ENT

Question 1

Conductive hearing loss at a young age with a family history - what to consider?

Answer 1

Otosclerosis

Question 2

What is the most common benign tumour of the parotid gland? How does it present?

Answer 2

Pleomorphic adenoma
Slow growing, gradual onset painless unilateral swelling of the parotid

Moveable on examination

Question 3

How are pleomorphic adenomas managed and why?

Answer 3

Routine resection due to possibility of malignant transformation

Question 4

What is sialadenitis?

Answer 4

Submandibular gland abscess due to staph aureus infection

Question 5

What is sialolithiasis? What is the most common location?

Answer 5

Salivary gland calculi

Most commonly in submandibular gland

Question 6

Ludwig’s angina

Answer 6

x

Question 7

Labyrinthitis vs. Vestibular neuronitis

Answer 7

Labyrinthitis=
Horizontal nystagmus
Sensorineural hearing loss
Vertigo

Vestibular neuronitis=
Horizontal nystagmus
No hearing loss

Question 8

How to treat otitis externa in diabetics?

Answer 8

Ciprofloxacin to cover Pseudomonas!!!1

Question 9

How long symptoms need to be present to call it chronic rhinosinusitis?

Answer 9

12 weeks

Question 10

What kind of nystagmus in vestibular neuronitis?

Answer 10

Horizontal nystagmus

Question 11

How can you manage epistaxis which has failed all emergency management?

Answer 11

Ligation of the sphenopalatine artery in theatre

Question 12

How does a nasal septal haematoma present and how should it be managed?

Answer 12

Head/facial trauma- may be relatively minor

Bilateral red boggy swelling from nasal septum
Surgical drainage + IV Abx

Question 13

Perforated tympanic membrane - after how long to review the patient? What advice to give patient?

Answer 13

Review in 6-8 weeks

Advise not to get ear wet

Question 14

Branchial cyst vs. Cystic hygroma?

Answer 14

Branchial cyst = oval, mobile cystic mass anterior to the sternocleidomastoid
Usually presents in early adulthood

Cystic hygroma = Congenital lymphatic lesion. Typically on left of neck. Most evident at birth.

Question 15

What is Ramsay Hunt syndrome and how is it managed?

Answer 15

Reactivation of varicella zoster in facial nerve distribution 
Auricular pain
FACIAL NERVE PALSY!
Vesicular rash around ear
May cause vertigo/tinnitus

Management = Oral acyclovir + corticosteroids.

Question 16

How is Bell’s palsy managed?

Answer 16

Oral prednisolone within 72 hours

Eye care - artificial tears/eye lubricants

Question 17

How can BPPV be managed?

Answer 17

1. Epley manoeuvre

2. Brandt-Daroff exercises (can do at home) aka. Vestibular rehabilitation exercise.

Question 18

How can chronic rhinosinusitis be managed?

Answer 18

Nasal irrigation with saline solution

Question 19

What are symptoms of a thyroid lump? (of the lump itself not the T4 levels)

Answer 19

Voice hoarseness
Difficulty swallowing – dysphagia, painful swallow
Airway compromise 
Weight loss 
Low-grade fever 
May be cervical lymphadenopathy

Question 20

What is laryngopharyngeal reflux?

How does it present?

Answer 20

Condition caused by gastro-oesophageal reflux which causes inflammatory changes to the larynx

Sensation of lump in the throat- typically worse when swallowing saliva
Hoarseness
Chronic cough
Dysphagia
Heartburn