ENT

Question 1

ENT

Answer 1

ENT

Question 2

Acute sinusitis is most commonly caused by which two pathogens?

Answer 2

Strep pneumoniae and haemophilus influenzae

Question 3

Oral herpes is best treated with systemic or topical antivirals?

Answer 3

Topical is the first line. Systemic antivirals will help but are only indicated for severe cases.

Question 4

A patient presents with several episodes of vertigo over the past few weeks. He has had intermittent unilateral hearing loss and a “blowing” in his ears. What is the most likely diagnosis?

Answer 4

Meniere’s disease

Question 5

A white oral lesion which cannot be scraped off should make you think of what diagnosis?

Answer 5

Oral leukoplakia (vs punctate lesions after scraping off is candida)

Question 6

What type of hearing loss is associated with aging?

Answer 6

Sensory (prepuscious)

Question 7

Which is the most commonly affected sinus in acute sinusitis?

Answer 7

Maxillary

Question 8

A patient presents with a hot potato or muffled voice. What is the most likely diagnosis?

Answer 8

Peritonsillar abscess, look for tonsil deviation

Question 9

What time frame are we talking about for chronic sinusitis?

Answer 9

> 3 months

Question 10

List the time of year when each of the following allergens is most prominent: pollen, grass mold and ragweed.

Answer 10

Pollen from trees and flowers = spring, grasses are the summer mold and ragweed are fall

Question 11

How long should pressure be applied to treat epistaxis?

Answer 11

15 minutes

Question 12

List the four things that suggest group A beta- hemolytic strep in a patient with pharyngitis.

Answer 12

Fever, tender anterior cervical adenopathy, no cough and an exudate in the throat

Question 13

A child presenting with an erythematous sandpaper rash should make you think of what diagnosis?

Answer 13

Scarlet fever

Question 14

In a patient with sensorineural hearing loss, what will be the results of the Weber test?

Answer 14

The patient will hear the sound louder in the unaffected ear. (This is opposite for conductive hearing loss)

Question 15

List four complications of untreated strep throat.

Answer 15

Scarlet fever, glomerulonephritis rheumatic fever and local abscess

Question 16

A patient presents with a round ulcer in her mouth that is yellow-grey and has a red halo. It is on the buccal mucosa and it is painful. What is the most likely diagnosis?

Answer 16

Aphthous ulcers

Question 17

A patient presents drooling, with stridor and in tripod position. What is the diagnosis and how do you treat it?

Answer 17

Epiglottitis is treated with a third generation cephalosporin - ceftriaxone.

Question 18

White oral lesions which can be scraped off leaving punctate bleeding should make you think of what diagnosis?

Answer 18

Oral candida

Question 19

What are three possible treatments for peritonsillar abscess?

Answer 19

Needle aspiration, I&D and tonsillectomy

Question 20

What virus causes mumps?

Answer 20

Paramyxovirus

Question 21

How do you treat allergic rhinitis?

Answer 21

Intranasal corticosteroid and antihistamines

Question 22

What is the treatment of choice for strep throat?

Answer 22

Penicllin, amoxicillin, erythromycin

Question 23

A patient presents with unilateral hearing loss and a decrease in speech discrimination. She has also had difficulty with balance over the past week. What is the most likely diagnosis?

Answer 23

Acoustic neuroma

Question 24

A patient presents with acute swelling and pain in the cheek that increases at meals. What is the most likely diagnosis?

Answer 24

Sialadenitis (salivary gland infection) - Staph aureus

Question 25

When is watchful waiting with a diagnosis of acoustic neuroma an appropriate plan?

Answer 25

This tumor is very slow growing. Watching a small tumor in an elderly patient is appropriate treatment.

Question 26

What type of hearing loss would be caused by cerumen impaction?

Answer 26

Conductive

Question 27

How do you administer the Weber hearing test?

Answer 27

Tuning fork placed in the middle of the forehead

Question 28

A 14 year old field hockey player presents with prominent adenopathy white purple exudates in the throat and a palpable spleen. What is the most likely diagnosis?

Answer 28

Mononucleosis

Question 29

How do you administer the Rinne hearing test?

Answer 29

Place the tuning fork on the mastoid and then move it next to the ear.

Question 30

Describe the result of a Weber hearing test in a patient with conductive hearing loss.

Answer 30

Patient will report the sound louder in the affected ear.

Question 31

An x-ray of the skull reveals coalescence of mastoid air cells. What is the most likely diagnosis?

Answer 31

Mastoiditis

Question 32

After 10 days of worsening sinusitis what antibiotic should you start?

Answer 32

Augmentin (amoxicillin/clavulanate)

Question 33

A 45 year old female complains of feeling the ground rolling under her feet at times. What is the most likely diagnosis?

Answer 33

Vertigo

Question 34

A patient with a history of smoking presents with a new onset hoarseness. This has been persistant for the past two weeks. What is the most likely diagnosis?

Answer 34

Laryngeal squamous cell carcinoma

Question 35

A patient presents with acute onset of continuous severe vertigo for the past five days. He does have a history of URI 2 weeks ago. What is the most likely diagnosis?

Answer 35

Labrynthitis

Question 36

What does Kiesselbach’s plexus refer to?

Answer 36

A group of vein’s in the anterior nose which bleed a lot

Question 37

Small grouped vesicles on the vermillion border should make you think of what diagnosis?

Answer 37

Herpes