ENT

Question 1

What is the most common bacteria that causes acute otitis media?

Answer 1

Strep. pneumonia

Question 2

What are the symptoms/signs of acute otitis media?

Answer 2

Recent onset earache

Red, bulging or perforated tympanic membrane on otoscopic examination

Question 3

What is the recommended management for acute otitis media?

Answer 3

Advise pt that usually resolves in 3 days to a week without abx required.
Advise regular analgesia.
Consider 5-7 days amoxicillin for those with severe symptoms, systemically unwell or other comorbidities

Question 4

What are the most common causes of otitis externa?

Answer 4

Swimming, trauma to ear canal (eg. from cotton buds), ear wax removal

Question 5

What are the symptoms and signs of otitis externa?

Answer 5

Ear pain +/- jaw pain
Discharge from ear
Itchiness
Redness, tenderness and swelling of ear canal
Conductive hearing loss (rare)

Question 6

What is the recommended management for otitis externa?

Answer 6

Mild = acetic acid 2%
Moderate = topical abx and steroid combo (eg. Otomize spray - neomycin, dexamethasone and acetic acid) (must exclude perforated TM before use)

Question 7

How would you differentiate between labyrinthitis and vestibular neuritis?

Answer 7

Both are associated with acute onset vertigo, but labyrinthitis can also cause hearing loss or tinnitus, while vestibular neuritis doesn’t.

Question 8

What is the recommended management for labyrinthitis and vestibular neuritis?

Answer 8

Supportive care

Up to 3 days of prochlorperazine or antihistamines.

Question 9

What causes Meniere’s Disease?

Answer 9

Excessive build up of endolymph in the labyrinth

Question 10

What is the typical triad presentation for Meniere’s Disease?

Answer 10

Vertigo (lasts 20mins-several hours, then settles)
Hearing loss
Tinnitus

Question 11

What is the recommended management for Meniere’s Disease? (acute and prophylaxis)

Answer 11

Acute attacks: prochlorperazine/antihistamines

Prophylaxis: betahistine