ENT

Question 1

Glue ear definition

Answer 1

Glue ear describes otitis media with an effusion (other terms include serous otitis media). It is common with the majority of children having at least one episode during childhood

Question 2

glue ear risk factors

Answer 2

male sex
siblings with glue ear
higher incidence in Winter and Spring
bottle feeding
day care attendance
parental smoking

Question 3

glue ear features

Answer 3

• peaks at 2 years of age
• hearing loss is usually the presenting feature (glue ear is the commonest cause of conductive hearing loss and elective surgery in childhood)
• secondary problems such as speech and language delay, behavioural or balance problems may also be seen

Question 4

glue ear management

Answer 4

• active observation: the management for a child with a first presentation of otitis media with effusion is active observation for 3 months - no intervention is required
• grommet insertion - to allow air to pass through into the middle ear and hence do the job normally done by the Eustachian tube. The majority stop functioning after about 10 months
• adenoidectomy

Question 5

Otitis externa in diabetics: treat with

Answer 5

Otitis externa in diabetics: treat with ciprofloxacin to cover Pseudomonas

Question 6

malignant otitis externa presentation

Answer 6

• Diabetes (90%) or immunosuppression (illness or treatment-related)
• Severe, unrelenting, deep-seated otalgia
• Temporal headaches
• Purulent otorrhea
• Possibly dysphagia, hoarseness, and/or facial nerve dysfunction

Question 7

malignant otitis externa organism and general pathophysiology

Answer 7

• Uncommon
• immunocompromised individuals (90% cases found in diabetics)
• Pseudomonas aeruginosa
• Infection commences in the soft tissues of the external auditory meatus, then progresses to involve the soft tissues and into the bony ear canal
• Progresses to temporal bone osteomyelitis

Question 8

malignant otitis externa investigation

Answer 8

CT scan usually required

Question 9

Recurrent otitis externa following numerous antibiotic treatment should raise suspicion of

Answer 9

Recurrent otitis externa following numerous antibiotic treatment should raise suspicion of Candida infection

Question 10

diagnostic test for obstructive sleep apnoea

Answer 10

Polysomnography is diagnostic for obstructive sleep apnoea

Question 11

URTI symptoms + amoxicillin → rash
diagnosis?

Answer 11

infectious mononucleosis

Question 12

when oral antibiotics are needed for otitis externa: which one is first line

Answer 12

flucoxicilline

Question 13

which sign is indicative of a positive Dix-Hallpike manoeuvre

Answer 13

Rotatory nystagmus is indicative of a positive Dix-Hallpike manoeuvre

Question 14

acute otitis media with perforation management

Answer 14

Oral antibiotics should be given in acute otitis media with perforation
5-7 amoxicillin