ENT I

Question 1

what are Aphthous ulcers (canker sores)?

Answer 1

• Single or multiple, shallow, mucosal ulcerations that are common, often recurrent and painful

Question 2

What causes these canker sores

Answer 2

• Can be associated with immunologic disorders e.g. inflammatory bowel disease

Question 3

How long to canker sores take to resolve

Answer 3

• Usually self-resolve in a week but may persist for longer especially in immunocompromised patients

Question 4

What causes oral herpes?

Answer 4

Oral herpes usually caused by HSV-1 but HSV-2 (genital herpes) can also occur

Question 5

How does herpes simplex virus infection present in children?

Answer 5

In children, usually present as acute herpetic gingivostomatitis (usually between 2-4 yo) with
vesicles and ulceration of the oral mucosa

Question 6

how does herpes infection present in adults

Answer 6

• In adults, usually presents as acute herpes pharyngitis

Question 7

What happens after acute herpes infection?

Answer 7

• After acute infection, the virus treks along regional nerves and becomes latent within local ganglia.

Question 8

what happens when the latent virus reactivates in ganglia?

Answer 8

Reactivation results in recurrent herpetic stomatitis

Question 9

In immunocompromised pts, herpes can persist as_________________

Answer 9

chronic mucocutaneous infection

Question 10

What is thrush

Answer 10

Thrush refers to the pseudomembranous form of oral candidiasis: superficial gray-white inflammatory membrane composed of matted organisms in a fibrinosuppurative exudate that can be scrapped off, showing an erythematous inflammatory base

Question 11

In what case can thrush be invasive?

Answer 11

Immunosuppression

Question 12

What is Ludwig’s angina?

Answer 12

This is a severe, acute streptococcal cellulitis involving the neck, tongue and back of the throat.

Question 13

What is Vincent’s angina?

Answer 13

Vincent’s angina is a painful condition of the throat
Characterised by local ulceration of the tonsils, mouth and pharynx.

Question 14

What causes Vincent’s angina?

Answer 14

Vincent’s Bacillus

Question 15

What is anotia/atresia?

Answer 15

Total Absence of the auricle and narrowing/absenc of external auditory meatus

Question 16

What is microtia?

Answer 16

Developmental malformation of the auricle and narrowing/absence of the ext. canal.

Question 17

What is accessory auricle?

Answer 17

Anomaly of the tragus area

Question 18

what is a preauricular sinus?

Answer 18

This is a dent, dip, or nodule anywhere adjacent to the external ear. Susceptible to infection

Question 19

What is another term for laceration of the ear?

Answer 19

Hematoma auris

Question 20

What is perichondritis of the pinna?

Answer 20

Inflammation of the perichondrium (CT lining the cartilage of the pinna)

Question 21

What is the cause of perichondritis?

Answer 21

1. Can follow trauma to the cartilage, such as hematoma auris, surgery (mastoid surgery), otitis externa and piercing
2. It is commonly caused by pseudomonas: Fever, pain, redness, swelling. It causes narrowing and further low hearing level.

Question 22

What are the complications of perichondritis or trauma?

Answer 22

Cauliflower ear (end stage of untreated hematoma)

Question 23

How does cauliflower ear form?

Answer 23

hematoma auris»> Ischaemia» necrosis» Ear deformity

Question 24

What is otitis externa?

Answer 24

Acute or chronic infection of the whole or part of the skin of the external ear canal. Any pathology of the skin can also affect the external ear.

Question 25

Explain the the pathophysiology of otitis externa

Answer 25

Aggressive washing of wax or retention of water Microtrauma of the ear canal caused by nails or cotton swabs.

Question 26

Type of otitis externa where there is a small rounded swelling in the external canal

Answer 26

Localised otitis externa (furuncle)

Question 27

What is the type of otitis externa where there is general narrowing of the ear canal? (swimmer's ear)

Answer 27

Diffuse infective otitis externa

Question 28

What is a fungal infection of the ear canal called?

Answer 28

otomycosis

Question 29

Describe herpetic otitis externa

Answer 29

Herpes zoster oticus is a form of Herpes zoster that causes pre-eruptive (pre-herpetic) lesions that become reactivated from either the trigeminal or cervical ganglions

Question 30

What are the characteristics and complications of herpetic otitis externa?

Answer 30

Characterized by Painful vesicles Complication: Facial n. paralysis

Question 31

Which types of otitis externa are painless?

Answer 31

Eczematous and seborrheic otitis externa

Question 32

What is referred earache?

Answer 32

It is pain in the ear caused by a disease in an area supplied by the same nerve that supplies the ear.

Question 33

nerves associated with referred earache and the diseases commonly affecting areas supplied by these nerves (4)

Answer 33

-Cervical II & III: cervical spondylosis, neck injury (disc, muscle spasm) etc. ○ V (trigeminal) cranial nerve: dental infections, sinonasal diseases etc. ○ IX (glossopharyngeal) cranial nerve (branch of CN 9): tonsillitis, pharyngitis, post-tonsillectomy, carcinoma etc. ○ X (vagus) cranial nerve: tumors of hypopharynx, larynx & Oesophagus

Question 34

What is Meniere's disease?

Answer 34

It is a rare disorder affecting the labyrinth of the inner ear, leading to progressive hearing loss.

Question 35

What are the symptoms of Meniere's disease?

Answer 35

Vertigo, tinnitus, hearing loss, sensation of pressure in the ear

Question 36

A benign tumour of the acoustic nerve sheath. Symptoms result from pressure exerted in the tissues surrounding ear. What is it called?

Answer 36

Acoustic neuroma

Question 37

What is the term for impairment of hearing resulting from old age?

Answer 37

Presbycusis