passmed

Question 1

Rinnes test is negative

Answer 1

Bone conduction is better then air conduction - conductive deafness

Question 2

Webber’s test : sound is localised on the left ear …

Answer 2

If conductive deafness then sound localises to the affected ear
If sensorineural deafness then sound localises to the unaffected ear

(Unilateral)

Question 3

Persistent mouth ulcer for over 4 weeks (herpes simplex virus) ? What to do

Answer 3

Refer to secondary care under 2 - week wait

Although yes oral aciclovir is used as treatment for HSV - need to rule out cancer

Question 4

What is nasopharyngeal carcinoma

Answer 4

Squamous cell carcinoma of the naropharynx
Associated with EBV - southern Chinese origin

Question 5

Signs and symptoms of nasopharyngeal carcinoma

Answer 5

Otalgia
Unilateral serious otitis media
Nasal obstruction / epistaxis
Cranial nerve palsies (III

Question 6

What would you expect to see in Rinnes and Webber test in a woman (40yrs) with reduced hearing on R side due to blocked ear canal with wax - left ear is clear

Answer 6

Weber = sound localises to the right (blocked ear canal = conductive hearing loss, lateralises on the affected side)
Rinne = negative (conductive) BC >

Question 7

First line for impacted earwax

Answer 7

Olive oil drops for 1 week

Question 8

Symptoms of viral labyrinthitis

Answer 8

sudden onset horizontal nystagmus
Hearing disturbances
Nausea
Vomiting and vertigo

Question 9

What is the HiNTS exam

Answer 9

Head Impulse
Nystagmus
Test of skew
Hearing

This is used to distinguish certain diseases from a posterior circulation stroke

Question 10

Management of vestibular neuronitis

Answer 10

Buccal or intramuscular prochlorperazine is often used to provide rapid relief for severe cases

*vestibular rehab exercises are the preferred treatment for patients who experience chronic symptoms

Question 11

Most common causative organism for acute otitis media

Answer 11

Strept. Pneumoniae, haemophilus influenzae

Question 12

Who needs to be referred to ENT with otitis media with effusion as oppose to ‘watch and wait approach’

Answer 12

Children with Down syndrome or cleft palate

Question 13

What is OME aka

Answer 13

glue ear

Question 14

empty nose syndrome symptoms

Answer 14

Shortness of breath, nasal dryness, nasal obstruction with no signs of obstruction

Usually following an inferior turbinate reduction