PassMed ENT

Question 1

What is otosclerosis ? Causes what? genes?

Answer 1

AD - onset 20-40

Otosclerosis describes the replacement of normal bone by vascular spongy bone
-> progressive conductive deafness

Question 2

Otosclerosis mx?

Answer 2

hearing aid

stapedectomy

Question 3

Most common benign neoplasm of parotod

Answer 3

warthin tumour

Question 4

Tumour affecting parotids in <1 year

Answer 4

Haemangioma

Question 5

Glue ear peak?

Presentation? other features?

Answer 5

2 years

conductive hearing loss

speech and language delay, behavioural or balance problems may also be seen

Question 6

Name 2 drugs that causes ototoxicity

Answer 6

aminoglycosides (e.g. Gentamicin), furosemide, aspirin and a number of cytotoxic agents

Question 7

Name 2 things that would make you think its a quinsy

Answer 7

prolonged 
severe pain on one side 
deviation of uvula 
difficulty opening mouth 
reduced neck movements

Question 8

A 59-year-old man presents with a severe pain deep within his right ear. He feels dizzy and reports that the room ‘is spinning’. Clinical examination shows a partial facial nerve palsy on the right side and vesicular lesions on the anterior two-thirds of his tongue. What is the most likely diagnosis? mx?

Answer 8

Ramsay hunt

oral aciclovir and corticosteroids

Question 9

Ramsay hunt features

Answer 9

auricular pain is often the first feature
facial nerve palsy
vesicular rash around the ear
other features include vertigo and tinnitus

Question 10

Differentiate thyroglossal cyst and brachial cyst

Answer 10

Thyroglossal - moves on tongue protrusion

Question 11

Which neck lump is in midline

Answer 11

dermoid

Question 12

Otitis externa in diabetics mx?

Answer 12

ciprofloxacin to cover pseudomonas

Question 13

Unilateral vs bilateral nasal polyps mx ?

Answer 13

Uni - urgent referal to ENT

Bilat - topical corticosteroids + routine referal

Question 14

ENT questions mentions Asian older man - answer is?

pres?

Answer 14

nasopharangeal ca

nexk lump / painless lymphadenopathy because of its tendency for early spread

Question 15

A 78-year-old male is recovering on the ward following a partial thyroidectomy to remove a thyroid nodule 48 hours previously.

He complains of muscle cramps and a ‘tingling sensation’ around his mouth. An ECG is performed on the ward.

Given the likely cause of his symptoms, which of the following abnormalities may be observed on his ECG?
Why?

Answer 15

Prolonged QT

Complications of thyroid surgery - damage to parathyroid glands can result in hypocalcaemia

Question 16

Barotrauma (eg diving) mx>

Answer 16

reassure and follow up - self limiting

Question 17

How long does perforated ear drum usually take to heal

Answer 17

6-8 weeks

Question 18

Conductive hearing loss right side
webber?
rinne?

Answer 18

w- localise to right

r - negative on right
[negative result = conductive FUCKIN STOOPID]

Question 19

Samter’s triad ?

Answer 19

asthma + aspirin sensitivity + nasal polyposis

Question 20

Never give amox with sore throat why?

Answer 20

incase its EBV -> scaring rash

Question 21

A 3-year-old boy is brought to surgery. His mum reports that he has been complaining of a sore left ear for the past 2-3 weeks. This morning she noticed some ‘green gunge’ on his pillow. On examination his temperature is 37.8ºC. Otoscopy of the right ear is normal. On the left side the tympanic membrane cannot be visualised as the ear canal is full with a yellow-green discharge. What is the most appropriate action?

Answer 21

Amox and review in 2 weeks

ear pain -> discharge after = otitis media

Question 22

cholesterol crystals in biosy of neck lump

Answer 22

branchial cyst

Question 23

Stridor post neck surgery?

Answer 23

contained haematoma

can also impair venous return resulting in laryngeal oedema and respiratory compromise.

Question 24

Haemorrhage 5-10 days after tonsillectomy is ? mx?

Answer 24

wound infection

antibiotics