100+ Free ABOHNS Otolaryngology Practice Questions

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Question 1

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A 28-year-old swimmer presents with severe right ear pain, otorrhea, and a tender tragus. Otoscopy shows a diffusely edematous, erythematous external auditory canal with debris obscuring the tympanic membrane. According to the AAO-HNSF 2014 clinical practice guideline for acute otitis externa, which is the most appropriate first-line therapy for an uncomplicated, immunocompetent patient?

Oral amoxicillin-clavulanate for 10 days

Topical ototopical antibiotic drops (with or without steroid)

Oral ciprofloxacin for 7 days

Oral prednisone taper alone

to track

2026 Statistics

Key Facts: ABOHNS Otolaryngology Exam

Full day

Exam Duration

Computer-based Pearson VUE proctored exam

July 9, 2026

2026 Exam Date

ABOHNS Upcoming Exam Dates 2025-2026

~$1,850

Exam Fee

2025 Written Exam fee (2026 TBA)

87%

2024 Pass Rate

ABOHNS Executive Director update (prior 3 years 90-92%)

2026

New Blueprint

Effective 2026 Written Exam (subdomains + consolidated management)

ACGME

Residency Required

Accredited otolaryngology-head and neck surgery residency

The ABOHNS Written Qualifying Exam (WQE) is a full-day computer-based multiple-choice exam administered via Pearson VUE. The 2026 Written Exam is scheduled for July 9, 2026. A new blueprint effective 2026 consolidates management categories (Non-Surgical + Surgical) and introduces subdomains for each practice area. The exam covers otology, rhinology/allergy, laryngology, head & neck oncology, facial plastics, pediatric otolaryngology, sleep, and general/foundations. The 2025 exam fee was $1,850 (2026 fee updated annually). Pass rate was 87% in 2024 and 90-92% in the three prior years. Successful candidates advance to the ABOHNS Oral Certifying Exam.

Sample ABOHNS Otolaryngology Practice Questions

Try these sample questions to test your ABOHNS Otolaryngology exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 28-year-old swimmer presents with severe right ear pain, otorrhea, and a tender tragus. Otoscopy shows a diffusely edematous, erythematous external auditory canal with debris obscuring the tympanic membrane. According to the AAO-HNSF 2014 clinical practice guideline for acute otitis externa, which is the most appropriate first-line therapy for an uncomplicated, immunocompetent patient?

A.Oral amoxicillin-clavulanate for 10 days

B.Topical ototopical antibiotic drops (with or without steroid)

C.Oral ciprofloxacin for 7 days

D.Oral prednisone taper alone

Explanation: The AAO-HNSF clinical practice guideline for acute otitis externa recommends topical preparations (antibiotic ± steroid, e.g., ciprofloxacin/dexamethasone or ofloxacin) as initial therapy for uncomplicated AOE. Systemic antibiotics are NOT recommended unless infection extends beyond the canal, the patient is immunocompromised, or diabetes is present. Aural toilet, pain control, and a wick if severe edema precludes drop penetration are adjuncts.

2A 72-year-old poorly controlled diabetic presents with deep, unrelenting otalgia disproportionate to otoscopic findings, otorrhea, and granulation tissue at the bony-cartilaginous junction of the EAC. Which investigation best confirms the suspected diagnosis and establishes a baseline for therapy?

A.Audiometry with tympanometry

B.Technetium-99m bone scan and/or gallium-67 scan with CT temporal bone

C.Flexible nasopharyngoscopy

D.Pure tone audiogram only

Explanation: Necrotizing (malignant) otitis externa should be suspected in elderly diabetics with disproportionate otalgia and canal granulation. Technetium-99m bone scan is highly sensitive for osteomyelitis of the skull base; gallium-67 scan follows disease activity during treatment. CT temporal bone delineates bony erosion. Pseudomonas aeruginosa is the most common pathogen; treatment is prolonged systemic antipseudomonal therapy (typically IV ciprofloxacin or piperacillin-tazobactam) and aggressive glycemic control.

3A 4-year-old presents with recurrent acute otitis media — 4 episodes in 6 months with middle ear effusion persisting between episodes. The AAO-HNSF 2022 clinical practice guideline update on tympanostomy tubes (ages 6 months to 12 years) recommends consideration of tubes for recurrent AOM when which criterion is met?

