Revised and Updated.
, Contents
Forewordvii
Preface to the Third Edition ix
Acknowledgementsxi
Authorsxiii
List of Abbreviations xv
The DO-HNS and MRCS (ENT) Examination and How to Pass It xvii
General Tips for the Communication and History Stations xix
1 History Stations 1
Rhinology2
1.1 Olfactory Dysfunction2
1.2 Nosebleeds in Adults5
1.3 Nasal Crusting7
1.4 Catarrh, Post-Nasal Drip and Chronic Rhinosinusits9
1.5 Septal Perforation11
1.6 Nasal Obstruction13
1.7 Facial Pain 15
Paediatrics17
1.8 Snoring in a Child17
1.9 Recurrent Tonsillitis19
1.10 Nosebleeds in Children21
1.11 Hearing Loss in a Child23
1.12 Child with Recurrent Ear Infections25
Head and Neck27
1.13 Neck Lump27
1.14 Dry Mouth30
1.15 Lump in the Throat33
1.16 Hoarse Voice35
Otology38
1.17 Tinnitus38
1.18 Facial Weakness41
1.19 Adult with Itchy, Painful Ear44
1.20 Adult with Non-Acute Hearing Loss46
1.21 Adult with Sudden Hearing Loss48
1.22 Otalgia50
1.23 Dizziness52
2 Examination Stations 55
2.1 Examination of the Ear56
2.2 Examination of the Nose63
2.3 Examination of the Neck66
v
Revised and Updated.
, Contents
2.4 Examination of the Oral Cavity71
2.5 Flexible Nasendoscopy74
2.6 Vestibular Assessment76
3 Communication Skills Stations 81
3.1 Consent Stations81
3.2 Explanation Stations90
3.3 Breaking Bad News96
3.4 Discharge Letter98
3.5 Operation Note99
4 Data and Picture Interpretation Stations: Cases 1–45103
Index197
vi
Revised and Updated.
, Foreword
Exams are a ‘necessary evil’ in life. As surgeons we have exposure to more than our fair
share of these ‘evils’ leaving many of us with a lifelong sense of deep foreboding whenever
we cross the portals of the Royal College of Surgeons! However, the tools to help one suc-
cessfully negotiate these life events are becoming more and more effective. This excellent
book, now in its highly successful third edition, exposes the reader not just to the type
and style of questions likely to be encountered in the OSCE sections of the MRCS (ENT)
exams but also gives advice on practical preparation, and how to make these situations
less daunting.
All exams have a syllabus and whilst there is no short cut to the acquisition of knowl-
edge to satisfy that syllabus, knowledge alone is not sufficient to guarantee a pass. Exam
technique plays an enormous part, particularly in relation to OSCE and communication
skills stations. Reading and re-reading this book will equip the candidate with the best
chance to avoid the dreaded ‘See you again in four months’! The scenarios set out in this
well illustrated book are the sorts of cases likely to be encountered on a regular basis in any
busy ENT department. The distillation of this knowledge will therefore not just help one to
pass the formal exams but also to become a better clinician.
It's a pleasure to provide the foreword to the third edition of this text – one that has
now provided countless current registrars and consultants in the UK and internationally a
guided way to MRCS. On a personal note, I had the pleasure of being Joe Manjaly's trainer
and he is now my consultant colleague at the Royal National ENT Hospital. He is a won-
derful and inspirational teacher and I look forward to his continued and ever-increasing
contribution to the ENT world.
Jeremy Lavy
FRCS (Eng) FRCS (ORL-HNS)
Consultant ENT Surgeon
The Royal National ENT Hospital & University College London Hospitals, UK
vii
Revised and Updated.
, Contents
Forewordvii
Preface to the Third Edition ix
Acknowledgementsxi
Authorsxiii
List of Abbreviations xv
The DO-HNS and MRCS (ENT) Examination and How to Pass It xvii
General Tips for the Communication and History Stations xix
1 History Stations 1
Rhinology2
1.1 Olfactory Dysfunction2
1.2 Nosebleeds in Adults5
1.3 Nasal Crusting7
1.4 Catarrh, Post-Nasal Drip and Chronic Rhinosinusits9
1.5 Septal Perforation11
1.6 Nasal Obstruction13
1.7 Facial Pain 15
Paediatrics17
1.8 Snoring in a Child17
1.9 Recurrent Tonsillitis19
1.10 Nosebleeds in Children21
1.11 Hearing Loss in a Child23
1.12 Child with Recurrent Ear Infections25
Head and Neck27
1.13 Neck Lump27
1.14 Dry Mouth30
1.15 Lump in the Throat33
1.16 Hoarse Voice35
Otology38
1.17 Tinnitus38
1.18 Facial Weakness41
1.19 Adult with Itchy, Painful Ear44
1.20 Adult with Non-Acute Hearing Loss46
1.21 Adult with Sudden Hearing Loss48
1.22 Otalgia50
1.23 Dizziness52
2 Examination Stations 55
2.1 Examination of the Ear56
2.2 Examination of the Nose63
2.3 Examination of the Neck66
v
Revised and Updated.
, Contents
2.4 Examination of the Oral Cavity71
2.5 Flexible Nasendoscopy74
2.6 Vestibular Assessment76
3 Communication Skills Stations 81
3.1 Consent Stations81
3.2 Explanation Stations90
3.3 Breaking Bad News96
3.4 Discharge Letter98
3.5 Operation Note99
4 Data and Picture Interpretation Stations: Cases 1–45103
Index197
vi
Revised and Updated.
, Foreword
Exams are a ‘necessary evil’ in life. As surgeons we have exposure to more than our fair
share of these ‘evils’ leaving many of us with a lifelong sense of deep foreboding whenever
we cross the portals of the Royal College of Surgeons! However, the tools to help one suc-
cessfully negotiate these life events are becoming more and more effective. This excellent
book, now in its highly successful third edition, exposes the reader not just to the type
and style of questions likely to be encountered in the OSCE sections of the MRCS (ENT)
exams but also gives advice on practical preparation, and how to make these situations
less daunting.
All exams have a syllabus and whilst there is no short cut to the acquisition of knowl-
edge to satisfy that syllabus, knowledge alone is not sufficient to guarantee a pass. Exam
technique plays an enormous part, particularly in relation to OSCE and communication
skills stations. Reading and re-reading this book will equip the candidate with the best
chance to avoid the dreaded ‘See you again in four months’! The scenarios set out in this
well illustrated book are the sorts of cases likely to be encountered on a regular basis in any
busy ENT department. The distillation of this knowledge will therefore not just help one to
pass the formal exams but also to become a better clinician.
It's a pleasure to provide the foreword to the third edition of this text – one that has
now provided countless current registrars and consultants in the UK and internationally a
guided way to MRCS. On a personal note, I had the pleasure of being Joe Manjaly's trainer
and he is now my consultant colleague at the Royal National ENT Hospital. He is a won-
derful and inspirational teacher and I look forward to his continued and ever-increasing
contribution to the ENT world.
Jeremy Lavy
FRCS (Eng) FRCS (ORL-HNS)
Consultant ENT Surgeon
The Royal National ENT Hospital & University College London Hospitals, UK
vii
Revised and Updated.
