ENT

Question 1

manoeuvre to diagnose BPPV

Answer 1

dix hallpike

Question 2

manoeuvre to treat BPPV

Answer 2

epleys

Question 3

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

Answer 3

Viral labyrinthitis

Question 4

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

Answer 4

Vestibular neuronitis

Question 5

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

Answer 5

BPPV

Question 6

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

Answer 6

Menieres

Question 7

Elderly patient
Dizziness on extension of neck

Answer 7

Vertebrobasilar ischaemia

Question 8

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

Can have ataxia, facial numbness/weakness, double vision

Answer 8

Acoustic neuroma

Question 9

Unexplained, unilateral ear ache for more than 4 weeks with unremarkable otoscopy management?

Answer 9

should be referred under the 2 week wait

Question 10

2ww for laryngeal cancer criteraa

Answer 10

aged 45 and over with:
persistent unexplained hoarseness or
an unexplained lump in the neck

Question 11

2ww referral for oral cancer?

Answer 11

Unexplained oral ulceration or mass persisting for greater than 3 weeks

Unexplained red, or red and white patches that are painful, swollen or bleeding

Unexplained one-sided pain in the head and neck area for greater than 4 weeks, which is associated with ear ache, but does not result in any abnormal findings on otoscopy

Unexplained recent neck lump, or a previously undiagnosed lump that has changed over a period of 3 to 6 weeks

Unexplained persistent sore or painful throat

Signs and symptoms in the oral cavity persisting for more than 6 weeks, that cannot be definitively diagnosed as a benign lesion

Question 12

conductive hearing loss, tinnitus and positive family history

Answer 12

Otosclerosis (the replacement of normal bone by vascular spongy bone)

Question 13

otosclerosis rx

Answer 13

stapedectomy
hearing aids

Question 14

Menieres treatment

Answer 14

acute attacks: buccal or intramuscular prochlorperazine. Admission is sometimes required

prevention: betahistine and vestibular rehabilitation exercises may be of benefit

Question 15

Who gets abx in otitis media

Answer 15

MEDIA:

More than 4 days of symptoms

Extremely unwell (systemically)

Discharge or perforation

Immunocompromised or significant co-morbidity

Age <2 & bilateral

Question 16

OM antibiotic

Answer 16

amoxicillin

Question 17

Fever PAIN score for tonsillitis

Answer 17

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

Question 18

Dry TM perf mx

Answer 18

reassure, f/u 4 weeks

Question 19

Sarcoid can cause what facial swelling

Answer 19

bilat parotid swelling

Question 20

Most common type of salivary neoplasm

Answer 20

pleomorphic adenoma (benign)

Question 21

child <2yo with a left sided transluminating lymphatic lump in posterior triangle

Answer 21

cystic hygroma

Question 22

Neck lump that is pulsatile, lateral and immobile on swallowing

Answer 22

carotid aneurysm

Question 23

Unilateral cystic lump between sternocleidomastoid and pharynx in a 20yo

Answer 23

Branchial cyst

Question 24

Midline neck lump that moves with the tongue in teenager

Answer 24

thyroglossal cyst

Question 25

Acute viral parotitis (mumps) pathogen

Answer 25

paramyxovirus

Question 26

do u routinely give abx in sinusitis

Answer 26

no not unless severe

Question 27

when do you consider intranasal steroids in sinusitis

Answer 27

intranasal corticosteroids may be considered if the symptoms have been present for more than 10 days

Question 28

drugs causing gingival hyperplasia

Answer 28

(Can Cause Puffy gums!) Cyclosporin, Ca Channel blocker and Pheyntoin.

Question 29

Haemorrhage 5-10 days after tonsillectomy is often due to?

Answer 29

infection- admit to ENT and abx