ENT

Question 1

`difference between chronic suppurative otitis media and chronic serous otitis media

Answer 1

Suppurative: tympanic membrane ruptured, +/- cholesteatoma, chronic otorrhoea for 6-12 weeks

Serous: tympanic membrane not ruptured, persists more than 4-12 weeks.

Question 2

Common organism for chronic suppurative otitis media?

Answer 2

P, aeruginosa

Question 3

Treatment of tonsillitis

Answer 3

phenoxymethylpenicillin 10days

Question 4

Centor criteria for tonsillitis

Answer 4

fever = 1
exudate on tonsils = 1
no cough = 1
tender lymphadenopathy = 1
age(3-14) = 1

Question 5

feverPAIN score

Answer 5

1 point for:
- fever >38
- purulent (pharyngeal or tonsillar exudate)
- no cough or coryza
- severely inflammed tonsils
- attend rapidly (3 days or less from onset of symptoms)

Question 6

the triad of Meniere’s disease

Answer 6

fluctuant hearing loss
vertigo
tinnitus

Question 7

treatment of meniere’s disease

Answer 7

vestibular rehabilitation
prochlorperazine - acute attacks
betahistine - preventative treatment

Question 8

otosclerosis VS cholesteatoma VS acoustic neuroma

Answer 8

otosclerosis: autosomal dominant, young patients, positive family history, normal bone is replaced by vascular spongy bone, pink tinge on eardrum (schwartz sign) tx: hearing aids or stapedectomy

cholesteatoma: unilateral destruction and expanding growth of skin cells, changes on eardrum, presents with ear discharge and conductive hearing loss, tx: surgical removal of growth

acoustic neuroma: found in cerebellopontine angle

Question 9

Major diagnostic symptoms of chronic sinusitis

Answer 9

12 weeks non-resolution of symptoms with:
- nasal obstruction
- nasal discharge
- facial pain
- loss of smell

Question 10

what is pseudopseudohypoparathyroidism

Answer 10

have features of pseudohypoparathyroidism: short 4th and 5th metacarpals, round face, short stature, basal ganglia calcification, decreased IQ

Question 11

Non-sedating antihistamine

Answer 11

Ceterizine
Loratadine

Question 12

Indications for tonsillectomy

Answer 12

cancer or suspected cancer
tonsillar haemorrhage
quinsy
Immunocompromised patients or other diseases such as diabetes, cystic fibrosis, guttate psoriasis
ALL of the following criteri: >= 5 episodes in the last year or >5episodes/year over a 2 year period or >3episodes/year over a 3 year period, symptoms for at least a year, episodes of sore throat are disabling and preventing normal function

Question 13

which drugs are ototoxic?

Answer 13

aminoglycoside: gentamicin, neomycin, streptocycin

loop diuretic: furosemide, ethacrynic acid

Question 14

most common organism causing otitis externa

Answer 14

pseudomonas

staph aureus

Question 15

treatment of cholesteatome

Answer 15

surgical removal

Question 16

side effect of chloramphenicol (topical/oral/pregnancy)

Answer 16

oral during pregnancy (esp 3rd trimester) - neonatal grey baby syndrome

topical: unknown for systemic effect but can cause eye stinging, skin reaction, angioedema, bone marrow disorders, fever, paraesthesia

oral: bone marrow suppression

Question 17

how to treat conjunctivitis?

Answer 17

viral: supportive

bacterial: only give abx after 3 days supportive tx: chloramphenicol eyedrops 0.5%, ointment 1% -> fusidic acid 1% as 2nd line

Question 18

vestibular neuronitis VS labrynthitis
differences in PC?

Answer 18

both has: vertigo, nystagmus to the opposite side of lesion, n&v

vestibular neuronitis will not have tinnitus or deafness (but labrynthitis has both)

post URTI

Question 19

Treatment of labrynthitis

Answer 19

anti-emetic: prochlorperazine, promethazine, cyclizine

vestibular sedative: cinnarizine (calcium blocker and histamine antagonist), betahistine (histamine analogue)

Question 20

what diseases can you associate with livedo reticularis?

Answer 20

idiopathic (most common)
polyarteritis nodosa
systemic lupus erythematosus
cryoglobulinaemia
antiphospholipid syndrome
Ehlers-Danlos Syndrome
homocystinuria

?polymyositis
?RA
?lymphoma
?TB
?Raynaud’s

Question 21

management of acute sinusitis

Answer 21

paracetamol/ibuprofen
topical nasal decongestant (not oral)
nasal irrigation with warm saline solution
adequate fluid and rest
antibiotics usually in severe/prolonged infection (>5 days) : phenoxybenzylpenicillin

Question 22

common organism for sinusitis

Answer 22

strep pneumonia
haem influenza
moraxella catarrhalis

Question 23

treatment of chronic suppurative otitis media

Answer 23

aminoglycoside or quinolone eardrop
(common organism is pseudomonas)