ENT

Question 1

autosomal dominant, unilateral conductive hearing loss, can be triggered by pregnancy

Answer 1

osteosclerosis

Onset is usually at 20-40 years
Conductive deafness
Tinnitus
Normal tympanic membrane although 10% of patients may have a ‘flamingo tinge’, caused by hyperaemia

Positive family history

Question 2

if perforated tympanic membrane does not heal by … then refer to ENT

Answer 2

6 weeks

Question 3

causes of gingival hyperplasia

Answer 3

phenytoin, ciclosporin, calcium channel blockers and AML

Question 4

… presents with bilateral high-frequency hearing loss

Answer 4

Presbycusis

Question 5

Viral labyrinthitis vs vestibular neuronitis

Answer 5

recent URTI
vertigo and vomiting
hearing also affected
sudden onset

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

Question 6

Benign paroxysmal positional vertigo presentation

Answer 6

Gradual onset
Triggered by change in head position
Each episode lasts 10-20 seconds

Question 7

Meniere’s disease

Answer 7

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

Question 8

Acoustic neuroma

Answer 8

Hearing loss, vertigo, tinnitus
Absent corneal reflex is important sign
Associated with neurofibromatosis type 2

Question 9

Vertebrobasilar ischaemia

Answer 9

Elderly patient
Dizziness on extension of neck

Question 10

… may be considered if sinusitis has been present for more than 10 days

Answer 10

intranasal corticosteroids

Question 11

… is characterised by conductive hearing loss, tinnitus and positive family history

Answer 11

Otosclerosis