ENT

Question 1

How should nasal polyps be investigated?

Answer 1

• Sweat test
• RAST/skin testing
• Nasal smear
• Coronal CT

Question 2

How can nasal polyps be treated?

Answer 2

• Oral and nasal steroids
• Immunotherapy
• Polypectomy

Question 3

How can rhinosinusitis be managed?

Answer 3

• Antibiotics (penicillins, clarithromycin etc.

- Intranasal steroids

Question 4

Which antibiotic would be used in tonsilitis?

Answer 4

Phenoxymethylpenicillin

Question 5

How does laryngeal cancer present?

Answer 5

• Persistent unexplained hoarseness

- A lump in the neck

Question 6

How does oral cancer present?

Answer 6

• Unexplained ulceration
• Lump in the neck
• A red or red and white patch in the oral cavity

Question 7

How do nasal cancers present?

Answer 7

• Blocked nose that doesn’t clear
• Nosebleeds
• Loss of sense of smell

Question 8

How do acoustic neuromas present?

Answer 8

• Sudden unilateral hearing loss
• Facial pain or numbness
• Earache
• Ataxia

Question 9

Which condition causes bilateral acoustic neuromas?

Answer 9

Neurofibromatosis type 2

Question 10

How can acoustic neuromas be investigated?

Answer 10

• Audiometric testing

- Gadolinium inhanced MRI

Question 11

How can acoustic neuromas be managed?

Answer 11

• Microsurgery
• Radiotherapy
• Observation

Question 12

How does benign paroxysmal positional vertigo present?

Answer 12

• Vertigo provoked by head movements
• Often worse on one side and in the morning
• Light-headedness and imbalance
• Nausea
• No changes to hearing

Question 13

Which test is used to confirm BPPV?

Answer 13

Dix-Hallpike test

Question 14

How can BPPV be managed?

Answer 14

• Self-limiting
• Get out of bed slowly and reduce head movements
• Epley’s manoeuvre
• Referral to secondary care if it does not resolve

Question 15

How does Meniere’s disease present?

Answer 15

• Acute attacks of vertigo, tinnitus and fluctuating hearing loss
• Unexplained falls
• Imbalance

Question 16

How can Meniere’s disease be managed?

Answer 16

• Informing the DVLA
• Vertigo: prochlorperazine, cyclizine etc.
• Avoid trigers
• Betahistine
• Hearing support
• Local steroid
• Surgery

Question 17

How can a peritonsillar abscess (Quinsy) be managed?

Answer 17

• IV fluids if required
• Analgesia
• IV antibiotics
• Needle aspiration or incision and drainage
• Tonsillectomy

Question 18

What is Ludwig’s angina?

Answer 18

Acute cellulitis in the region of the submandibular gland

Question 19

How does Ludwig’s Angina present?

Answer 19

• Toxic patient
• Non-fluctuant swelling below the angle of the jaw
• Oedema of the floor of the mouth and around the larynx
• Airway obstruction

Question 20

How can Ludwig’s angina be managed?

Answer 20

• Hospital admission
• Airway safety
• Antibiotic treatment
• Surgical drainage