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Key Facts: UKOM Sp.THT-BKL Exam

CBT

Current national knowledge-assessment component confirmed

Kolegium Ilmu Kesehatan THT-BKL Indonesia

OSCE

Current national performance-assessment component confirmed

Kolegium Ilmu Kesehatan THT-BKL Indonesia

Perkonsil 45/2016

Official national competency and education standard for Sp.THT-BKL

Konsil Kedokteran Indonesia (KKI)

100

Questions in this independent practice bank

OpenExamPrep

The UKOM Sp.THT-BKL is the Indonesian national specialist exit examination with confirmed CBT and OSCE components. This OpenExamPrep question bank provides an independent English-language 100-question MCQ study adaptation for clinical reasoning, surgical decision-making, and disease-management review. It is not an official translation, test simulation, OSCE substitute, or PERHATI-KL endorsement.

Sample UKOM Sp.THT-BKL Practice Questions

Try these sample questions to review concepts for the UKOM Sp.THT-BKL exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 4-year-old boy has severe otalgia and fever for 24 hours. Otoscopy shows a markedly bulging tympanic membrane with purulent middle-ear effusion and no perforation. What is the appropriate initial management?
A.Acute suppurative otitis media; provide analgesia and an appropriate antibiotic, reserving tympanocentesis or myringotomy for selected severe or complicated cases
B.Occlusion stage (stadium oklusi tuba); administer topical nasal decongestants and oral amoxicillin
C.Perforation stage (stadium perforasi); perform gentle ear toileting and instil topical polymyxin B eardrops
D.Hyperemic stage (stadium hiperemis); administer oral high-dose antihistamines and watchful waiting
Explanation: Marked tympanic-membrane bulging with acute symptoms establishes acute otitis media. Treat pain and, given severe symptoms, use an appropriate systemic antibiotic under the current pediatric protocol. Routine immediate myringotomy is not required for uncomplicated AOM; tympanocentesis or drainage is reserved for complications, treatment failure, unusual hosts or a need for microbiologic diagnosis.
2A 34-year-old man presents with persistent, foul-smelling, purulent left otorrhea for the past two years. Otoscopy reveals an epitympanic (attic) retraction pocket with scutum erosion, friable granulation tissue, and pearly white keratinaceous flakes. Pure-tone audiometry demonstrates a 45 dB conductive hearing loss in the left ear. High-resolution CT of the temporal bone confirms soft tissue opacification in Prussak's space with ossicular chain erosion. What is the definitive management of this patient's condition?
A.Canal-wall-up or canal-wall-down mastoidectomy with tympanoplasty to completely eradicate cholesteatoma
B.Conservative management with prolonged topical ciprofloxacin-dexamethasone eardrops and water precautions
C.Office microscopic aspiration and chemical cautery of granulation tissue with 20% trichloroacetic acid
D.Simple Type I tympanoplasty without exploration of the mastoid antrum
Explanation: The clinical and radiological findings confirm chronic suppurative otitis media (CSOM / OMSK) of the unsafe/malignant type (OMSK tipe bahaya) with cholesteatoma. Cholesteatoma is an expansile, bone-eroding epidermoid lesion of the middle ear and mastoid that harbors bacterial biofilm and releases osteolytic enzymes. Definitive management requires surgical eradication via mastoidectomy (canal-wall-down or canal-wall-up depending on extent and anatomy) combined with tympanoplasty, because conservative medical therapy cannot eradicate the trapped matrix and bone destruction.
3A 28-year-old woman with chronic suppurative otitis media (OMSK benigna aktif) has persistent purulent greenish-yellow ear discharge that has failed oral amoxicillin-clavulanate. What are the two most frequently isolated predominant aerobic bacterial pathogens in active OMSK that should guide empirical topical antimicrobial therapy?
A.Pseudomonas aeruginosa and Staphylococcus aureus
B.Streptococcus pneumoniae and Haemophilus influenzae
C.Moraxella catarrhalis and Mycoplasma pneumoniae
D.Streptococcus pyogenes and Klebsiella pneumoniae
