Ears Nose And Throat

Question 1

Midline neck lump differentials

Answer 1

Dermoid cyst

Thyrogolossal cyst

Question 2

Lateral neck lumps differentials

Answer 2

Cystic hygroma
Brachial cyst
Carotid body tumour
Lymph nodes

Question 3

Lateral neck lump in a 17 year old woman, soft, fluctuant, non-tender, doesn’t transluminate. Diagnosis?

Answer 3

Branchial cyst

Question 4

Painless midline swelling, cystic swelling, moves upwards with protusion of the tongue

Answer 4

Thyroglossal cyst

Question 5

Sensioneural hearing loss on audiogram

Answer 5

Both air and bone conduction less than 20 dB

Question 6

Conductive hearing loss on audiogram

Answer 6

Air conduction below 20 dB

Question 7

Mixed hearing loss on audiogram

Answer 7

Both air and bone below 20 dB

Question 8

Progressive paraesthesia of peripheries post thyroid removal as well as muscle cramps and spasms. What will ECG show?

Answer 8

QT elongation

- thyroid surgery can damage parathyroid glands resulting in hypocalcaemia

Question 9

Viral infection, acute, severe virtigo, nausea vomiting and ataxia. Diagnosis and management?

Answer 9

Vestibular neuronitis

Vestibular rehabilitation exercises
Then prochloperazine

Question 10

Facial nerve palsy and rash around ear

Diagnosis management

Answer 10

Ramsay hunt syndrome

Aciclovir and prednisolone

Question 11

Conductive deafness in pregnancy think what?

Answer 11

Otoerosclèrosis

Fixation of stapes to oval window

Autosomal dominant condition

Question 12

Centor criteria

Answer 12

Tender anterior cervical lymphadenopathy
Presence of tonsilar exudate
History of fever
Absence of cough

> 3
Abx
Phenoxymethylpenicillin (penicillin V) or clarithromycin

Question 13

What is a cystic hygroma

Answer 13

Collection of fluid-filled sacs resulting from malformation in the lymphatic system

Classically on the left of the neck
Most are evident at birth
Soft fluctuant
Highly transilluminable