Management in ENT

Question 1

How long does acute pharyngitis normally last and what is the management?

Answer 1

3-4 days

supportive/analgesia

Question 2

When should immediate antibiotic prescription be considered for tonsillitis?

Answer 2

patients with 3 or more condor criteria, very unwell, signs/symptoms of complications eg peritonsillar abscess

Question 3

Peritonsillar abscess treatment?

Answer 3

same day hospital admission for aspiration and drainage
IV antibs such as benzylpenicillin
2 episodes indicate tonsillectomy

Question 4

Glandular fever treatment?

Answer 4

analgesia, antipyretics, advice

Question 5

What advice should glandular fever patients be given?

Answer 5

avoid contact sports for 6 weeks

Question 6

Treatment of parapharyngeal abscess should focus on what?

Answer 6

ensure airway obstruction does not occur

Question 7

Treatment of retropharyngeal abscess should focus on what?

Answer 7

emergency admission under ENT specialist (risk of airway compromise)
Airway care, drainage of abscess, IV antibiotics

Question 8

Treatment of oral candida?

Answer 8

miconazole gel or nystatin for less severe

For severe infection: systemic treatment with fluconazole

Question 9

Treatment for epiglottitis?

Answer 9

emergency referral for airway care

IV antibiotics

Question 10

Treatment of scarlet fever?

Answer 10

antibiotics

Question 11

Treatment for dipetheria?

Answer 11

IV benzylpenicillin (also refer)

Question 12

Treatment of rhinitis?

Answer 12

allergen avoidance, antihistamine, topic steroids, then topical steroids AND antihistamine

Question 13

Treatment of nasal polyps?

Answer 13

steroids

Question 14

Treatment of nasal trauma?

Answer 14

manipulation under anaesthesia

Question 15

Treatment of septal haematoma?

Answer 15

needs to be drained

Question 16

Treatment of sinusitis?

Answer 16

Nasal decongestants, broad spectrum antibs, steam inhalations, inflammatory therapy
May need drainage of sinus - functional endoscopic sinus surgery

Question 17

Treatment of presbycusis?

Answer 17

hearing aids

Question 18

Acoustic neuroma treatment?

Answer 18

surgery difficult/often not necessary

Question 19

Treatment of OME?

Answer 19

surgical interventation: if below 3 = grommets, if over 3 = grommets and adenoidectomy

Question 20

Treatment of AOM?

Answer 20

80% resolve in 4 days without antibiotics

Question 21

Treatment of cholesteatoma?

Answer 21

mastoid surgery

Question 22

Treatment of mastoiditis?

Answer 22

hospitalization, antibiotics, myringotomy

Question 23

Treatment of bullous myringitis?

Answer 23

supportive treatment

Question 24

Treatment of barotrauma?

Answer 24

supportive

Question 25

Treatment of otitis externa?

Answer 25

topical aural toilet

treatment depends on culture eg topical clotrimazole for aspergillus niger

Question 26

If otitis externa is resistant to treatment, what may this suggest?

Answer 26

malignancy

Question 27

Treatment of TMJ dysfunction?

Answer 27

NSAIDs eg diclofenac, stabilizing orthodontic occlusal prostheses, cognitive therapy

Question 28

Treatment of vestibular neuronitis?

Answer 28

supportive with vestibular sedatives

generally self limiting

Question 29

Treatment of pinna haematoma?

Answer 29

drainage quickly

Question 30

Treatment of nasal polyps?

Answer 30

oral then topic steroids

Question 31

Treatment of otosclerosis?

Answer 31

hearing aid and surgery
fluoride
cochlear implant