ENT Oneliners by Swammy – Mock for PLAB
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- Diabetic + ext ear furunculosis= Rx : Oral flucloxacillin
- Syringing of the ear done >>> sudden onset of pain+ ruptured TM = immediate referaal to the specialist
- h/ o vericella now complains of earache vesciles near pinna nd external ear = SHINGLES= oral Acyclovir
- Progressive CD + pearly white mass + scarred ear drum = cholestetoma >> routine referral to the specialist for surgery
- LVF 6 months back now complains of epistaxix = drug induced ( Aspirin)
- Child in ICU with cellulititis >> Complains of epistaxis + Spleenomegaly. Cause of epistaxis = SEPSIS
- Smoker + unilateral diplopia+ recurrent epistaxis+ wt loss>> Maxillary opacification seen on X-ray+ MAXILLARY ADENOCARCINOMA
- Head trauma >> leakage of watery fluid from nose = ETHMOID BONE FX
- Rx: Epistaxis= Pinch soft part of the nose
- DVT+ neurological manifestation( facial numbness) = ACOUSTIC NEUROMA
- Child with continuous stridor + mild fever + drooling of saliva + very ill>>> EPIGLOTITIS>> H. influenza>> Call anesthetist
- Child with FB in ear ( plastic bead) + agitated >>> beast Rx refer to ENT for removal under GA
- Post thyroidectomy >>> hoarseness after 6 hours of surgery + RECURRENT LARYNGEAL NERVE INJURED
- Hoarseness of voice for 6 months of a school teacher >>>> SINGERS NODULE
- 80 yr old smoker >> hoarseness (progressive ) + fever+ malaise + weight loss = Ca LARYNX
- Unilateral conductive deafness>> eardrum obscured by brown mass>> WAX
- Difficulty hearing in both ears + loss of lower frequency + family history present >>> paracusis Willisii >>> Otosclerosis ( Autosomal Dominat + bilatereral conductive deafness, pregnancy Rx: Stedectomy) As Graph
- Meiner’s disease = TVS >>> low frequency hearing loss
- 80 year old>>>difficulty in hearing>>>audiogram-marked high frequency hearing loss>>>can hear better in quiet surroundings =PRESBYCUSIS
- 3 nose bleeds in the last two days + petechial hge + bruising over limbs and trunks = Platelet count
- Nose bleed + GI bleed + talengectasia + Family history = HERIDITARY TALENGECTITIA >>> Inv Upper GI endoscopy
- Repeated epitaxis+ menorrhagia+ family history+ clotting screen is n ormal . BT prolonged >>> Von Willibrand factoe assay
- Warfarin gfro AF >>> epistaxis >>> check INR ( 2-3)
- 65 yearold +epistaxis+ perifollicular hemorrhages + bruises over the limbs>>> Scurvy >>> Vit C assay
- Intermittent tinnitus, vertigo, giddiness = meneire’s disease
- Bilateral conductive hearing loss>>>father similar history=OTOSCLEROSIS-A.D.
- Sudden onset conductive hearing loss>>>brown mass=wax impaction
- 52year old woman>>>3month history of increasing neck swelling>>> hoarseness>>> inspiratory and expiratory wheeze =CARCINOMA THYROID
- H/o smoking 20 ciggs/day>>>2 month history of drooping eyelid+chronic cough+supraclavicular mass=PANCOAST TUMOUR
- Tinnitus + muffled hearing+increased pressure in ear+ vertigo=MENIERE’S DISEASE
- ventilated person >>>now extubated>>>develops hoaseness of voice>>>laryngoscopy normal=FUNCTIONAL DYSPHONIA
- Drug abuser>>>weight loss 13kgs>>>cough+night sweats>>>hoarseness of voice>>>swelling in the neck+several non tender swellings in both side of the neck=TUBERCULOSIS
- Teacher>>>hoarseness>>>circumscribed nodules on both vocal cords=VOCAL CORD NODULES
- Painful sore swollen throat+ earache+difficulty in swallowing fluids+temp 39.7>>>treatment=inpatient parenteral antibiotics
- Long-standing ear discharge >>>presents with fever, earache , anorexia, nausea, rigors>>>tenderness over mastoid>>>mastoiditis=ADMISSION FOR PARENTERAL ANTIBIOTICS
- earache+pain in left maxilla>>>post root filling dental procedure >>>temp 37.8=maxillary sinusitis=ORAL AMOX+METRO
- deafness in right ear after a swim>>>ear normal on examination>>>wax present>>>treatment=SYRINGING
- acute pain and little bleed from the era after he sustained a blow to the ear>>>minimal blood in EAC+small perforation in tympanic membrane>>>next step>>>KEEP EAR DRY AND OBSERVE (OR PROPHYLACTIC ORAL AMOX)
- furniture maker>>>anaesthesia of left cheek>>>repeated epistaxis=MAXILLARY ANTRAL CA
- repeated epistaxis+ whistling on inspiration =SEPTAL PERFORATION>>>CAUSES:COCAINE , CHROME
