ENT

Question 1

Answer 1

IV abx

Question 2

Woman with a history of recurrent tonsillitis has submandibular swelling and pain on the right side. Odynophagia, dysphonia, and trismus. Diagnosis?
a) Acute tonsillitis
b) Pharyngitis
c) Peritonsillar abscess
d) Parapharyngeal abscess
e) Acute laryngitis
f) Submandibular sialadenitis

Answer 2

Peritonsillar abscess

Question 3

33 year old NZ euro man with 2/7 painful ear, yellowish discharge and unilateral hearing loss. On exam auditory canal oedematous with yellow discharge and tympanic membrane unable to be visualised. Tenderness on retraction of the pinna. Has not recently had an URTI. What is best management?
a) Urgent ENT referral
b) Oral amoxicillin
c) Warm saline rinse
d) Topical broad spectrum antibiotic ear drops
e) Paracetamol

Answer 3

) Topical broad spectrum antibiotic ear drops

Question 4

Older lady with 3 days of left ear hearing loss (came on suddenly just after waking). Previous URTI. Eardrum perforation repair in 20s, worked in noisy environment for 15 years when young. On exam Weber’s goes to right. Diagnosis?
a) Acute sensorineural hearing loss
b) Senile presbycusis

Answer 4

Acute sensorineural hearing loss

Question 5

Asian boy slapped on ear. Next day has hearing loss. On examination notice a tear of Tympanic membrane. What do you do?
a) Perform audiometry
b) Refer for surgery
c) Do nothing

Answer 5

Perform audiometry

Question 6

30 year old with a 5cm rubbery lump on neck lateral and anterior to the sternocleidomastoid. Has been enlarged and successfully treated using antibiotics for in the past few months. No pain or fever. Diagnosis?

Answer 6

a) Laryngocele
b) Pharyngeal pouch
c) Branchial cyst
d) Reactive lymphadenitis

Branchial cyst = swelling in the upper part of neck anterior to sternocleidomastoid (anterior triangle) - Tx: abx (if infected), surgery

Question 7

Neck mass one sided more noticeable at end-expiration (while playing the trumpet). Otherwise does not cause any problems other than being annoying. Diagnosis?
a) Laryngocele
b) Pharyngeal pouch
c) Branchial cyst
d) Reactive lymphadenitis

Answer 7

Laryngocele

blowing too much

Question 8

Young man in MVA. What do you deal with first?
a) Hand amputation with vascular compromise
b) Scrotal injury with ruptured testicles
c) Neck bruising and inspiratory stridor
d) Rigid abdomen with peritonitis
e) Blood and CSF leaking from head wound

Answer 8

Neck bruising and inspiratory stridor

Question 9

Old lady with progressive high-pitched hearing loss mainly on left. Weber’s lateralized to right ear. Diagnosis?
a) Senile presbycusis
b) Acute sensorineural hearing loss

Answer 9

Senile presbycusis = age related hearing loss – higher pitch lost first

Question 10

Child with midline neck lump, fluctuant, trans illuminates, move with swallowing. Diagnosis? a) Thyroglossal cyst
b) Colloid nodule
c) Thyroid cancer

Answer 10

Thyroglossal cyst

Most common in children
Can get infected

Question 11

Patient with toothache and clear nasal discharge from one nostril. Diagnosis?
a) Maxillary sinusitis
b) Dental infection

Answer 11

Sinusitis sx: facial pain, impaired smell, unilateral blocked/runny nose