ENT

Question 1

What is otitis media?

Answer 1

Infection in the middle ear where bacteria enter from the eustachian tube and proceeds a viral URTI

Question 2

What is the most common cause of otitis media?

Answer 2

Strep pneumoniae

Question 3

What are the viral causes of otitis media?

Answer 3

RSV and rhinovirus

Question 4

What is the presentation of otitis media?

Answer 4

Ear pain, reduced hearing, fever, coryzal symptoms, balance issues and vertigo, ear discharge

Question 5

What does otitis media show on examination?

Answer 5

Otoscope to visualise the tympanic membrane which should be pearly grey, translucent and slightly shiny but in otitis media it is bulging, red and inflamed

Question 6

What is the treatment for otitis media?

Answer 6

Most cases resolve without antibiotics but a delayed prescription of amoxicillin for 5 days can be given

Question 7

What is glue ear?

Answer 7

Otitis media with effusion - the middle ear fills with fluid causing loss of hearing

Question 8

What are the risk factors for glue ear?

Answer 8

Bottle fed, parental smoking, atopy, CF, Downs

Question 9

What does glue ear show on examination?

Answer 9

Otoscopy can show a dull tympanic membrane with air bubbles or a visible fluid level or also look normal. The light reflex will be lost.

Question 10

What is the treatment for glue ear?

Answer 10

It can resolve itself or require grommets to drain the fluid

Question 11

What are some congenital causes of hearing loss?

Answer 11

Maternal rubella or CMV infection during pregnancy, genetic deafness, Downs

Question 12

What are 2 perinatal causes of deafness?

Answer 12

Prematurity and hypoxia during or after birth

Question 13

What are some postnatal causes of deafness?

Answer 13

Jaundice, meningitis, encephalitis, otitis media, glue ear

Question 14

What is the range of normal hearing?

Answer 14

0-20 dB

Question 15

What are the two types of hearing loss?

Answer 15

Sensorineural and conductive

Question 16

What is periorbital cellulitis?

Answer 16

Infective oedema of the eyelids and periorbital skin with no involvement of hte orbit

Question 17

What causes periorbital cellulitis?

Answer 17

Staph, strep or Hib

Question 18

What is the presentation of periorbital cellulitis?

Answer 18

Unilateral eyelid swelling and erythema, eye pain, tenderness, fever, malaise, irritability, ptosis

Question 19

Give some red flags in periorbital cellulitis

Answer 19

painful or restricted eye movements, diplopia, loss of colour vision, proptosis, severe headache

Question 20

What is the treatment for periorbital cellulitis?

Answer 20

Mild - co-amoxiclav for 7-days (oral)
Moderate to severe - IV ceftriaxone

Question 21

What is srabismus?

Answer 21

A squint - misalignment of the eyes so the images on the retina don’t match

Question 22

What are some causes of a squint?

Answer 22

Idiopathic, hydrocephalus, cerebral palsy, retinoblastoma, trauma

Question 23

What are the treatments for a squint?

Answer 23

Occlusive patch, atropine drops

Question 24

What is otalgia?

Answer 24

Ear ache

Question 25

List 2 extra-cranial complications of acute otitis media

Answer 25

Mastoiditis
Tympanic membrane perforation

Question 26

How might a child with hearing loss present?

Answer 26

Parental concern, speech development delayed, behaviour, education

Question 27

Give 4 ways in which deafness rehabilitation is conducted

Answer 27

Grommets, amplification hearing aids, bone conduction hearing aids, cochlear implant