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