ENT

Question 1

first line for otitis externa?

Answer 1

topical antibiotic +/- steroids

Question 2

diagnostic test for BPPV?

Answer 2

Dix-Hallpike manoeuvre

Question 3

treatment for BPPV?

Answer 3

Epley manoeuvre.

Question 4

Presentation of Vestibular neuronitis?

Answer 4

• follows viral infection
• horizontal nystagmus
• vertigo attacks lasting hours or days
• N&V

Question 5

Management of vestibular neuronitis?

Answer 5

• buccal or IM prochlorperazine - rapid relief in severe cases
• oral prochlorperazine or antihistamine
• vestibular rehab

Question 6

When would you medically manage otitis media?

Answer 6

• Symptoms > 4 days / not improving
• Systemically unwell
• Immunocompromise or high risk of complications secondary to significant heart, lung, kidney, liver, or neuromuscular disease
• < 2 years with bilateral otitis media
• Otitis media with perforation and/or discharge in the canal

Question 7

Medical management of otitis media?

Answer 7

5-7 day course of amoxicillin - first-line

if allergy then, erythromycin or clarithromycin.

Question 8

Presentation of BPPV?

Answer 8

• vertigo triggered by change in head position (e.g. rolling over in bed or gazing upwards)
• nausea
• each episode typically lasts 10-20 seconds
• positive Dix-Hallpike manoeuvre, indicated by:
  patient experiences vertigo
  rotatory nystagmus

Question 9

classical symptoms of acoustic neuroma?

Answer 9

Hearing loss
Tinnitus
Balance problems

can be associated with facial nerve palsy

Question 10

What are acoustic neuromas and Where do they occur?

Answer 10

Tumours of the Schwann cells surrounding the auditory nerve that innervates the inner ear. They occur around the “cerebellopontine angle”

Question 11

which condition is bilateral acoustic neuromas seen in?

Answer 11

Neurofibromatosis type 2

Question 12

Investigations for acoustic neuroma?

Answer 12

MRI of the cerebellopontine angle

Question 13

Management of acoustic neuroma?

Answer 13

Surgery, radiotherapy or observation.