ENT 👂🏼

Question 1

What is Meniere’s Disease?

Answer 1

The triad of tinnitus, vertigo + hearing loss.

Can also get feeling of fullness/pressure in the ears

Question 2

How do you treat ottitis externa?

Answer 2

1st line Acetic acid

If doesn’t work, give Ciprofloxacin drops

Question 3

What are the most common infectious agents seen in acute sinusitis?

Answer 3

Haemophilia influenzae
Streptococcus pneumoiae
Rhinoviruses

Question 4

What is the Px of sinusitis?

Answer 4

Facial pain (worse on leaning forward)
Nasal discharge (thick + purulent) 
Nasal obstruction 
Post-Nasal drip (may produce chronic cough)

Question 5

Acute sinusitis management?

Answer 5

DON’T offer abx unless severe

If severe, 1st line = Phenoxymethylpenicillin or Co-Amoxiclav

If present for > 10 days, high dose intranasal corticosteroids

Question 6

What condition does uvular deviation indicate?

Answer 6

Quinsy (peritonsillar abscess)

Question 7

What do purulent tonsils indicate?

Answer 7

Bacterial infection

Question 8

Which condition presents with a ‘toxic’ appearance of head extended, drooling and tripoding?

Answer 8

Epiglottitis

Question 9

What are the features of Quinsy?

Answer 9

• Severe throat pain, which literalists to one side
• Deiation of ulna to unaffected side
• Trismus (difficulty opening the mouth)
• Reduced neck mobility

Question 10

What typically predisposes you to Quinsy?

Answer 10

A peritonsillar abscess is typically a complication of bacterial tonsillitis.

Question 11

Quinsy Rx?

Answer 11

• Needle aspiration or incision + drainage, + IV Abx.

- Tonsillectomy considered to prevent recurrence.

Question 12

What is the most common cause of neck swellings?

Answer 12

Reactive lymphadenopathy.

May be a Hx of local infection or generalised viral illness.

Question 13

Thyroglossal cyst Px?

Answer 13

• Common in <20yrs old
• Midline of neck, between isthmus of thyroid and hyoid bone
• Moves upwards with protrusion of the tongue
• May be painfully infected

Question 14

Pharyngeal pouch Px?

Answer 14

• Older men
• Usually not seen, but if large then midline lump in neck that gurgles on palpation
  Sx = dysphagia, regurgitation, aspiration, chronic cough

Question 15

What is a Cystic Hygroma?

Answer 15

A cystic hygroma is a congenital lymphatic lesion (lymphangioma) typically found in the neck, classically on left side.

Most evident before 2yrs old.

Question 16

What is a Branchial cyst?

Answer 16

• An oval, mobile cystic mass that develops between the sternocleidomastoid muscle and the pharynx
• Develop due to failure of obliteration of the second branchial cleft in embryonic development
• Usually present in early adulthood

Question 17

Carotid aneurysm Px?

Answer 17

Pulsatile lateral neck mass which doesn’t move on swallowing

Question 18

What is the treatment of sudden-onset sensorineural hearing loss?

Answer 18

High-dose oral corticosteroids