ENT
Ear, nose and throat presentations, and head and neck cancer.
- Otitis Media Distinguishing the bulging red drum of acute infection from the effusion of glue ear, why most cases don't need antibiotics, and when persistent effusion needs grommets.
- Otitis Externa Why tragus tenderness separates it from otitis media, topical treatment as first line, and the granulation tissue that should trigger a same-day referral for malignant otitis externa.
- Cholesteatoma Why chronic foul-smelling discharge that won't clear with antibiotics needs an ENT referral rather than another prescription, and why surgery is the only definitive treatment.
- Mastoiditis The protruding, tender ear that follows untreated otitis media, why IV antibiotics and myringotomy resolve most cases, and the intracranial spread that makes this an emergency.
- Perforated Eardrum Why keeping the ear dry and reviewing at 6-8 weeks is correct for most perforations, and which trauma features mean CT rather than watchful waiting.
- Hearing Loss Using Rinne and Weber to classify conductive versus sensorineural loss, matching hearing aids/BAHA/cochlear implants to the pathology, and why sudden loss is an emergency.
- Tinnitus Why asking whether the sound beats with the pulse reframes the whole work-up, and which unilateral or pulsatile patterns need MRI or vascular imaging.
- Benign Paroxysmal Positional Vertigo Reading the Dix-Hallpike test to confirm the diagnosis, why the Epley manoeuvre cures most patients in one sitting, and the nystagmus patterns that point to a central cause instead.
- Meniere Disease Applying the diagnostic tetrad and formal criteria, tiering treatment from betahistine to intratympanic gentamicin, and the DVLA notification rule that's easy to forget.
- Labyrinthitis and Vestibular Neuritis Using the HINTS exam to tell peripheral vertigo from a posterior circulation stroke, why hearing loss separates labyrinthitis from neuritis, and when bacterial labyrinthitis is an emergency.
- Vertigo A framework for separating true vertigo from presyncope and disequilibrium, distinguishing vestibular migraine from Meniere's disease, and knowing when a peripheral picture is actually a stroke.
- Epistaxis First aid that actually works (lean forward, pinch the soft tip), the escalation from cautery to packing, and the systemic and red-flag causes worth asking about in recurrent bleeds.
- Rhinosinusitis Why most acute cases are viral and settle with saline and intranasal steroids, and the orbital and intracranial complications that turn a sinus infection into an emergency.
- Nasal Polyps Telling a pale, insensitive polyp from a tender turbinate, the Samter's triad link to asthma and aspirin sensitivity, and why a unilateral polyp needs biopsy rather than a steroid spray.
- Tonsillitis and Pharyngitis Using Centor and FeverPAIN to target antibiotics, why amoxicillin is contraindicated if glandular fever is possible, and the tonsillectomy frequency criteria.
- Quinsy Why trismus and uvular deviation separate this from severe tonsillitis, and the needle aspiration plus IV antibiotics that treat it.
- Upper Respiratory Tract Infection Why thick nasal discharge alone isn't a reason to prescribe, how to tell a cold from flu or allergic rhinitis, and the "double sickening" pattern that flags a bacterial complication.
- Hoarseness and Voice Change Why the 3-week rule mandates a laryngoscope, tracing vocal cord palsy from skull base to aorta, and the smoking/alcohol history that should trigger a 2-week-wait referral.
- Head and Neck Cancer Mapping red-flag symptoms to subsite, why unilateral glue ear in an adult means nasopharyngeal exam, and how HPV status is reshaping oropharyngeal cancer prognosis.
- Thyroid Cancer Working a thyroid nodule through ultrasound and Thy-classified FNA cytology, why Thy3 means diagnostic surgery, and the post-thyroidectomy haematoma that demands bedside wound reopening.
- Neck Lumps Working through a neck lump by triangle and age, the swallow/tongue-protrusion tests for midline masses, and why Virchow's node points to the abdomen, not the neck.
- Airway Compromise Recognising stridor and the ominous silent chest across epiglottitis, Ludwig's angina and post-thyroidectomy haematoma, and the can't-intubate-can't-oxygenate algorithm.