Explanation: In chronic suppurative otitis media (OMSK), the microbiological profile differs fundamentally from acute otitis media. The predominant aerobic isolates are Pseudomonas aeruginosa (the most frequent organism, isolated in 50-70% of cases) and Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA), followed by Proteus mirabilis and mixed anaerobes (such as Bacteroides and Peptostreptococcus). Therefore, first-line topical treatment requires coverage against Pseudomonas and S. aureus, typically using topical fluoroquinolones (e.g., ciprofloxacin or ofloxacin).
4During middle ear exploration for chronic otitis media, the surgeon discovers that the tympanic membrane is largely perforated, the malleus and incus are completely eroded by past infection, but the stapes suprastructure is intact and mobile. The surgeon places a temporalis fascia graft directly onto the mobile stapes capitulum (head). According to the classic Wullstein classification, which type of tympanoplasty was performed?
A.Type III tympanoplasty (myringostapediopexy)
B.Type I tympanoplasty (myringoplasty)
C.Type II tympanoplasty
D.Type IV tympanoplasty (cavum minor)
Explanation: According to the classic Wullstein classification of tympanoplasty, Type III (myringostapediopexy) is performed when both the malleus and incus are absent or eroded, but the stapes suprastructure is mobile and intact, allowing the reconstructed tympanic membrane or fascia graft to be placed directly onto the stapes head (capitulum). In modern ossiculoplasty, this is also accomplished with a partial ossicular replacement prosthesis (PORP).
5A 32-year-old woman in her third trimester has progressive bilateral conductive hearing loss, paracusis Willisii, a Schwartz sign and a 2-kHz Carhart notch. What is the diagnosis and appropriate treatment principle?
A.Otosclerosis with stapes fixation; offer amplification during pregnancy and consider stapes surgery electively after pregnancy
B.Ossicular chain dislocation; incudostapedial rebridging using glass ionomer cement
C.Malleus head ankylosis; canaloplasty and transcanal atticotomy with malleus head resection
D.Tympanosclerosis involving the incudomalleolar joint; total ossicular replacement prosthesis (TORP)
Explanation: The findings indicate otosclerosis with stapes-footplate fixation. A hearing aid can provide safe amplification during pregnancy. Stapedotomy with a prosthesis is an elective definitive option for an appropriate conductive loss, but it should generally be deferred until after pregnancy rather than presented as an immediate third-trimester procedure.
6A 45-year-old woman wakes up with profound hearing loss and roaring tinnitus in her right ear that developed over 12 hours. Pure-tone audiometry confirms a 45 dB sensorineural hearing loss across 500, 1000, and 2000 Hz in the right ear compared to normal thresholds on the left. Neuro-otologic examination is otherwise unremarkable and otoscopy is normal. According to international and national clinical guidelines, what is the initial, time-sensitive first-line medical treatment for sudden sensorineural hearing loss (SSNHL)?
A.Oral high-dose corticosteroids (e.g., prednisone 1 mg/kg/day, maximum 60 mg/day for 7–14 days with taper)
B.Intravenous acyclovir combined with oral carbamazepine
C.Immediate exploratory tympanotomy for round window perilymph fistula repair
D.High-dose oral pentoxifylline combined with betahistine mesylate
Explanation: Sudden sensorineural hearing loss (SSNHL / sudden deafness) is defined as a sensorineural hearing loss of ≥30 dB across at least 3 contiguous frequencies occurring within a 72-hour window. The standard first-line, evidence-based management is prompt initiation of high-dose systemic corticosteroids (oral prednisone 1 mg/kg/day, up to 60 mg/day, for 7-14 days followed by a taper) within the first 2-4 weeks of onset. Intratympanic dexamethasone can be used as primary therapy in patients with contraindications to systemic steroids or as salvage therapy for incomplete recovery.
7A 6-year-old child presents with speech delay and suspected hearing difficulty at school. Otoscopy shows dull, amber-colored tympanic membranes with restricted mobility on pneumatic otoscopy. Tympanometry shows a flat curve with no compliance peak and normal equivalent ear canal volume (0.8 mL) bilaterally. According to the Jerger classification, what tympanogram type is present and what is the underlying condition?
A.Type B tympanogram; otitis media with effusion (OME)
