ENT quick

Question 1

treatment of otitis externa

Answer 1

Topical abx +/- steroids

Question 2

Otis media with perforation

Answer 2

Oral antibiotics should be given in acute otitis media with perforation

Question 3

When to prescribe abx immediatley in otitis media?

Answer 3

Symptoms lasting more than 4 days or not improving

Systemically unwell but not requiring admission

Immunocompromise or high risk of complications secondary to significant heart, lung, kidney, liver, or neuromuscular disease

Younger than 2 years with bilateral otitis media
Otitis media with perforation and/or discharge in the canal

If an antibiotic is given, a 5-7 day course of amoxicillin is first-line. In patients with penicillin allergy, erythromycin or clarithromycin should be given.

Question 4

Main side effects of prolonged use of Intranasal decongestant’s / steroids

Answer 4

Intranasal decongestants (e.g. oxymetazoline) should not be used for prolonged periods as increasing doses are required to achieve the same effect (tachyphylaxis)

Question 5

Ototoxic drugs

Answer 5

Aspirin/nsaids
Aminoglycosides
Loop diuretics
quinine

Question 6

Most common cause of bacterial otitis media

Answer 6

H. influenzai

Question 7

tosniltiis treatment

Answer 7

Phenoxymethylpenicllin or clarithro

Question 8

Otosclerosis

Answer 8

Autosomal dominant

Conductive deafness, tinnitus, tymapanic membrane normal, positive family history

Question 9

Mastoiditis

Answer 9

Otalgia, fever, vey unwell, ear may protrude forwards, ear discharge

IV ABX!!

can get facial nerve palsy and hearing loss

Question 10

Ramsay hunt

Answer 10

Herpes zoster
Auricular pain
Vesicular rash
Oral aciclvoir and corticosteroids

Question 11

Menieres

Answer 11

UNILATERAL symptoms
vertigo, herring loss (sensorineural ) and tinnitus

Nystagmus, positive romberg test

Inform the DVLA and cease driving until satisactory control fo symptoms

BUcal or IM propchlorpeazine for acute attacks

Betahistaine/ vestibular rehabilitation for prevenetion

Question 12

Epistaxis management

Answer 12

Initial management for epistaxis is with adequate first aid - pinch the nasal Ala (nostrils) cartilidgenous soft area firmly and lean forward for 20 minutes

Cautery if bleeding point

Packing if no bleeding point

—> ED

—> sphenopalatine ligation

Question 13

Otitis externa in diabetes

Answer 13

TREAT WTH CIORO

Question 14

Bartonella infection

Answer 14

Cat scratch

Question 15

Malignant otitis externa

Answer 15

Osteomyelitis of teh temporal bone following external ear canal infection
Diabetes, old age, immunocompromised, prolonged otitis externa

SYSTEMICALLY unwell high fever, pinna, cranial nerve involvement
IV abx and fever

Question 16

Vestibular neuronitis treatment

Answer 16

Prochlorperazine for rapid
Vestibular rehab for chronic symptoms

Question 17

Menieres

Answer 17

Acute = prochlorperazine
prophylaxis = beta histine

Question 18

Gingival hyperplasia cause

Answer 18

Phenytoin, ciclosporin, CCBs and AML

Question 19

Haemorrhage 5-10 days post tonsillectomy

Answer 19

Wound infection —> AXB

Question 20

Dizzy on extending neck

Answer 20

Vertebrobasilar ischaemia

Question 21

Mastoiditis

Answer 21

IV abx urgent admit

Question 22

Aspirin + other NSAIDS

Answer 22

Tinnitus!!

Question 23

Otitis media likely organism

Answer 23

Strep pneumoniae

Question 24

Conductive hearing loss

Answer 24

BC>AC in affected ear
Lateralise to affected ear

Question 25

Sensinueral hearing loss

Answer 25

AC>BC LAteralises to unaffected ear