Answer to Question 1
ANS: C
Nasal discharge should be assessed for its amount and color as well as any associated symptoms. Clear, profuse discharge is allergic in nature; yellow-green purulent discharge indicates bacterial infection.
Answer to Question 2
ANS: B
With an acoustic neuroma, the onset of symptoms usually occurs after age 30. Early complaints include unilateral hearing loss, tinnitus, and vertigo. As the tumor advances, symptoms may include headache, facial pain, ataxia, nausea/vomiting, and lethargy. The ear structures appear normal. Cholesteatoma is not a cancer; it is a destructive and expanding growth consisting of keratinizing in the middle ear and/or mastoid process. The growth erodes the ossicles and can spread through the base of the skull into the brain. Otosclerosis involves degenerative changes to the bony structures of the middle ear and results in gradual onset of hearing deficit as the bones lose their vibratory ability. The patient typically complains of painless, progressive changes in hearing. Symptoms are usually bilateral, and tinnitus may be present. The physical examination is usually normal, with the exception of the hearing acuity test.
