ENT

Question 1

Which cranial nerve supplies the intrinsic muscles of the tongue?

Answer 1

Hypoglossal

Question 2

Which facial bone contributes significantly to both lateral walls of the nasal cavity and the nasal septum?

Answer 2

Ethmoid

Question 3

Which muscle connects the tongue to the temporal bone?

Answer 3

Styloglossus

Question 4

Attachment points for the temporalis muscle?

Answer 4

Lateral surface of the skull and coronoid process

Question 5

Which nerve supplies both taste and somatic sensation to a part of the tongue?

Answer 5

Glossopharyngeal

Question 6

Management of sudden SN hearing loss with no trigger?

Answer 6

High dose prednisolone PO
If this fails: intra-tympanic dexamethasone

Question 7

Gradual and symmetrical bilateral hearing loss in older patient?

Answer 7

Presbycusis

Question 8

Unilateral hearing loss better with background noise and quiet voice?

Answer 8

Otosclerosis

Question 9

Singular nasal polyp in asthma patient?

Answer 9

Sign of NP cancer
Urgent ENT referral

Question 10

Down syndrome, recurrent ear infection and air-bone conduction gap on audiogram?

Answer 10

Bilateral conductive hearing loss
Likely caused by glue ear

Question 11

Management of bacterial otitis externa

Answer 11

Ciprofloxacin ear drops
If cipro resistant, sofradex ear drops

Question 12

How to differentiate between stroke and TIA?

Answer 12

Stroke does not resolve

Question 13

First line management of unilateral nosebleed of 30 mins?

Answer 13

Nasal cautery

Question 14

Define tympanosclerosis

Answer 14

Calcium phosphate plaques forming in the lamina propria of the tympanic membrane after increased fibroblast activity depositing collagen

Question 15

Investigation of suspected nasophar cancer?

Answer 15

Flexible nasal endoscopy

Question 16

Ear discharge with halo sign on filter paper?

Answer 16

Basal skull fracture (CSF leak causing halo)

Question 17

Unilateral conductive hearing loss would cause what signs on Rinne’s?

Answer 17

Negative Rinne’s test on the ipsilateral side

Question 18

Most common parotid gland malignancy

Answer 18

Mucoepidermoid carcinoma

Question 19

Management of suspected paranasal sinus cancer

Answer 19

2 week ref to ENT

Question 20

Paget’s is assoc with what ENT condition

Answer 20

Conductive hearing loss

Question 21

History of atopy, 5 cigs per day, pressure behind face - no systemic symtpoms?

Answer 21

Chronic sinusitis
- saline nasal irrigation
- steroid nasal sprays or drops (e.g., mometasone or fluticasone)
- functional endoscopic sinus surgery (FESS)

Question 22

First line for tonsillitis with penicillin allergy

Answer 22

Clarithromycin

Question 23

Diagnostic investigation of cholesteatoma

Answer 23

CT head
- plans for surgical removal of cholesteatoma

Question 24

Labrynthitis vs vestibular neuritis?

Answer 24

Lab = hearing loss
VN = no hearing loss

Question 25

What 4 extra-ENT tests should you run in tinnitus?

Answer 25

FBC for anaemia Glucose for DM TSH for thyroid disorder Lipids or hyperlipidaemia

Question 26

Dix-Hallpike vs Epley in BPPV?

Answer 26

Dix-Hallpike is diagnostic (Dix=Dx) Epley is for management

Question 27

What causes a black and hairy tongue?

Answer 27

Decreased exfoliation of keratin from tongue surface - dehydration, dry mouth, poor oral hygeine, smoking

Question 28

Pathophysiology of Ménière's disease

Answer 28

Excessive buildup of endolymph in labyrinth of inner ear

Question 29

Short term management for vestibular neuritis

Answer 29

Prochlorperazine Antihistamine (can be used up to 3 days)

Question 30

Management to reduce frequency of Ménière's attacks

Answer 30

Betahistine

Question 31

Most common bacterial cause of OME

Answer 31

Group A strep (strep pyogenes)

Question 32

Most common bacterial causes of otitis externa

Answer 32

Pseudomonas aeruginosa Staph aureus

Question 33

Painless, pulsatile neck lump in anterior triangle with bruit and only side-to-side mobility?

