ENT

Question 1

most common cause of otits media?

Answer 1

H influenza

Question 2

Mx of septal haematoma

Answer 2

urgent ENT review
surgical drainage
IV ABx

Question 3

what happens if septal haematoma is left untreated?

Answer 3

irreversible septal necrosis within 3-4 days
–> saddle shaped defect in nose

Question 4

drugs which cause gingival hyperplasia (4)

Answer 4

phenytoin
ciclosporin
CCB
AML (not a drug hehe!)

Question 5

mild OE treatment (ie no discharge/deafness)

Answer 5

Topical acetic acid 2% spray

Question 6

mod/severe OE treatment

Answer 6

7 days TO ABx +/- TO steroid

Question 7

bacterial causes of otitis externa

Answer 7

staph aureus
pseduomonas aeruginosa

Question 8

define primary haemorrhage post tonsillectomy

Answer 8

6-8 hours post surgery

Question 9

Mx primary haemorrhage post tonsillectomy

Answer 9

return to theatre

Question 10

define secondary haemorrhage post tonsillectomy

Answer 10

5-10 days pot surgery

Question 11

cause of secondary haemorrhage post tonsillectomy

Answer 11

wound infection

Question 12

Mx secondary haemorrhage post tonsillectomy

Answer 12

ENT admission + Abx

Question 13

why are posterior nose bleeds more significant than anterior ones?

Answer 13

deeper vessels origin
higher risk of aspiration + airway compromise

Question 14

step by step mx of nose bleed

Answer 14

1) first aid
- sit with torso forward,mouth open
- pinch soft cartilage firmly for 20 mins, brathing through mouth
2) Topical antiseptic e.g. naseptin
3) cautery - 1st TO anaesthestic, wait 3-4 minute to take effect, then AgNO3 to cauterise bleeding point for 10s
4) nasal packing - again anaesthetise first
5) if all else fails - surgical Mx

Question 15

surgical Mx of nose bleed

Answer 15

sphenopalatine ligation

Question 16

first line Mx AOM

Answer 16

self limiting
consider alt if not self limiting after 3 days

Question 17

ABx Mx AOM

Answer 17

5-7 course of amox
erythromycin if pen allergic

Question 18

what % of AOM is viral?

Answer 18

50%

Question 19

audiometry findings presbycusis

Answer 19

bilateral hihg freq hearing loss

Question 20

inheritance pattern otosclerosis

Answer 20

autisoal dominant

Question 21

what is otosclerosis

Answer 21

replacement of normal bone by vascular pongy bone

Question 22

peak age glue ear

Answer 22

2 years old

Question 23

most common PS glue ear

Answer 23

hearing loss

Question 24

hearing loss frequency for noise induced hearing loss

Answer 24

3000-6000Hz

Question 25

Sx if acoustic neuroma affects CN VIII

Answer 25

hearing loss,vertigo tinnitus

Question 26

Sx if acoustic neuroma affects CN V

Answer 26

absent corneal reflex

Question 27

Sx if acoustic neuroma affects CN VII

Answer 27

facial palsy

Question 28

which condition do you see bilateral acoustic neuromas in?

Answer 28

NFM 2

Question 29

how long for tymapanic membrane perforation not to have healed before considering referral to ENT

Answer 29

6 weeks

Question 30

what pathogen to suspect if recurrent OE not improving despite numerous ABx treatment?

Answer 30

candida albicans

Question 31

average age of onset BPPV

Answer 31

55

Question 32

what type of nystagmus is noted in BPPV

Answer 32

rotatory nystagmus towatd affected ear

Question 33

reocurrence rate BPPV after Tx

Answer 33

50% within 3-5 years of diagnosis

Question 34

which drug is most useful for preventing attqacks of menieres?

Answer 34

betahistine

Question 35

>4 w unexplained unilateral otalgia with unremarkable otoscopy mx?

Answer 35

2ww ENT

Question 36

what causes ramsay hunt syndrome

Answer 36

reactivation of VZV in the geniculate ganglion of CN VII

Question 37

symptoms of ramsay hunt syndrome

Answer 37

auricular pain 1st then CN VII palsy vesicular rash round ear vertigo/tinnitus

Question 38

Mx ramsay hunt syndrome

Answer 38

PO aciclovir corticosteroids

Question 39

Webers test in unilateral SNHL

Answer 39

lateralised to unaffected side

Question 40

webers test in unilateral CHL

Answer 40

lateralises to affected side

Question 41

Rinne's test in CHL

Answer 41

Rinne's 'negative' BC >AC

Question 42

cause of black hairy tongue

Answer 42

accumulation of keratinin and dead cells staining from food/drink tobacco products

Question 43

Sx of black hairy tongue

Answer 43

tickling sensation or asymptomatic

Question 44

Mx of black hairy tongue

Answer 44

good oral hygiene

Question 45

appearance of hairy leukoplakia

Answer 45

white, corrugated lesions along border of tongue

Question 46

what conditions is hairy leukoplakia associated with?

Answer 46

immunosuppressed pt particularly those with HIV/AIDS

Question 47

which salivary glands have the most tumours?

Answer 47

parotid

Question 48

which salivary glands have the most stones?

Answer 48

submandibular

Question 49

what type of gland is a parotid gland

Answer 49

serous

Question 50

what type of gland is a submandibular gland

Answer 50

serous and mucous

Question 51

what type of gland is a sublingual gland

Answer 51

mucous

Question 52

what type of tumour makes up the majority of parotid tumours?

Answer 52

pleomorphic adenoma (80%)

Question 53

complications of thyroid surgery? (3)

Answer 53

damage to parathyroid glands --> hypocalcaemia --> QTC prolongation rec laryngeal nn damage bleeding --> haematoma --> laeryngeal oedema