ENT

Question 1

What is the most common cause of deafness?

Answer 1

Age related damage to the cochlear

Question 2

What is conductive hearing loss?

Answer 2

Problem in the transmission of waves from external ear to middle ear

Question 3

Causes of conductive hearing loss

Answer 3

Occlusion, infection, perforations, cholesteatoma, adenoids

Question 4

What is sensorineural hearing loss?

Answer 4

Problems in the cochlear (most common), cochlear nerve or brain stem.

Question 5

Causes of sensorineural hearing loss

Answer 5

Noise induced, ototoxic hearing loss, immune conditions, acoustic neuroma and Meniere’s disease

Question 6

Define tinnitus

Answer 6

The perception of sound in the ears or head where no external source exists

Question 7

What is subjective tinnitus?

Answer 7

Common - no acoustic stimulus exists

Question 8

Causes of subjective tinnitus

Answer 8

Otological, neurological, infections, drug related

Question 9

What is objective tinnitus?

Answer 9

Rare - actual noise to be heard is generated within the head

Question 10

Causes of objective tinnitus

Answer 10

Pulsatile, muscular or anatomical

Question 11

Treatment of tinnitus

Answer 11

No cure - reassure that condition will not progress.

Association between tinnitus and stress so relaxation techniques effective

Question 12

3 symptoms of Meniere’s disease?

Answer 12

Unilateral vertigo + hearing loss + tinnitus

Question 13

What is vertigo

Answer 13

Sensation of spinning in the head - symptom not a diagnosis

Question 14

What are the 3 types of vertigo?

Answer 14

Vestibular Neuronitis - most common
Benign Paroxysmal Positional Vertigo
Meniere’s disease

Question 15

What is the pathology in vestibular neuronitis

Answer 15

Inflammation of the middle ear

Question 16

Symptoms of vestibular neuronitis

Answer 16

Nausea + vomiting, rapid onset rotary vertigo

Very debilitating - symptoms settle over a few weeks

Question 17

Treatment of vestibular neuronitis

Answer 17

Prochlorperazine - vestibular sedative

Exercise encourages compensation, drugs prevent it

Question 18

What is the pathology in benign paroxysmal positional vertigo

Answer 18

Cellular debris in the SCC’s - head movement sets them in motion which gives the spinning sensation

Question 19

BPPV symptoms

Answer 19

Head spinning on movement - esp when looking up or turning in bed
May follow URTI, head injury or vestibular neuronitis

Question 20

Treatment of BPPV

Answer 20

Epley manouvre

Question 21

Cause of Meniere’s disease

Answer 21

Unknown

Question 22

Time course of Meniere’s disease

Answer 22

Pt well between attacks but gradually lose hearing in affected ear

Question 23

Treatment of Meneire’s

Answer 23

Cure - surgical removal of affected vestibular apparatus
Vestibular sedatives for acute attacks
Gentamicin injections to inner ear

Question 24

What is the basilar membrane?

Answer 24

Contains the nerve endings within the cochlear to transfer sound waves into neurlogical impulse

Question 25

How is the frequency of the basilar membrane arranges?

Answer 25

High pitch noises stimulate the base | Low pitch noises stimulate the tip

Question 26

Presentation of otitis externa

Answer 26

Acute, itchy and painful with discharge | Painful pinna

Question 27

Common causative agents of OE

Answer 27

Pseudomonas Aeruginosa/ Staph A

Question 28

Treatment of OE

Answer 28

Antibiotic eardrops

Question 29

Presentation of Otitis Media

Answer 29

Earache, cold symptoms, general malaise | Hearing loss

Question 30

Treatment of OM

Answer 30

Analgesics + NSAIDS first | Avoid Abx till day 5 - then oral amoxicillin if symptoms still present

Question 31

Presentation of perforated tympanic membrane

Answer 31

May follow OM infection - pain disappears as pressure released Blood and pus coming out of ear Hearing loss

Question 32

Treatment of perforated membrane

Answer 32

Analgesics and Abx | Slowly heals over 2 months

Question 33

Presentation of mastoiditis

Answer 33

Earache, fever, general malaise | Become more unwell with pain and swelling behind ear

Question 34

Treatment of mastoiditis

Answer 34

Admit to hospital IV abx Myringotomy - surgical incision into eardrum to relieve pressure Surgery if develop abscess

Question 35

Complications of mastoiditis

Answer 35

Meningitis, abscess, venous thrombosis

Question 36

What is a cholesteatoma

Answer 36

Benign skin growth in the middle ear behind the ear drum

Question 37

Symptoms of cholesteatoma

Answer 37

Intermittent smelly ottorhoea and hearing loss | No pain

Question 38

What is the pathology in necrotising otitis externa

Answer 38

Osteomyelitis of the temporal bone and skull base

Question 39

Presentation of Necrotising otitis externa

Answer 39

Diabetes, pain that keeps awake at night, ipsilateral facial palsy

Question 40

NOE treatment

Answer 40

Admit to hospital Swab for culture Oral abx for weeks Control diabetes

Question 41

What is Bells Palsy

Answer 41

Ipsilateral facial paralysis where not other cause can be identified

Question 42

How does an UMN lesion (Stroke) differ from a LMN lesion (Bell's Palsy)

Answer 42

Upper 1/4 facial sparing UMN = Contraleteral LMN = Ipsilateral

Question 43

What is Ramsey Hunt Syndome?

Answer 43

Reactivation of Herpez Zoster in the geniculate ganglion

Question 44

Symptoms of Ramsey Hunt Syndrome

Answer 44

Triad of ipsilateral facial paralysis, ear pain and vesicles of the face, ear or tongue