ENT

Question 1

Labyrinthitis and vestibular neuronitis

Answer 1

Both: URTI first then symptoms
Vertigo+ Nystagmus+ Tinnitus
Difference: Labytinthitis = Loss of hearing
Vestibular neuronitis= NO loss of hearing

Question 2

Thyroid cancer

Answer 2

Anaplastic: most aggressive, often mets, women in 60-70s
Medullary: diarrhoea and facial flushing, ”妈的”一直拉稀真丢脸（脸红）
Papillary: most common, women in 30-40s, presents as a painless nodule, treated by total thyroidectomy +node excision+ radioiodine

Question 3

Nasopharyngeal carcinoma

Answer 3

Chinese or south East Asian get it
Associated with EBV, smoking, salted fish(咸鱼太腥所以鼻子长东西,chemicals

Px: bilateral cervical lymph nodes
Nasal obstruction
Epistaxis
Deafness(as ET tube involved)

Needs external irradiation

Question 4

Nasal polyp

Answer 4

Associated with atopy: asthma, hay fever
Also associated with: Cystic fibrosis, aspirin sensitivity
Asthma + aspirin sensitivity + nasal polyp = samter’s triad

Px: nasal congestion, post nasal drip non stop, change in smell/taste

Unilateral polyp = ENT 2 weeks
Ix: coronal sinus CT

Question 5

ENT 2 weeks wait

Answer 5

Unilateral polyp- nasal cancer

> 45 with persistent hoarseness/unexplained neck lump- laryngeal cancer

Oral ulcer > 3 weeks, unexplained white/red mouth patch- oral cancer

Unexplained thyroid lump- thyroid cancer

Question 6

Bullous myringitis

Answer 6

painful vesicles on the tympanic membrane (not around the aural region as that will be Ramsay-Hunt)