ENT revision

1) MCQ
2) OSCE
RInne test: all true normal, conductive, snhl+
PTA: not use for children cannot cooperate, mentally chalenge
Acoustic admission: cochlea, screening, children, mentally challenge, define level
BERA: all age group malinger- very expensive, time consuming, specialised,
sedate
Neural: station hearing, not conductive
Ear drum: conductive nerve : neurosensory: neuro: choclea: sensory the
nerve: hearing centre
Causes of hearing loss
Causes non-inherited congenital hearing loss: not pass down
Pregnancy, woman:
Pinna: anomalies: pre-auricular sinus
Allergic, perichondritis
Otitis externa: acute pain! Not touch the ear. Fungal growth
Oral Ab: false!!!
Local infection
Malignant OE: immunosuppress- DM and Heart failure: pseudomonas: fissure of
sarotini and skull base: 7,8,9,12 palsy
Mortality rate: 100% before Ab
Ear infection! : gram
Nose and paranasal sinus: gram +!!!
Traumatic perforation: jacket
Middle ear effusion! Children with OM middle ear effusion
Prevention!
-

Dont smoke/ passive smoker

Breast feeding

Treat the cause: allergic rhinitis

Not drainage the fluid!!!:

Ventilation + balance te pressure
AOM:
Sore throad + ear pain: AOM children
4 stages
Intra-cranial, extra cranial complications!!!!
Very bulging- myringotomy: pus to come up, not grommet
Need Ab
Chronic suppurative OM: Unsafe- choleastotoma
Safe: copius discharge central perforation
unsafeL comication: marginal/ attic: pus flaccida
intra-cranial, extra-cranial
brain abscess:
otitic hydrocephalus
bezolds abscess
apex of temporal bone: gradenigos syndrome
otosclerosis: cochlea
-

Conductive
Can get sensory

Referred ear pain:

Tinnitus: pulsatile tinnitus: glomus tumour, chemotectoma
Vertigo:
Position: A few seconds: BPPV
Epley manoeuvre
Minutes and hours: menieres disease
Hearing loss: fluctuating snhl
Women: 30-60 age group: aetiology unknown: self-limiting
Bedridden, vertigo with hearng loss: inject ototoxic drug into cochlea: end
spectrum

Weeks: vestibular neuronitis

Facial nerve palsy:
Management!!
Bells palsy: idiopathic: steroid, physiotherapy, re-assured the patient!
Protect eyes: tarsorraphy, artificial eye
Facial nerve: upper vs lower motor
Nasopharynx
1)
2)
3)
4)
5)
6)
7)

Turbinate and polyp: touch it:

Test patency: chona atresia: oral airway on child refer
Foreign body: unilateral foul smeely discharge
Trauma
Csf leak: how to treat
X-ray cannot be used!! Nasal fracture
Causes of epistaxis: local, packing, ligation of vessels: blood supply
internal, external carotid artery! Millary artery, ext carotid artery: one has
branch one no branch
8) Dont ligate internl carotid, common carotid
9) Angiofibroma: adolescent epistaxis: male [not seen in female]
10)
Acute sinusitis, recurrent snusis, treat, intra-cranial, extra-cranial:
frontal lobe, mengintis, cavernous sinus, no otitic hydrocephalus, eye
[orbital cellulitis, orbital abscess, cellulitis abscess] chronic
osteomyelitis
11)
Surgery for sinusits; functional endoscopic surgery: complication
same
12)
Acute ethmoiditis: how to treat: admit patient! Take swab culture
and sensitive, empirical AB, CT scan!
13)
Nasal phraygeal carcinoma: painless neck lump! :
radiochemotherapy!
14)
Allergic rhinitis: treat the patient environment, avoid allergens:
house dust mite [hot water kill]. Medical therapy: immunotherapy: nasal
spray
15)
Choana atresia: icompatile with life in newborn
16)
Tonsil: tonsillitis: ab: no! slough! Big, red angry: viral infection!!!
17)
Complication: retropharyngeal, pertonsillar abscess
18)
Complication of tonsillectomy: primary 2nd
19)
Obstructive sleep apnoea: tonsillectomy: obstructive: friend say:
stop breathing at ngiht, poor concentration, uncontrol hypertension, CCF,
pickwekian syndrome sleep study
20)
CPAP
21)
Larynx: vocal cord palsy: stridor: under stridor: alryngomalacia!!1
self-limiting< premature aby, acute epiglottitis, LTB [croup], foreign boyd,
tumour, foreign body
22)
Trauma! Gen surgeon, ent, cardiothoracic,
23)
Inhalation: post-trauma
24)
Juvenile papilloamtosis: transmitted: prevent, universal,

