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Trauma > ENT Emergencies > Flashcards

ENT Emergencies Flashcards

1
Q

Define a hematoma auricle.

A

Collection of blood within the cartilaginous auricle.

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2
Q

Define a hematoma auricle laceration.

A

Damage to the perichondrium (connective tissue that envelopes cartilage).

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3
Q

Define chondritis.

A

Infection of the cartilage of the ear.

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4
Q

State bacteria that could cause the hematoma infection.

A

1) S. aureus 2) Pseudomonas aeruginosa

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5
Q

Define otitis externa.

A

Inflammation of the ear canal.

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6
Q

State bacteria that could cause otitis externa.

A

1) Pseudomonas 2) Staphylococcus aureus.

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7
Q

State a treatment of otitis externa.

A

1) Antibiotic (ciproflacin) - steroid (dexamethasone) drops 2) Use wicks to drain tight canals

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8
Q

State 2 symptoms of otitis externa.

A

Swelling. Redness. Heat. Discharge of pus.

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9
Q

What is the treatment for foreign bodies in the ear canal?

A

1) Lidocaine (anaesthetic to block pain)

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10
Q

What is a tympanic membrane perforation?

A

Hole in thin tissue separating ear canal from the eardrum. (Treate with antbiotics)

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11
Q

State the cause of a tympanic membrane perforation.

A

Middle ear pressure secondary to fluid or barotrauma (ear damage).

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12
Q

Define otitis media (middle ear).

A

Inflammation and build up of fluid behind the ear drum.

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13
Q

State a symptom of tympanic membrane perforation.

A

Vertigo (spinning sensation). Ear pain. Hearing loss. Tinnitus (ringing in ear).

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14
Q

State a cause of otitis media (middle ear).

A

1) Commonly in children 3-6 years old 2) May follow an upper respiratory tract infection (e.g. Strep pneumoniae, H infuenzae)

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15
Q

State 2 symptoms of otitis media.

A

Earache. Hearing loss. Fever. Deafness. Irritability. Lethargy.

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16
Q

State a complication of otitis media.

A

1) Drum perforation 2) Secondary mastoiditis

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17
Q

State a treatment of otitis media.

A

1) Analgesia 2) Antibiotics 3) Consider AB if no improvement within 72 hrs or earlier if worsening or perforation

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18
Q

Define peripheral vertigo (vestibulopathy).

A

It’s a problem with the inner ear which controls balance, resulting in a mild-moderate spinning sensation.

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19
Q

State the 4 types of vertigo.

A

1) Benign paroxysmal positional vertigo (BPPV) 2) Labyrinthitis 3) Vestibular neuronitis 4) Meniere’s disease

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20
Q

Define Benign paroxysmal positional vertigo (BPPV).

A

Small pieces of debris break off in the inner ear, to stimulate small hairs.

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21
Q

State how Benign paroxysmal positional vertigo (BPPV) is diagnosed.

A

Hallpike manoeuvre results in Fatiguable nystagmus.

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22
Q

State how you clear the debris in Benign paroxysmal positional vertigo (BPPV).

A

Epley manoeuvre.

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23
Q

Define labyrinthitis.

A

It’s a viral infection of the inner ear, resulting in damage to vestibular-end organs responsible for hearing.

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24
Q

Define vestibular neuronitis.

A

Infection that has spread to the vestibular nerve (controls balance).

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25
Q

State a symptom of labyrinthitis.

A

Severe vertigo. Nausea. Vomiting. No deafness/tinnitus.

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26
Q

Define vestibular neuronitis.

A

Disorder characterised by a sudden onset - infection spread to the vestibular nerve (controls balance).

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27
Q

State 2 symptoms of vestibular neuronitis.

A

Unsteadiness. Earache. Nausea. Vomiting.

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28
Q

Define meniere’s disease.

A

Increased pressure in the endolymphatic system of the inner ear causes recurrent attacks of vertigo.

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29
Q

State 2 symptoms of meniere’s disease.

A

Nausea. Vomiting. Hearing loss. Fullness in ears.

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30
Q

State a treatment of inner ears.

A

Antihistamine. Prochlorperazine (anti-psychotic medicine). Fluids. Rest.

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31
Q

Define central vertigo.

A

Refers to problems with your brain/brainstem rather than your ear.

32
Q

Define mastoiditis.

A

Bacterial infection of mastoid cells in mastoid bone (located behind the ear).

33
Q

State 2 symptoms of acute mastoiditis.

A

Pain. Swelling. Tenderness.

34
Q

State the treatment for milf Epistaxis.

A

1) ABC 2) Trotter’s method (make patient sit up, pinch the nose for 5-10 minutes, head bent forward, open mouth and breathe) 3) Ice packs behind neck

35
Q

State the 2 types of Epistaxis.

A

1) Anterior - 90% Kisselbach’s plexus (usually in children/young adults) 2) Posterior - 10% (usually in elderly).

36
Q

State a cause of anterior Epistaxis.

A

Trauma. Winter syndrome. Irritants-cocaine. Pregnancy.

37
Q

State a cause of posterior Epistaxis.

