2. ENT

Question 1

What is an indication for grommets?

a. previous ear infection complicated by mastoiditis
b. ear pain > 2 days

c. language delay
d. 2 ear infections a year

Answer 1

language delay

Question 2

A Weber test lateralising to the left ear (louder in the left ear), followed by a Rinne positive in the right ear means:

a. left ear sensorineural hearing loss
b. right ear sensorineural hearing loss
c. left ear conductive hearing loss
d. right ear conductive hearing loss

Answer 2

right ear sensorineural hearing loss

Question 3

A positive Dix-Hallpike manoeuvre is diagnostic of

a. benign paroxysmal positional vertigo
b. central cause of vertigo
c. meniere’s disease

d.vestibular neuritis

Answer 3

benign paroxysmal positional vertigo

Question 4

A pus-sy otorrhoea (ear discharge) is highly suggestive of the following:

a. it is a non-specific sign
b. foreign body
c. otitis media with perforation
d. cholesteatoma

Answer 4

it is a non-specific sign

Question 5

Temporal arteritis is a medical emergency because:

a. it is associated with ischemic heart disease
b. it is sight threatening
c. it causes jaw claudication
d. it is associated with polymyalgia rheumatics

Answer 5

it is sight threatening

Question 6

Which one of the following is a function of nasal turbinates?

a.to create turbulent air flow

b. to protect the airways during swallowing
c. to cool air before it enters the lungs
d. to enhance taste

Answer 6

They project into the nasal passages as ridges of tissue. The turbinates help warm and moisturize air as it flows through the nose. The inferior turbinates can block nasal airflow when they are enlarged.

Question 7

Which one of the following correctly matches Hutchinson’s sign to the underlying disease and appropriate immediate management?

a. shingles of the ear, antivirals
b. herpes simplex of the lips, antivirals
c. herpes simplex of the genitals, antivirals

d.shingles of the ophthalmic nerve, ophthalmology review

Answer 7

shingles of the ophthalmic nerve, ophthalmology review

Question 8

What is abnormal about this oropharynx?

a. Dental abscess
b. Crooked teeth

c. Benign bony overgrowth midline of the hard palate
d. Loss of normal papillae on tongue due to vitamin deficiency

Answer 8

Benign bony overgrowth midline of the hard palate

Question 9

Palatal petechiae might be suspicious of which of the following?

a. shingles
b. dental abscess

c. sexual abuse in a child
d. primary herpes simplex infection

Answer 9

sexual abuse in a child

Question 10

Which of the following is a reasonable first line treatment option for allergic rhinitis?

a. desensitisation
b. oral steroids

c. intranasal steroids
d. allergy specialist referral

Answer 10

intranasal steroids

Question 11

The aim of treatment of rosacea is to prevent what complication?

a. rhinophyma
b. scarring

c. skin cancer
d. acne

Answer 11

rhinophyma

Question 12

Which of the following is a red flag for an enlarged cervical lymph node?

a. bilateral
b. concurrent upper respiratory tract infection
c. tenderness
d. persists longer than 1 month

Answer 12

persists longer than 1 month

Question 13

Why are children of Aboriginal and Torres Trait Islander from rural areas more prone to ear infections?

a. swimming in natural bodies of water
b. more likely to have been breastfed
c. spend more time outdoors
d. crowded living conditions

Answer 13

crowded living conditions

Question 14

How would you manage this lesion?

Answer 14

Cryotherapy

This therapy utilizes extreme cold temperatures to treat the lesion.

Vermilionectomy (lip shave)

This is a surgical procedure for precancerous lesions of the lips, involving the excision of the lip layer under proper anesthesia.

Laser therapy

This therapy employs a particular wavelength of light that interacts with the lip tissue to treat AC.

Question 15

What are some questions you would ask someone who has recurrent oral thrush?

Answer 15

Do you smoke?

Do you ewear dentures?

Are you stressed?

Do you suffer from: Uncontrolled diabetes, HIV infection, Cancer, Dry mouth or have any Hormonal changes that happen when pregnant?

Question 16

What is hirsutism? What underlying condition would you consider? What is the significance of that condition?

Answer 16

a condition of unwanted, male-pattern hair growth in women. Hirsutism results in excessive amounts of dark, course hair on body areas where men typically grow hair — face, chest and back

It is caused by excess production or action of hormones called androgens, secreted by the ovaries or adrenal glands and produced locally in the hair follicle.

The two most common: polycystic ovary syndrome (PCOS) and idiopathis hirsutism.

Hirsutism is linked with decreased fertility.

Question 17

How do you differentiate between Bell’s palsy and a stroke? What treatment considerations are needed for Bell’s palsy?

Answer 17

Bell’s Palsy: peripheral facial weakness

Stroke: central facial weakness that involves the mouth and spares the eye and forehead. Strokes involving the brainstem can sometimes cause weakness of the mouth, eye and forehead—mimicking a peripheral lesion

Tx for Bells Palsy: Medication (steroid, antivirals), artificial tears (moisten eyes for relief), eye patch (protect eye from injury)

Question 18

Who is at risk for cholesteatoma? What is the complication if left untreated?

Answer 18

Risk: poor eustachian tube function as well as infection in the middle ear.

Complication: cyst can become infected, causing inflammation and continual ear drainage, over time, may also destroy the surrounding bone, permanent hearing loss, facial weakness, chronic infection of the ear, swelling of the inner ear, paralysis of the facial muscle, meningitis, which is a life-threatening brain infectio, brain abscesses, or collections of pus in the brain

Question 19

What are the key assessment areas in evaluating tinnitus?

Answer 19

Subjective – patient can hear

Objective – patient and observe – arteriovenous malformation, clicking muscles in middle ear or palate

Ask for associated vertigo or hearing loss

Question 20

What body systems could lead to a patient feeling unsteady?

Answer 20

VESTIBULAR PROBLEMS

SENSORY DISORDER – as in poor vision or peripheral neuropathy causing poor feedback (diabetic)

JOINT & MUSCLE PROBLEMS – painful joints in arthritis, muscle weakness from neuromuscular disorders or ageing or poor conditioning

NEUROLOGICAL –in conditions affecting the cerebellum or Parkinson’s disease

MEDICATIONS – anti-seizure medications, sedatives, tranquilisers