ENT

Question 1

A patient has a polyp in the left nostril.

What is your management plan? [1] Why? [1]

Answer 1

An urgent referral to ENT is required because a unilateral polyp requires investigation as a suspected nasopharyngeal cancer. Nasopharyngeal cancers are usually squamous cell carcinomas.

Question 2

How do you manage a thyroglossal cyst? [1]

Answer 2

Surgical excision:
- Sistrunk procedure: cyst and central portion of hyoid bone removed

Question 3

When do you treat AOM conservatively vs with Abx? [1]

Answer 3

Most patients with otitis media can be managed with simple analgesia and will resolve without antibiotics within 3-7 days.

Some patients may benefit from a backup prescription to be used if symptoms do not improve after 3 days. A 5-7 day course of amoxicillin or a macrolide (for penicillin-allergic patients) are usually used first line.

Question 4

? nasal bridge fracture investigation [1]

Answer 4

Obtain a CT scan of the nasal bones and perform a nasal endoscopy

Question 5

This patient has presented with malignant (necrotising) otitis externa (MOE) as evidenced by worsening symptoms not responding to topical treatment and evidence of facial nerve palsy. The most common organism associated with MOE is [].

Answer 5

This patient has presented with malignant (necrotising) otitis externa (MOE) as evidenced by worsening symptoms not responding to topical treatment and evidence of facial nerve palsy. The most common organism associated with MOE is Pseudomonas.