Presentations

Question 1

Sneezing
Nasal itching
Nasal discharge / congestion
‘Allergic crease’ may be present

Answer 1

Allergic rhinitis

Question 2

Rhinorrhoea
Sneezing
Itchy nose
Nasal congestion

Answer 2

Non-allergic rhinitis

Question 3

Nasal blockage / discharge
Facial pain / pressure
Headache
Reduction in sense of smell

Answer 3

Acute sinusitis

Question 4

Blocked nose or runny nose
Reduced sense of taste & smell
Otherwise well

Answer 4

Nasal polyps

Question 5

Progressive breathing difficulty often exacerbated by exertion
Associated with vasculitis
Often idiopathic

Answer 5

Subglottic stenosis

Question 6

Redness / swelling of ear canal
Itching in early stages
Can become sore and painful
Discharge / increased earwax
Hearing may be impacted

Answer 6

Otitis externa

Question 7

Ear pain
Fever
Inflamed ear
Middle ear effusion may occur
Opaque tympanic membrane

Answer 7

Acute otitis media

Question 8

Pain, tenderness and swelling behind the ear

Answer 8

Acute mastoiditis

Question 9

Disproportional pain and headache, very severe
Granulation tissue at bone-cartilage junction of ear canal
Exposed bone in ear canal
Facial nerve palsy

Answer 9

Malignant otitis externa

Question 10

Unilateral discharge from ears
Foul smelling discharge
Conductive hearing loss may occur

Rarely vertigo, facial nerve palsy, meningitis or intracranial abscess

Answer 10

Cholesteatoma

Question 11

Sudden severe ear pain followed by bleeding and hearing loss / tinnitus

Answer 11

Perforated tympanic membrane

Question 12

Gradual onset hearing loss
Typically 2nd and 3rd decades

Answer 12

Otosclerosis

Question 13

Middle ear effusion - fluid visible
Altered TM colour
TM retraction
May present with hearing loss

Answer 13

Otitis media with effusion

Aka. Glue ear

Question 14

Gradual onset hearing loss
Typically in older generations

Answer 14

Presbycusis

Question 15

Progressive sensorineural unilateral hearing loss and tinnitus
Imbalance may occur
Facial numbness can occur

Answer 15

Vestibular schwannoma

Question 16

Firm, red nodules on ear
Sores on skin of ear
Hearing problems
Tinnitus
Vertigo

Answer 16

Squamous cell carcinoma of the ear

Question 17

Severe inflammatory reaction
Vesicle formation and painful ulcers surrounding the mouth

Answer 17

Gingivostomatitis

Primary infection of Herpes Simplex Virus 1 (HSV-1)

Question 18

Often misdiagnosed as bacterial
On fingers and nails
Occupational hazard (dentistry and anaesthetics)
Use of gloves for prevention

Answer 18

Herpetic whitlow

Question 19

Rapid onset of fever, headache, seizures, focal neurological signs and impaired consciousness

Answer 19

Herpes simplex encephalitis

Question 20

High fever
Hyperemia
Yellow / greyish-white papulovesicular lesions in the mouth

Answer 20

Herpangina

Question 21

Oral enanthem
Macular / maculopapular / vesicular rash of the hands & feet

Answer 21

Hand, foot and mouth disease

Question 22

Recurrent painful ulcers in mouth
Ulcers are round or ovoid
Ulcers have inflammatory halos
Confined to the mouth
No systemic disease

Answer 22

Aphthous ulcer

Question 23

White patches on red, raw mucous membranes in the throat / mouth
White patches come off easily

Answer 23

Oral candidiasis

Question 24

Painful lesions
Commonly in the mucosa of hard and soft palate
Can occur anywhere there is stratified squamous epithelium

Answer 24

Squamous cell papilloma

Question 25

Malaise Sore throat, mild analgesia needed Temperature Lasts 3-4 days Possible lymphadenopathy

Answer 25

Viral tonsilitis

Question 26

Systemic upset Fever Odynophagia Halitosis Unable to go to work / school Lymphadenopathy Lasts ~1 week

Answer 26

Bacterial tonsilitis

Question 27

Unilateral throat pain Odynophagia Trismus Medial displacement of tonsil and uvula Concavity of palate lost

Answer 27

Peritonsilar abscess Aka. Quinsy

Question 28

Chronic sore throat 'Malodorous breath' Tonsilliths Peritonsilar erythema Tender cervical lymphadenopathy

Answer 28

Chronic tonsillitis

Question 29

Severe sore throat Greyish-white membrane across pharynx (pseudomembrane)

Answer 29

Diptheria

Question 30

Classic triad of fever, pharyngitis and lymphadenopathy Malaise, lethargy Sore throat Gross tonsillar enlargement Palatal petechial changes

Answer 30

Infectious mononucleosis

Question 31

Mild pain while speaking / swallowing Varying degrees of hoarseness

Answer 31

Contact ulcer

Question 32

Severe sore throat Drooling saliva Pyrexia Normal oral cavity Stridor may be present

Answer 32

Epiglottitis

Question 33

Hoarse voice Dysphonia Throat discomfort

Answer 33

Reinke's oedema

Question 34

Obligate mouth breathing Hyponasal / muffled voice Snoring / sleep disturbance Seen in children

Answer 34

Adenotonsillar hypertrophy

Question 35

Dysphonia Dysphagia Odynophagia (unilateral) Otalgia Neck lump Stridor may be present

Answer 35

Head and neck cancer

Question 36

A tumour with features of catecholamine excess - headaches, palpitations, diaphoresis and hypertension

Answer 36

Sympathetic paraganglioma

Question 37

A tumour with mass effects - cranial nerve palsies, a neck mass or tinnitus

Answer 37

Parasympathetic paragangliomas

Question 38

Persistent clear rhinorrhoea Headache

Answer 38

CSF leak

Question 39

'Cauliflower ear' Common in rugby players / boxers

Answer 39

Pinna haematoma

Question 40

Bruising behind ear - 'battle sign'

Answer 40

Base of skull fracture

Question 41

Sore throat Generally unwell Limited neck movement Febrile Trismus Red / tender neck

Answer 41

Deep neck space infection

Question 42

SOB upon rest / exertion Choking Coughing Inability to complete sentences Sternal recession Tracheal tug Pyrexia Cyanosis Stridor

Answer 42

Airway obstruction

Question 43

Nausea and vomiting Vertigo upon: Looking up Turning over in bed First lying down at night Bending forward Rising from bending

Answer 43

Benign positional paroxysmal vertigo

Question 44

Severe first attack - lasts hours Nausea and vomiting Prolonged vertigo (days) Viral symptoms - headache, malaise

Answer 44

Vestibular neuritis

Question 45

Severe first attack - lasts hours Nausea and vomiting Prolonged vertigo (days) Viral symptoms - headache, malaise Tinnitus / hearing loss

Answer 45

Labyrinthitis

Question 46

Light-sensitive during dizzy spells Phonophobia Fluctuating hearing loss Motion sensitivity / motion sickness

Answer 46

Vestibular migraine

Question 47

Attacks characterised by triad of: Sever paroxysmal vertigo Sensorineural hearing loss Tinnitus of affected side Sensation of ear being full Change in hearing or tinnitus around time of dizzy spells

Answer 47

Meniere's disease