Answer 33

Paraganglioma - imaging shows splaying of internal/external carotids - manage with surgical removal

Question 34

Presentation of eustachian tube dysfunction?

Answer 34

Reduced/altered hearing, popping, pain, tinnitus, fullness - symptoms worsen with pressure changes

Question 35

Management of acute otitis externa

Answer 35

Neomycin, dexamethasone, acetic acid spray

Question 36

Management of acute necrotising ulcerative gingivitis

Answer 36

Metronidazole Review by dentist

Question 37

Differentiating between a facial palsy and stroke?

Answer 37

Upper motor neurone = foreheaad can move, STROKE Lower motor neurone = forehead can't move on one side, prob not stroke

Question 38

Management of vestibular schwannoma

Answer 38

Benign but can develop Small/medium tumours = repeat scan in 6 months Larger than 40mm/fast growing = surgical resection

Question 39

First line management of TMJD

Answer 39

Explanation and reassurance (due to stress) - may refer to CBT or physio - potentially dental occulsion therapy or surgery

Question 40

When is CT indicated in mastoiditis?

Answer 40

If no improvement with admission ad IV antibiotics - to assess invasion into neuro structures

Question 41

When to reverse anticoagulation in patients with AF and epistaxis?

Answer 41

Minor bleeding, INR above target range - stop warfarin, give vit K (+PT complex if major haemorrhage)

Question 42

Which parotid gland cancer can invade and cause facial nerve palsy?

Answer 42

Adenoid cystic carcinoma

Question 43

Incision drainage or needle aspiration for quinsy?

Answer 43

Aspiration - decreases likelihood of injury to carotid

Question 44

What would indicate immediate hospital admission in a child with tonsillitis?

Answer 44

Signs of dehydration - dry tongue, no eating or drinking for prolonged tme Airway compromise Systemically unwell

Question 45

Management of pinna haematoma

Answer 45

Antibiotics + Incision with primary closure - then compression banding

Question 46

Management of pinna haematoma

Answer 46

Antibiotics + Incision with primary closure - then compression banding

Question 47

Which tumour of parotid gland is well-circumscribed, usually bitlateral (can happen at diff times) and assoc with smoking?

Answer 47

Warthin's tumour

Question 48

Loop diuretic (rarely) causing SN hearing loss

Answer 48

Furosemide

Question 49

Progressive hearing loss with intermittent attacks that sound like Ménière's?

Answer 49

Vestibular schwannoma

Question 50

Reinke's oedema presenting with voice hoarseness is linked to which disorder

Answer 50

Hypothyroidism

Question 51

When to prescribe antibios in acute rhinosinusitis?

Answer 51

10 days of persistent symptoms or presence f worrying symptoms

Question 52

Visual symptom assoc with vestibular schwannoma

Answer 52

Loss of corneal reflex

Question 53

After how long a course of amoxicillin is grommet insertion indicated in glue ear?

Answer 53

2-6 weeks

Question 54

How can throat cancer cause otalgia?

Answer 54

Referred pain via V3 of trigeminal nerve

Question 55

Non-tender and rubbery lymph nodes suggests?

Answer 55

Hodgkin's lymphoma

Question 56

When should vestibular schwannomas be operated on?

Answer 56

>40mm

Question 57

Sensorineural deafness found at 2 years is most likely caused by?

Answer 57

Congenital cytomegalovirus

Question 58

14y/o boy with hearing loss, tinnitus and dizziness with no aural fullness could suggest

Answer 58

Otosclerosis

Question 59

Tenderness over hyoid bone assoc with stridor...

Answer 59

Supraglottitis - manage with nebulised adrenaline and IV dexamethasone

Question 60

When should you do nasal packing?

Answer 60

If cautery fails If bleeding is not visible

Question 61

Management of vestibular neuronitis

Answer 61

Oral prochlorperazine

Question 62

Which type of NF is assoc with bilateral vestibular schwannoma?

Answer 62

NF2

Question 63

How to differentiate between presentation of VN and Ménière's disease?

Answer 63

VN - tends to come on more suddenly Ménière's - episodic and fluctuating hearing loss