ENT

Question 1

symptoms of otitis externa

Answer 1

discharge
pain
hearing loss
itching

Question 2

causes of otitis externa

Answer 2

S. Aureus
P. Aeruginos

Question 3

investigations of otitis externa

Answer 3

swab
topical Abx
microsuction

Question 4

necrotising otitis externa

Answer 4

leads to osteomyeltitis
pseudomonas
= give systemic antibiotics

Question 5

management of nasal fractures

Answer 5

ENT referral
reviewed at 7-10 days post injury
MUA nose carried out 10-14 days

Question 6

what is Ludwig’s angina?

Answer 6

rapidly spreading infection of submandibular space

Question 7

symptoms of Ludwig’s angina

Answer 7

mouth/throat pain
trismus
dysphagia/drooling
palpate = submandibular crepitus/tenderness

Question 8

management of Ludwig’s angina

Answer 8

co-amoxiclav
metronidazole

Question 9

management of post-tonsillectomy bleed

Answer 9

ABCDE
- stop bleeding: hydrogen peroxide gargles, adrenaline soaked swabs
- contact ENT SpR

Question 10

primary vs secondary post-tonsillectomy bleed

Answer 10

primary: <24 hrs post-op
secondary: >24 hrs post op (usually 5-14 days)
Risk of airway loss and haemorrhagic shock

Question 11

complications of acute otitis media

Answer 11

facial nerve palsy
chronic perforation

Question 12

what is SNHL?

Answer 12

both air and bone conduction are impaired (AC>BC)

Question 13

what is conductive HL?

Answer 13

only air conduction is impaired

Question 14

what is mixed HL?

Answer 14

air and bone conduction both impaired
BC>AC

Question 15

otitis media cause

Answer 15

S pneumonia (secondary to URTI)

Question 16

Meniere’s disease aetiology

Answer 16

dilatation of endolymph spaces of membranous labyrinth

Question 17

BPPV disease aetiology

Answer 17

displacement of otoliths in SCC

Question 18

acoustic neuroma symptoms

Answer 18

slow onset
unilateral SNHL
tinnitus
+/- vertigo

Question 19

red flags for sinusitis

Answer 19

unilateral symptoms
persistent
>3m despite treatment
epistaxis

Question 20

what causes septal haematoma?

Answer 20

untreated nasal fracture

Question 21

features of septal haematoma?

Answer 21

• septal necrosis
• nasal collapse as cartilage blood supply from mucosa
• boggy swelling with nasal obstruction

Question 22

tonsillitis causes

Answer 22

EBV
GAS

Question 23

What is Bell’s sign?

Answer 23

failure of eye closure
= dryness and conjunctivitis

Question 24

3 complications of otitis media

Answer 24

1. facial nerve palsy
2. chronic perforation
3. mastoiditis

Question 25

what is the commonest parotid malignancy?

Answer 25

mucoepidermoid tumours

Question 26

TMJ dysfunction management

Answer 26

NSAIDs
Orthodontic prosthesis

Question 27

Otitis media with effusion management

Answer 27

Usually resolve spontaneously
Consider grommets

Question 28

Drugs that cause tinnitus

Answer 28

Aspirin
Aminoglycosides
Loop diuretics
ETOH

Question 29

History in vertigo

Answer 29

Is it true vertigo or just light headedness ?
Associated symptoms

Question 30

Vertigo + Romberg’s positive

Answer 30

Vestibular or proprioception

Question 31

Ménière’s disease surgical treatment

Answer 31

Grommet

Question 32

Vestibular Schwannoma

Answer 32

CN palsies 5,7,8

Question 33

Otosclerosis improvement and worsened

Answer 33

Improved by noise
Worsened by pregnancy/menstruation/menopause

Question 34

Anterior epistaxis bleed

Answer 34

Usually Little’s area / Kisselbach’s plexus
(Ant. Ethmoidal Artery, Sphenopalatine Artery, Facial artery)

Question 35

Scarlet Fever cause

Answer 35

12-48 hours after tonsillitis
Pen V
Notify HPA

Question 36

What treatment do you not give in facial nerve / Bell’s palsy?

Answer 36

No antivirals

Question 37

Treatment in Ramsay Hunt

Answer 37

Give valaciclovir and prednisone within first 24 hours