ENT

Question 1

Define tonsillitis

Answer 1

Inflammation of the tonsils - most commonly viral infection

Question 2

Presentation of tonsillitis

Answer 2

Fever
Sore throat
Painful swallowing
Poor intake
Headache
Vomiting
Red inflamed tonsils
Exudate

Question 3

Centor crtieria

Answer 3

Fever >38
Tonsillar exudate
Absence of cough
Tender anterior cervical lymph nodes
3 or more = 40-60% chance of bacterial

Question 4

Management of tonsillitis

Answer 4

Conservative!
Safety netting
Antibiotics if centor >3 or FeverPain >4
Penicillin

Question 5

Define quindy

Answer 5

Peritonsillar abscess - arises when there is a bacterial infection with trapped pus forming an abscess

Question 6

Presentation of quinsy

Answer 6

Sore throat
Painful swallowing
Fever
Neck pain
Referred ear pain
Swollen tender lymph nodes
Trismus - cant open mouth
Change in voice - hot potato

Question 7

Management of quinsy

Answer 7

Incision and drainage
Abx
?steroids

Question 8

Indications for tonsillectomy

Answer 8

7 or more in 1 year
5 per year for 2 years
3 per year for 3 years

Recurrent peritonsillar abscesses
Enlarged tonsils - affecting breathing

Question 9

Complications to tonsilectomy

Answer 9

Pain
Sore throat
Damage to teeth
Infection
Post-tonsillectomy bleeding

Question 10

Define otitis media

Answer 10

Infection in the middle ear - often preceded by viral URTI

Question 11

Common organism in otitis media

Answer 11

Streptococcus pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
Staphylococcus aureus

Question 12

Presentation of otitis media

Answer 12

Ear pain
Reduced hearing
Preceding or ongoing UrTI
Balance
Vertigo
Discharge from ear

Question 13

Otoscopy in otitis media

Answer 13

Bulging red inflamed tympanic membrane

Question 14

Management of otitis media

Answer 14

Most resolve within 3 days out abx
Simple analgesia

Question 15

Define glue ear

Answer 15

Otitis media with effusion - middle ear fills with fluid as a result of infection

Question 16

Otoscopy in glue ear

Answer 16

Dull tympanic membrane with air bubbles or visible fluid level

Question 17

Management of glue ear

Answer 17

Often resolves within 3 months
Grommets

Question 18

Congenital causes of hearing loss

Answer 18

Maternal rubella,
CMV
Genetic deafness
Down’s syndrome

Question 19

Perinatal causes of hearing loss

Answer 19

Prematurity
Hypoxia during or after birth

Question 20

Causes of hearing loss

Answer 20

Jaundice
Meningitis
Encephalitis
Otitis media
Glue ear
Chemo

Question 21

Presentation of hearing loss

Answer 21

Newborn hearing screening programme
Parental concerns
Behavioural changes
Ignoring calls or sounds
Frustration or bad behaviour
Poor speech and language development
Poor school performance

Question 22

Define epistaxis

Answer 22

Nosebleeds - often originate in Kiesselbach’s plexus, little’s area caused by picking nose

Question 23

Management of epistaxis

Answer 23

Sit up and tilt head forwards
Squeeze soft part of the nostrils together
Spit any blood don’t swallow
If does not stop in 10-15 minutes
Nasal pack
Nasal cauteru -
Naseptin - reduces inflammation and crusting

Question 24

Define cleft lip

Answer 24

A congenital condition where there is a split or open section of the upper lip

Question 25

Define cleft palate

Answer 25

A defect exists in the hard or soft palate at the roof of the mouth

Question 26

Complications of cleft lip or palate

Answer 26

Feeding difficulties
Swallowing dificulties
Speech problems
Psycho-social difficulties

Question 27

Management of cleft lip or palate

Answer 27

Plastics - surgical correction

Question 28

Define tongue tie

Answer 28

Also know as ankyloglossia - baby is born with a short tight lingual frenulum, resulting in poor extension of the tongue

Question 29

Management of tongue tie

Answer 29

Conservative support
Frenotomy