A.≥3 episodes in 6 months or ≥4 episodes in 12 months with one episode in the preceding 6 months AND middle ear effusion present at the time of decision

B.Any single episode of AOM

C.Bilateral effusion with no history of AOM for 1 month

D.Tympanic membrane perforation only

Explanation: The 2022 AAO-HNSF tympanostomy tube CPG update recommends clinicians OFFER tubes for recurrent AOM (≥3 episodes in 6 months, or ≥4 in 12 months with ≥1 in the prior 6 months) IF unilateral or bilateral middle ear effusion is present at the time of assessment. If no effusion, clinicians should NOT routinely offer tubes. For chronic OME, bilateral OME ≥3 months with hearing loss or symptoms is the threshold.

4A 35-year-old presents with 3 days of unilateral hearing loss. Audiogram shows a right sensorineural hearing loss of 45 dB at 500, 1000, and 2000 Hz compared to the prior normal left ear. The AAO-HNSF 2019 clinical practice guideline for sudden sensorineural hearing loss recommends initial treatment with which intervention?

A.Oral (or intratympanic) corticosteroids initiated within 2 weeks of symptom onset

B.Antiviral therapy alone

C.Hyperbaric oxygen as monotherapy at 6 weeks

D.Observation with no treatment

Explanation: Sudden SNHL is defined as ≥30 dB loss over 3 contiguous frequencies within 72 hours. The 2019 AAO-HNSF CPG update recommends clinicians OFFER systemic corticosteroids (oral prednisone ~1 mg/kg/day for 10-14 days or equivalent), and/or intratympanic steroids, as INITIAL therapy within 2 weeks of symptom onset. Salvage intratympanic steroids are an option for incomplete recovery up to 6 weeks. HBO can be considered as adjunct within 2 weeks (initial) or up to 1 month (salvage). Antivirals are NOT recommended.

5A 55-year-old woman reports recurrent brief episodes of vertigo provoked by rolling in bed or looking up. A Dix-Hallpike maneuver to the right produces upbeating-torsional (geotropic) nystagmus after a 3-second latency that fatigues. Which diagnosis and treatment pair is correct?

A.Right posterior canal BPPV; Epley (canalith repositioning) maneuver

B.Vestibular neuritis; head impulse testing only

C.Meniere disease; low-salt diet and diuretic

D.Superior canal dehiscence; round window reinforcement

Explanation: The classic upbeating-torsional nystagmus with latency, crescendo-decrescendo, and fatigability during a Dix-Hallpike is diagnostic of posterior canal BPPV (ipsilateral to the down-pointing ear). The Epley canalith repositioning maneuver is the evidence-based first-line treatment (AAO-HNSF BPPV guideline). Lateral (horizontal) canal BPPV is identified by supine roll test with horizontal nystagmus and is treated with Lempert/barbecue roll or Gufoni maneuver.

6A 45-year-old man presents with episodic vertigo lasting 2 to 6 hours, low-frequency fluctuating sensorineural hearing loss in the right ear, tinnitus, and aural fullness. Based on the 2015 AAO-HNS/Bárány Society diagnostic criteria, how many qualifying vertigo episodes and what audiometric documentation are required for definite Meniere disease?

A.≥2 spontaneous vertigo episodes each lasting 20 minutes to 12 hours, with low-to-medium frequency SNHL documented in the affected ear on at least one occasion

B.A single episode of vertigo with any hearing loss

C.≥5 episodes of vertigo lasting >24 hours with high-frequency SNHL

D.Persistent vertigo with mixed hearing loss

Explanation: 2015 AAO-HNS / Bárány criteria for definite Meniere disease require: (1) ≥2 spontaneous vertigo episodes lasting 20 minutes to 12 hours each; (2) audiometrically documented low- to medium-frequency SNHL in the affected ear on at least one occasion before, during, or after an episode; (3) fluctuating aural symptoms (tinnitus, fullness, hearing); (4) not better accounted for by another diagnosis (e.g., vestibular migraine). Treatment escalates from low-salt diet + diuretics → intratympanic steroid → intratympanic gentamicin or endolymphatic sac surgery → labyrinthectomy/vestibular nerve section.

7A 65-year-old man presents with a unilateral right-sided asymmetric sensorineural hearing loss on audiogram, with good word discrimination on the left (95%) and poor on the right (55%). Which imaging is the standard of care to evaluate for retrocochlear pathology?

