ENT

Question 1

Drugs that cause gingival hyperplasia?

Answer 1

phenytoin
ciclosporin
calcium channel blockers (especially nifedipine)

Question 2

What is ramsay hunt syndrome?

Answer 2

caused by the reactivation of the varicella zoster virus in the geniculate ganglion of the seventh cranial nerve.

Question 3

Viral labyrhnthitis symptoms?

Answer 3

Recent viral infection
Sudden onset
Nausea and vomiting
Hearing may be affected

Question 4

Vestibular neuronitis symtoms?

Answer 4

Recent viral infection
Recurrent vertigo attacks lasting hours or days
No hearing loss

Question 5

Symptoms of vertebrobasilar ischaemia?

Answer 5

Elderly patient
Dizziness on extension of neck

Question 6

What kind of hearing loss is aged related hearing loss?

Answer 6

Sensorineural deafness

Question 7

What is vestibular neuronitis?

Answer 7

recurrent vertigo attacks lasting hours or days
nausea and vomiting may be present
horizontal nystagmus is usually present
no hearing loss or tinnitus

Question 8

What should be used if source of the bleeding can be seen in a nosebleed 10-15 minutes after just using pressure?

Answer 8

Silver nitrate Cautery

Question 9

Management of vestibular neuronitis?

Answer 9

buccal or intramuscular prochlorperazine is often used to provide rapid relief for severe cases
a short oral course of prochlorperazine, or an antihistamine (cinnarizine, cyclizine, or promethazine) may be used to alleviate less severe cases
vestibular rehabilitation exercises are the preferred treatment for patients who experience chronic symptoms

Question 10

Centor criteria?

Answer 10

presence of tonsillar exudate
tender anterior cervical lymphadenopathy or lymphadenitis
history of fever
absence of cough

Question 11

FeverPAIN criteria?

Answer 11

Fever over 38°C.
Purulence (pharyngeal/tonsillar exudate).
Attend rapidly (3 days or less)
Severely Inflamed tonsils
No cough or coryza

Question 12

What are nasal polyps associated with?

Answer 12

asthma (particularly late-onset asthma)
aspirin sensitivity
infective sinusitis
cystic fibrosis
Kartagener’s syndrome
Churg-Strauss syndrome

Question 13

How long after a perforated eardrum should referral be indicated?

Answer 13

After 6-8 weeks

Question 14

What is secondary haemorrhage after a tonsillectomy associated with>

Answer 14

Wound infection
Treatment is admission and abx

Question 15

How many weeks does a mouth ulcer have to be present to be persistent?

Answer 15

3 weeks

Question 16

What should you do if a patient fails to respond to topical antibiotics?

Answer 16

ENT referral

Question 17

What is Meiner’s disease?

Answer 17

Associated with hearing loss, tinnitus and sensation of fullness or pressure in one or both ears

Question 18

Management of vestibular neuronitis?

Answer 18

buccal or intramuscular prochlorperazine is often used to provide rapid relief for severe cases
a short oral course of prochlorperazine, or an antihistamine (cinnarizine, cyclizine, or promethazine) may be used to alleviate less severe cases
vestibular rehabilitation exercises are the preferred treatment for patients who experience chronic symptoms

Question 19

Management of vestibular neuronitis?

Answer 19

buccal or intramuscular prochlorperazine is often used to provide rapid relief for severe cases
a short oral course of prochlorperazine, or an antihistamine (cinnarizine, cyclizine, or promethazine) may be used to alleviate less severe cases
vestibular rehabilitation exercises are the preferred treatment for patients who experience chronic symptoms

Question 20

Most common cause of bacterial otitis media?

Answer 20

Haemophilus influenzae

Question 21

Features of Meiner’s disease?

Answer 21

Recurrent episodes of vertigo, tinnitus and hearing loss (sensorineural). Vertigo is usually the prominent symptom
a sensation of aural fullness or pressure is now recognised as being common
other features include nystagmus and a positive Romberg test
episodes last minutes to hours
typically symptoms are unilateral but bilateral symptoms may develop after a number of years

Question 22

What is meiner’s disease?

Answer 22

Disorder of the inner ear of unknown cause. It is characterised by excessive pressure and progressive dilation of the endolymphatic system

Question 23

Most important part of ear to visualise in cholesteatoma?

Answer 23

Attic crust. Seen in upper most part of ear drum

Question 24

What is otosclerosis?

Answer 24

Progressive conductive deafness due to fixation of the stapes at the oval window

Question 25

Tympanic membrane in otosclerosis

Answer 25

• the majority of patients will have a normal tympanic membrane
• 10% of patients may have a ‘flamingo tinge’, caused by hyperaemia

Question 26

Haemorrhage 5-10 days after tonsillectomy is commonly associated with what?

Answer 26

Wound infection

Question 27

What is Wallenberg syndrome?

Answer 27

posterior inferior cerebellar artery stroke
vertigo (‘sensation of room spinning’), nystagmus, ipsilateral facial pain, and contralateral loss in temperature sensation)

Question 28

Hearing loss in labrynthitis?

Answer 28

Sensorineural hearing loss

Question 29

What is Ludwig’s angina?

Answer 29

progressive cellulitis that invades the floor of the mouth and soft tissues of the neck. Most cases result from odontogenic infections which spread into the submandibular space.

Question 30

Sudden-onset sensorineural hearing loss is treated with what?

Answer 30

Oral corticosteroids

Question 31

normal corrected QT interval

Answer 31

less than 430 ms in males and 450 ms in females

Question 32

normal PR interval is

Answer 32

120 - 200 ms.

Question 33

Normal QRS duration is

Answer 33

80 - 120 ms

Question 34

First line for otitis externa in diabetics?

Answer 34

ciprofloxacin to cover Pseudomonas

Question 35

What is a brachial cyst filled with?

Answer 35

Acellular fluid with cholesterol crystals and encapsulated by stratified squamous epithelium.

Question 36

Typical features of a brachial cyst?

Answer 36

unilateral, typically on the left side
lateral, anterior to the sternocleidomastoid muscle
slowly enlarging
smooth, soft, fluctuant
non-tender
a fistula may be seen
no movement on swallowing
no transillumination

Question 37

What is halitosis?

Answer 37

Bad breath

Question 38

If a patient presents with acute necrotizing ulcerative gingivitis CKS recommend the following management:

Answer 38

refer the patient to a dentist, meanwhile the following is recommended:
oral metronidazole* for 3 days
chlorhexidine (0.12% or 0.2%) or hydrogen peroxide 6% mouth wash
simple analgesia

Question 39

Presentation of acute necrotising ulcerative gingivitis?

Answer 39

painful bleeding gums with halitosis and punched-out ulcers on the gums

Question 40

Ramsay hunt treatment?

Answer 40

Oral aciclovir