ENT presentations

Question 1

painless smelly chronic discharge

Answer 1

chronic suppurative otitis media / cholesteatoma

Question 2

fever, malaise, ear pain, acute discharge

treatment

Answer 2

acute otitis media

antibiotcs

Question 3

patient systemically well
acute discharge
ear pain

Answer 3

otitis externa (looks gross)

topical treatment - use otowicks to drop treatment into

Question 4

mastoiditis can be a complication of which ear infection

Answer 4

acute otitis media

Question 5

sudden onset vertigo, sick, not been 100% for months prior

Answer 5

acute vestibular neuonitis (labyrinthitis) - failure of inner ear due to inflammation of vestibular nerve (branch of CN8). often viral infection.

Question 6

facial n palsy is a complication of which ear infection

Answer 6

chronic suppurative otitis media

Question 7

painful , purulent discharge from nose, less than 3 months, after URTI

Answer 7

acute sinusitis

needs decongestants and antibiotics

Question 8

difference between acute/chronic sinusitis

Answer 8

3 months

painful/painless around face/eyes

Question 9

treatment of chronic rhinosinusitis

Answer 9

topical +/- oral steroids

ong course macrolide abx (azithromycin)

Question 10

high temp, difficulty swallowing, one sided, big swelling in throat

Answer 10

peritonsillar abcess - quinsy

DRAIN + IV antibiotics

Question 11

severe sore throat, fever, near complete dysphagia, drooling/difficulty breathing
throat normal or slightly red

Answer 11

supra-/epiglottitis
might avoid examination
ENT emergency

Question 12

acute onset loss of voice
malaise
painless throat (or slightly sore)

Answer 12

laryngitis

Question 13

commonest causes of conductive hearing loss

Answer 13

1. otitis media with effusion
2. wax
3. CSOM/cholesteatoma
4. otosclerosis

Question 14

commonest causes of sensorineural hearing loss

Answer 14

1. noise induced
2. presbyacusis
3. congenital

Question 15

first line treatment for otitis media with effusion

Answer 15

decongestants
nasal steroid spray
tot-inflation/valsalva

then grommets

Question 16

what does OME look like on tympanometry

Answer 16

type B

flat line curves down

Question 17

tympanometry for wax impaction

Answer 17

like OME - type B - flat line

Question 18

what type of hearing loss does cholesteatoma/CSOM cause

Answer 18

shorter term: CHL

long term if cochlea eroded: SNHL

Question 19

what is otosclerosis

Answer 19

excessive ossification around footplate of stapes, where transmits sound to oval window

progressive and conductive hearing loss. TM appearance normal.

Question 20

what happens in noise-induced hearing loss

Answer 20

permanent damage and loss of hair cells in cochlea over time

Question 21

what is presbyacusis

Answer 21

age-related reduction in hearing due to progressive hair cell death
high freq happen first

Question 22

what type of hearing loss is hearing aids for

Answer 22

conductive (implantable bone hearing aids)

Question 23

what do you use stapedectomy for

Answer 23

otosclerosis

disconnect otosclerotic stapes footplate from oval window and insert prosthesis