A.MRI of internal auditory canals with gadolinium

B.Non-contrast CT of the temporal bone

C.Plain radiographs of the mastoid

D.Ultrasound of the neck

Explanation: Asymmetric SNHL (typically defined as ≥15 dB difference at two or more frequencies or poor word recognition asymmetry) requires MRI with gadolinium of the internal auditory canals and cerebellopontine angle to rule out vestibular schwannoma and other retrocochlear pathology. Non-contrast CT is used for bony anatomy (e.g., cholesteatoma, dehiscence, otosclerosis). Vestibular schwannomas are the most common CPA tumor (80-90%).

8A 40-year-old woman presents with progressive bilateral conductive hearing loss, worse during pregnancy. Otoscopy is normal and tympanograms are type A. Audiometry shows Carhart notch (dip at 2 kHz on bone conduction). What is the most likely diagnosis?

A.Otosclerosis

B.Cholesteatoma

C.Ossicular discontinuity from trauma

D.Tympanic membrane perforation

Explanation: Otosclerosis causes progressive conductive hearing loss from stapes fixation at the oval window, classically with a Carhart notch (apparent bone conduction dip at 2 kHz that reverses after stapes surgery). It is more common in women, progresses during pregnancy, and is autosomal dominant with variable penetrance. Treatment: hearing aid or stapedectomy/stapedotomy with prosthesis. Cochlear otosclerosis causes SNHL.

9A 38-year-old presents with chronic otorrhea, hearing loss, and a retraction pocket filled with keratin debris in the pars flaccida (attic) on otoscopy. CT temporal bone shows erosion of the scutum. Which is the definitive treatment?

A.Tympanomastoidectomy with removal of the cholesteatoma

B.Oral antibiotics indefinitely

C.Observation with annual otoscopy

D.Tympanostomy tube placement only

Explanation: Cholesteatoma (stratified squamous epithelium in the middle ear/mastoid) is locally destructive — eroding the scutum, ossicles, tegmen, and labyrinth. Medical therapy cannot eradicate it. Surgical removal via tympanomastoidectomy (canal-wall-up or canal-wall-down) is definitive. Complications of untreated cholesteatoma include SNHL, facial paralysis, labyrinthine fistula (especially lateral semicircular canal), meningitis, and brain abscess.

10A 7-year-old with bilateral profound sensorineural hearing loss is being evaluated for cochlear implantation. The 2020 FDA and current AAO-HNS expanded candidacy guidelines for pediatric CI include which criterion?

A.Pediatric candidates down to 9 months of age with bilateral profound SNHL and limited benefit from appropriately fit hearing aids

B.Only children older than age 10

C.Only children with normal cochlear anatomy on CT

D.Children with mild hearing loss and normal speech development

Explanation: FDA and current AAO-HNS practice allow cochlear implantation for children as young as 9 months of age (Cochlear Nucleus approved 2020, MED-EL approved 2023) with bilateral severe-to-profound SNHL and limited auditory benefit from well-fitted hearing aids. Earlier implantation (before 12-18 months) is associated with better spoken language outcomes. Cochlear nerve aplasia is a contraindication; auditory brainstem implant may be considered.

About the ABOHNS Otolaryngology Exam

The ABOHNS Written Qualifying Examination (WQE) is Phase 1 of the two-phase ABOHNS primary certification process. It is a computer-based, proctored, closed-book multiple-choice exam assessing candidates' knowledge across the breadth and depth of otolaryngology-head and neck surgery — otology/neurotology, rhinology/allergy, laryngology, head and neck oncology, facial plastic and reconstructive surgery, pediatric otolaryngology, sleep medicine, and general otolaryngology. ABOHNS implemented a new blueprint in 2026 with updated practice area weights and subdomains. Candidates must have completed an ACGME-accredited otolaryngology residency.

Questions

300 scored questions

Time Limit

Full-day computer-based exam (~8 hours including breaks)

Passing Score

Criterion-referenced scaled passing standard set by ABOHNS

Exam Fee

~$1,850 (2025); 2026 fee subject to annual update (American Board of Otolaryngology-Head and Neck Surgery (ABOHNS))

ABOHNS Otolaryngology Exam Content Outline

~18%

Otology / Neurotology

Otitis externa/media (AAO-HNS CPGs), tympanostomy tubes (2022 CPG), cholesteatoma, otosclerosis, sudden SNHL (2019 CPG, steroids ≤2 wks), Meniere disease (AAO-HNS/Bárány 2015 criteria), BPPV (Dix-Hallpike + Epley), vestibular schwannoma, cochlear implantation (pediatric down to 9 months), Bell palsy/Ramsay Hunt, glomus tumors, superior canal dehiscence.

