ENT

Question 1

Give 4 indications to send someone with a sore throat to hospital

Answer 1

Breathing difficulties
Oral abscesses (e.g. quinsy)
Clinical dehydration
Suspected epiglottitis 
Signs of systemic illness/sepsis
Suspected rare cause

Question 2

What feverpain score should antibiotics be prescribed at?

Answer 2

4 or 5

Question 3

What feverpain score would you consider delayed antibiotic prescribing for?

Answer 3

2 or 3

Question 4

First line antibiotic for generic sore throat?

Answer 4

phenoxymethylpenicillin

Question 5

What drug is prescribed for oral candida infection

Answer 5

Nystatin

Question 6

Give 3 safety netting pieces of advice for someone with a suspected viral sore throat

Answer 6

If pain does not improve after 3 days
Difficulty swallowing
one sided neck/throat swelling

Question 7

What counts as recurrent tonsilitis?

Answer 7

7 episodes in a year
5 per year for 2 years
3 per year for 3 years

Question 8

Which lymph nodes are often enlarged in pharyngitis

Answer 8

cervical

Question 9

What 5 things are on the feverpain score

Answer 9

Fever (last 24h)
P us
A ttended within 3 days
I nflamed tonsils
N o cough

Question 10

What does feverpain predict

Answer 10

Chance of isolating strep A

Question 11

What abdominal finding would you expect in infectious mononucleosis?

Answer 11

splenomegaly

Question 12

Name 4 common viral causes of sore throat

Answer 12

Infectious mononucleosis (EBV)
Influenza
Herpetic pharyngitis
Common cold (adeno/rhino/coronavirus)

Question 13

Name 3 non-infectious causes of sore throat

Answer 13

Smoking
Allergic rhinitis
GORD
Kawasaki disease
Oral mucositis (secondary to cancer treatments)

Question 14

Signs of peritonsillar abscess?

Answer 14

Trismus (difficulty opening mouth)
hot potato voice
Fetid breath
Drooling
displaced uvula

Question 15

Suggest 2 options for wax removal

Answer 15

Electronic irrigation
Microsuction
Manual probe removal

All should be preceded by up to 5 days of using wax softener

Question 16

What age does otosclerosis usually present?

Answer 16

15 to 35

Question 17

What is the pathophysiology of otosclerosis

Answer 17

Sclerosis of the bones in the middle ear over time leads to progressive hearing loss

Question 18

What range of sound is typically lost in otosclerosis?

Answer 18

Low tone

i.e. deep male voice

Question 19

Signs of otosclerosis

Answer 19

Auroscopy normal
Conductive deafness with tuning fork test
Speak quietly due to increased resonance of own voice

Question 20

Management of otosclerosis?

Answer 20

Hearing aids

Surgery (stapedectomy or stapedotomy)

Question 21

What condition is endolymphatic hydrops part of?

Answer 21

Meniere’s disease

It is the progressive distension of the membranous labyrinth

Question 22

Core symptoms of meniere’s disease

Answer 22

vertigo
tinnitus
fluctuating hearing loss (with a sensation of pressure)

Question 23

Is meniere’s typically unilateral or bilateral?

Answer 23

Unilateral, although it can progress

Question 24

Drop attacks (without consciousness loss) can be a feature of which ENT condition?

Answer 24

Meniere’s disease (reported in 5% of patients)

Question 25

What test is used to diagnose BPPV

Answer 25

Dix-hallpike manouevre

Question 26

Acoustic neuroma's affect which nerve?

Answer 26

Crainial nerve 8 (vestibulocochlear)

Question 27

Which condition is a risk factore for acoustic neuroma

Answer 27

Neurofibromatosis

Question 28

Triad of symptoms in acoustic neuroma

Answer 28

unilateral progressive hearing loss vestibular dysfunction tinnitus (e.g. very similar to muniere's)

Question 29

What ENT tumour can result in facial pain and numbness?

Answer 29

Acoustic neuroma

Question 30

3 things to diagnose sinusitis

Answer 30

Facial discomfort/pain/pressure Nasal obstruction/purulent discharge Decreased/absent sense of smell

Question 31

What treatment can be given after 10 days to someone with sinusitis

Answer 31

High dose corticosteroid intranasally for 2 weeks

Question 32

Where does sinus pain often refer to?

Answer 32

The upper jaw

Question 33

What chemical is used for cautery of nasal bleeds?

Answer 33

Silver nitrate

Question 34

Which illicit drug often causes nosebleeds

Answer 34

Cocaine

Question 35

Most common cause of vertigo?

Answer 35

BPPV

Question 36

Which semicurcular canal is most commonly affected in BPPV

Answer 36

Posterior

Question 37

Age of onset for BPPV?

Answer 37

40-60

Question 38

BPPV is provoked by what?

Answer 38

Head movements, often in a certain way

Question 39

what does a positive dix hallpike test show?

Answer 39

nystagmus (normally rotational if posterior canal)

Question 40

management of BPPV

Answer 40

Epley's manouvre! | other than that, benign is in the name, its conservative but with a nod to possible falls

Question 41

What investigation should be done to investigate hoarse voice?

Answer 41

Flexible nasal endoscopy

Question 42

Which team treats benign vocal cord disease?

Answer 42

SALT team

Question 43

name 3 benign causes of hoarseness

Answer 43

``` Vocal cord nodules muscle tension dysphonia Vocal cord polyps Laryngeal papillomas Reflux laryngitis Reinke's oedema ```

Question 44

What virus causes laryngeal papillomas?

Answer 44

HPV

Question 45

2 infective causes of hoarse voice

Answer 45

laryngitis | Epiglottitis

Question 46

What nerve palsy causes vocal dysfunction?

Answer 46

Recurrent laryngeal

Question 47

If a patient has vocal cord paralysis on investigation with flexible nasal endoscopy, what further investigation is needed?

Answer 47

CT neck and chest | To try to find lesion