B.Type A tympanogram; normal middle ear function
C.Type C tympanogram; significant Eustachian tube dysfunction without fluid
D.Type B tympanogram with large volume; tympanic membrane perforation
Explanation: A Type B tympanogram with normal equivalent ear canal volume (typically 0.6 to 1.5 mL in children) indicates absence of tympanic membrane compliance due to fluid filling the middle ear cleft, which is classic for otitis media with effusion (OME / glue ear). In contrast, a Type B tympanogram with an abnormally large volume (>2.0-2.5 mL) reflects a patent tympanic membrane perforation or a functioning tympanostomy ventilation tube.
8During pure-tone audiometry using standard supra-aural earphones, a patient has a bone-conduction threshold of 10 dB HL in the non-test ear and an unmasked air-conduction threshold of 65 dB HL in the test ear. In clinical audiology, what is the minimum interaural attenuation (IA) value for standard supra-aural earphones, and is clinical masking mandatory in this scenario?
A.40 dB; masking is required because the test ear air threshold exceeds the non-test ear bone threshold by ≥40 dB
B.70 dB; masking is not required because the difference is less than 70 dB
C.20 dB; masking is only required if the air-bone gap in the non-test ear exceeds 30 dB
D.0 dB; masking is never used for air conduction testing
Explanation: The minimum interaural attenuation (IA) for standard supra-aural earphones (e.g., TDH-39) across the speech frequencies is clinically accepted as 40 dB (compared to 60–70 dB for insert earphones). Masking for air conduction is required whenever the air-conduction threshold of the test ear exceeds the bone-conduction threshold of the non-test ear by 40 dB or more (ACTE - BCNTE ≥ 40 dB). Here, 65 dB - 10 dB = 55 dB, which exceeds 40 dB, meaning crossover to the non-test cochlea has occurred and masking of the non-test ear with narrow-band noise is mandatory.
9In Auditory Brainstem Response (ABR / BERA) testing for retrocochlear pathology, each positive wave peak corresponds to an anatomical neural generator along the auditory pathway. Which anatomical structure is the primary electrophysiological generator of Wave V, the most robust and clinically scrutinized wave?
A.Inferior colliculus (and termination of lateral lemniscus)
B.Distal portion of the eighth cranial nerve (cochlear nerve near the internal auditory meatus)
C.Cochlear nucleus in the lower brainstem
D.Superior olivary complex in the pons
Explanation: In Auditory Brainstem Response (ABR / BERA), the five vertex-positive peaks correspond to discrete auditory pathway generators: Wave I arises from the distal portion of the cochlear nerve (CN VIII); Wave II from the proximal cochlear nerve and cochlear nucleus; Wave III from the superior olivary complex; Wave IV from the lateral lemniscus; and Wave V from the inferior colliculus and the lateral lemniscus termination. Wave V is the most resilient wave used for threshold estimation and latency analysis (I-V and III-V interpeak latencies) in screening for vestibular schwannoma.
10A 52-year-old man with asymmetric progressive left-sided sensorineural hearing loss undergoes acoustic stapedial reflex testing. The acoustic reflex decay test demonstrates that the amplitude of the reflex decreases by more than 50% within 5 seconds of sustained 10-second stimulus presentation at 10 dB above reflex threshold at 500 Hz and 1000 Hz. What is the clinical significance of this finding?
A.Positive reflex decay indicative of a retrocochlear lesion (such as vestibular schwannoma)
B.Negative reflex decay confirming cochlear recruitment from endolymphatic hydrops
C.Middle ear conductive pathology resulting from otosclerotic stapes fixation
D.Normal physiological adaptation of the stapedius muscle in adults
Explanation: Acoustic reflex decay (reflex adaptation) is defined as an inability of the stapedius muscle contraction to maintain at least 50% of its initial reflex amplitude during a continuous 10-second acoustic stimulus at 10 dB SL above threshold at 500 or 1000 Hz. A positive reflex decay is a hallmark of neural fatigue and retrocochlear pathology, most commonly vestibular schwannoma (acoustic neuroma) or cerebellopontine angle mass compressing the eighth cranial nerve, warranting urgent contrast-enhanced MRI of the internal auditory canal.