~16%

Rhinology & Sinus / Allergy

Acute and chronic rhinosinusitis, CRSwNP with AERD (Samter triad), biologic therapy (dupilumab, omalizumab, mepolizumab), inverted papilloma (Krouse), JNA (Radkowski/Fisch), CSF rhinorrhea confirmed by beta-2 transferrin, invasive fungal sinusitis (mucormycosis), GPA (c-ANCA), HHT, esthesioneuroblastoma (Kadish).

~14%

Laryngology / Voice / Airway

Vocal fold paralysis (medialization), vocal nodules/polyps, spasmodic dysphonia (Botox), laryngopharyngeal reflux (RSI/RFS), laryngeal dysplasia, early glottic SCC (TLM vs RT), recurrent respiratory papillomatosis (HPV-6/11), Zenker diverticulum, Plummer-Vinson.

~18%

Head and Neck Oncology

AJCC 8th edition staging (oral DOI, HPV+ OPSCC separate chapter), ATA 2015 thyroid cancer guidelines, salivary gland (pleomorphic, Warthin, adenoid cystic carcinoma, carcinoma ex pleomorphic), nasopharyngeal carcinoma (EBV), RTOG 91-11 organ preservation, RTOG 9501/EORTC 22931 adjuvant CRT for positive margins/ENE, neck dissection anatomy (CN XI, great auricular).

~10%

Facial Plastic & Reconstructive Surgery

Rhinoplasty (L-strut ≥10 mm, spreader grafts, saddle nose), Mohs reconstruction aesthetic subunits (paramedian forehead flap), facial nerve anatomy (frontal branch Pitanguy's line), facial reanimation (hypoglossal-facial, gracilis), cutaneous melanoma (Breslow, 1-2 cm margins, sentinel node ≥0.8 mm).

~10%

Pediatric Otolaryngology

Laryngomalacia (supraglottoplasty), subglottic stenosis (Myer-Cotton), choanal atresia (CHARGE/CHD7), tonsillectomy CPG (Paradise criteria), pediatric OSA (oAHI >1), thyroglossal duct cyst (Sistrunk), branchial anomalies, airway foreign body (rigid bronchoscopy), retropharyngeal abscess, microtia/aural atresia (Jahrsdoerfer).

~8%

General Otolaryngology / Sleep

Nasal trauma (septal hematoma), peritonsillar abscess, pregnancy-safe antibiotics, Sjögren syndrome (anti-SSA/SSB), adult OSA (CPAP/MMA/HGNS), DISE and Inspire criteria (BMI <35, AHI 15-65), Plummer-Vinson, infectious mono (avoid amoxicillin).

~6%

Foundations / Basic Science

Temporal bone and skull base anatomy, facial nerve anatomy, embryology (branchial arches, ear), genetics (GJB2 connexin 26, Pendred/SLC26A4, NF2), pharmacology, histopathology, professionalism and patient safety.

How to Pass the ABOHNS Otolaryngology Exam

What You Need to Know

Passing score: Criterion-referenced scaled passing standard set by ABOHNS
Exam length: 300 questions
Time limit: Full-day computer-based exam (~8 hours including breaks)
Exam fee: ~$1,850 (2025); 2026 fee subject to annual update

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ABOHNS Otolaryngology Study Tips from Top Performers

1Master the AAO-HNSF clinical practice guidelines (acute otitis externa 2014, tympanostomy tubes 2022, sudden SNHL 2019 requiring corticosteroids within 2 weeks of onset, Bell palsy 2013 with steroids within 72 hours, BPPV with Dix-Hallpike and Epley, tonsillectomy 2019 with Paradise criteria) — these generate high-yield board questions

2Memorize AJCC 8th edition staging changes — oral cavity SCC incorporates depth of invasion (DOI >5 mm = T2), and HPV+ oropharyngeal SCC has a SEPARATE staging chapter with more favorable groupings than HPV-negative OPC

3Know the 2015 AAO-HNS/Bárány Society diagnostic criteria for Meniere disease: ≥2 vertigo episodes lasting 20 minutes to 12 hours, audiometrically documented low-to-medium-frequency SNHL in the affected ear on at least one occasion, and fluctuating aural symptoms

4Recognize cystic level II neck masses in adults over 40 (especially never-smokers) as HPV+ OPSCC with cystic nodal metastasis until proven otherwise — order p16 IHC and perform panendoscopy with bilateral tonsillectomy and TORS lingual tonsillectomy/mucosectomy if primary not identified

5Learn the Myer-Cotton subglottic stenosis grading system (I ≤50%, II 51-70%, III 71-99%, IV no lumen) — Grade III-IV typically requires laryngotracheal reconstruction or cricotracheal resection

Frequently Asked Questions

What is the ABOHNS Written Qualifying Examination?

