Ent

Question 1

Laryngeal ca signs

Answer 1

Smoker
Constant ear pain (referred)
Neck lump
Progressive 
Pain

Question 2

Bleeding after tonsillectomy

Answer 2

Emergency admission, abx and fluids straight away and band and cauterise

Question 3

Centaur criteria

Answer 3

3 or more then 40-60% chance sore throat is group A streptococcus

Presence of tonsillar exudate
No cough
Tender anterior cervical Lymphadenopathy or lymphadenitis
Hx of fever

Question 4

Nasal polyps… Associations and features

Answer 4

Men (2-4X more common )
Asthma (esp late onset)
Aspirin sensitivity (assx of aspirin asthma and polyps=Samter’s triad)
Infective sinusitis
Cf
Kartageners syndrome (have dextrocardia/situs inversus, and bronchiectasis)
Churg Strauss

….nasal obstruction, Rhinorrhoea, sneezing, poor taste or smell

Question 5

Biggest preventable risk factor for child with otitis media with effusion

Answer 5

Parental smoking!

Question 6

Trauma to head / ear and hearing loss on one side afterwards. What are two top Ddx and way to differentiate

Answer 6

Tympanic membrane perforation (relatively common comp of skull trauma) - most common tymp perc is from infection though. CONDUCTIVE loss. Heal in 6-8 weeks and avoid water

Basal skull #. Sensorineural loss

Question 7

Dizziness and right sided hearing loss and tinnitus with Absent corneal reflex…

Answer 7

Vestibular schwannoma
Affects CN 8, but can also affect 7, 5

Cerebellopontine angle syndrome (90% are VS)

Question 8

Otosclerosis features

Answer 8

20-40 yr
Conductive deafness
Tinnitus
Normal tymp membrane (hyperaemic and flamingo coloured in 10%)
\+ve FH (auto Dom)

Give hearing aid or stapedectomy

Question 9

Otosclerosis pathology

Answer 9

Rolacement of normal bone by vascular spongy bone causing fixing of stapes (so conductive hearing loss)

Question 10

Drugs fthat can cause drug ototoxicity

Answer 10

Aminoglycosides like gentamicin
Furosemide
Aspirin
Quinine

(Can by hearing loss, vertigo, tinnitus)

Question 11

Thyroglossal Cyst location

Answer 11

between isthmus of thyroid and hyoid usually
from remnants of thyroglossal duct
(anechoic on USS …echogenity indicates infection)
usually aged under 20

Question 12

branchial cyst vs Cystic hygroma

three things about to differetniate each.

Answer 12

branchial cyst: anterior triangle, level of hyoid, teens young adult
cystic hygroma: posterior triangle, LEFT, from birth

Question 13

Causes of mastoid tenderness in ENT exam

Answer 13

Mastoiditis (linked to otitis media, and is big red flag…risk of meningitis etc!!)
Cholesteaotoma can invade into mastoid

Question 14

Otitis externa management

Answer 14

Mild: cases (mild discomfort and/or pruritus; no deafness or discharge), consider prescribing topical acetic acid 2% spray.
Severe inflammation are present, such as in this case, they advise 7 days of a topical antibiotic with or without a topical steroid.
Features of severe:
…red, oedematous ear canal which is narrowed and obscured by debris
…conductive hearing loss
…discharge
…regional lymphadenopathy
…cellulitis spreading beyond the ear
…fever