ENT questions

Question 1

presentation acoustic neuroma

Answer 1

unilateral sensorineural hearing loss, tinnitus
dizziness or imbalance
feeling of fullness in ear
CN affected

Question 2

CN affected in acoustic neuroma

Answer 2

CNV (corneal reflex), CNVII (facial palsy), CNVIII (vertigo, hearing loss, tinnitus)

Question 3

which ear is louder in conductive hearing loss

Answer 3

sound heard louder on side of affected ear in conductive hearing loss

Question 4

result of rinne’s test in conductive hearing loss

Answer 4

negative
bone conduction > air conduction

Question 5

what pattern of hearing loss is found in acoustic neuroma

Answer 5

sensorineural

Question 6

pathophysiology BPPV

Answer 6

calcium carbonate crystals displaced into semicircular canals
due to viral infection, head trauma, ageing
disruption of normal endolymph flow through canals

Question 7

describe dix-hallpike manouvre

Answer 7

move patients head 45 degrees towards affected ear
lie down
observe for vertigo and rotatory nystagmus

Question 8

most common cause epiglottitis

Answer 8

haemophilus influenzae type B

Question 9

features epiglottitis

Answer 9

rapid onset
high temp
stridor
tripodding

Question 10

management epiglottitis

Answer 10

senior involvement - intubation
oxygen + abx

Question 11

presentation infectious mononucleosis

Answer 11

fever
sore throat
fatigue
hepato/splenomegaly
palatal petechiae
haemolytic anaemia - cold agglutinins
rash after taking amoxicillin

Question 12

diagnosis infectious mononucleosis

Answer 12

heterophil antibody (monospot) in 2nd week illness

Question 13

menieres disease pathophysiology

Answer 13

excessive pressure and progressive dilation of endolymphatic system

Question 14

meniere’s disease features

Answer 14

vertigo
tinitus
hearing loss (sensorineural)
fullness in ear
typically unilateral

Question 15

management meniere’s

Answer 15

inform DVLA
prophylaxis with betahistine
acutely - prochlorperazine

Question 16

causes otitis externa

Answer 16

pseudomonas
stah aureus

Question 17

features otitis externa

Answer 17

ear pain
itch
discharge
red, swollen canal

Question 18

management otitis externa

Answer 18

keep ears dry
mild - moderate - combined abx and steroid drops
oral abx if systemic features
pope wicks if meatus occluded

Question 19

what is malignant otitis externa

Answer 19

infection spread to bones - osteomyelitis of temporal bone
CN involvement
meningitis
intracranial thrombosis

Question 20

common bacterial organisms otitis media

Answer 20

strep pneumoniae
haemophilus influenzae
moraxella

Question 21

features otitis media

Answer 21

otalgia
fever
recent URTI
hearing loss
discharge if membrane perforates
middle ear effusion
erythema tympanic membrane

Question 22

indication abx in otitis media

Answer 22

symptoms > 4 days
systemically unwell
immunocompromised or diseased
<2 years + bilateral
perforation and/or discharge in canal

Question 23

abx and length in otitis media

Answer 23

5-7 days amoxicillin
if penicillin allergic - erythromycin or clarithromycin

Question 24

management glue ear

Answer 24

grommets if amoxicillin fails

Question 25

management rhinosinusitis

Answer 25

conservative
if symptoms >10 days - high dose nasal steroid
no improvement in 7 days - phenoxymethylpenicillin

Question 26

nasal spray technique

Answer 26

tilt head forward
opposite hand to spray in opposite nostril
don’t sniff hard during spray
gentle inhale through nose after spray
shouldn’t taste in back of throat

Question 27

most common cause tonsilitis

Answer 27

strep. pneumoniae
EBV

Question 28

centor criteria

Answer 28

fever >38
tonsillar exudates
tender anterior cervical lymphadenopathy
no cough
abx for patients with 3/4 criteria

Question 29

fever PAIN score

Answer 29

fever
purulence
attend rapidly (3 days or less)
inflamed tonsils
no cough
2-3 points - delayed abx
>3 - abx

Question 30

surgery for tonsilitis criteria

Answer 30

> 5 episodes sore throat a year
symptoms occurring for > 1 year
episodes disabling

Question 31

borders anterior triangle

Answer 31

superior - mandible
medial - neck midline
lateral - sternocleidomastoid

Question 32

borders posterior triangle

Answer 32

anterior - sternocleidomastoid
posterior - trapezius
inferior - clavicle

Question 33

features thyroglossal cyst

Answer 33

patients <20
moves upwards with protrusion of tongue

Question 34

features cystic hygroma

Answer 34

evident at birth, present < 2 years
transilluminates

Question 35

features branchial cyst

Answer 35

swelling between angle of jaw and sternocleidomastoid in anterior triangle
does not transilluminate
presents teens/twenties

Question 36

features carotid body tumour/paraganglioma

Answer 36

pulsatile neck mass
can cause horner’s syndrome

Question 37

symbols for air and bone conduction

Answer 37

bone - sides of brackets
air - circle (right) cross (left)

Question 38

labyrinthitis vs vestibular neuronitis

Answer 38

both - vertigo due to recent viral infection
neuronitis - no hearing loss

Question 39

paraneoplastic features adenocarcinoma of lung

Answer 39

gynaecomastia
hypertrophic pulmonary osteoarthropathy

Question 40

what frequency hearing loss is lost in presbycusis

Answer 40

high-frequency lost

Question 41

what does a noise-induced hearing loss audiogram look like

Answer 41

notch down at 4000Hz

Question 42

meniere’s disease audiogram

Answer 42

low-frequency sensorineural hearing loss