ENT

Question 1

Management of glue ear

Answer 1

Conservative (review in 3m)

If persistent - hearing aids or grommits

Question 2

Inheritane of otosclerosis

Answer 2

Autosomal dominant

Question 3

Organisms for otitis externa

Answer 3

Bacterial - pseudomonas aerguinosa, staph aureus

Fungal - aspergillus niger (divers)

Question 4

Who gets malignant otitis externa and how is it managed?

Answer 4

Diabetics - IV antibiotics

Question 5

Management of bacterial otitis externa

Answer 5

antibiotic + steroid (ciprofloxacin/dexamethasone)

Question 6

Organisms that cause otitis media

Answer 6

Resp viruses

• strep pnemoniae
• H. influenzae
• Moraxella catarhalis

Question 7

Management of otitis media

Answer 7

Delayed Abx (5 days)
Give immediately if:
 - symptoms >4d + not improving 
 - systemically unwell 
 - immunocomprimised 
 - <2y with bilteral OM 
 - perforation and/or discharge

Question 8

Presentation of vestibular schwannoma

Answer 8

Unilateral sensorineural HL
Intermittent dizziness
Facial numbness

Question 9

Investigation of vestibular schwannoma

Answer 9

MRI

Question 10

Duration of vertigo with cause (mins, hours, days, days/weeks)

Answer 10

Mins = BPPV
Hours = Menieres
Days = Vestibular neuronitis
Days - Weeks = Labrynthitis

Question 11

What does the facial nerve provide parasympathetic supply to?

Answer 11

H + N glands

Submandibular + sublingual salivary glands

Question 12

What type of hypersensitivity reaction is allergic rhinitis?

Answer 12

Type I hypersensitivity reaction

Question 13

When are nasal polyps concerning? How should this be managed?

Answer 13

If UNILATERAL (considered neoplastic until proven otherwise) - CT + biopsy

Question 14

How are nasal polyps managed?

Answer 14

Mild-Mod = intranasal corticosteroid +/- anti-leukotriene (montelukast)
Severe = oral corticosteroids - surgery

Question 15

How are acute and chronic sinusitis differentiated?

Answer 15

Acute = <4 weeks 
Chronic = >4 weeks

Question 16

Management of persistent sinusitis

Answer 16

Penicillin V for 7 days

Question 17

What prophylactic treatment redduces recurrence of chronic sinusitis?

Answer 17

Corticosteroids

Question 18

Which arteries are ligated (progressing) when managing a nosebleed?

Answer 18

Sphenopalantine
Anterior ethmoidal
External carotid

Question 19

What are the steps of epistaxis management?

Answer 19

First aid measures
topical anti-septic (noseptin or mupuracin)
if vessels visible - cautery with silver nitrate
if not visible - packing
(^^^give co-phenylcaine first^^^)

Question 20

Most common salivary gland tumour

Answer 20

Pleomorphic adenoma

Question 21

Most common salivary gland to get stone (sialothiasis)

Answer 21

Submandibular gland

Question 22

What are the centor criteria?

Answer 22

Tonsillar exudate
No cough
Tender cervical lymphadenopathy
Fever

Question 23

Management of bacterial tonsilitis

Answer 23

Phenoxymethylpenicillin (5days) - if unable to swallow admit for benzylpenicillin + IV fluids

Question 24

Management of peritonsillar abscess (quinsy)

Answer 24

Needle aspiration 
Iv pen (10 days) + IV dex

Question 25

How long to avoid contact sports in glandular fever?

Answer 25

8 weeks

Question 26

Investigation of glandular fever

Answer 26

BC + film

• lymphocytosis + atypical lymphocytes
• heterophil ab test (monospot or Paul Bunnell)

Question 27

What is most common type or nasal, oropharyngeal and larygneal ca?

Answer 27

SCC

Question 28

Which younger patients may present wiht laryngeal ca?

Answer 28

HPV +ve