Head and Neck

Question 1

Symptoms of acute otitis media

Answer 1

Infection assoc. with viral illness

otalgia
irritability
sleep disturbance
fever
loss of appetite

bulging tympanic membrane

Question 2

Treatment of acute otitis media

Answer 2

analgesics

Antibiotics

Question 3

Symptoms of otitis media with effusion

Answer 3

“glue ear” - peaks at 2yo and 5yo

aural discharge
poor listening skills

dull grey tympanic membrane
possible visible fluid air level

Question 4

Treatment of otitis media with effusion

Answer 4

refer to ENT if severe

Grommets

Question 5

Symptoms of otitis externa

Answer 5

ear pain
ear canal swelling
otorrhoea
loss of hearing

Risk factor = swimming

Question 6

Treatment for otitis externa

Answer 6

If bacterial
- antibacterial drops (ciproflaxin)

If fungal oral

• first line acetic acid
• second line clotrimazole
• third line fluclonazole

Question 7

Symptoms of allergic rhinitis

Answer 7

sneezing
nasal pruritis
palate/throat/ear/eye itching
eye redness/puffiness

Question 8

Diagnosis of allergic rhinitits

Answer 8

therapeutic trial of antihistamine or intranasal corticosteroid

Question 9

treatment of allergic rhinitis

Answer 9

oral antihistamine
intranasal antihistamine

persistent moderate - severe; intranasal corticosteroid and/or antihistmine

Question 10

What is cholesteatoma?

Answer 10

Presence of keratinising squamous epithelium in middle ear

Question 11

Symptoms of cholesteatoma

Answer 11

hearing loss
ear discharge (resistant)
tinnitus
otalgia

Question 12

Diagnosis of cholesteatoma

Answer 12

pure tone audiogram

CT scan petrous temporal bones

Question 13

treatment of cholesteatoma

Answer 13

canal wall up surgery

canal wall down surgery; leaves a cavity

Question 14

Investigations for achalasia

Answer 14

Upper GI endoscopy
barium swallow
oesophageal manometry

Question 15

Treatment of achalasia

Answer 15

Awaiting diagnosis; CCB or nitrate

Surgical

• pneumatic dilation
• laparoscopic cardiomyotomy

Question 16

Treatment for pharyngeal pouch

Answer 16

Endoscopic stapling

open neck surgery

Question 17

symptoms of benign positional vertigo

Answer 17

vertigo of brief duration
nausea
imbalance
lightheadedness

Question 18

Diagnosis of benign positional vertigo

Answer 18

Dix Hallpike manouevre

Supine lateral head turns

Question 19

Treatment of benign positional vertigo

Answer 19

Epley manoeuvre

Semont manoeuvre if Epley fails

Question 20

symptoms of Meniere’s disease

Answer 20

vertigo
hearing loss
tinnitus
nystagmus
Romberg's test
bilateral symptoms

Question 21

Diagnosis of meniere’s disease

Answer 21

pure tone audiometry

electrocochleography

Question 22

Treatment of meniere’s disease

Answer 22

low salt diet and diuretics

vestibular suppressants, antiemetics, corticosteroids

Question 23

Acute sinusitis symptoms

Answer 23

<10days viral
>10days but <4weeks bacterial

nasal discharge
cough
sore throat

Question 24

Treatment of acute sinusitis

Answer 24

viral

• supportive
• analgesia

Bacterial
- antibiotics

Question 25

symptoms of chronic sinusitus

Answer 25

>12 weeks ``` facial pain nasal obstruction nasal discharge fatigue cough ```

Question 26

Diagnosis of chronic sinusitus

Answer 26

anterior rhinoscopy | nasal endoscopy

Question 27

Treatment of chronic sinusitis

Answer 27

antibiotics nasal saline irrigations intranasal corticosteroids If medical therapy fails --> endoscopic sinus surgery

Question 28

Symptoms of nasal polyps

Answer 28

nasal obstruction nasal discharge facial pain/pressure anosmia

Question 29

Diagnosis nasal polyps

Answer 29

anterior rhinoscopy | nasal endoscopy

Question 30

Treatment nasal polyps

Answer 30

intranasal corticosteroid surgical polypectomy if no/minimal improvement with corticosteroid after three months (one month if severe)