ENT

Question 1

Otitis media

Question 2

Acute tonsillitis
when do we give antibiotics
CENTOR score ?

Answer 2

CENTOR score more than 3 = antibiotics
Phenoxymethylpenicillin or erythromycin
CENTOR score :
- exudate
-tender cervical lymphadenopathy
-fever
- no cough

Question 3

Bells palsy features

Answer 3

CANT WRINKLE THEIR foreheads
- acute onset
- facial paralysis
if they present within 72hrs give Prednisolone
+ aciclovir
+ Eye care etc

Question 4

BPPV diagnosis and treatment

Answer 4

Diagnosis = Dix hall pike
Treatment = Epley

Question 5

Ludwigs angina

Answer 5

• progressive cellulitis that invades the floor of the mouth and soft tissue of neck
• Life threatening as it can cause airway obstruction
• ABCDE
• Broad spectrum antibiotics = ampicillin , sulbactam , clindamycin , metronidazole

Question 6

Mastoiditis management

Answer 6

CT, MRI head = to look for inter cranial infection

• ceftriaxone ( or vancomycin )
• Myringotomy and grommet insertion
  -Mastoidectomy

Question 7

Nasal polyps symptoms
management

Answer 7

nasal Obstruction and mouth breathing
- absent smell
-runny nose
- facial pain or pressure
- Snoring
- nose bleed

REFER TO ENT for full exam
topical steroids to shrink the polyp

Question 8

Otitis externa

Answer 8

swimmers ear most commonly due to Pseudomonas aeruginosa
topical antibiotic+/- steroid

Question 9

Quinsy
what is it?
symptoms and treatment ?

Answer 9

peritonsillar abscess

SERIOUS COMPLICATION OF Tonsillitis treatment

+ sore throat
+ difficulty opening mouth (Trismus)
+difficulty swallowing or speaking
+ reduced neck mobility
+ deviation of the Uvula

treatment : drainage with needle aspiration

Question 10

Pharyngeal pouch

Answer 10

halitosis
regurgitation
cough and aspiration
dysphagia
neck swelling

SCAN : OGD, barium swallow is gold standard

REFER TO ENT
SURGERY

Question 11

Pleomorphic adenoma

Answer 11

most common salivary gland tumor
PAROTID GLAND
BENIGN
slow growing , painless firm mass . moves freely

USS guided fine needle aspiration , core needle biopsy

Question 12

Sudden onset sensorineural hearing loss (SSNHL)

causes ?

Answer 12

MEDICAL emergency
+ tinnitus
+ vertigo

can be due to :
- viral infection
- autoimmune disorders
- strokes

Question 13

Vestibular neuritis

Answer 13

inflammatory condition of the vestibular nerve
- sudden vertigo , imbalance
- nystagmus
- after URTI

more cranial symptoms ( no hearing loss or ringing like in labrynthitis )

management :

acute = prochlorperazine
vestibular rehab

Question 14

Viral Labrynthitis

Answer 14

hearing loss and tinnitus
+ vertigo after URTI

self limiting
- Prochlorperazine

Question 15

Treatment of acute sinusitis

Answer 15

paracetamol
nasal saline irrigation
decongestants

Question 16

cholesteatoma

Answer 16

growths o keratinising squamous cells that form in the attic of the ear
+ infected and then produce could smelling discharge
+ debris fills canal causing hearing loss

Question 17

otosclerosis

Answer 17

conductive hearing loss
onset in early adulthood and excerbated by pregnancy
+ tinnitus

Question 18

Acoustic neuroma features

Answer 18

AKA vestibular schwannoma
+ unilateral sensorineural deafness
+5 ate 7 palsy (5,8,7)
+ 5= corneal reflex absent
+ 7= facial nerve palsy
+ 8= Vertigo

if bilateral think NF2

Question 19

Presbycusis

Answer 19

symmetrical bilateral hearing loss = sensorineural
- higher frequency affected first
- due to age

Question 20

branchial cyst

Answer 20

painless cystic mass
anterior to sternocleidomastoid muscle

Question 21

Thyroglossal cyst

Answer 21

midline mass
moves with swallowing or tongue protusion

Question 22

dermoid cyst

Answer 22

painless midline mass , slow growing

Question 23

Mucoepidermoid carcinoma

Answer 23

most common malignant tumour x salivary glands

+ rapidly growing mass
+ pain
+ facial nerve weakness

Question 24

Menieres disease

Answer 24

ear fullness
sensorineural hearing loss
tinnitus
vertigo

due to too much endolymph

low salt diet
+ prochlorperazine in acute
- Betahistine for prophylaxis

Question 25

adult onset asthma + bilateral polyps

Answer 25

Eosinophilic granulomtosis with polyangitis