Placement

Question 1

In a patient with a smoking history who presents with a hoarse voice, what should you be suspicious of

Answer 1

laryngeal cancer 
lung cancer (RLN hooks wound the hilum)

Question 2

what are common immediate complications of tonsillectomy

Answer 2

pain

haemorrhage

Question 3

what causes haemorrhage post tonsillectomy:
within 24 hours
after 24 hours
and how are they managed

Answer 3

within 24 hours - surgical error –> return to surgery

after 24 hours - infection from not eating / drinking enough –> antibiotics

Question 4

causes of gingival hyperplasia

Answer 4

phenytoin 
ciclosporin 
CCB
AML - acute myeloid leukaemia
scurvy

Question 5

where do the lymph nodes in the posterior triangle receive drainage from

Answer 5

nasopharynx

Question 6

where do the lymph nodes in the anterior triangle receive drainage from

Answer 6

larynx
buccal mucosa
tonsillar fossa

Question 7

what is Reinke’s oedema

Answer 7

vocal cords become oedematous, swollen and distended

Question 8

what is the biggest RF for Reinke’s oedema

Answer 8

smoking

Question 9

what are the 5 cardinal features to ask in an ear history

Answer 9

deafness 
discomfort 
dizziness 
discharge 
tinnitus 
defective movement

Question 10

causes of nasal collapse / saddle nose deformity

Answer 10

cocaine 
SVV - GPA, EGPA 
trauma 
infection - syphilis 
tumours 
accessory tooth

Question 11

how long would you wait to do a nasal reconstruction in someone with SVV or other systemic disease

Answer 11

12 months

to ensure there are no more flares

Question 12

what are the EPOS guidelines used for

Answer 12

rhinosinusitis and nasal polyps

Question 13

what is Surfer’s ear

Answer 13

external exostosis of the ear canal

basically bony outgrowth of the ear canal due to repeated exposure to cold water hence why it is called surfers ear

Question 14

what is tympanosclerosis

Answer 14

hardening of the tympanic membrane

Question 15

how do you approach examination of the ear

Answer 15

inspect the skin and area around the ear
look behind and in front of the ear for swelling, scars…
pull the pinna superoposteriorly in adults or inferoposteriorly in children
identify the features of the tympanic membrane and inspect ear canal

Question 16

what do you expect to see on otoscopy in a patient with glue ear / middle ear effusion

Answer 16

straw coloured fluid

retracted membrane

Question 17

what must you do in adults who present with middle ear effusions

Answer 17

check for anything that may block the Eustachian tube eg nasopharyngeal carcinoma or lymphoma

Question 18

what is a BAHA

Answer 18

bone anchored hearing aid

Question 19

what is branchiootorenal syndrome

Answer 19

AD inherited condition where there are abnormalities of the H+N involving impaired hearing and kidney malformations

Question 20

how might a cholesteatoma hide

Answer 20

they may exist behind polyps of the ear canal (which are very vascular)

Question 21

how much blood does a person have

Answer 21

70ml/kg

Question 22

indications for tonsillectomy

Answer 22

recurrent tonsillitis criteria
OSA
Malignancy
stones (rarely done now)

Question 23

when you remove a foreign body from the nose, what else should be done

Answer 23

check the naso/oropharynx and other nostril to ensure there is nothing elsewhere

Question 24

if you see nasal polyps in a child, what could that suggest

Answer 24

CF

Question 25

indications for adenoidectomy

Answer 25

OSA
malignancy
recurrent glue ear

Question 26

can you ever fully remove your adenoids?

Answer 26

no

it is not a well defined structure or encapsulated and so it would be hard to know if you had removed it all

Question 27

surgery for cholesteatoma

Answer 27

mastoidectomy

make incision behind the ear and lift ear canal and skin forward to access middle ear

Question 28

factors leading to poor wound healing

Answer 28

smoker 
DM 
liver disease - clotting, low albumin 
anaemia 
hygiene 
human factors

Question 29

where can you get a graft for the tympanic membrane

Answer 29

fascia of temporalis muscle

Question 30

what should you check the patient for following surgery to the ear

Answer 30

facial nerve function