ENT

Question 1

Difference between intermittent and persistent rhinitis?

Answer 1

Intermittent - symptoms <4 days per week or symptoms for less than 4 weeks

Persistent - symptoms >4 days per week or symptoms for more than 4 weeks

Question 2

What is the most common bacterial cause of sore throat?

Answer 2

Group A Beta Heamolytic Streptococcus (GABHS) - e.g. Streptococcus pyogenes

Question 3

Treatment of GABHS sore throat

Answer 3

Penicillin

Question 4

Which organism causes a grey-white membrane across the pharynx?

Answer 4

Corynbacterium diphtheriae –> Diphtheria

Question 5

Treatment of oral candiadiasis

Answer 5

Nystatin

Question 6

Management of Acute Otitis Media

Answer 6

Amoxicillin (or Clarithromycin)

Amoxicillin medication for treating otitis media at 500mg TDS for 7 days.

Co-amoxiclav is used as a second line agent if amoxicillin doesn’t work

Question 7

Common cause of Acute Otitis Media

Answer 7

Strep pneumo

Question 8

Management of acute sinusitis

Answer 8

Penicillin V

Doxycycline

Question 9

Main risk factor for malignant otitis externa

Answer 9

Diabetes

Question 10

EBV testing

Answer 10

Paul-Bunnell test or Monospot

Question 11

Cause of Hand, Foot and Mouth Disease

Answer 11

Coxsackie virus

Question 12

Centor Criteria

Answer 12

Tender anterior cervical lymphadenopathy
No cough
Tonsilar exudate
Fever >38

Question 13

Which condition is associated with trismus (lockjaw)?

Answer 13

Quinsy

Question 14

Dizziness for months associated with tinnitus and viral illness

Answer 14

Labyrinthitis

Question 15

Dizziness for hours associated with tinnitus, hearing loss and fullness in ear

Answer 15

Meniere’s disease

Question 16

Investigate BPPV

Answer 16

Hallpike’s test (if nystagmus observed go on to perform Epley Manouvre)

Question 17

Nasal polyps in the young consider …

Answer 17

Cystic Fibrosis

Question 18

Associated factors of nasopharyngeal cancers

Answer 18

EBV and volatile nitrosamines in food

Question 19

Most common salivary gland tumour

Answer 19

pleomorphic adenoma

Question 20

Second most common salivary gland tumour

Answer 20

Warthin’s

Question 21

Warthin’s Tumour features

Answer 21

Benign usually parotid gland tumour
Males >50
Associated with smoking
Bilateral and multi-centric

Question 22

Most common malignant salivary gland tumour

Answer 22

Worldwide -> Mucoepidermoid Carcinoma

UK -> Adenoid Cystic Carcinoma

Question 23

Throat tumour in <5 year olds associated with HPV

Answer 23

Squamous papilloma

Question 24

Which individuals are at an increased risk of getting cholesteatoma?

Answer 24

Children born with cleft lip (100x)

Question 25

Choleasteatoma features

Answer 25

Main features foul-smelling, non-resolving discharge hearing loss Other features are determined by local invasion: vertigo facial nerve palsy cerebellopontine angle syndrome

Question 26

Bilateral vestibular schwannomas

Answer 26

NF type 2

Question 27

Features and Management of otosclerosis

Answer 27

``` Family history of condition Conductive Hearing Loss Tinnitus Audiometry -> Carhart's Notch at 2kHz Treatment -> Oval Window Fixation ```

Question 28

Which type of hearing loss is associated with low frequency hearing loss?

Answer 28

CHL

Question 29

Which type of hearing loss is associated with high frequency hearing loss?

Answer 29

SNHL

Question 30

Features of hypocalcaemia

Answer 30

``` Features tetany: muscle twitching, cramping and spasm perioral paraesthesia if chronic: depression, cataracts ECG: prolonged QT interval ```

Question 31

What can be seen in a branchial cyst biopsy?

Answer 31

cholesterol crystals

Question 32

Treatment of Ramsay Hunt syndrome

Answer 32

oral aciclovir and corticosteroids

Question 33

'flamingo tinge' tympanic membrane

Answer 33

otosclerosis

Question 34

Onset of otosclerosis, inheritance

Answer 34

20-40yo - autosomal dominant

Question 35

Otitis externa in diabetics . Treatment

Answer 35

Ciprofloxacin for pseudomonas cover

Question 36

Otitis externa. Treatment

Answer 36

Fluclox

Question 37

Adults with otitis media with effusion consider ...

Answer 37

rhinosinusitis nasopharyngeal carcinoma nasopharyngeal lymphoma

Question 38

Conductive Hearing Loss + Flat Tympanogram

Answer 38

OME

Question 39

Conductive hearing loss which worsens dramatically during pregnancy or HRT

Answer 39

Otosclerosis

Question 40

Trauma and "battlesign" bruising behind ear

Answer 40

Temporal bone fracture

Question 41

What are the 5 cardinal ear symptoms?

Answer 41

Hearing loss, Otalgia, Discharge, Tinnitus, Vertigo

Question 42

TMJ Cardinal Symtoms

Answer 42

Pain Trismus Crepitus Muscle tenderness

Question 43

ENT Red Flags

Answer 43

``` Hoarseness Lumps Dysphagia Weight loss Stridor Fatigue Haemoptysis Unilateral nasal polyps Persistent Otalgia Persistent Sore Throat Unilateral Tinnitus ```

Question 44

If first aid fails to control epistaxis, what are the next options? (in treatment ladder order)

Answer 44

``` Silver nitrate Cautery Nasal packing Ligation of the sphenopalatine artery Ligation of the external carotid Embolisation ```

Question 45

Ligation of the sphenopalatine artery - risks (3)

Answer 45

The patient should be warned about the risks of continued bleeding, visual disturbance and CSF leak.

Question 46

Which area of the nose is the principal region supplied by the sphenopalatine artery, and therefore the area best treated by its ligation?

Answer 46

Lateral wall of nose

Question 47

How long do symptoms have to persist to be diagnosed with chronic otitis media with effusion?

Answer 47

3 months

Question 48

Retracted and dull tympanic membrane

Answer 48

Otitis media with effusion (glue ear)

Question 49

Audiogram of Meniere's disease

Answer 49

Low frequency SN loss