ENT

Question 1

where do superficial lymph nodes receive lymph from

Answer 1

scalp
face
neck

Question 2

name 5 superficial lymph nodes

Answer 2

post auricular
pre auricular
parotid
submental
submandibular

Question 3

examples of cutaneous things

Answer 3

sebaceous cyst
lipoma
skin neoplasms

Question 4

NICE referral guidelines for neck lumps

Answer 4

if suspected, allow 2-4 weeks to settle if not»_space; USOC referral

if lump plus red flags»_space; USCO referral

generalised lymphadenopathy or B symptoms need FBC and consider referral

if >40 years old needs CXR to exclude lung cancer, TB or sarcoid

Question 5

red flags in H+N cancer

Answer 5

oral lump, erythroplakia, erythroleukoplakia
unexplained oral ulceration lasting more than 3 weeks
persistent or unexplained neck lump
persistent throat pain or painful swallow
stridor

Question 6

what is oropharyngeal malignancy

Answer 6

cancer of the tonsil or tongue base

Question 7

increasing common cause of oropharyngeal malignancy

Answer 7

HPV-related tumours

Question 8

oropharyngeal malignancy presentation

Answer 8

odynophagia
throat pain often unilateral
unilateral ear pain without ear symptoms

Question 9

3 paired salivary glands

Answer 9

parotid
submandibular
sublingual

Question 10

sialadenitis

Answer 10

inflammation of the salivary gland

Question 11

acute infective sialadenitis symtpoms

Answer 11

sudden swelling
pain
systemically unwell

Question 12

acute bacterial sialadenitis symptoms

Answer 12

systemic illness
pyrexia
pus from ducts
facial swelling and redness and or raised FOM
confusion and pain

Question 13

most common salivary gland tumour

Answer 13

parotid

Question 14

most common salivary gland malignancy

Answer 14

sublingual

Question 15

ear disorders that mimick TMD

Answer 15

acute otitis media
otitis media with effusion
otitis externa

Question 16

symptoms suggestive of ear causes

Answer 16

aural discharge
reduced hearing
tinnitus
vertigo

Question 17

acute otitis media symptoms

Answer 17

systemically unwell
increasing pain over 2-3 days followed by resolution/ discharge
common in children

Question 18

otitis media with effusion (glue ear) symptoms

Answer 18

fluid in middle of ear
not acutely infected
common in children
may be concerning for post-nasal space mass in adults

Question 19

otitis externa causes

Answer 19

ear phones/ hearing aids
skin conditions - eczema
ear trauma - cotton buds
narrow ear canals

Question 20

otitis externa presentation

Answer 20

ear discharge
ear pain
reducing hearing

Question 21

otitis externa bacteria

Answer 21

pseudomonas
may become fungal

Question 22

otitis externa tx

Answer 22

topical antibiotics +/- steroid as first line
keep ears dry and dont use headphones

Question 23

paranasal sinuses

Answer 23

paired maxillary
ethmoids
sphenoid
frontal

Question 24

acute sinusitis cause

Answer 24

usually follows a cold

Question 25

acute sinusitis symptoms

Answer 25

nasal blockage discharge pain/ pressure around cheek smell loss

Question 26

when does sinusitis become chronic

Answer 26

lasts more than 12 weeks

Question 27

sinusitis cause

Answer 27

secondary to dental pathology

Question 28

odontogenic maxillary sinusitis

Answer 28

result of infection spreading at root apex

Question 29

signs of sinonasal and nasopharyngeal cancer

Answer 29

unilateral nasal discharge unilateral middle ear effusion orbital complications - proptosis, diplopia

Question 30

3 phases of swallow

Answer 30

voluntary pharyngeal oesophageal

Question 31

dysphagia red flags

Answer 31

more than 3 weeks throat pain (especially unilateral), painful swallow, hoarseness, oral swelling/ ulcer, neck lump short history of progressive dysphagia, over 55yrs with unexplained weight loss plus dyspepsia