The ABOHNS Written Qualifying Exam (WQE) is Phase 1 of the two-phase ABOHNS primary certification process for otolaryngologist-head and neck surgeons. It is a computer-based, proctored, closed-book multiple-choice exam administered by Pearson VUE. It assesses knowledge across the breadth and depth of otolaryngology-head and neck surgery. Candidates must have completed an ACGME-accredited otolaryngology residency. Candidates who pass proceed to the ABOHNS Oral Certifying Examination.

When is the 2026 ABOHNS Written Exam administered?

The 2026 Written Exam is scheduled for July 9, 2026, at Pearson VUE computer-based test centers. Application opens in early February 2026 (approximately). The 2025 Written Exam was administered on July 10, 2025. Dates are published on the ABOHNS website and are subject to confirmation annually.

What is on the new 2026 ABOHNS Written Exam blueprint?

The new 2026 ABOHNS blueprint (announced December 2025 and effective for the 2026 Written Exam) features updated weights for Practice Areas, consolidation of management categories from three (Non-Surgical, Surgical Concepts, Surgical Procedures) into two (Non-Surgical, Surgical), and introduces Subdomains for each Practice Area. Practice areas include otology/neurotology, rhinology/allergy, laryngology, head & neck oncology, facial plastic, pediatric otolaryngology, sleep, and foundations/general otolaryngology.

What is the passing score and pass rate for the ABOHNS Written Exam?

The ABOHNS Written Exam uses a criterion-referenced scaled passing standard (modified Angoff) — candidates are measured against content-expert-defined competence, not curved against peers. Recent pass rates: 87% for the 2024 Written Exam and 90-92% for the three preceding years. Score reports provide pass/fail plus diagnostic performance by content domain.

What is the exam fee for the ABOHNS Written Qualifying Exam?

The 2025 ABOHNS Written Exam fee was $1,850 (ABOHNS 2024 leadership update). The 2026 fee is subject to annual update and is published by ABOHNS during the application period. Late application incurs additional fees. Fees are non-refundable.

What are the eligibility requirements for the ABOHNS Written Exam?

Candidates must (1) successfully complete an ACGME-accredited Otolaryngology-Head and Neck Surgery residency program; (2) have an active, unrestricted US or Canadian medical license at the time of certification; (3) obtain program director attestation of clinical competence, ethical conduct, and professionalism. Canadian candidates must be Fellows of the RCPS(C) in good standing.

What are the highest-yield topics on the ABOHNS Written Exam?

High-yield topics include: AAO-HNSF CPGs (acute otitis externa, tympanostomy tubes, sudden SNHL with steroids within 2 weeks, Bell palsy with steroid within 72 hours, tonsillectomy Paradise criteria, BPPV Dix-Hallpike + Epley). AJCC 8th edition staging (oral cavity DOI, separate HPV+ OPSCC chapter, mucosal melanoma). Meniere disease criteria (2015 AAO-HNS/Bárány). CSF rhinorrhea confirmation with beta-2 transferrin. Cochlear implantation criteria (pediatric down to 9 months). Laryngeal cancer management (RTOG 91-11). Adjuvant CRT (RTOG 9501/EORTC 22931). Pediatric OSA (oAHI >1 is abnormal). Choanal atresia and CHARGE syndrome.

How should I study for the ABOHNS Written Qualifying Exam?

Use a 12-18 month structured plan during PGY-4/PGY-5. Start with the AAO-HNSF Otolaryngology Core Curriculum (OCC) to establish foundations. Master AAO-HNSF clinical practice guidelines (acute otitis externa, tympanostomy tubes, sudden SNHL, Bell palsy, BPPV, tonsillectomy) — high-yield on board exams. Integrate AJCC 8th edition staging (especially HPV+ OPSCC and oral cavity DOI) and ATA 2015 thyroid guidelines. Take the ABOHNS Otolaryngology Training Exam (OTE) yearly as a practice test. Complete thousands of board-style MCQs, review weak domains, and take at least two full-length timed practice exams.