Miscellaneous ENT

Question 1

Cholesteatoma definition

Answer 1

Locally destructive expansion of stratified squamous epithelium

Middle ear

Question 2

Types of cholesteatoma

Answer 2

Congenital

Acquired

Question 3

Acquired cholesteatoma causes

Answer 3

Attic perforation in chronic OM

Question 4

Presentation of cholesteatoma

Answer 4

Foul smelling white discharge

Pain / Headache

Cranial nerve involvement

Question 5

Cranial nerve sx of cholesteatoma

Answer 5

Vertigo

Deafness

Bell’s palsy

Question 6

Examination findings of cholesteatoma

Answer 6

Pearly white

Surrounding inflammation

Question 7

Complications of cholesteatoma

Answer 7

Ossicle destruction (deafness)

Meningitis

Cerebral abscess

Question 8

Mx of cholesteatoma

Answer 8

“Surgery”

That’s a direct quote

Question 9

Causes of facial nerve palsy

Answer 9

Bell’s palsy

Ramsay Hunt syndrome

Lyme disease

Stroke

Acoustic neuroma

Parotid tumour

Question 10

Features of Bell’s palsy

Answer 10

Unilateral facial weakness

Sudden onset

No forehead sparing

Question 11

Other name for Bell’s palsy

Answer 11

Idiopathic facial nerve palsy

Question 12

Prognosis of Bell’s palsy

Answer 12

Usually complete recovery in few wks

~15% have axonal degeneration (recovery around 3months)

Question 13

Mx of Bell’s palsy

Answer 13

< 72 hrs steroids speed recovery

Eye care

Question 14

Eye care for Bell’s palsy

Answer 14

Regular manual eyelid closure

Tape eye closed at night

Artificial tears if needed

Question 15

Types of allergic rhinosinusitis

Answer 15

Seasonal (Hayfever)

Perennial

Question 16

Perennial rhinosinusitis definition

Answer 16

Occurs year round

Eg. pet hair, mould

Question 17

Pathology for allergic rhinosinusitis

Answer 17

Type 1 hypersensitivity reaction

IgE mediated

Question 18

Sx of allergic rhinosinusitis

Answer 18

Sneezing

Pruritis

Rhinorrhoea

Nasal polyps

Question 19

Ix for allergic rhinosinusitis

Answer 19

Skin prick test

RAST test

Question 20

RAST test

Answer 20

Radioallergosorbent test

Blood test of IgE antibodies

Finds allergens

Question 21

Mx of allergic rhinosinusitis

Answer 21

Allergen avoidance

Medical mx

Question 22

1st line medical mx of allergic rhinosinusitis

Answer 22

Antihistamines OR Beclometasone nasal spray

Question 23

Antihistamines used for allergic rhinosinusitis

Answer 23

Cetirazine

Loratidine

Question 24

2nd line mx of allergic rhinosinusitis

Answer 24

Steroid nasal spray + antihistamine

Question 25

3rd line mx of allergic rhinosinusitis

Answer 25

Leukotrine receptor antaganoist

Question 26

4th line mx of allergic rhinosinusitis

Answer 26

Immunotherapy Induces desensitization to allergen

Question 27

Adjuvant therapy for allergic rhinosinusitis

Answer 27

Pseudoephedrine

Question 28

Sx of sinusitis

Answer 28

Dull ache over frontal / maxillary sinuses +/- post nasal drip Pain worse on bending forward Coryza

Question 29

Prognosis of sinusitis

Answer 29

Pain lasts 1-2 wks

Question 30

Ix for sinusitis

Answer 30

CT Rarely needed

Question 31

Leucoplakia definition

Answer 31

White patch on oral mucosa Does not rub off Premalignant

Question 32

Oral hairy leucoplakia definition

Answer 32

Shaggy white patch On side of tongue

Question 33

Causes of oral hairy leucoplakia

Answer 33

EBV Seen in HIV

Question 34

Aphthous ulcers definition

Answer 34

Shallow, painful ulcers Tongue / oral mucosa Heal w/o scarring Not severe

Question 35

Causes of severe oral ulcers

Answer 35

Crohn's Behcet's Pemphigoid / Pemphigus

Question 36

Rx of minor oral ulcers

Answer 36

Avoid oral trauma Avoid acidic drink/food Tetracycline / antimicrobial mouth wash

Question 37

Rx of major oral ulcers

Answer 37

Oral prednisolone Thalidomide

Question 38

Follow up for oral ulcers

Answer 38

Biopsy any ulcer not healing after 3 weeks Exclude malignancy