ENT

Question 1

Vestibular schwannoma
Signs, nerves involved

Answer 1

Aka acoustic neuroma
Vertigo, sensorineura deafness, tinnitus, absent corneal reflex
CN 5,7,8 involved

Question 1

RAPD aka marcus gunn pupil

Answer 1

Affected eye pupil dilates as light shown-Defect in optic nerve or severe retinal disease eg retinal detachment

Question 2

SSRI if co prescitbed with NSAID

Answer 2

Prescribe PPI as increased risk of GI

Question 3

Suitable antidepressent adolescents and children

Answer 3

Fluoxetine

Question 4

Vestibular neuronitis vs labrynthitis

Answer 4

VN: Tinnitis, vertigo following viral infection

Labyrnthitis:
tinnitis, vertigo, hearling loss following recent viral ifection, sudden onset nausea nd Vomiting

Question 5

Cholesteatomoa

Answer 5

-foul smelling discharge, attic crust on upper part of ear drum, vertigo, facial nerve palsy
Mx: ENT referral for surgical removal

Question 6

Unilateral nasal polyp , or unilateral bleeding

Answer 6

Urgent ENT 2ww pathway

Question 7

Nasal polyps associations

Answer 7

Churg straus
Infectious
Allergic
CF ( if polyps in children, strong suspicioun of CF)
Karatgeners syndrome

Question 8

Samters tiad

Answer 8

Aspirin sensitivity, polyps and asthma

Question 9

Chronic sinusitis management

Answer 9

1) nasal irrigation with salan
2) nasal steroids
3) avoid allergen

Question 10

ethmoidal sinusitis

Answer 10

most common cause of orbital cellulitis

Question 11

First line for otitis media

Answer 11

amox for 5-7 days, alternate erythromycin
treat if more than 4 days, systemmic signs present or OM with perforation or dc or immuno comrpomised

Question 12

GLue ear Tx

Answer 12

observe for 3 months
grommet insertion
adenoidectomy

Question 13

Downward sloping pure tone thresholds
High frequency hearing loss
B/L impairment

Answer 13

Presbycusis
Difficulty hearing in noise environment, and difficulty hearing womens voice more than mens

Question 14

common cause of OM

Answer 14

1) H influenza
2) strep pneumo
3) moraxelaa
Mx Amox

Question 15

cystic hygroma

Answer 15

transilluminates, midline, compressible, on left side

Question 16

Rinnes test

Answer 16

Air conduction better than bone conduction- Normal
Bone conduction better than air conduction- Conductive deafness

Question 17

Webers test

Answer 17

centralised- normal
Conductive deafness- lateralises to affected ear
Sensorineural deafness- lateralises to un affected ear

Question 18

Drugs causing ototoxicity

Answer 18

Quinine, Amioglycosdies, Furosemide, aspirin and chemotherapy agents

Question 19

MEniere’s disease prophylaxis

Answer 19

BEtahistine
vestibular rehab

Question 20

MEniere’s disease acute attack Mx

Answer 20

buccal or IM prochlorperazine