ENT common problems

Question 1

ear structures

Answer 1

pinna 
external auditory canal
tympanic cavity with membrane
vestibule
cochlea

Question 2

communication between middle ear and nasopharynx

Answer 2

eustation tube

Question 3

ear symptoms history taking

Answer 3

hearing loss
otalgia
otorrhoea
tinnitus
vertigo
concurrent nasal symptoms
drug/family history

Question 4

perichondritits

Answer 4

skin and soft tissue infection of the pinna

tx with IV Ab and analgesic

Question 5

otitis externa

Answer 5

infection of external auditory canal
pseudomonas, staph aura

can have otalgia, otorrhoea, pruritus, heading loss

Question 6

hepes zoster optics

Answer 6

acute facial palsy
otalgia
varicella like cutaneous lesions of the conch

Question 7

otitis media with effusion/glue ear

Answer 7

persistent mucoid/serous middle ear effusion for more than 3 mns

Question 8

symptoms of glue ear

Answer 8

hearing loss
recurrent infernos
delayed speech in children

Question 9

acute Otitis media

Answer 9

infection/inflammation of the middle ear

either no supportive or supportive (no effusion vs with pus)

Question 10

complications of acute otitis media

Answer 10

Extracranial

• TM perforation
• facial nerve palsy
• mastoiditis
• labyrinthitis
• petrositis

Intracranial complications

• meningitis
• extradural abscess
• subdural abscess
• intracerebral abscess
• lateral sinus thrombosis

Question 11

chronic otitis media

Answer 11

Persistent or intermittent discharge through a pathological/abnormal TM (perforation, retraction pocket)

Question 12

cholestaetoma

Answer 12

Destructive and expanding keratinised squamous cell debris (skin going inside middle ear, will carry on growing and spreading, destroy middle ear and can lead to the brain)
- congenital or acquired

Question 13

what can cholesteatoma lead to - hearing loss (erosion of osicles)

Answer 13

• chronic ear discharge
• recurrent infections
• vertigo
• intracranial complications

Question 14

acute mastoiditis

Answer 14

Infection of mastoid air cells as a complication of acute otitis media (spreads to the bone)

• mastoid tenderness
• pyrexia
• oedema and erythema of post auricular soft tissue
• antero-inferior displacement of pinna

Question 15

benign paroxysmal positional vertigo

Answer 15

Brief intense episodes of rotatory vertigo lasting seconds triggered by head movements
- causes by misplaced otoconia in middle ear eg in bed turning, feel spinning but then it settles down

Question 16

menieres

Answer 16

fluid imbalance in the inner eat

can lead to vertigo hearing loss and tinnitus

Question 17

vestibular neuronitis labrinthitis

Answer 17

Inflammation of vestibular nerve (vestibular neuronitis) or inner ear (labyrinthic)
causes
- acute intense vertigo (dehabilitating) that lasts days/weeks followed by gradual recovery (via compensation by opposite inner ear)

Question 18

main types of deafness

Answer 18

1) conductive
- obstacle to the passage of sound wave between external ear and cochlea
2) sensorineural
- fault in the cochlea (sensory) or cochlear nerve (neural)
- inner ear

Question 19

sinuses in the face

Answer 19

maxillary
ethmoidal
frontal
sphenoid

Question 20

what is in the nose and what does it do

Answer 20

turbinates

helps air flow- turbulent humidifies it

Question 21

epistaxis

Answer 21

commonly from the Kisselbach plexus

Question 22

causes of epistaxis

Answer 22

1) idiopathic
2) coagulopathy
3) rhinitis
4) trauma
- nose picking
- injury
- surgery
5) drugs
- aspirin
- warfarin
6) systemic diseases
- Wegener’s/sarcoidosis
7) neoplastic

Question 23

management of epistaxis

Answer 23

1) first aid measures (compression 10-15 mins)
- at cartilage not bone
2) cautery (silver nitrate/bipolar)
3) nasal packing
- absorbable packs (nasopore) – not taken out
- haemostatic packs, flow seal
- balloon catheter
- posterior packs (folet catheter, rapid rhino/BIPP/Vaseline):
4) surgery (SPA or anterior ethmoid ligation)
5) interventional radiology

Question 24

rhinosinusitis and nasal polyposis

Answer 24

Inflammation of the nose and paranasal sinuses

• nasal congestion or nasal discharge
• facial pain/pressure
• anosmia

Question 25

periorbital celluliis

Answer 25

complication of ethmoid sinusitis

Question 26

nasal trauma

Answer 26

1) nasal bone fracture
2) sepal haematoma
- can cause haematoma inside septum

Question 27

history taking for the larynx

Answer 27

• dysphonia
• cough/haemoptysis
• pain
• dyspnoea
• globus
• stridor

Question 28

bacteria which can cause tonsillitus

Answer 28

• B haemolytic strep
• Pneummococcus
• haemophilis

Question 29

censor criteria

Answer 29

Set of criteria which can be used to identify likihood of bacterial infection in patietns complaining of sore throat

Question 30

quinsy

Answer 30

Peritonsillar abscess in potential space between tonsillar capsule and pharyngeal muscle bed

Question 31

glandular fever

Answer 31

Infectious mononucleosis

Question 32

epiglottis

Answer 32

Iflammation of epiglottis and or supraglottic tissue