ENT

Question 1

What are the causes of conductive hearing loss?

Answer 1

External canal obstruction
Tympanic membrane perforation
Acute mastoiditis
Otosclerosis
Cholesteatoma

Question 2

Which inherited condition causes slowly progressive bilateral hearing loss?

Answer 2

Otosclerosis

Question 3

When does otosclerosis typically worsen?

Answer 3

Around menstruation and pregnancy

Question 4

What test is done to assess hearing?

Answer 4

Audiogram

Question 5

What are the causes of sensorineural hearing loss?

Answer 5

Ototoxicity
Menieres disease
Infections
Presbyacusis
Noise-induced
Acoustic neuroma

Question 6

How do you distinguish noise-induced hearing loss from presbyacusis?

Answer 6

Nose induced is not progressive

+ trough on audiogram at 4000Hz

Question 7

Which drugs are ototoxic?

Answer 7

Aminoglycosides (gentamicin)
Loop diuretics (furosemide)
Platinum based drugs (e.g. cisplatin)
Macolides (clarithromycin)

Question 8

What frequency sounds are lost first in presbyacusis?

Answer 8

High frequency

Question 9

How is acoustic neuroma dx?

Answer 9

Audiology and MRI

Question 10

What are the mx options for acoustic neuroma?

Answer 10

Watch and wait
Radiotherapy
Microsurgery

Question 11

What are the central causes of vertigo?

Answer 11

Acoustic neuroma
MS
Head injury

Question 12

What type of crystals cause BPPV?

Answer 12

Otoliths formed from calcium carbonate

Question 13

What conservative measures can help improve BPPV?

Answer 13

Reduce alcohol
Get out of bed slowly
Head turning

Question 14

What drug can be used as prophylaxis in menieres?

Answer 14

Betahistine

Question 15

What drug can be used in an acute menieres attacks to relieve sx?

Answer 15

Antihistamines (e.g. cinnarizine)

Question 16

Which type of bacteria most commonly cause otitis externa?

Answer 16

Pseudomonas aeruginosa

S.Aureus

Question 17

Which fungi most commonly cause otitis externa?

Answer 17

ASPERGILLUS NIGER
Candida albicans (less commonly)

Question 18

RFs for otitis externa

Answer 18

Swimming
Cotton buds
Eczema/psoriasis
Immunocompromised/DM
Allergies

Question 19

What is the tx for otitis externa?

Answer 19

Topical abx (gentamicin) + topical steroid (e.g. dexamethasone)

Question 20

How does Ramsey-Hunt syndrome px?

Answer 20

Bells palsy + very painful vesicular rash in ear and anterior 2/3 of tongue
Ipsilateral HEARING LOSS and vertigo

Question 21

How is ramsey hunt syndrome tx?

Answer 21

Pred
Aciclovir
Artificial tears

Question 22

What should you suspect if otitis externa is accompanied with a CN VII palsy?

Answer 22

Necrotising otitis externa

Question 23

How does necrotising otitis externa px?

Answer 23

Severe pain out of keeping with ear findings
Temporal headaches
CN VII palsy

Question 24

What organism mainly causes necrotising otitis externa?

Answer 24

Pseudomonas aeruginosa

Question 25

What is a big risk factor for necrotising otitis externa?

Answer 25

DIABETES

Question 26

Define necrotising otitis externa?

Answer 26

External otitis media that progresses into osteomyelitis of temporal bone

Question 27

What might you find on exam in necrotising otitis externa?

Answer 27

Granulations in ear canal

Question 28

Which organisms most commonly cause AOM?

Answer 28

RSV Rhinovirus S.PNEUMONIAE H.influenzae

Question 29

How does AOM px?

Answer 29

Otalgia followed by discharge

Question 30

What are the comps of AOM?

Answer 30

Mastoiditis | Meningitis

Question 31

What must you exclude if an adult presents with unilateral otitis media with effusion?

Answer 31

Head and neck tumour

Question 32

What does otitis media with effusion look like on exam?

Answer 32

Yellow retracted tympanic membrane with loss of light reflex

Question 33

What test can be done to test the mobility of the ear drum?

