Corrections 2

Question 1

1st line mx of epistaxis (pt is stable)?

Answer 1

1) Asking the patient to sit with their torso forward and their mouth open

2) Pinch the cartilaginous (soft) area of the nose firmly for at least 20 minutes

Question 2

2nd line mx of epistaxis?

Answer 2

1) consider using a topical antiseptic such as Naseptin (chlorhexidine and neomycin)

2) consider silver nitrate cautery (if bleeding source is visible)

3) packing may be used if cautery is not viable or the bleeding point cannot be visualised

Question 3

Mx of epistaxis that has failed all emergency management?

Answer 3

may require sphenopalatine ligation in theatre

Question 4

What needs to be excluded in SSNHL?

Answer 4

An MRI scan is usually performed to exclude a vestibular schwannoma.

Question 5

What imaging is indicated in SSNHL?

Answer 5

MRI - exclude a vestibular schwannoma.

Question 6

Time of ENT assessment in SSNHL?

Answer 6

24h

Question 7

What is the main duct that sialolithiasis occurs in?

Answer 7

Wharton’s duct in the submandibular gland

Question 8

When can patients be offered a cochlear implant in hearing loss?

Answer 8

In adults, patients should have completed a trial of appropriate hearing aids for at least 3 months which they have been objectively demonstrated to receive limited or no benefit from.

Question 9

What abx drops are indicated in otitis externa in diabetics?

Answer 9

Ciprofloxacin to cover Pseudomonas

Question 10

What is sialadenitis?

Answer 10

Inflammation of the salivary gland likely 2ary to obstruction by a stone impacted in the duct.

Question 11

Mx of unilateral nasal polyps?

Answer 11

Red flag –> urgent ENT referral

Question 12

Mx of acute attacks of Meniere’s?

Answer 12

Buccal or IM prochlorperazine

Question 13

What can be used to help prevent attacks of Meniere’s?

Answer 13

Betahistine & vestibular rehabilitation exercises

Question 14

Give 4 causes of gingival hyperplasia?

Answer 14

1) phenytoin
2) ciclosporin
3) CCBs
4) AML

Question 15

Which leukaemia can cause gingival hyperplasia?

Answer 15

AML

Question 16

Routine vs urgent referral in nasal polyps?

Answer 16

Routine –> All patients with suspected nasal polyps should be referred routinely to the ENT team

Urgent –> Unilateral symptoms or blood-stained discharge

Question 17

What can be used to shrink nasal polyps?

Answer 17

Topical steroids

Question 18

Imaging investigation of choice in mastoiditis?

Answer 18

CT temporal bone

Question 19

What operation can be performed in cases of tympanic membrane rupture where spontaneous healing has failed to occur?

Answer 19

Myringoplasty

Question 20

What is double sickening?

What is it typically seen in?

Answer 20

An initial period of recovery followed by a sudden worsening of symptoms.

Typically seen in bacterial sinusitis.

Question 21

Key features of Meniere’s?

Answer 21

• tinnitus
• vertigo (minutes to hours)
• hearing loss (sensorineural)
• nystagmus
• aural fullness
• +ve Romberg’s

Question 22

Acute mx of Meniere’s?

Answer 22

IM or buccal prochlorperazine

Question 23

Prevention of Meniere’s?

Answer 23

Betahistine

Question 24

How long do symptoms take to resolve in Meniere’s?

Answer 24

5-10y

Question 25

Timeline of acute vs chronic sinusitis?

Answer 25

Acute: <4 weeks

Chronic: ≥12 weeks

Question 26

1st line abx in sinusitis when indicated?

Answer 26

Penicillin V

Question 27

When can nasal steroids be offered in sinusitis?

Answer 27

> 10 days

Question 28

If 1st aid measures are successful in epistaxis, what can the patient be given on discharge?

Answer 28

Topical antiseptic e.g. naseptin (chlorhexidine & neomycin) –> to reduce crusting and risk of vestibulitis