About the UKOM Sp.THT-BKL Exam

The Ujian Kompetensi Dokter Spesialis THT-BKL (UKOM Sp.THT-BKL) is the national qualifying exit examination required for all otorhinolaryngology-head and neck surgery residency graduates in Indonesia. Regulated under Konsil Kedokteran Indonesia (KKI) Regulation No. 45 of 2016 (Standar Pendidikan dan Standar Kompetensi Dokter Spesialis THT-BKL), successful completion awards the national Certificate of Competence (Sertifikat Kompetensi), a mandatory prerequisite for obtaining the specialist medical registration (Surat Tanda Registrasi / STR Dokter Spesialis) and practice license (Surat Izin Praktik / SIP Dokter Spesialis THT-BKL). The exam evaluates expert clinical decision-making across Otologi, Rinologi, Faringo-Laringologi, Onkologi Bedah Kepala Leher, Bronkoesofagologi, Plastik Rekonstruksi, and THT Emergensi.

Exam sponsor: Kolegium Ilmu Kesehatan THT-BKL Indonesia / Konsil Kesehatan Indonesia (KKI) / PERHATI-KL. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

A national CBT and OSCE are confirmed. This bank covers specialist knowledge and clinical reasoning in four-option MCQ form and does not simulate clinical performance.

Time Limit

Not published in the official sources reviewed.

Passing Score

Not published in the official sources reviewed.

Exam / Certification Fees

Not published in the official sources reviewed.

Exam sponsor website

Reported exam pass rate: Not published in the official sources reviewed.. Not published in the official sources reviewed. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

25 of 100 practice questions

Otologi & Neurotologi

Acute otitis media (OMA stages, myringotomy indications), chronic suppurative otitis media (OMSK benign vs cholesteatoma, microbiological profile, mastoidectomy, tympanoplasty types I-V), otosclerosis and stapedotomy, sudden SNHL corticosteroid protocols, pure-tone audiometry and masking, tympanometry Jerger types A/B/C, acoustic reflex decay, BERA/ABR neural generators, peripheral vestibulopathy (BPPV canalithiasis vs cupulolithiasis, Dix-Hallpike and Epley maneuvers, supine roll test, Meniere disease, vestibular neuritis), facial nerve disorders (House-Brackmann scale, Bell palsy, Ramsay Hunt, traumatic facial nerve decompression criteria), and longitudinal vs transverse temporal bone fractures.

20 of 100 practice questions

Rinologi, Alergi & Imunologi

Allergic rhinitis classification under ARIA guidelines, skin prick testing and antihistamine washout, non-allergic rhinitis (rhinitis medicamentosa decongestant withdrawal, vasomotor rhinitis ipratropium bromide), acute and chronic rhinosinusitis (EPOS diagnostic criteria, double-sickening in ABRS), nasal polyps, Aspirin-Exacerbated Respiratory Disease (AERD / Samter triad leukotriene pathophysiology), functional endoscopic sinus surgery (FESS / BSEF: uncinate attachments, basal lamella, retrobulbar hematoma emergency lateral canthotomy, Keros skull base classification), epistaxis management (Kiesselbach plexus vs sphenopalatine artery endoscopic ligation), septoplasty L-strut preservation, and invasive vs allergic fungal rhinosinusitis.

20 of 100 practice questions

Laringo-Faringologi & Traktus Aerodigestivus Superior

Acute and chronic tonsillitis, Paradise criteria for adenotonsillectomy, deep neck space infections (peritonsillar abscess / quinsy needle aspiration, retropharyngeal abscess prevertebral widening and mediastinitis risk, parapharyngeal space compartments, Ludwig angina emergency airway prioritization), hoarseness and vocal fold lesions (vocal nodules voice therapy, vocal polyps, Reinke edema smoking cessation, intracordal cysts, recurrent respiratory papillomatosis HPV 6/11), vocal fold paralysis (left recurrent laryngeal nerve vulnerability, Isshiki Type I medialization thyroplasty, bilateral abductor paralysis emergency airway), superior laryngeal nerve injury, laryngopharyngeal reflux (LPR / pachydermia), Zenker diverticulum Killian dehiscence, and acute laryngeal fracture airway stabilization.

20 of 100 practice questions

Onkologi Bedah Kepala & Leher

Nasopharyngeal carcinoma (KNF: Indonesian endemic epidemiology, EBV DNA load, IgA anti-VCA, Fossa of Rosenmüller biopsy, WHO I-III histopathology, AJCC 8th ed staging, concurrent chemoradiotherapy with cisplatin), oral cavity cancer (tongue SCC, depth of invasion DOI >4 mm neck dissection threshold), laryngeal cancer (early glottic T1a TLM vs EBRT, locally advanced T3/T4 total laryngectomy vs organ preservation RTOG 91-11), thyroid neoplasms (Bethesda reporting system, hypocalcemia Chvostek and Trousseau signs, medullary thyroid cancer RET proto-oncogene), salivary gland tumors (pleomorphic adenoma superficial parotidectomy, Warthin tumor oncocytic scintigraphy, mucoepidermoid carcinoma CRTC1-MAML2, adenoid cystic carcinoma cribriform pattern and perineural invasion), adult solitary neck mass evaluation (presumed metastatic SCC until proven otherwise), and Robbins neck levels I-VI.

