ENT

Question 1

presentation menieres disease

Answer 1

recurrent spontaneous attacks of:
vertigo
aural fullness / tinnitus
fluctuating hearing loss (low-frequency)

Question 2

causes of anterior neck lumps

Answer 2

pulsatile: carotid artery aneurysm, carotid body tumour

non-pulsatile: lymph nodes, goitre, branchial cyst

Question 3

causes of midline neck lumps

Answer 3

dermoid cyst
thyroglossal cyst
thyroid nodules

Question 4

causes of posterior neck lumps

Answer 4

lymph nodes
pharyngeal pouch
cervical rib
cystic hygroma

Question 5

features thyroglossal cyst

Answer 5

midline
moves on swallowing + tongue protrusion
painless, smooth, fluctuant

Question 6

features branchial cyst

Answer 6

upper 1/3 ant border of SCM
congenital remnant (failure of fusion of branchial cleft)
smooth, fluctuant
may increase in size after URTI
FNA → cholesterol crystals, scattered foamy macrophages
Tx: 1. sclerotherapy 2. surgery

Question 7

features cystic hygroma

Answer 7

anterior triangle 
lymph malformation 
transilluminates 
increases in size w coughing / crying 
soft, fluctuant 
Tx: 1. sclerotherapy 2. surgery

Question 8

features pharyngeal pouch

Answer 8

posterior triangle
dysphagia, halitosis, regurgitation, chronic cough, aspiration
diffuse, soft, gurgling on palpation
older pts

Question 9

features carotid body tumour

Answer 9

ant upper 1/3 of SCM 
pulsatile, bruit 
moves laterally but not up / down 
palpation → dizziness 
CT angio → Lyre sign

Question 10

borders of anterior + posterior triangle of neck

Answer 10

anterior: mandible, ant SCM, midline
posterior: post SCM, mid 3rd of clavicle, ant trapezius

Question 11

Lyre sign on CT angio

Answer 11

carotid body tumour