High Yield Exam Cram

Question 1

What is the most common histological type of head and neck cancer?

Answer 1

squamous cell carcinoma

Question 2

What are some of the risk factors associated with squamous cell carcinoma?

Answer 2

• Chewing betel quid or tobacco
• HPV 16 & EBV
• Smoking and alcohol

Question 3

What are the 2 most common causes of otitis externa

Answer 3

Pseudomonas aeruginosa & s. aureus

Question 4

What is the treatment for mild otitis externa?

Answer 4

topical acetic acid 2%

Question 5

What is the treatment for moderate otitis externa?

Answer 5

topical abx and steroid (Otomize spray = neomycin, dexamethasone and acetic acid)

Question 6

What is the treatment for severe otitis externa?

Answer 6

oral or IV abx

Question 7

What is the treatment for fungal otitis externa?

Answer 7

clotrimazole

Question 8

How do pathogens get access to the middle ear in order to cause otitis media?

Answer 8

Pathogens enter from the back of the throat via the Eustachian tube

Question 9

What are the two most common bacterial causes of otitis media?

Answer 9

strep pneumoniae & H. influenzae

Question 10

How is otitis media managed?

Answer 10

Analgesia only unless :
* >4 days & not improving
* systemically unwell
* Ruptured eardrum
* <2 years old and bilateral

In cases as above, give Amoxicillin

Can give a Delayed prescription of abx (3 day delay) if suspect symptoms may worsen

Question 11

what is the risk associated with mastoiditis?

Answer 11

can cause intracranial infection if left untreated

Question 12

How are peripheral and central causes of vertigo differentiated?

Answer 12

HINTs test

Question 13

What causes BPPV?

Answer 13

otolith crystal free in the semi-circular canal

Question 14

How does BPPV present?

Answer 14

Short bursts of vertigo and nystagmus triggered by head movement

Question 15

How is BPPV diagnosed?

Answer 15

Dix-Halpike manoeuvre

Question 16

How is BPPV treated?

Answer 16

Eply manoeuvre

Question 17

What causes labrynthitis?

Answer 17

Inflammation of the semi-circular canals, vestibule and cochlea (usually triggered by a recent viral URTI)

Question 18

How does labrynthitis present?

Answer 18

Vertigo
Tinnitus
Hearing loss

Question 19

How is labrynthitis managed?

Answer 19

Prochlorperazine
Antihistamines

Question 20

What causes Ménière’s?

Answer 20

Excessive build-up of endolymph

Question 21

How does Ménière’s present?

Answer 21

Episodic Vertigo
Tinnitus
Unilateral sensioneural
hearing loss
Unidirectional nystagmus

Question 22

How is Ménière’s managed?

Answer 22

Manage symptoms during an attack
Prochlorperazine
Antihistamines

Question 23

What drug is given as Ménière’s prophylaxis?

Answer 23

Betahistine

Question 24

What causes vestibular neuritis?

Answer 24

Inflammation of the vestibular nerve (usually triggered by a recent viral URTI infection)

Question 25

How does vestibular neuronitis present?

Answer 25

Vertigo NO hearing loss!

Question 26

How is vestibular neuronitis managed?

Answer 26

Prochlorperazine Antihistamines

Question 27

What time frame counts as 'rapid onset' hearing loss?

Answer 27

<72 hours

Question 28

What should happen if a patient has rapid onset sensioneural hearing loss?

Answer 28

Refer to ENT

Question 29

What is the hearing test conducted in the newborn period (and what is the 2nd line test if they fail the first one?)

Answer 29

Otoacoustic Emissions then Auditory Brain stem responses if they fail the first test

Question 30

What is the hearing test conducted from 6-18 months?

Answer 30

Distraction test

Question 31

what is the hearing test conducted in children aged 1-3 years?

Answer 31

Visual reinforced audiometry

Question 32

What is the hearing test conducted in children aged 3-5 years?

Answer 32

Play audiometry

Question 33

What is the hearing test conducted in those >4 years old?

Answer 33

Pure tone audiometry

Question 34

How are Rinne's and Weber's interpreted?