25)
Head and neck cancer: laryngeal cancer, rehab
26)
Thyroid cancer: male, men syndrome, very young, old, radiotherapy
[female is false]. Types
27)
Meduallary: men syndrome
28)
Papillary: neck lump: lateral neck lump
29)
Anapalsitc: very old >60 : extension into larynx
30)
Parotid Ca: pleomorphic adenoma: carcinoma ex
31)
Iinflitative; adenoid cystic carcinoma: parotid swelling!
32)
Long term prognosis: lung metstassis!
33)
Parotid infection: mumps, facial nerve palsy+ infection earfox
disease: parotid infection+ sarcoidosis
34)
Lyme disase: tick
35)
Leucoplakia:20%
36)
Eryhtorplakia: 90%
37)
Tracheostomy: indication, complication
38)
Thyroiglassoa cyst: excision: sistrunk procedure
39)
Branchial cyst: middle age
40)
Cystic hygroma: congenital
41)
Best answer, true or false: - marking: dont tick everything
42)
IV bisphopnate, erythromycin, cispatin
43)
Tinnitus: 60%
44)
Tinnitus: subjective
45)
Tinnitus; SNHL: hearing aid: true
46)
Objective tinnitus: carotid artery: true!
47)
Acoustic neuroma: false!!! Von reclinghausn disease type 1: type 2:
CNS: AD
48)
Chronic unsafe incetion: true: pars flaccida, ear pain, pain+
mucopus discharge
49)
Upper motor neurone
50)
Surgical exploration: Chronic
51)
Acute renal failure: liver failure: epitaxis
52)
Winter month: humidifcaitoN:: true
53)
Obstructive sleep apnoea +p acking: true
54)
Ethomidal against gravity: nasal poly: oedema of mucosa
55)
Allergic nasal polyp: false: herniation of encephalocele: children no
polyps
56)
Swollen turbinate: yes
57)
20% asthma: true: samsters triad
58)
Aspirin sensitivity
59)
Excision tube: false: more than 20%
60)
Posterior 1/3 bone?: ear canal: true
61)
Swallow: tensor veli palatine: dilate and contract: true
62)
Palatal myoclonus: true
63)
Narorest portion: middle ear narrowest
64)
Acute SNHL: false
65)
Cannot hear
66)
Oral anti-viral: acylclovir: idiopathic: ? no! no cause: dont treat
67)
Optimum treatment: systemic steroid + vasodilator [beta-histne]
can!
68)
Chorni iron def anaemia, incomplete dysphagia, post-cricoid: ca:
true
69)
False; oesophageal werb: caanot detected

70)
Post-cricoid: menstruation, multiple childbirth, poor economic, poor
diet, vegetarian, post-cricoid caner: mediastinal lymph nodes: true!
71)
Chemotherapy: post-cricoid: radiotherapy
72)
Thyroglossal cyst: true, common, below hyoid bone, U/S: only
functioning thyroid, potential malignant potential: false
73)
NPC: associated Ab: EBV: yes, 2nd commonest: false [anatomical
site: false]later, unilateral glue ear, painless neck lump,
74)
Unilateral SNHL: nope, env noise, [bilateral], true [menieres
disease], mumps [true], ototoxicty, acoustic neuroma [true]
75)
Conductive hearing loss, false: pagets disease: false, false: SNHL
76)
Calculi swelling: true: radiopaque: false, reflex ectasia, false
[sjogrens syndrome] , surgical stone: sialonoscope
77)
Pleomorphic adenoma: recurrent true! Pseudopalse
78)
Peri-auricilar region: false! , make painful by eating: plemorohic not
painful, facial nerve paralysis [false], superifical parotidectomy: true,
peritonsillar bascess: trismus, unilateral tonsillar swelling, abscess: cannot
swallow
79)
Relative indication tonsillectomy:
80)
Referred ear pain: vagus,
81)
Lower mtn palsy:
82)
Loss of corneal reflex: 5th nerve:false
83)
Hyperacusis: stapedius:
84)
Tongue deviation:
85)
Safe perforation tympanic membrane: perforation in pars flaccida,
-tensa!
86)
Recurring ear ache
87)
Gram otorrhea [ear infection]
88)
Retracted tympanic-unsafe, perforation aprs tensa: true
Picture:
Functional endoscopis sinus surgery [FESS]
Typanoscelrosis, unsafe perforation, tracheostomy, speech rehab
Angry looking, erythoplakia,
Attic perforation