial paralysis can not occur in case of: A. poliomyelitis B. herpes zoster oticus C. mastoiditis D. cholesteatoma E. otosclerosis 101. Perceptive loss of hearing can be caused by: A. mumps B. chicken-pox C. measles D. meningitis serosa A. true: 1,2,3 B. true: 1,3 C. true: 1,3,4 D. true: 2,3,4 E. true: 3,4 102. Therapy for diffuse otitis externa: A. aural toilette, drying up B. ear drop containing antibiotic and steroid C. Valsalva method D. antiinflammatory ointment 103. Clinical symptoms of acute otitis media are: A. ear-ache B. dilated blood vessels, bulging tympanic membrane C. sensorineural loss of hearing D. horisontal nystagmus in the opposite side E. all of them 104. The therapy of acute purulent otitis media is: A. paracentesis B. nasal drops C. antibiotics D. ear drops 105. The symptoms of traumatic rupture of the tympanic membrane are: A. regular shaped perforation B. haemorrhage around the perforation C. irregular shaped perforation D. purulent discharge 106. Choose the correct sign for the following diseases: A. acute purulent otitis B. viral otitis C. secretory otitis media 1. haemorrhagic bleb formation on the eardrum 2. thickened, pale eardrum, unclear structure 3. bulging, reddish eardrum 107. Long lasting snuffles, nasal discharge, loss of hearing, itching of the eye can be caused by: A. allergic rhinitis B. viral infection C. alien body in the nose A. ossicles B. middle ear C. mastoid process D. inner ear E. apex of the pyramid 109. Mastioditis can occur after the onset of acute otitis: A. on the third day B. on the eighth day C. at the end of the third week D. on eighth-tenth week 110. Conductive loss of hearing can be caused by: A. cerumen B. otitis C. labyrinth hydrops D. otosclerosis E. extreme noise 111. Perceptive loss of hearing can be caused by: A. viral infection B. Meniere’s disease C. chronic otitis D. Streptomycin therapy 112. The symptoms of chronic otitis media are: A. perceptive loss of hearing B. pain C. conductive loss of hearing D. discharge E. perforation of the tympanic membrane 113. The therapy of chronic otitis media is: A. paracentesis B. radical operation C. tympanoplasty and mastoidectomy D. drying A. perforation B. conductive loss of hearing C. tinnitus D. Schwartze-sign 115. The surgical therapy of otosclerosis consists of: A. making perforation B. making mobile connection between the incus and the oval window C. making connection between the incus and the round window 116. The complications of chronic otitis with cholesteatoma are: A. labyrinthitis B. sinus thrombosis C. paralysis of the accessorial nerve D. paralysis of the trigeminal nerve E. paralysis of the facial nerve A. radical removal of the elements of the middle ear B. making an externally controllable common cavity from the mastoid and tympanic cavity C. radical clearing of the entire cellular system of the mastoid D. turning the zygomatical process and the tympanic cavity into a common cavity A. clearing of the antrum mastoideum B. cleaning of the aditus ad antrum C. cleaning the entire cellularity of mastoid D. total resection of the proc.mastoid 119. The intratemporal otogenic complications are A. cerebral abscess B. labyrinthititis C. facial paresis D. mastoiditis 120. The intracranial otogenic complications are A. meningitis B. subdural abscess C. thrombosis of sigmoid sinus D. petrositis 121. The characteristic symptoms of inflammatory laryngeal disesases are 122. Recognising the abnormal crying vocalization of the infant what do you think of. 123. Which one of the following is appropriate as a dominant symptom of epiglottitis. 124. The cause of neck resistance changing simultaneously with breath is: 125. The cause of repetitive mis-swallowing is: 126. The possible cause of abrupt hoarseness is 127. Opening of the respiratory canal at tracheotomy should be at the: C. between the second and third tracheal cartilages 128. The possible cause of gradual hoarseness is 129. The laryngeal abnormality, resulting from vocal cord overstrain, can be: 130. The characteristic feature resulting from laryngeal tbc. is 131. The inhalatory therapy prescribed for treatment of acute laryntitis is 132. The therapy proposed for treatment of long lasting hoarseness at the age of 4 to 5 is 133. The symptoms indicating laryngitis subglottica are 134. What is the most possible cause of continous coughing with no expectoration and no laryngeal alteration, 135. Which one of the causes below is excluded in haemoptoe accompanying coughing: 136. The possible cause of voice deepening in a woman,: 137. In hyperfunctional vocalisation trouble what else can serve as an additional cause: 138. What is the possible cause of the fact that a boy at the age of 15-16 is incapiable of keeping a standard pitch: 139. The duration of continous hoarseness that neccesitates laryngological examination is 140. The type of respiratory disturbance resulting in laryngeal oedema is 141. Which one of the following diseases occurs as the cause of the continuous progressive hoarseness in childhood: 142. In the localisation of laryngeal cancers which one predicts the best outcome: 143. In continous hoarseness laryngeal inspection is necessitated after 144. The primary symptom of supraglottic cancer is 145. The appropriate order of sequence of events replacing tracheal cannula: B. preparation of the cannaula to be inserted 146. Subsequent to total laryngectomy, cannulised patient complains of dyspnoe. What should you do? A. immediate removal of the cannula, therapeutic forced coughing B. admittance to the department of laryngology by ambulance car 147. The primary principle of surgical treatment of laryngeal cancer is A. maintaining the function of larynx in respiration and vocalisation as perfectly as possible B. radical removal adjusted to the localisation and stage of the tumor 148. The primary duty in isolated persisting lymph node enlargement in the neck of the adult is A. laryngeal examination: seek for primary tumor C. removal of the lymph node with its succeeding histology investigation 149. What do you mean under radical neck block dissection. A. removal of the chain of lymph nodes surrounding the jugular vein B. removal of the sternocleidomastoid muscle with the internal jugular vein C. unilateral radical removal of tissuses beetwen the superficial and deep fasciae of the neck with preservation of the vagal nerve and the carotid artery: 150. The cause of a close control of the patient subjected to radiotherapy of laryngeal cancer is A. to estimatie tumor regression B. to follow up tumor reaction to overcome the possible adverse effects of irradiation therapy C. thractostomy may be required due to laryngeal oedema - the relative thickeness of the paranasal sinuses - obstructed nasal airflow caused by the adenoid vegatation - the changing characteristic of the mucosa caused by endocrin changes


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Título: VARIANTE DIDÁCTICA DEL EXPERIMENTO DOCENTE EN LAS CIENCIAS NATURALES EXPERIMENTALES SUSTENTADO EN UN MODELO DIDÁCTICO INTEGRADOR PARA LA FORMACIÓN DE PROFESORES GENERALES INTEGRALES. Dr. C. Rolando Márquez Lizaso Profesor asistente de la facultad de Formación de Profesores Generales Integrales de Secundaria Básica del Instituto Superior Pedagógico "José Martí" d

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