ENT 1

Question 1

Management of intranasal polyps? (3)

What are red flags for urgent referral? (2)

Samsters triad

Answer 1

1. Nasal washout/ douche
2. Intranasal corticosteroids spray or drops
3. Refer to ENT within 3 months

2ww- unilateral symp or bleeding

Samsters:
asthma, aspirin sensitivity and nasal polyposis

Question 2

slowly progressive conductive hearing loss, tinnitus and positive family history… ?

management

Answer 2

Otosclerosis

1. Hearing aid
2. Stapedectomy

Question 3

medications which are ototoxic

Answer 3

1. Furosamide (if fluid bolus too quick)
2. Aminoglycosides- gentamicin
3. aspirin
4. cytotoxic agents
5. Quinine (anti-marlial)

Question 4

Gingvitis

cause-

if simple (ie.) then management =

If acute necrotizing gingivitis management is:
1. refer to..
2.
3.
4.

Answer 4

secondary to poor dental hygeine

simple (ie. (painless, red swelling on gum margin)

acute necrotizing gingivitis
1. refer to.. dentist
2. Chlorhexidine mouthwash or hydrogen peroxide
3. metronidozole 3 days (or amoxicillin)
4. simple analgaesia

Question 5

Post-tonsilectomy bleeding

when to go back to theatre?

When to admit with IV abx?

Answer 5

Theatre
Primary, or reactionary haemorrhage occurs in the first 6-8 hours

Secondary haemorrhage
5 and 10 days - associated with a wound infection.

Question 6

The management of sudden-onset sensorineural hearing loss is… (2)

Answer 6

1. Referral urgent to ENT
2. High dose oral pred

Question 7

Nasal polyps

red flag and 2ww =

management - by ENT if benign (1)

Answer 7

if unilateral

topical corticosteroids shrink polyp size

Question 8

Branchial cyst

where is it?

due to….

presents at age…

Answer 8

oval, mobile cystic mass that develops between the sternocleidomastoid muscle and the pharynx

due to failure of obliteration of the second branchial cleft in embryonic development

early adulthood

Question 9

perforated tympanic membrane but acute otitis media now treated- what do you do?
1

2. then…

Answer 9

see in 6-8 weeks from the original infection (time it takes to heal perforation)

• if isn’t healed by then- ref to ENT

Question 10

Auricular haematomas (cauliflower ear)
Management
1.
2.

Answer 10

1. same-day assessment by ENT
2. incision and drainage has been shown to be superior to needle aspiration

Question 11

Antibiotics should be prescribed immediately if:

Answer 11

Symptoms lasting more than 4 days or not improving
Systemically unwell but not requiring admission
Immunocompromise or high risk of complications secondary to significant heart, lung, kidney, liver, or neuromuscular disease
Younger than 2 years with bilateral otitis media
Otitis media with perforation and/or discharge in the canal