Answer 34

Rinne’s * Positive test = normal Weber’s * Sensioneural = louder in normal ear * Conductive = louder in abnormal ear

Question 35

Name three medications/types of medication that cause sensioneural hearing loss

Answer 35

- Loop diuretics - Gentamycin (aminoglycoside abx) - Chemotherapy (cisplatin)

Question 36

What is plotted on the x and y axis of an audiogram

Answer 36

X = Frequency Y = Volume

Question 37

Above what decibels is considered a normal hearing range?

Answer 37

>20dB

Question 38

What does conductive hearing loss look like on an audiogram?

Answer 38

Gap between the lines

Question 39

What does sensioneural hearing loss look like on an audiogram?

Answer 39

drops off

Question 40

what is the name given to age related hearing loss

Answer 40

Presbycusis

Question 41

Which pitch of sounds are lost first in presbycusis?

Answer 41

High pitched sounds

Question 42

Which pitch of sounds are lost first in otosclerosis:?

Answer 42

Low pitched sounds

Question 43

How is otosclerosis managed?

Answer 43

Hearing aids, stapedectomy or stapedotomy

Question 44

What condition is associated with bilateral acoustic neuromas?

Answer 44

Neurofibromatosis Type II

Question 45

Where in the brain are acoustic neuromas found?

Answer 45

Cerebellopontine angle

Question 46

How can acoustic neuromas be managed?

Answer 46

conservative management, surgery or radiotherapy

Question 47

Name 4 causes of sinusitis

Answer 47

- Infection - Allergy - Obstruction of drainage (trauma, polyp, foreign body) - Smoking

Question 48

How should acute sinusitis be managed?

Answer 48

Watch and wait for first 10 days Then 14 days of steroid nasal spray and a 7 day delayed abx prescription

Question 49

How should chronic sinusitis be managed?

Answer 49

- Saline nasal irrigation - Steroid nasal sprays - Functional endoscopic sinus surgery

Question 50

Name 6 causes of nasal polyps

Answer 50

- Asthma - chronic rhinitis - sinusitis - Cystic fibrosis (test for this using the sweat test) - Allergic fungal sinusitis - Churg-Strauss syndrome

Question 51

How are nasal polyps managed?

Answer 51

Bilateral = nasal steroids to shrink themor polypectomy Unilateral = urgent referral to ENT

Question 52

What is the most common cause of tonsillitis

Answer 52

Viral cause

Question 53

What is the most common bacterial cause of tonsillitis?

Answer 53

Group A strep (strep pyogenes)

Question 54

What is the antibiotic of choice in bacterial tonsillitis? How long should the course be?

Answer 54

Phenoxymethylpenicillin (10 days)

Question 55

What are the indications of antibiotic prescription in patients with bacterial tonsillitis?

Answer 55

Centor score ≥ 3 FeverPAIN score ≥ 4 immunocompromised very young co-morbid rheumatic fever

Question 56

What are the indications for tonsillectomy?

Answer 56

- 7 or more in 1 year - 5 per year for 2 years - 3 per year for 3 years - >2 episodes of quinsy - Enlarged tonsils causing difficulty breathing, swallowing or crying

Question 57

How should a post tonsillectomy bleed be managed A) within 24 hours of tonsillectomy B) >24 hours post tonsillectomy

Answer 57

A) return to theatre B) admit for IV ABx

Question 58

What should you worry about if you see a patient with leukoplakia or eryhtoplakia?

Answer 58

They are pre-cancerous lesions- refer!!

Question 59

What causes gingival hyperplasia?

Answer 59

vit C deficiency pregnancy AML gingivitis

Question 60

What causes glossitis?

Answer 60

iron deficiency anaemia B12 deficiency folate deficiency coeliac disease

Question 61

What causes geographic tongue?

Answer 61

stress mental illness psoriasis atopy diabetes

Question 62

What causes strawberry tongue?

Answer 62

Kawasaki disease and scarlet fever

Question 63

What causes black hairy tongue?

Answer 63

dehydration dry mouth poor oral hygiene smoking