- sheep farmer>>>epistaxis+bleeding polyp from anterior nasal septum=ORF
- old patient>>>epistaxis ×2hours>>>cause=HYPERTENSION
- vertigo worsening on movement =BPPV>>>test=TILT TEST/HALPIKE MANOEUVRE
- Painkiller for shoulder pain>>>tinnitus =SALICYLIC ACID LEVELS
- blow behind ear>>>difficulty hearing+tinnitus =FRACTURE OF PETROUS TEMPORAL BONE
- loss of corneal reflex+diminished hearing>>>ct-widened ear canal=ACCOUSTIC NEUROMA
- unilateral sensory neural hearing loss =ACCOUSTIC NEUROMA
- bilateral sensory hearing loss>>>resolves spontaneously =NOISE INDUCED HEARING LOSS
- Family history of hearing loss>>>bilateral conductive deafness=OTOSCLEROSIS
- bilateral sensory hearing loss=PRESBYCUSIS
- sudden pain following ear syringing >> drum obscured with water and residual wax >>> Mx : same day referral to the specialist
- travel history+ severe pain in both ears + swelling + redness around EAC + pain on pinna movement + TM normal >>> OTITIS EXTERNA>> Rx: topical GENTAMYSIN + oral CIPROFLOXACIN
- sudden onset of pain + deafness in the ear + vescicular rash on the right side of the surface of the ear drum + Vescicles in the auditory canal >> Ram Say Hunt Syndrome >> Rx: Oral Acyclovir
- Repeated h/o of pain and d/c from childhood + white mass visible thru drum>>> ??? same day referral to the specialist
- Warfarin for prosthetic valve >> presents with severe nose bleed >> INR =10 + haemodynamically compromised >>> PROTHOMBIN COMPLEX CONCENTRATE.
- FRESH FROZEN PLASMA >>> FOR STABLE PT
- Vit K >> Warfarin toxicity in stable pt
- Intermittent epitaxis + crusting over ant nasal mucosa= CHROM=NIC INF VESTIBULITIS>> Rx: Apply neomysin cream
- no history of bleeds>>> now presents with epistaxis + small haematoma in the nasal septum=REASSURANCE (if large=incision and drainage)
- Before leaving house >>>feels out of breath +room goes round=ANXIETY
- Atrial fibrillation +attack of vertigo+confusion which lasted for 2-3=TIA
- Recurrent episode of TVS + deafness increases as vertigo settles=MENIERE’S
- Vertigo without deafness>>>following URTI=labyrinthitis
- traumatic head injury>>>nose bleed+ clear fluid>>>diagnosis-CSF RHINORRHOEA >>>ethmoid bone fracture
- epistaxis 9 days after polypectomy>>>tender over nostril+febrile=SEPSIS
- facial pain+recurrent nose bleeds for four weeks>>>xray-opacification of right maxillary antrum=ADENOCARCINOMA OF MAXILLARY SINUS
- recurrent nose bleeds ×1year +splenomegaly=
- Short history of earache+rhinorrhoea+pink left ear drum+ temp 38=viral infection>>>PARACETAMOL AND REVIEW
- previous history of URTI +mild righ era ache+wax impaction>>>management =ERA SYRINGING
- Persistent ear infection following 7 day antibiotics treatment +left ear drum dull amd scarred +purulent discharge=suppurative otitis media=CO AMOXICLAV
- 5 day history of temp and ear ache>>>right ear drum red>>> Otitis media= amoxicillin
- Child+ foreign body in ear>>>does not allow for examination =REMOVE UNDER GA
- Gentamycin=ototoxicity
- Poor personal hygiene>>>hearing loss after shower=WAX OBSTRUCTION
- Cornmeal anaesthesia +SNHL+ xray- widening of internal acoustic meatus=ACOUSTIC NEUROMA
- .Bruising to mastoid process+ hearing loss= petrous temporal fracture
- return from spain with ear ache+pus in ear canal>>> otitis externa=gentamycin e/d
- Red painful right ear following rugby match>>>erythematous pinna=PARACETAMOL
- Pain in right ear following URTI>>>rhinorrhoea+pink tympanic membranes=viral=PARACETAMOL
- Temperature, lethargy, red bulging inflamed tympanic membrane =otitis media=AMOXICILLIN
- Bbb
- 48 hour earache+high temp >>>purulent discharge which relieves pain>>>otitis media=AMOXICILLIN
- ct scan=loss of aeration of middle ear cleft+ mastoid air cells+middle ear flood>>>bilateral hearing loss=OTITIS MEDIA WITH EFFUSION
- ct scan of petrous bone=normal mastoid and middle ear+ cochlea appear hyper radio-dense + cochlear duct narrowed on both sides + discrete areas of rarefaction in cochlear bone=PAGETS DISEASE OF PETROUS BONE
- Ct scan =soft tissue mass within the attic +extensive destruction of malleus and incus + mastitis air cells opacified + horizontal facial canal erosion +LCC eroded =CHOLESTEATOMA
- HEREDITARY TELENGECTASIA=heavy nose bleeds + GI bleeds+ telengectasia (prominent small veins on lips + family history (3/4)
