ears, nose, throat, head, neck

Question 1

what is, and what causes, exostoses

Answer 1

swimmers ear

due to chronic exposure of the middle ear to cold water causing bony growths to try and protect it

Question 2

which vessel is most likely to be involved in a posterior epistaxis

Answer 2

sphenopalatine vessels - may be a BIG bleed

Question 3

5 causes of a discharging ear

Answer 3

wax
otitis externa
foreign body
acute otitis media with perforation
chronic suppurative otitis media +/- cholesteatoma

Question 4

common virus associated with nasopharyngeal carcinoma

Answer 4

EBV

Question 5

presentation of otitis externa

Answer 5

painful, itchy, blocked ear

Question 6

main causes of facial paralysis other than stroke

Answer 6

acute otitis media complicated by facial nerve palsy

herpes zoster oticus (Ramsay hunt syndrome)

Question 7

when do you insert grommits

Answer 7

when otitis media with effusion does not resolve within 4 months or the child is ‘at risk’ or is associated with structural damage to the tympanic membrane

Question 8

what are the sequelae of septal haematoms

Answer 8

abscess –> necrosis of the cartilage –> saddle nose or perforation

Question 9

complications of cholesteatomas

Answer 9

erosion into the temporal bone –> infection and brain abscesses and erosion of the facial nerve

Question 10

common organisms that cause acute otitis media

Answer 10

strep pneumonia
Hamophilus influenza
morexella catarrhalis

Question 11

what do you see with the otoscope in a patient with otitis media with effusion

Answer 11

• bubbles of fluid
• tympanic membrane is brown/redish
• very concave eardrum

Question 12

causes of referred ear pain

Answer 12

• oropharyngeal pathology (IX)
• Laryngopharynx pathology (X)
• Upper molar teeth (V)
• temporomandibular joing (V)
• parotid gland (V)
• cervical spine (C2,3)

Question 13

classic 4 symptoms for Meniere’s

Answer 13

rotatory vertigo
tinnitus
hearing loss
fullness in the ear

Question 14

what must you always check for in a patient with a nasal fracture

Answer 14

septal haematoma

Question 15

what is a cholesteatoma

Answer 15

collection of keratin and skin in the middle ear from a complication from chronic otitis media

Question 16

most common area of the nose causing epistaxis

Answer 16

Little’s area (anterior septum) - confluence of many vessels

Question 17

management of Ramsay hunt syndrome

Answer 17

• oral steroids
• if seen within 3 days of onset = acyclovir
• protect eye from exposure with artificial tears and a pad

Question 18

functions of grommets

Answer 18

ventilates the middle ear

acts as a pressure equalisation device

Question 19

which structures are present in the cavernous sinus

Answer 19

• CN 2, 3,4,6 (eyes)
• CN 5
• venous sinus
• ICA
• sympathetic plexus

Question 20

classic presentation of otitis media in children

Answer 20

wake up in the middle of the night with pain

Question 21

typical AB given for acute otitis media

Answer 21

amoxycillin

Question 22

causes of conductive hearing loss

Answer 22

middle ear fluid
perforated tympanic membrane
wax
otosclerosis
ossicular discontinuity

Question 23

acute Rx of Meniere’s

Answer 23

prochlorperazine or diazepam

Question 24

when do you prescribe topical AB for otitis media

Answer 24

only if there is a perforation

Question 25

what do you see through the otoscope with acute otitis media

Answer 25

- injected vessels running doing the malleus - fluid level - convex ear drum - yellow/red discolouration

Question 26

when do you give AB for otitis media

Answer 26

- patient less than 2 - tympanic membrane perforation - is Indigenous - has known ID - has cochlear implant - has the only hearing ear infected

Question 27

what is the difference between rhinitis and rhinosinusitis

Answer 27

rhinosinusitis = infectious