15 of 100 practice questions

Bronkoesofagologi, Emergensi THT & Plastik Rekonstruksi

Emergency airway management: Jackson classification stages I-IV of acute upper airway obstruction, surgical tracheostomy technique (2nd-3rd ring incision, subglottic stenosis avoidance), emergency cricothyroidotomy; foreign bodies in tracheobronchial tree (organic peanut aspiration, Jackson triad, rigid bronchoscopy) and esophagus (button battery liquefactive necrosis emergency, coin radiographic orientation); maxillofacial trauma (nasal bone fracture closed reduction timing, Le Fort I/II/III craniofacial disjunction, ZMC tripod fractures, pediatric trapdoor orbital blowout fractures and oculocardiac reflex); congenital anomalies (thyroglossal duct cyst Sistrunk procedure, 2nd branchial cleft cyst carotid bifurcation relation, cleft lip/palate Rule of 10s); and facial reconstructive local flaps (paramedian forehead flap supratrochlear artery, bilobed transposition flap).

Preparing for the UKOM Sp.THT-BKL Exam

What You Need to Know

  • Passing score: Not published in the official sources reviewed.
  • Assessment: A national CBT and OSCE are confirmed. This bank covers specialist knowledge and clinical reasoning in four-option MCQ form and does not simulate clinical performance.
  • Time limit: Not published in the official sources reviewed.
  • Exam / certification fees: Not published in the official sources reviewed. Official sources

Using Our Practice Resources

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

UKOM Sp.THT-BKL: Suggested Study Strategy

1Master the precise anatomical boundaries of the paranasal sinuses (uncinate process attachments, basal lamella, fovea ethmoidalis, sphenopalatine foramen) and the temporal bone (facial nerve course, Fallopian canal segments, otic capsule).
2Memorize landmark staging systems and clinical guidelines, especially the AJCC 8th edition staging for oral cavity cancer (Depth of Invasion criteria) and nasopharyngeal carcinoma, as well as the EPOS rhinosinusitis definitions.
3Understand emergency airway algorithms: recognize Jackson stages of upper airway obstruction, indications for emergent surgical cricothyroidotomy vs elective tracheostomy, and avoid blind intubation in acute laryngeal trauma.
4Thoroughly review audiology graphs: practice rapid identification of tympanometry types (A, As, Ad, B with normal/large volume, C), acoustic reflex decay interpretation, and BERA/ABR wave generators.
5Review the classic histopathological hallmarks of head and neck tumors: Orphan Annie eye nuclei in papillary thyroid carcinoma, cribriform 'Swiss cheese' patterns in adenoid cystic carcinoma, oncocytic bilayered epithelium in Warthin's tumor, and CRTC1-MAML2 fusions in mucoepidermoid carcinoma.

Frequently Asked Questions

What is the UKOM Sp.THT-BKL examination?

The UKOM Sp.THT-BKL (Uji Kompetensi Dokter Spesialis THT-BKL) is the national exit examination administered by Kolegium Ilmu Kesehatan THT-BKL Indonesia for eligible residency graduates. Current registration afterward follows the Konsil Kesehatan Indonesia and health-authority framework.

What is the official format and scoring of the national exit examination?

Current sources confirm CBT and OSCE components. The official item count, option count, station count, timing, scoring rules, and detailed station tasks were not published in the sources reviewed.

What regulatory framework defines the scope of the Sp.THT-BKL examination?

The official scope is defined by Peraturan Konsil Kedokteran Indonesia (Perkonsil) No. 45 Tahun 2016 concerning 'Standar Pendidikan dan Standar Kompetensi Dokter Spesialis Telinga Hidung Tenggorok Bedah Kepala dan Leher'. The curriculum encompasses Otologi, Rinologi, Faringo-Laringologi, Onkologi Bedah Kepala Leher, Bronkoesofagologi, Plastik Rekonstruksi, Alergi Imunologi, and THT Komunitas.

How should candidates prepare for the CBT component?

Preparation requires reviewing core international clinical practice guidelines (such as EPOS for rhinosinusitis, ARIA for allergic rhinitis, AAO-HNS guidelines for sudden SNHL and otitis media, and AJCC 8th edition for head and neck staging), alongside Indonesian national clinical pathways and textbooks. Practicing multi-step clinical vignette questions that emphasize surgical landmarks, complication prevention, and diagnostic algorithms is essential.

Is this OpenExamPrep practice bank an official test simulation?

No. This practice bank is an independent English-language four-option MCQ study adaptation created by OpenExamPrep for clinical decision-making and specialist knowledge review. It is not an official test release, translation, testing simulation, or substitute for OSCE preparation by Kolegium THT-BKL or PERHATI-KL.