ENT

Question 1

what causes hand foot and mouth disease?

Answer 1

coxsackie virus

Question 2

what are apthous ulcers?

how long do they last?

Answer 2

• non viral self limiting ulcers

- less than 3 weeks, if last longer investigate other causes e.g. IBD, behcet’s

Question 3

what is Behcet’s disease?

Answer 3

• inflammatory disease of unknown aetiology

- usually involves inflammation of mucous membranes/mucosa

Question 4

what are the components of the centor criteria?

how must you get to receive AB?

Answer 4

• tonsillar exudate
• tender anterior cervical lymph nodes
• history of fever
• absence of cough

-3 or 4 (indicates 32-56% risk of bacterial cause)

Question 5

symptoms of a peritonsilar abscess/quinsy

Answer 5

• unilateral throat pain
• odynophagia (painful swallowing)
• 3-7 post tonsillitis
• loss of concavity of palate o/e

Question 6

treatment of diphtheria infection?

Answer 6

-antitoxin

diphtheria produces potent cardio and neurotoxic exotoxin

Question 7

what is a side effect of chronic CO2 retention/sleep apnoea

Answer 7

• pulmonary hypertension

- cor pulmonale

Question 8

treatment for oral thrush

Answer 8

• nystatin

- fluconazole

Question 9

main causes of otitis externa

Answer 9

• staph aureus
• proteus!
• pseudomonas
• aspergillus
• candida

Question 10

what is malignant otitis?

Answer 10

-extension of otitis externa to effect mastoid air cells and temporal bone

Question 11

what cell type are cholesteatomas?

Answer 11

-squamous epithelium

middle ear is normally columnar/glandular epithelium

Question 12

which sounds lost first in presbycusis?

Answer 12

-high frequency ones

Question 13

which sounds tend to be lost in meniere’s disease?

Answer 13

-low frequency ones

Question 14

symptoms of meniere’s

Answer 14

• rotational vertigo
• tinnitus on affected side
• aural fullness
• sensorineural hearing loss
• episodes last between 20mins and hours

Question 15

In BPPV where does otolith usually enter?

Answer 15

-posterior semi-circular canal

gives rise to vertigo when looking up

Question 16

Test/investigation for BPPV

Answer 16

Dix hallpike test

• lie patient down, move head in different directions
• look for nystagmus and ask patient if experiencing symptoms

Question 17

what is likely to cause vertigo which lasts for days?

Answer 17

-vestibular neuritis

Question 18

risk factors for nasopharyngeal carcinoma

Answer 18

• males form far east
• epstein-barr virus
• nitrosamine (chemical in smoked/preserved food)

Question 19

what are patients who worked with wood or nickel at risk of?

Answer 19

-head/neck adenocarcinoma

Question 20

features of pleomorphic adenoma

Answer 20

• single slow growing nodule on salivary gland
• usually affects parotids
• benign
• women 40-60Y
• v common

Question 21

features of warthin’s tumour

Answer 21

• cytsic, multicentric, often bilateral
• almost always in parotids
• benign
• men 50+ who smoke

Question 22

features of mucoepidermoid carcinoma

Answer 22

• non encapsulated, slow growing tumour
• contain mucous secreting cells
• parotids
• any age group
• malignant (but usually good prognosis)

Question 23

features adenoid cystic carcinoma

Answer 23

• slow growing tumour of exocrine mucous glands (usually salivary glands)
• well differentiated
• often demonstrates neural invasion and metastasis
• prognosis not fab

Question 24

how can hereditary haemorrhagic telangiectasia present

Answer 24

-recurrent severe nosebleeds

Question 25

temporal bone fracture associated with injury to middle ear ossicles

Answer 25

• longitudinal

- from lateral blows

Question 26

temporal bone fracture associated with injury to facial nerve and sensorineural hearing loss

Answer 26

• horizontal

- from frontal blows