ENT

Question 1

What investigation is Diagnostic for BPPV?

Answer 1

Dix-Hallpike manouever

Question 2

What sign on Dix-Hallpike manouever suggest BPPV?

Answer 2

Rotatory nystagmus

Question 3

How do you treat BPPV?

Answer 3

Epley manoeuvre

Question 4

What are the CF of Mastoiditis? (3 things)

Answer 4

1. Fever
2. Ear protruding forwards
3. Post-auricular bulging + erythema

Question 5

How is Mastoiditis Dx?

Answer 5

Clinically

Question 6

What is a risk factor for Mastoiditis?

Answer 6

Recurrent OM infection

Question 7

What is the Mx of Mastoiditis?

Answer 7

IV abx (ceftriaxone)

Question 8

What are the complications of Mastoiditis? (3 things)

Answer 8

1. HL
2. Facial nerve palsy
3. Meningitis

Question 9

What are the CF of Viral labyrinthitis? (6 things)

Answer 9

1. Hx of recent URTI
2. Sudden onset
3. Vertigo
4. Horizontal nystagmus (towards unaffected side)
5. HL (sensorineural)
6. N + V

Question 10

What is the Mx of Viral labyrinthitis?

Answer 10

Self limiting

Question 11

How do you differentiate between Vestibular neuritis and Labyrinthitis?

Answer 11

• Labyrinthitis only one with HL
  Both:
• Vertigo not assoc w head position (so not BPPV)
• Recent viral inf

Question 12

When should you refer for 2ww for sus HnN cancer?

Answer 12

Unexplained sore throat for few wks

Question 13

What is the most common tumour of the parotid gland?

Answer 13

Pleomorphic adenoma

Question 14

What is a bilateral purple bulge in septum (after trauma) a sign of?

Answer 14

Septal haemotama

Question 15

How do you Tx Septal haematoma?

Answer 15

Surgical drainage (urgent referral)

Question 16

What type of nasal polyp is cancer until proven otherwise, and should be urgently reffered?

Answer 16

Unilateral nasal polyp

Question 17

What should you treat Necrotizing Ulcerative Gingivitis with? (3 things)

Answer 17

1. Paracetamol
2. Oral metronidazole
3. Chlorhexidine mouthwash
   (while they go see dentist)

Question 18

What Perforated tympanic membrane should you not prescribe amox for?

Answer 18

Peroration caused by barotrauma (aka diving)

Question 19

What should you do if there is Post-tonsillectomy haemorrhage (even small bleeding 3 hrs post op)?

Answer 19

Urgent ENT assessment + consider return to theatre
(primary haemorrhage)

Question 20

What should you do if there is Post-tonsillectomy haemorrhage (5-10 days after surgery)

Answer 20

Admit to ENT for assessment + give abx
(secondary haemorrhage, probs infected wound)

Question 21

What is the CENTOR criteria that suggest Tonsillitis is BACTERIAL?

Answer 21

CENTor
* C - Cervical lymphadenopathy (tender)
* E - Exudative tonsils
* N - No cough
* T - Temperature (38+)

Question 22

How are pt with Sudden onset Sensorineural HL tx with following referral to ENT?

Answer 22

High dose oral corticosteroids

Question 23

What are the basic rules to interpreting Audiograms? (3 things)

Answer 23

1. Anything above 20dB is NORMAL (green line)
2. SN HL = both air + bone conduction impaired
3. CD HL = only air conduction impaired (aka only X n O drop)
4. Mixed HL = both air + bone impaired (air usually worse)

Question 24

What medications can cause Tinnitus? (2 things)

Answer 24

1. NSAIDs
2. Aspirin

Question 25

What is Otosclerosis?

Answer 25

Replacement of normal bone by Spongy bone @ stapes + oval window place

Question 26

What are the CF of Otosclerosis? (3 things)

Answer 26

1. Progressive CD HL
2. Tinnitus
3. Usually normal tympanic membrane

Question 27

What are the RF for Otosclerosis? (2 things)

Answer 27

1. FHx
2. Age 20-40 yrs

Question 28

What are the Mx options for Otosclerosis? (2 things)

Answer 28

1. Hearing aid
2. Stapedectomy