Clinical Presentations in ENT Flashcards
Prodromal illness with headache, malaise and fever before onset of sore throat, odyndophagia, neck pain and otalgia (caused by referred pain along glossopharyngeal nerve)
Tonsils enlarged and erythematous
tonsillitis
Is cervical lymphadenopathy common in tonsillitis?
Yes
Are exudates present in tonsillitis?
may be
What may also be present in tonsillitis if viral?
rhinorrhoea and a productive cough
Unilateral sore throat, odyndophagia, headache, ipsilateral otalgia, hot potato voice, drooling, peritonsillar swelling, deviaeted uvula
Peritonsillar abscess (quinsy)
Does peritonsillar abscess tend to have cervical lymphadenopathy?
yes, unilateral
sore throat accompanied by high fevers, enlarged tonsils bilaterally, rash, lymphadenopathy, haemorrhagic petechiae on the palate, splenomegaly, hepatomegaly, jaundice
glandular fever
What is the lymphadenopathy like in glandular fever?
symmetrical cervical, axillary and inguinal
Are there exudates in glandular fever?
Yes, tonsils are often completely covered by exudates
Sore throat, trismus (lockjaw), fever and malaise
Patient has swelling in lateral pharyngeal wall which can cause displacement of the tonsil medially
Externally, there is often an erythematous upper lateral neck
parapharyngeal abscess
Sore throat, odynophagia, dysphagia, neck stiffness, voice change, malaise, feeling of lump in throat
rarely can also present with spinal cord compression
May look normal on examination or may have posterior pharyngeal wall swelling
May also have fevers, rigors, unilateral lymphadenopathy or airway compromise
retropharyngeal abscess
Sore throat
On examination, creamy white plaques on oropharynx
oral candida
Rapid onset of sore throat, fever, odynophagia, cough, change in voice and otalgia
droopling, pyrexia, stridor, hoarse voice, cervical lymphadenopathy
Epiglottitis
Initial causes sore throat, then 1-2 days later, red rash over the chest, which spreads to rest of body, sparing palms of hands, soles of feet and face
May see tonsillitis and pharyngitis
Red swollen STRAWBERRY TONGUE
scarlet fever
Purulent nasal discharge, fever, sore throat
On examination, tonsil and oropharynx are initially discoloured white before forming a grey green membrane that can cause airway obstruction
diptheria
Nasal congestion or discharge
May also have facial pain/pressure
rhinitis
Epistaxis, loss of consciousness, breathing difficulties, swelling, bruising, nasal tenderness and deviation
nasal trauma
frontal headache, purulent rhinnorrheoas, facial pain, tenderness and fever
severe pain and tenderness with purulent nasal discharge
sinusitis
Worsened hearing and ability to understand speech due to high frequency hearing loss
prebycusis
progressive, ipsilateral tinnitus with or without sensorineural hearing loss
Large tumour may cause unilateral cerebellar symptoms
giddiness common, vertigo rare
trigeminal nerve compression can lead to numb face
acoustic neuroma/vestibular schwannoma
Impaired tympanic membrane mobility, hearing loss, poor school performance, behavioural problems, speech delay, balance problems
NO OTALGIA
Otitis Media with Effusion (GLUE EAR)
Rapid onset otalgia, opaque/bulging tympanic membrane, impaired tympanic membrane mobility, may have hearing loss
Acute Otitis Media
Foul discharge with/without deafness, headache, pain, facial paralysis, vertigo
cholesteatoma
Tender mastoid and protruding auricle
mastoiditis