Answer 33

Tympanogram

Question 34

What is the tx for cholesteatoma?

Answer 34

Surgery

Question 35

What forms the vestibular system?

Answer 35

Semicircular canals (rotation) Utricle (horizontal) Saccule (vertical)

Question 36

Before thinking of an ENT causes, what should you rule out in the patient px with dizziness?

Answer 36

Cardiac causes and stroke

Question 37

What test can be done to determine whether a central cause of vertigo?

Answer 37

Head thrust test

Question 38

What are the symptoms of menieres?

Answer 38

Tinnitus | Low frequency sensorineural hearing loss

Question 39

What are the symptoms of labyrinthitis?

Answer 39

Preceding URTI Sudden, severe vertigo (no triggers) Sensorineural hearing loss N & V

Question 40

What is the main difference between vestibular neuronitis and labyrinthitis?

Answer 40

No hearing loss in vestibular neuronitis (cochlear not affected)

Question 41

What should you suspect in a patient with unilateral nasal obstruction/rhinorrhoea?

Answer 41

Benign/malignant neoplasm

Question 42

What does bone conduction louder than air conduction mean on Rinnes test?

Answer 42

Means that there is CHL in that ear

Question 43

What majority is commonly responsible for bacterial tonsillitis?

Answer 43

Group A beta haemolytic strep (S.pyogenes)

Question 44

When should you do a monospot test if suspect EBV?

Answer 44

2 weeks after onset of sx

Question 45

What is it important to advise people post EBV infection?

Answer 45

No contact sports for 8 weeks due to risk of splenic rupture

Question 46

How does quinsy px?

Answer 46

``` Severe sore throat Drooling Bad breath Trismus Fever ```

Question 47

What are the comps of bacterial tonsillitis?

Answer 47

Rheumatic fever Glomerulonephritis Scarlet fever Quinsy

Question 48

Which symbol on an audiogram inducates bone conduction?

Answer 48

Triangle

Question 49

In what condition would you get a flat tympanogram?

Answer 49

Otitis media with effusion

Question 50

What examination is uselful to distinguish labyrinthitis from stroke?

Answer 50

HINTS test

Question 51

What does the HINTS test involve?

Answer 51

Head impulse test Nystagmus type Skew

Question 52

Which organisms are the main bacterial causes of acute sinusitis?

Answer 52

S.pneumoniae | H.influenzae

Question 53

Should you admit a patient with quinsy?

Answer 53

Yes

Question 54

How can the history suggest salivary duct stone over a tumour?

Answer 54

``` Stone = pain exacerbated by eating Tumour = pain constant and slowly progressing ```

Question 55

Which type of malignancy most commonly affects the naso and oropharynx?

Answer 55

Squamous cell carcinoma

Question 56

What does unilateral parotid swelling with CN VII palsy suggest?

Answer 56

Neoplasm

Question 57

What is the most common type of salivary neoplasm?

Answer 57

Pleomorphic adenoma (benign)

Question 58

What is the name for inflammation of the salivary glands?

Answer 58

Sialoadenitis

Question 59

What Ix can be used to visualise salivary stones?

Answer 59

Sialography

Question 60

What virus is responsible for bilateral parotid involvement?

Answer 60

Mumps

Question 61

When does obstructive sleep apnoea most commonly px and what is the mx?

Answer 61

children (2-6) | Adenotonsillectomy

Question 62

What is the only way to exclude foreign body in the trachea?

Answer 62

Bronchoscopy

Question 63

When to refer nasal #?

Answer 63

Deformity at 5-7 days | Septal haematoma

Question 64

What is Pott's puffy tumour?

Answer 64

Osteomyelitis of the frontal bone

Question 65

What are the differentials for salivary gland swelling?

Answer 65

``` Viral parotitis stone in salivary duct Tumour Sjogren syndrome HIV ```

Question 66

Which conditions is sialadenosis (generalized swelling of the salivary glands) associated with?

Answer 66

Sjogrens syndrome Bulimia Anorexia

Question 67

Which viruses can cause congenital hearing loss?

Answer 67

Rubella | CMV