ENT

Question 1

In pinna haematoma how do you treat and whats a possible complication of poor treatment?

Answer 1

Aspiration with firm packing of the auricle

Complication: Ischaemic necrosis -> Fibrosis (cauliflower ear)

Question 2

State 5 predisposing factors of otitis externa? (not organisms)

Answer 2

Moisture (swimming)
Trauma (fingernails)
High humidity
Absence of wax
Narrow ear canal
Hearing aids

Question 3

Name 2 organisms implicated in otitis externa?

Answer 3

Pseudomonas Aeruginosa

Staphylococcus aureus

Question 4

Describe the different types of discharges you can get from the ear and which area they’ve come from?

Answer 4

External ear
Inflammation = scanty watery discharge
Trauma = blood

Middle ear
Middle ear disease = mucous discharge
Cholesteatoma = Offensive discharge

Inner/Brain
Trauma = CSF

Question 5

Name 3 organisms that can cause otitis media?

Answer 5

Streptococcus pneumoniae
Haemophilus influenzae
Moraxella catarrhalis

Question 6

How do you manage otitis media?

Answer 6

Analgesia

Abx (Amoxicillin)

Question 7

Give 3 risk factors for developing otitis media?

Answer 7

URTI
Passive smoker
Presence of adenoids
Asthma

Question 8

What are the different causes of vertigo and how might you differentiate them?

Answer 8

Seconds to minutes = BPPV
Mins to hours = Mennieres/ Migraines
Hours to weeks = Acute vestibular failure

Question 9

What is diagnostic test for BPPV?

Answer 9

Hallpike test

Question 10

How can you manage BPPV? 3 things

Answer 10

Lower Alcohol intake
Vestibular habituation exercises
Epley manouvres

Question 11

Give 2 causative organisms of tonsillitis?

Answer 11

Group A streps (Strep. Pyogenes)
Staphyloccous’
Moraxella catarrhalis

Question 12

How do you manage tonsillitis?

Answer 12

Paracetamol +/- Difflam

Question 13

Give 2 possible complications of tonsillitis?

Answer 13

Retropharyngeal abscess
Peritonsillar abscess (quinsy)

Question 14

Give 4 possible causes of stridor?

Answer 14

Laryngomalacia
Foreign body
Croup
Epiglottitis
Anaphylaxis

Question 15

How can you clinically tell the difference between a thyroglossal cyst and goitre?

Answer 15

A cyst will move on protrusion of the tongue

Question 16

Give 4 differentials for otalgia?

Answer 16

Otitis media/externa
Mastoiditis
Trauma/Foreign body
Referred pain (dental caries, tonsilitis, pharyngitis)

Question 17

Give 5 possible complications of otitis media?

Answer 17

Mastoiditis
Hearing loss
Dizziness
Brain Abscess
Meningitis

Question 18

How can you manage otitis media +/- effusion?

Answer 18

Otitis media = Supportive and Amoxicillin

With effusion = Supportive/Abx, surgical insertion of grommet

Question 19

Describe a tympanograms:-

• Peak in the middle (0)
• Flatline
• Early peak in the negative x axis

Answer 19

1) Normal
2) Perforated membrane or effusion in the middle ear
3) Eustachian tube dysfunction

Question 20

State 4 ways you can manage epistaxis?

Answer 20

First aid - pinch soft part of nose and head forward
Cautery (with adrenaline) - silver nitrate/bipolar diathermy
Nasal packing
Surgical ligation or radiological embolisation

Question 21

Give 3 clinical features which are seen in rhinosinusitis?

Answer 21

Nasal obstruction/congestion/blockage
Facial pain/pressure
Reduction/loss of smell