ENT

Question 1

3 common organisms that cause otitis media

Answer 1

strep pneumoniae, h influenzae and moraxella

Question 2

what normally precedes otitis media ?

Answer 2

viral URTI

Question 3

What will you see on otoscopy when a person has otitis media ?

Answer 3

Loss of light reflex
bulging tympanic membrane
perforation with purulent otorrhoea

Question 4

When should medical advice be sought for otitis media ?

Answer 4

If symptoms worsen or do not improve after 3 days

Question 5

Should a child with bilateral otitis media and under the age of 2 get antibiotics?

Answer 5

Yes

Question 6

Should a child with otitis media with perforation get antibiotics?

Answer 6

Yes

Question 7

First line course of abx for otitis media

Answer 7

Amoxicillin
If penicillin allergic give erythromycin

Question 8

First and second-line treatment for sinusitis?

Answer 8

Analgesia and nasal decongestant
2nd line: intranasal corticosteroids

Question 9

What is a normal value on an audiogram ?

Answer 9

Above 20dB line is normal

Question 10

What happens in an audiogram for a patient with sensorineural hearing loss?

Answer 10

both air and bone conduction are impaired

Question 11

What happens in an audiogram for a patient with conductive hearing loss?

Answer 11

only air conduction is impaired

Question 12

What happens in an audiogram for a patient with mixed hearing loss?

Answer 12

both air and bone conduction are impaired but air conduction is usually worse than bone.

Question 13

What is a positive Dix Hall pike manoeuvre and who is it normally seen in?

Answer 13

experience vertigo and rotatory nystagmus
positive in BPPV

Question 14

What are two treatments for BPPV?

Answer 14

Epley’s manoeuvre
Betahistine

Question 15

What condition increases your incidence of getting a cholesteatoma?

Answer 15

cleft palate

Question 16

when is rhinosinusitis classed as chronic?
how do you manage it?

Answer 16

When it lasts more than 12 weeks
Use of intranasal steroids

Question 17

What is presbycusis?

Answer 17

Presbycusis describes age-related sensorineural hearing loss. Patients may describe difficulty following conversations

Audiometry shows bilateral high-frequency hearing loss

Question 18

What is otosclerosis ?

Answer 18

Autosomal dominant, replacement of normal bone by vascular spongy bone. Onset is usually at 20-40 years - features include:

Question 19

How does otosclerosis present?

Answer 19

typically in their 20-40s
conductive deafness
tinnitus
tympanic membrane - 10% of patients may have a ‘flamingo tinge’, caused by hyperaemia

Question 20

3 drugs that cause ototoxicity?

Answer 20

Aspirin
Gentamicin
Furosemide

Question 21

3 causes of gingival hyperplasia

Answer 21

phenytoin
ciclosporin
calcium channel blockers

Question 22

When should a larygneal cancer be suspected?

Answer 22

laryngeal cancer in people aged 45 and over with:
persistent unexplained hoarseness or
an unexplained lump in the neck

Question 23

3 causes of voice hoarseness

Answer 23

voice overuse
smoking
viral illness
hypothyroidism
gastro-oesophageal reflux
laryngeal cancer
lung cancer

Question 24

who is malignant otitis externa found in?

Answer 24

people who are immunocompromised

Question 25

what is malignant OE

Answer 25

osteomyelitis of the bone typically caused by pseudomonas and needs a CT head scan.

Question 26

What is meniere’s a disease of ?

Answer 26

endolymph system

Question 27

How do you treat an acute attack of Meniere’s disease?

Answer 27

acute attacks: buccal or intramuscular prochlorperazine. Admission is sometimes required
prevention: betahistine and vestibular rehabilitation exercises may be of benefit

Question 28

Management for otosclerosis ?

Answer 28

Management
hearing aid
stapedectomy

Question 29

What is a positive and negative Rinne’s test?

Answer 29

positive test’: air conduction (AC) is normally better than bone conduction (BC)
‘negative test’: if BC > AC then conductive deafness

Question 30

What is the response of Weber’s test in conductive and sensorineural deafness?

Answer 30

in unilateral sensorineural deafness, sound is localised to the unaffected side
in unilateral conductive deafness, sound is localised to the affected side

Question 31

What is Ramsay Hunt syndrome?

Answer 31

Reactivation of the VZV virus causing patients to have auricular pain that then leads to a facial palsy and tinnitus

Question 32

How do you normally treat Ramsay Hunt syndrome?

Answer 32

Acyclovir and steroids

Question 33

Which salivary gland do you mostly get stones in?

Answer 33

submandibular (mixed) - most stones

Question 34

Which salivary gland do you mostly get tumours in?

Answer 34

parotid (serous)

Question 35

What is the most common type of parotid gland swelling?

Answer 35

Pleomorphic adenomas a tumour that is benign non painful and slow growing

Question 36

What are the four componments of the centor criteria ?

Answer 36

The Centor criteria are: score 1 point for each (maximum score of 4)
presence of tonsillar exudate
tender anterior cervical lymphadenopathy or lymphadenitis
history of fever
absence of cough

Question 37

3 complications of thyroid surgery:

Answer 37

1. Anatomical such as recurrent laryngeal nerve damage.
2. Bleeding. Owing to the confined space haematoma’s may rapidly lead to respiratory compromise owing to laryngeal oedema.
3. Damage to the parathyroid glands resulting in hypocalcaemia.

Question 38

What is the main distinguishing feature between vestibular neuritis and labyrinthitis

Answer 38

Labyrinthitis should be distinguished from vestibular neuritis as there are important differences: vestibular neuritis is used to define cases in which only the vestibular nerve is involved, hence there is no hearing impairment; Labyrinthitis is used when both the vestibular nerve and the labyrinth are involved, usually resulting in both vertigo and hearing impairment.

Question 39

Management of vestibular neuritis and labyrinthitis

Answer 39

prochlorperazine

Question 40

In conductive hearing loss is bone and air conduction affected?

Answer 40

No only air

Question 41

In sensorineural hearing loss is bone and air conduction affected?

Answer 41

Yes both are.