ENT Summary Q's

Question 1

Patient walks into clinic with hoarseness, name 5 causes?

what examinations could be done IN CLINIC?

Answer 1

recurrent laryngeal nerve palsy, 
lung CA, 
acute laryngitis, 
gord, 
polyps, 

head and neck exam, fibre optic laryngoscopy

Question 2

causes of dysphagia? + Tests

Answer 2

Bengin Stricture (GORD, foreign body)
Malig stricture (CA)
achalasia
bulbar palsy
pharyngeal pouch

Question 3

DDx for neck lump? how would you assess cause?

Answer 3

Central : thyroid (goitre / cyst), lipoma
Lat : branchial, abscess, lymph node, salvery gland, lipoma

clinical exam and Hx –> US –> CT/cxray –> FNA

Question 4

causes of hearing loss (make sure to split them up)

Answer 4

conductive -
blockage (ottitis externa/media, earwax)
perf eardrum
faulty equipment (osteosclerosis, infection)

SN -
menieres, post-infection (meningitis), medication (gent)

Question 5

DDx of otorrhea

Answer 5

external - ottitis externa
middle - AOM with effusion / cholesteoma
csf - fx basal skull

Question 6

complications occuring after grommets inserted?

Answer 6

extrude after 3-12 months
infection (OM)
scarring

Question 7

look into the ear and suspect cholesteoma, what signs would point to this diagnosis?

Answer 7

cottage cheese/ burnt scarring appearance

hearing loss, pain, facial palsy, smelly discharge +/- vertigo

Question 8

otalgia DDx?

Answer 8

AOM, cholesteoma?? perf eardrum, ottitis externa

Question 9

most common association with tinnitus (2)

Answer 9

menieres, acoustic neuroma

Question 10

man walks in with droopy face, suspected 7th nerve palsy. 5 causes (2upper,3lower)

Answer 10

Upper - stroke, tumor,

Lower - Guillan Barre, bells, MS (both), polio

Question 11

RED FLAGS for Ear / Nose / Throat

Answer 11

Ear - csf leakage, unilat effusion, sudden hearing loss,

Nose - lost tooth, uncontrolled bleeding, unilateral obsrtuction, face pain,

throat - dysphagia, lump, hoarse, pain, stridor

Question 12

sensori neural deafness and ipsilateral tinnitus diagnosis?

Answer 12

vestibular schwannoma (aka acoustic neuroma)

Question 13

what are 2 main tests done for hearing loss investigation?

Answer 13

AUdiometry (subjective test)

tympanometry (objective)

Question 14

DDx for sore throat

Answer 14

infection (pharyngitis / tonsillitis)
abscess/quinsy
mono
malignancy
laryngopharyngeal reflux??

Question 15

menieres triad?

Answer 15

tinnitus, hearing loss, vertigo

Question 16

key words for Benign Positional Vertigo?

Answer 16

• head movments

- short duration epsiodes

Question 17

best way to split up DDx for neck lymphadenopathy?

Answer 17

Infectious/Reactive - bact/viral
Autoimmune - sarcoid/ SLE
CA - lymphoma

Question 18

patient walks in with central neck lump, what Q’s will you ask and what tests?

Answer 18

stick out tongue then ask about thyroid CF’s
do TFT’s and US
if symptomatic or abnormal TFT’s, refer to specialist

Question 19

patient has itchy ear, on examination it looks flakey and red, what is your course of action?

Answer 19

Topical ABx’s and oral steroids then discahrge

Question 20

what treatment is possible for nasal polyps? what would first course of action be if unilat obstruction?

Answer 20

intra nasal steroids –> systemic steroids –> surgery

refer immediately to ENT

Question 21

how to tell AOM and AOM with effusion apart?

Answer 21

AOM - more red, eardrum doesnt have bubbles behind it, PAINFUL

AOM with effusion - more whitish, bubbly bulging drum, painless, hearing loss

Question 22

treating AOM?

Answer 22

analgesia and amox

Question 23

if you are going to prescribe ABx;s for sore throat what must be avoided?

Answer 23

amoxicillan

Question 24

causes of vertigo (5)

Answer 24

BPV
menieres (assoc tinnitis + fullness)
vestibular neuronitis (no hearing loss/ vomiting)
acute labrinthytis (hearing loss, vomiting)
vestibular schwanoma (unilat/ tinnitus)

Question 25

pt has bells palsy, what treatment?

Answer 25

oral pred and eye drops (lube)

Question 26

what is most likely cause of tonsilitis? and what is main complication?

Answer 26

group A strep

quinsy - trismus, hot potato voice, dysphagia