ENT - throat

Question 1

What is a deep neck space infection?

Answer 1

Infection spread from the oropharyngeal region to form either parapharyngeal or retropharyngeal abscess

Question 2

Most common organism causing DSNIs?

Answer 2

Strep Viridians

Question 3

Features of DSNIs?

Answer 3

Severe sore throat, difficulty swallowing, voice changes, neck stiffness
Fever,

Question 4

What should you do in examination for DSNI?

Answer 4

fibreoptic nasal endoscopy

Question 5

Ix for Dsnis?

Answer 5

Blood cultures

CT neck with IV contrast!

Question 6

Mx of DSNIs?

Answer 6

Broad spectrum antibiotics!
Fluids and humidified oxygen w nebulisers
Senior support

+ SURGICAL drainage and washout is definitive management

Question 7

Definition of Obstructive Sleep apnea?

Answer 7

over 5 events per hour

associated symptoms: excessive day sleepiness and reduced concentraion

Question 8

How can you quantify abnormal daytime sleepiness?

Answer 8

Epworth sleeping scale >10 = problem

Question 9

Ix and grading of sleep apnea?

Answer 9

Polysomnography
Apnea-Hypopnea Index:

Mild 5 -14
Moderate 15-30
Severe >30

Question 10

Mx of sleep apnea?

Answer 10

Lifestyle advice about obesity

CPAP

Intra-pral devices

Question 11

Mx for children with large adenoids that have sleep apnea?

Answer 11

Tonsillectomy/Adenectomy!

Question 12

If on CPAP, need to inform which organisation

Answer 12

DVLA

Question 13

What is a complication of sleep apnea?

Answer 13

Cardiovascular co-morbidities - check cardiovascular risk profile regularly

Question 14

What is the criteria to check likelihood of tonsillitis being bacterial?

Answer 14

Centor criteria

Question 15

What are the Centor criteria?

Answer 15

Antibiotics considered if 2 or more of:

Tonsil exudates
Fever
No cough
Tender lymph nodes

Question 16

Mx of uncomplicated tonsillitis?

Answer 16

Hydration and painkillers

Question 17

If bacterial tonsillitis, which antibiotic to avoid?

Answer 17

Amoxicillin in case it’s EBV –> maculopapular rash

Question 18

Indications for surgery for tonsillectomy?

Answer 18

7 or more in one year
5 or more two years each
3 or more three years each

Malignancy suspected

Sleep apnea

Two peritonsillar abscesses

Question 19

complication of tonsillectomy and how to manage it?

Answer 19

Post-op bleeding

antibiotics and hydrogen peroxide mouthwash

Question 20

What is a complication of tonsillitis?

Answer 20

Peritonsillar abscess

• uvula deviated, lots of pain

Question 21

Mx of peritonsillar abscess?

Answer 21

IV antibiotics, painkillers and needle aspiration or surgical drainage