Common Conditions (ENT)

Question 1

What is acute sinusitis?

Answer 1

Acute inflammation of the lining of the nose and paranasal sinuses

Question 2

Acute sinusitis aetiology

Answer 2

• Infections (viral or bacterial)
• Allergies
• Non-allergic causes

Question 3

Acute sinusitis SSx

Answer 3

• Pain over cheek, radiating to frontal region or teeth
• Red nose, cheeks or eyelids
• Tenderness over the frontal sinus
• Referred pain to the vertex, pterion or occiput
• Postnasal discharge
• Blocked nose
• Persistent coughing or pharyngeal irritation
• Headache or facial pain
• Hyposmia

Question 4

Acute sinusitis red flags

Answer 4

• Unilateral symptoms
• Bleeding
• Cocosmia
• SSx of meningitis
• Altered neurology
• Frontal swelling
• Any orbital involvement

Question 5

Sinus headache management

Answer 5

• Regular analgesia
• Nasal saline irrigations
• Nasal decongestants
• Intranasal steroids
• Antibiotics (amoxycillin)

Question 6

What is acute otitis externa (AOE)?

Answer 6

Inflammation of the external auditory canal, auricle, or both

Question 7

AOE aetiology

Answer 7

• Bacteria
• Fungi (otomycosis)
• Skin conditions

Question 8

AOE SSx

Answer 8

• Otalgia
  - Mild to severe
  - Severe deep pain in immunocompromised patients
• Hearing loss (± tinnitus)
• Ear pressure
• Fever
• Itching
• Painful tragus or pinna on palpation
• Narrowing of the EAC
• Tympanic membrane ± erythema and
  oedema
• Otorrhoea
• ± cervical lymphadenitis
• ± eczema of the pinna
• ± conductive hearing loss

Question 9

What is acute otitis media (AOM)?

Answer 9

Inflammation accompanied by fluid in the middle ear

Question 10

AOM aetiology

Answer 10

• Viral
• Streptococcus pneumoniae (35%)
• Non-typable strain of haemophilus influenzae
• Moraxella catarrhalis

Question 11

AOM SSx

Answer 11

• Middle ear effusion
• Otalgia
• Post auricular cervical lymphadenopathy
• Otorrhea (indicates tympanic perforation)
• Headache
• Fever (usually >40oC)
• Irritability (often sole symptom in very young children)
• ± gastrointestinal symptoms: nausea, vomiting, diarrhoea
• Lethargy

Question 12

What is acute pharyngitis?

Answer 12

Infection or irritation of the pharynx and/or tonsils

Question 13

Acute pharyngitis aetiology

Answer 13

• Viral

- Bacterial

Question 14

Acute cervical lymphadenitis SSx

Answer 14

• Suggestive of infection
  - Soft
  - Fluctuant
  - Tender
  - Overlying erythema
  or streaking
• Suggestive of malignancy
  - Firm
  - Fixed
  - Non-tender