A

Coagulopathy. Atherosclerosis. Neoplasm (abnormal mass of tissue that forms when cells grow and divide). Hypertension (debatable).

38
Q

State how anterior epistaxis is managed.

A

Using rapid rhino (high volume low pressure tamponade to ensure gentle compression). These packs require antibiotic prophylaxis.

39
Q

State how anterior epistaxis is managed.

A

1) Using rapid rhino (high volume low pressure tamponade to ensure gentle compression). These packs require analgesia and sedation 2) Require admission and O2 saturation monitoring

40
Q

State a complication of epistaxis.

A

1) Severe bleeding 2) Hypoxia, hypercarbia 3) Sinusitis, otitis media 4) Necrosis

41
Q

Define Bell’s Palsy.

A

Lower motor neurone weakness of cranial nerve VII (facial nerve).

42
Q

State 2 symptoms of Bell’s Palsy.

A

Mnemonic (Bell’s) - Blink reflex abnormal. Ear sensitvity. Lacrimation: deficient, excess. Loss of taste. Sudden onset. Palsy: CN VII nerve muscles.

43
Q

State a treatment of Bell’s Palsy.

A

Corticosteroid (symptom onset begins within 3-4 days).

44
Q

State a cause of Bell’s Palsy.

A

Viral associated ischaemia. Epstein-Barr virus/Lyme disease.

45
Q

Define a stroke.

A

Upper motor neurone lesion in which the lower facial muscles are affected, but forehead not affected.

46
Q

State cause of facial sinusitis.

A

1) Acute - Gram positive and H. flu 2) Chronic - Anaerobes, gram neg

47
Q

State a sign/symptom of sinusitis.

A

Purulent yellow-green rhinorrhea (nasal cavity filled with amount of mucous fluid). Fever

48
Q

State a treatment of facial infection sinusitis.

A

1) Acute: amoxil, septra (both antibiotics) 2) Chronic: amoxil-clavulinic acid, clindamycin, quinolones.

49
Q

State a complication of sinusitis.

A

1) Orbital cellulitis and abscess 2) Frontal sinusitis - may erode bone.

50
Q

State a symptom of facial cellulitis.

A

Red, swollen, feel hot, tender on touch.

51
Q

Define parotiditis.

A

Inflammation of the parotid salivary gland - can be acute/chronic.

52
Q

State a cause of parotiditis.

A

1) Viral - paramyxovirus 2) Bacteria - elderly, immunocompromised; associated with dehydration

53
Q

Define pharyngitis.

A

Sore throat.

54
Q

State a cause of pharyngitis.

A

1) Viral infection e.g. common cold 2) Bacterial infection e.g. group A streptococcus

55
Q

Define a peritonsillar abcess.

A

Bacterial infection which begins as complications to tonsilitis. Pus-filled pocket forms near tonsils.

56
Q

State a symptom of peritonsillar abscess.

A

Inferior - medial displacement of tonsil and uvula. Dysphagia, ear pain, muffled voice, fever.

57
Q

What defines a mild soar throat?

A

Able to tolerate oral fluids and medication.

58
Q

What defines a moderate soar throat?

A

Unable to swallow fluids or oral analgesia.

59
Q

What defines a severe soar throat?

A

Drooling saliva. Hoarse voice. Airway compromise. Signs of sepsis.

60
Q

State the treatment for mild sore throat.

A

1) Analgesia (mild) 2) Treat with antibiotics penicillin (if more severe) 3) Treat with antibiotics clarithomycin (if allergic)

61
Q

State the treatment for moderate sore throat.

A

1) IV fluids, IV paracetamol, benzylpenicillin + metronidazole (if penicillin allergic use vancomycin) 2) Activate full sepsis protocol

62
Q

State the treatment for severe sore throat.

A

1) Move to RESUS (high dependency unit) 2) IV access, FBC, U&Es

63
Q

State a symptom of epiglottitis.

A

Drooling. Changes to voice. Fever. Increased breathing rate.

64
Q

State a treatment of epiglottitis.

A

IV antibiotics. +/- steroids. Adrenaline.

65
Q

Define a retropharyngeal abcess.

A

Collection of pus in the back of the throat.

66
Q

State 2 symptoms of a retropharyngeal abcess.

A

Pain. Dysphagia. Dyspnea. Fever.

67
Q

State who tends to suffer from a retropharyngeal abcess.

A

Usually in children under 4 (lymphoid tissue in space).

68
Q

Define Ludwigs Angina.

A

Skin condition that occurs on the floor of the mouth underneath the tongue.

69
Q

What causes Ludwigs Angina?

A

Bacterial infection which occurs after a tooth abscess, which is a collection of pus in the center of the tooth.

70
Q

State how Ludwigs angina is treated.

A

ICU. Antibiotics. Airway management.

71
Q

Define angioedema.

A

Rapid swelling of area beneath the skin (normally after an allergic reaction).

72
Q

State a treatment of angioedema.

A

Antihistamines. Steroids.

73
Q

Define aphonia.

A

Loss of complete upper airway.

74
Q

Define stridor.

A

Incomplete upper airway.

75
Q

Define wheezing.

A

Incomplete lower airway.

Trauma (15 decks)

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