Rhinotology CBD

Question 1

25 y/o W, 2wk history of pain and discharge from ear
Most appropriate Rx:
a - systemic antibs
b - topical antibs
c - Syringing
d - myringoplasty

Answer 1

Topical antibiotics

Syringing would put more fluid on ear

Question 2

A 5 year old girl, parents are concerned about
her hearing. An audiogram shows a conductive hearing loss 25dB
bilaterally

The most appropriate Rx would be:

a. nasal decongestant
b. systemic antibiotics
c. grommet insertion
d. review in 3 months

Answer 2

Review in 3 months, grommets likely the only Rx to work

Question 3

A 60 year old man presents with a 5 year history of bilateral tinnitus

The most appropriate Rx
would be:
a. systemic steroids
b. cochlear nerve section
c. ear plugs
d. hearing aids

Answer 3

Hearing aids - likely Dx Presbycusis

Question 4

60 yo M presents with
a 5 year history of episodes of vertigo
associated with hearing loss, tinnitus
and pressure in right ear.

The most appropriate treatment
would be:
a. bendroflumethazide
b. vestibular rehabilitation
c. propranolol
d. Epley manoevre

Answer 4

Bendroflumethazide

patient likely Dx with Meniere’s disease

Question 5

25 yo man presents
with left sided nasal obstruction after a nasal injury 3 months ago

Most appropriate
management would be:
a. manipulation under anaesthesia
b. septoplasty
c. septorhinoplasty
d. CT scan of sinuses

Answer 5

Septorhinoplasty

Question 6

30 yo woman presents with episodes of severe pain above the left
eye, photophobia, visual disturbance, not
improved by a nasal steroid spray

The most appropriate management would be:

a. oral steroids
b. amitriptiline
c. CT scan of sinuses
d. endoscopic sinus surgery

Answer 6

Amitriptiline

Question 7

A 25 year old man presents with nasal obstruction. No response to maximal medical treatment. The most appropriate management would be:

a. nasal polypectomy
b. septoplasty
c. reduction of inferior turbinates
d. endoscopic sinus surgery

Answer 7

Reduction of inferior turbinates or nasal polypectomy - depending on what causes obstruction

Question 8

5 year old girl presents with a 2 month history of an offensive discharge from the left nostril. Uncooperative with examination.

The most appropriate management
would be:
a. examination under anaesthesia
b. systemic antibiotics
c. nasal steroid spray
d. CT of sinuses

Answer 8

Examination under anaesthesia as this is the classic presentation of a foreign body in the nose