ENT Examination

Question 1

Label a tympanic membrane

Answer 1

.

Question 2

What is Weber’s and Rinne’s test used for? Describe what is involved in the test.

Answer 2

They are performed if deafness is suspected but are not useful as screening exams.

Weber’s: 512Hz tuning fork placed in the middle of the forehead.
- NO LATERALISATION = NORMAL.
- LATERALISATION = sound heard louder on the side of
the INTACT ear

Rinne’s: 512Hz tuning fork placed on the mastoid process until they can no longer hear it, then is moved in front of the ear.

• POSITIVE: AC > BC (normal)
• NEGATIVE: BC > AC (conductive hearing loss)

Question 3

What types of hearing loss can Weber’s and Rinne’s help differentiate?

Answer 3

SENSORINEURAL VS. CONDUCTIVE

NORMAL = no lateralisation (Weber’s) and AC > BC (Rinne’s: heard louder in front of the ear than at the mastoid process)

SENSORINEURAL = sound heard louder on the side of the INTACT/NORMAL ear (Weber’s) and AC > BC (Rinne’s)

CONDUCTIVE = sound heard louder on the side of the AFFECTED ear (Weber’s) and BC > AC (Rinne’s)

Question 4

Rule of 3s: 3 turbinates, 3 bones. Name the 3 most important bones.

Answer 4

Ethmoid bone
Maxilla
Sphenoid bone

Question 5

What is the ostiomeatal complex?

Answer 5

.

Question 6

The majority of sinusitis cases are…?

Answer 6

Viral

Question 7

Which structure is the cause of more ENT presentations in children compared to adults?

Answer 7

Adenoids

Question 8

Little’s area / Kiesselbach’s plexus and nosebleeds??

Answer 8

.

Question 9

7 S’s to describe a lump

Answer 9

SIZE
SITE
SHAPE
SURFACE
SENSITIVITY (tenderness, anaesthesia)
SOLID (vs. cystic)
SURFACE ATTACHMENTS (superficial and deep)

Question 10

In which population group is epiglottitis (an otherwise rare disease) more common?

Answer 10

Unvaccinated

Question 11

Clinical presentation of tonsilitis

Answer 11

Marked by fever and malaise. People feel very unwell.

Question 12

Absolute indications for tonsillectomy

Answer 12

Airway obstruction

Asymmetric enlargement indicative of malignancy

Question 13

ENT symptoms suggestive of cancer

Answer 13

PERSISTING OR WORSENING: UNILATERAL Sx

• Throat pain
• Otalgia
• Odynophagia
• Dysphagia
• Dysphonia
• Painless neck lump
• Ulcers lasting >4 weeks
• Nerve palsies
• Unilateral glue ear in adult (PNS tumour until proven otherwise)