ENT

Question 1

ABx for sore throat - Centor criteria

Answer 1

1. Tonsilar exudate
2. Absence of cough
3. Tender cervical lymphadenopathy
4. Fever

3+ is 50% likely to be group A Beta- haemolytic Strep

Question 2

Furunculosis

Answer 2

Infection of hair follicle in external canal

Causes pain at site of lesion (severe) and on moving pinna or tragus

Question 3

Acute otitis media
- management 1,2,3

Answer 3

1. If well, self-limiting so no/delayed ABX
2. Phenazone/lidocaine ear drops
3. Oral amoxicillin or clarithromycin

Question 4

Peritonsilar abscess
- Organism
- Management

Answer 4

Strep pyogenes
1. Same day ENT review
2. IV ABx (BenPen + metro) , analgesia +/- IV fluids
3. Needle aspiration - MCS and some drainage
4. I+D
5. Interval tonsillectomy if chronic/recurrent tonsilitis

Question 5

Menniere’s disease - AKA
- Triad
- Age of onset
- Management

Answer 5

Idiopathic endolymphatic hydrops
Vertigo, tinnitus, hearing loss
Age 35-55

Acute: Cinnerazine, prochlorperazine
Secondary Prevention: Betahistine

Surgery in extreme/refractory cases

Question 6

Vestibular neuritis

Answer 6

Recurrent vertigo lasting several days, follows viral infection.
NO tinnitus or hearing loss

Question 7

AOM causative organisms

Answer 7

1. Viral - RSV, adenovirus, rhinovirus, influenza
2. Bacterial - Strep pneumoniae, haemophilus influenzae, Moraxella catarrhalis