ENT

Question 1

Fluid level or bubbles seen at tympanic membrane suggests?

Answer 1

Otitis media with effusion

Question 2

Where do we place the grommet?

Answer 2

Anterior and inferior quadrant as less important structures

Question 3

If you see a donut shaped , pushed out tympanic membrane, what would this suggest?

Answer 3

Acute otiis media

Question 4

What are the 2 parts of the tympanic membrane?

Answer 4

Pars tensa (thick part)
Pars flaccida (thin part, supriorly)

Question 5

What is the umbo?

Answer 5

Most inwardly depressed part of the tympanic membrane

Question 6

What is a cholesteatoma?

Answer 6

Build up of dead skin cells which can get infected

Question 7

Hearing:

Answer 7

1. Sound waves make tympanic membrane vibrate
2. Vibrations transmitted through ossicles
3. Footplate of stapes vibrates in oval window
4. Vibration of stapes creates pressure waves in perilymph
5. Hair cells in the cochlea are moved, AP’s stimulated and conveyed to brain by cochlear nerve
6. Pressure waves descend and become vibrations again
7. Pressure waves are dampened at the round window

Question 8

Function of the tympanic cavity?

Answer 8

Conduct sound waves in the air towards the fluid filled cavities of the inner ear

Question 9

Causes of deafness?

Answer 9

Presbycusis
Otosclerosis
Noise induced
Ototoxicity

Question 10

What is presbycusus?

Answer 10

Age induced deafness

Question 11

What is otosclerosis?

Answer 11

Build up of new bone formation of stapes footplate. Genetic condition more common in women in 30’s and 40’s

Question 12

What is ototoxicity?

Answer 12

Drugs that have been toxic to the ear causing hearing loss

Question 13

If vertigo lasts seconds it suggests?

Answer 13

BPPV

Question 14

If vertigo lasts hours it suggests?

Answer 14

Meniere’s

Question 15

If vertigo lasts days it suggests?

Answer 15

Vestibular neuritis

Question 16

If vertigo time frame is variable it suggests?

Answer 16

Migraine associated vertigo

Question 17

Acute otitis media is?

Answer 17

Infection in the middle ear

Question 18

How does acute otitis media present?

Answer 18

Present with fever, fluid behind eardrum, bulging and possibly hearing loss

Question 19

How do we treat Acute Otitis Media?

Answer 19

Usually settles alone.

Only give antibiotics if not settling

Question 20

What is a vestibular schwannoma?

Answer 20

Benign tumour arising in the internal auditory meatus

Question 21

how does a vestibular schwannoma present?

Answer 21

hearing loss, tinnitus, imbalance

Question 22

How do we diagnose a vestibular schwannoma?

Answer 22

MRI

Question 23

Red flag symptoms?

Answer 23

Persistent hoarseness
Dysphagia 
Odynophagia
Throat pain 
Referred otalgia
Neck mass
Bloody nasal discharge

Question 24

How likely is a parotid gland mass to be benign?

Answer 24

70%

Question 25

Which glands are malignant tumours more likely to be found in?

Answer 25

Submandibular and sublingual glands

Question 26

3 phases of swallowing?

Answer 26

1. oral phase 2. pharyngeal phase 3. oesophogeal phase

Question 27

Common causes of difficulty swallowing?

Answer 27

Laryngopharyngeal reflux Pouch Spasm Eosinophillic oesophagitis

Question 28

What is recurrent respiratory pappilomatosis?

Answer 28

small wart like growths on the respiratory tract

Question 29

The reconstructive ladder:

Answer 29

1. Secondary intention 2. Primary intention 3. Delayed primary closure 4. Skin grafts 5. Tissue expansion 6. Local tissue transfer 7. Free tissue transfer

Question 30

How to diagnose glandular fever?

Answer 30

Atypical lymphocytes in peripheral blood +ve monospot or Paul Bunnell test Low CRP (<100)

Question 31

Management of Glandular fever?

Answer 31

Symptomatic treatment, antibiotics and steroids

Question 32

Why do we not prescribed ampicillin in glandular fever?

Answer 32

will cause a macular rash

Question 33

Symptoms of acute sinusitis?

Answer 33

Facial pain Discharge Nasal blockage

Question 34

Most common emergency?

Answer 34

Epistaxis

Question 35

Management of epistaxis?

Answer 35

1. First aid - pinch soft part of nose for 5-10 mins 2. Cauterise 3. Nasal pack

Question 36

How to treat sudden sensorineural hearing loss?

Answer 36

Something has happened to cochlear or cochlear nerve so we must treat as EMERGENCY. Do a Weber test. Can give steroids

Question 37

What is stridor?

Answer 37

Inspiratory high pitched noise, airway obstruction around larynxy