treatments

Question 1

epistaxis

Answer 1

resuscitate 
pressure, ice
remove clot - nose blowing, suction
30 degree rigid nasendoscopy 
cauterise vessel

Question 2

csf leak

Answer 2

should stop within 10 days if not then immediate repair

Question 3

treatment for pinna haemaoma

Answer 3

aspirate
incision and draining
pressure dressing

Question 4

treatment for temporal bone fracture

Answer 4

facial nerve decompression
manage csf leak
hearing restoration

Question 5

treatment of neck injury

Answer 5

abcde

angiography - Embolize, occlude

Question 6

orbital blowout fracture

Answer 6

surgical repair if entrapment, large defect, significant enopthalmus

Question 7

treatment for acute tonsillitis

Answer 7

penicillin 10 days (clarithro 5 days)
hospital if not managing at home - IV fluids, IV abs, steroids
surgery only if 7 or more episodes in 1 year, 5 or more episodes in 2 years and 3 or more episodes in 3 years

Question 8

treatment of quinsy

Answer 8

aspiration
benzyl penicillin (IV)/penicillin for 10 days (clinda)
if unable to swallow IV clindamycin
if not resolved by 48 hours add metronidazole to penicillin

Question 9

infectious mononucleosis

Answer 9

bed rest
paracetamol
avoid sport - risk of splenic rupture (rare)
steroids if complications present

Question 10

BPPV

Answer 10

epleys manœuvre
brandt daroff exercises
semont manouvre

Question 11

treatment of vestibular neuronitis and labrynthitis

Answer 11

supportive with vestibular sedatives
self limiting
if prolonged - further investigations and may be helped by rehab exercises

Question 12

menieres disease

Answer 12

supportive treatment during episodes 
prevention - salt, alcohol, caffeine, stress, beta histamine 
tinnitus therapy, hearing aids
grommet insertion 
tympanic gent/surgery

Question 13

nasal polyps

Answer 13

oral the topical antibiotics

Question 14

diphtheria

Answer 14

antitoxin

penicillin/erythromycin

Question 15

candida/oral thrush

Answer 15

nystatin suspension

Question 16

otitis externa

Answer 16

topical aural toilet
mild - no swab acetic acid for 7 days
mod - no swab gent
if unresolving swab and treat according to culture results
pseudomonas - topical gent
fungal - topical clotrimazole
ear canal oedema - topical corticosteroid

Question 17

acute sinusitis

Answer 17

if uncomplicated don’t give antibiotics - will resolve in 14 days
complicated - penicillin/doxycycline

Question 18

glue ear

Answer 18

self limiting but refer if:
persistant (>3/12), bilateral, speech, language developmental problems
under 3’s grommets
over 3s grommets first line then second line is grommets and adenoidectomy

Question 19

aom

Answer 19

resolve (80%) in 4 days without abs

bilateral in under 2s or aom with otto rhea treat. amoxicillin for 5 days or clarithro for 5 days