ENT

Question 1

what is the typical presentation of vestibular neuronitis?

Answer 1

A history of vertigo lasting hours-days, preceded by a viral infection. Typically resolves within weeks. no hearing loss or tinnitus

Question 2

What is the long term management of vestibular neuronitis?

Answer 2

vestibular rehabilitation exercises

Question 3

What are the centor criteria?

Answer 3

• presence of tonsillar exudate
  -tender anterior cervical lymphadeopathy
• fever
• absence of cough

Question 4

What are the 5 criteria of the feverpain score?

Answer 4

• fever over 38
• purulent tonsils
• attended rapidly (within 3 days)
• severely inflamed tonsils
• no cough or coryza

Question 5

What is the treatment of bacterial tonsilitis?

Answer 5

phenoxymethylpenicillin (7/10 days)
clarithromycin if pen-allergic

Question 6

What is the management of a unilateral glue ear in adults?

Answer 6

2-week wait to ENT to evaluate for posterior nasal space tumour

Question 7

What is the management of acute otitis media with perforation?

Answer 7

Oral amoxicillin

Question 8

What is the management of otitis externa?

Answer 8

combined gentamicin and dexamethasone drops

Question 9

What do you use a HiNTs exam for?

Answer 9

To distinguish between peripheral and central causes of vertigo such as vestibular neuronitis and posterior circulation stroke

Question 10

What are the HiNTs findings if there is a peripheral cause of vertigo?

Answer 10

abnormal head impulse test, with either unidirectional nystagmus or no nystagmus or vertical skew

Question 11

What are the HiNTs findings if it is a central cause of vertigo?

Answer 11

a normal head impulse test, with either bidirectional or vertical nystagmus and a vertical skew

Question 12

What is the management of OME in children?

Answer 12

• active observation for 3 months
• grommet insertion
• adenoidectomy to improve eustachian tube function

Question 13

What is the management of persistent hoarseness in an over 45 y/o?

Answer 13

Chest X-ray and urgent referral to ENT

Question 14

What are the otoscopy findings of acute otitis media?

Answer 14

• bulging tympanic membrane with loss of light reflex
• red/opacification of the tympanic membrane
• perforation

Question 15

What is the management of a patient with acute sensorineural hearing loss?

Answer 15

Urgent referral to ENT for audiology and brain MRI
high dose oral corticosteroids in ENT

Question 16

What are the features of viral labyrinthitis?

Answer 16

• recent viral infection
• sudden onset vertigo
• nausea and vomiting
• can affect hearing

Question 17

What are the features of vestibular neuronitis?

Answer 17

• recent viral infection
• recurrent vertigo attacks lasting hours/days
• no hearing loss

Question 18

What is the management of unresolving otitis externa?

Answer 18

urgent referral to ENT ?necrotising otitis externa
IV Abx that cover pseudomonas

Question 19

What are the key features of malignant otitis externa?

Answer 19

• diabetic/immunocompromised
• severe otalgia
• temporal headaches
• purulent otorrhea
• not clearing despite treatment

Question 20

What is the initial management of epistaxis?

Answer 20

Pinch the nostrils firmly and lean forwards for 20 mins

Question 21

What is the management of mastoiditis?

Answer 21

IV antibiotics

Question 22

What is the most common type of parotid tumour?

Answer 22

Benign pleomorphic adenoma

Question 23

What are the features of a benign pleomorphic adenoma?

Answer 23

Slow-growing, lobular, most common parotid tumour

Question 24

What are the features of a warthin tumour?

Answer 24

benign parotid tumour, associated with smoking,

Question 25

What exercises can be done at home for BPPV?

Answer 25

Brandt-Daroff

Question 26

What is the most likely causative organism for otitis externus?

Answer 26

Pseudomonas Aeruginosa

Question 27

Which drugs are ototoxic?

Answer 27

FAV.Q&A
Furosemide, Aminoglycoside (gentamicin), vancomycin, quinine, aspirin

Question 28

What is the first-line management of compacted earwax in GP?

Answer 28

1 week olive oil drops or ear syringing, then review

Question 29

What are the features of vestibular neuronitis?

Answer 29

Vertigo following recent viral infection, attacks last hours to days, may have vomiting, no effects to hearing, horizontal nystagmus

Question 30

What does the hints test distinguish?

Answer 30

Central Vs peripheral causes of vertigo

Question 31

What is the management of vestibular neuronitis?

Answer 31

Prochlorperazine for rapid relief, antihistamine for longer term, vestibular rehabilitation exercises for treatment

Question 32

What are the examination findings of quinsy?

Answer 32

Trismus, drooling, deviation of the uvula to the unaffected side

Question 33

What are the tonsillitis indications for a tonsillectomy?

Answer 33

7 episodes in 1 year, 5 per year in 2 years, 3 per year for 3 years

Question 34

What are the features of sialadenitis?

Answer 34

• inflammation of the salivary gland
• painful one sided neck swelling, temperature, submandibular mass, painful lymphadenopathy

Question 35

What is ludwig’s angina?

Answer 35

infection of the submandibular or sublingual space

Question 36

What is the management of unilateral glue ear in an adult?

Answer 36

Urgent referral to ENT to evaluate for posterior nasal space tumour

Question 37

What is the management of Ramsey Hunt syndrome?

Answer 37

High dose aciclovir, high dose oral steroids and eye protection