ENT Cases – KFP public report review 2016-2024 topics in exam

Otolaryngology – Sinus and Nasal Disorders

1. Chronic Rhinosinusitis

• Key Areas:
  • Initial pharmacological management, including cessation of nasal decongestants
  • Selecting appropriate investigations if symptoms persist
  • Considering smoking cessation management, factoring in monoamine oxidase inhibitor use
• Common Errors:
  • Prescribing bupropion for smoking cessation despite contraindications with monoamine oxidase inhibitors
  • Failing to consider medication interactions and contraindications

2. Nasal Congestion Management and Skin Lesion Diagnosis

• Key Topics Discussed:
  • Education on prescribed therapy use
  • Additional pharmacological management
  • Skin lesion diagnosis
• Candidate Performance:
  • Education not tailored to clinical case, irrelevant to key case features
• Improvement Areas:
  • Provide specific, relevant therapy use education
  • Accurate skin lesion diagnosis based on clinical presentation

3. Persistent Nasal Symptoms

• Key Topics:
  • Management of chronic nasal discharge and blockage
  • Antibiotic prescribing
• Candidate Performance:
  • Incorrect antibiotic dosing
  • Not following contemporary guidelines
• Improvement Areas:
  • Adherence to guidelines for the management of nasal symptoms
  • Accurate antibiotic prescribing

4. Rhinosinusitis and Behavioral Management

• Key Topics Discussed:
  • Initial investigations and management of rhinosinusitis
  • Handling inappropriate and aggressive conduct
• Candidate Performance:
  • Failing to take responsibility for clinical care
  • Focusing solely on organic causes of behavior
• Improvement Areas:
  • Assume responsibility for comprehensive care
  • Address behavioral issues with appropriate strategies

Otolaryngology – Hearing Disorders

1. Hearing Loss and Tinnitus

• Insight:
  • The importance of appropriate investigations for hearing loss and tinnitus to exclude serious underlying conditions
• Strengths:
  • Providing practical advice for communication with hearing-impaired individuals
• Improvements:
  • Avoid overcoding in responses
  • Focus on specific, actionable advice

2. Hearing Loss and Ear Pain Management

• Key Topics Discussed:
  • Pharmacological management for initial symptoms
  • Diagnosis and management for bilateral hearing loss
• Candidate Performance:
  • Lack of comprehensive management strategies for hearing loss
• Improvement Areas:
  • Implement evidence-based pharmacological and non-pharmacological management strategies for hearing conditions

3. Chronic Tinnitus Management

• Key Topics Discussed:
  • Examination indicative of serious underlying causes
  • Initial investigations
  • Non-pharmacological management
• Candidate Performance:
  • Management actions not tailored to clinical presentation
• Improvement Areas:
  • Focus on specific, relevant examination findings
  • Appropriate investigations
  • Effective non-pharmacological management strategies

4. Acute Otitis Media Management and Follow-up for Persistent Symptoms

• Key Topics Discussed:
  • Pharmacological management of acute ear pain and fever
  • Handling persistent purulent ear discharge
• Candidate Performance:
  • Incorrect dosing in pharmacological management
• Improvement Areas:
  • Ensure accurate dosing in pharmacological management
  • Follow evidence-based guidelines for persistent otitis media

5. Hearing Impairment in a Child

• Key Topics Discussed:
  • Interpretation of audiogram
  • History taking
  • Differential diagnosis
  • Management of a complaint
• Candidate Performance:
  • Difficulty in interpreting audiogram
  • Providing relevant history and differential diagnoses
• Improvement Areas:
  • Enhance skills in audiogram interpretation
  • Specific history taking
  • Identifying relevant differential diagnoses

6. Audiogram Interpretation

• Specifics:
  • Candidates missed the directive to identify conditions other than hearing loss
  • Struggled with interpreting the audiogram accurately
• Improvement Areas:
  • Enhance understanding of audiogram interpretation
  • Ensure responses directly address the question asked
  • Focus on conditions beyond the obvious hearing loss

Otolaryngology – Combined Conditions

1. Ear Lesion and Concerns About Fetal Abnormalities

• Key Topics Discussed:
  • Differential diagnoses for ear lesion
  • Management actions
  • Antenatal advice for fetal abnormalities
• Candidate Performance:
  • Answers incongruent to case presentations
  • Misunderstanding of antenatal screening/diagnostic tests
• Improvement Areas:
  • Tailor answers to case specifics
  • Understand the role and interpretation of antenatal tests