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Year 6 > ENT > Flashcards

ENT Flashcards

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1
Q

Tx of otitis media externa

A

Topical ABx +/- steroids then oral flucloxaccilin

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2
Q

Necrotising otitis media externa sx and mx

A

Extension to mastoid and temporal bones
Urgent ENT referral, CT head, IV cipro

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3
Q

Management of otitis media

A

Admit if severe systemic, complications, <3m with 38

W/o perf- >4d abx
With perf- oral amor 5d
With effusion- observe

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4
Q

Complications of otitis media

A

Perforation- damage chordates tympani- reduce taste in anterior 2/3

Mastoiditis- discharge and swelling behind ear

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5
Q

Mx of cholesteatoma

A

Referral for surgery

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6
Q

Sx of meniere disease

A

Clustered attacks- <12hrs
Fullness
Progressive SNHL- unilateral
Vertigo
Tinnitus

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7
Q

Ix and Mx of Menderes disease

A

Audiometry
Cyclizine- anti emetic , betahistine- anti vertigo

Surgical

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8
Q

Viral neuronitis vs labyrinthitis sx

A

After URTI
Vertigo and nystagmus

VL- hearing may be affected
VN- no hearing

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9
Q

BPPV sx

A

Sudden rational vertigo <30s
Provoked by head turning
Nystagmus

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10
Q

BPPV ix and mx

A

Ix- Dix hallpike- up beat nystagmus

Mx- Epley + beta histine

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11
Q

Causes of hearing loss

A

Conductive- external canal obstruction
Tympanic membrane perf
Ostsclerosis

SN
Drugs- aminoglycosides, vancomycin
Infective
Menieres, MS

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12
Q

Sx of vestibular schwannoma

A

Unilateral
SNHL
Vertigo
Headahce
CN palsies- absent corneal. reflex

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13
Q

Otosclerosis sx

A

Bilateral conductive deafness and tinitus

Can have redness of promontory of cochlea

Family history
Improve with noise and worse with pregnancy, menstruation

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14
Q

Mx of otosclerosis

A

Hearing aid
Stapes implant

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15
Q

Mx of vestibular schwannoma

A

Gamma knife surgery
Radio

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16
Q

Mx of sinusitis

A

> 10d- high dose nasal CS for 14d

Phenoxymethylpenicillin- 7d if think infective

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17
Q

Samters triad

A

Asthma, nasal polyps, aspirin hypersensitivity

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18
Q

Mx of fractured nose

A

If septal haematoma- evacuation, packing and suturing

Reduce before swelling
Or if swelling- re examine after 1 week

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19
Q

Mx of epistaxis

A

Compress nasal cartilage 15 mins
If bleeding visualised- cautery
Non- packing
If continue- referral

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20
Q

What is quinsy

A

Peri tonsillar abscess causing uvula deviation

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21
Q

What prompts tonsillectomy

A

7 in 1 year
5 for 2 years
3 for 3

2 of quinsy or 1 quinsy with significant tonsillitis

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22
Q

Sx of Scarlett fever

A

2-4 days after GAS
Sandpaper rash

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23
Q

Organsim causing tonsillitis

A

Strep pyogenes

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24
Q

Bells palsy mx

A

Eye care
Pred 50mg 10 days

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25
Ramsay hunt syndrome sx
Vesicular rash around ear Facial nerve palsy Vertigo
26
Mx of Ramsay hunt
Valciclovir 7d and steroids 5d
27
Sx of septal haematoma
Bilateral purple swelling
28
Mx of septal haematoma
Surgical drainage Examination underanaesthatic If not swelling reduce, if swelling- examine in 1 week
29
Sx of brachial cyst
Cyst in lateral neck, superficial to SCM muscle With acellular fluid with cholesterol crystals in aspirate
30
Sx of thyroglossal cyst
Midline Moves with tongue
31
When to refer oral ulcer to secondary care
>3 weeks of unexplained persistent ulcer
32
Mx of sudden vertigo and dysduadochokinesis
Referral CT head ?stroke
33
Problem with using nasal decongestants for long periods
Rhinitis medicamentosa Withdrawal of extended use Should cease use Tachyphylaxis
34
Sx of nasopharyngeal cancer
Unilateral ear effusion Not associated with URTI Otalgia 2ww referral
35
Sx of perforation
Discharge
36
Bleeding after tonsillectomy mx
If 6-8hrs- primary- return to theatre If 5-10d- secondary haemorrhage urgent seen by ENT and ABx
37
Interpretation of audiograms
Above 20db line normal In SN- both bone and air impaired Conductive- only air Mixed- both
38
Bleed after thyroid surgery mx
Removal of stitches and call for senior help
39
Organism for otitis media
H influenza
40
Sx of bacterial sinusitis
Double sickening Initial period and recovery Then sudden worsening Frontal pressure- worse leaning forwards Thick discharge
41
Surgical management of untreatable epistaxis
Ligation of sphenopalatine artery
42
Mx of vestibular neuritis
Prochlorperazine for acute phase
43
Sx of cholesteoma
Chronic ear infections Offensive discharge SNL Vertigo
44
Antiseptic for epistaxis and its CI
Naseptin Contains peanuts
45
Mx of perf tymp from barotrauma
Self limiting Follow up in a few weeks
46
Organism of otitis external
Pseudomonas aeruginosa
47
Sx of otitis externa vs media
Externa- recent swimming- ear pain, itch, discharge - red swollen canal on otoscopy Pain on trigs pull Media- bulging tympanic membrane on otoscopy after URTI Discharge- perforation Glue- retracted tympanic membrane
48
Sx of cholesteatoma
foul-smelling, non-resolving discharge hearing loss
49
Mx of menieres
Prochlorperazine Prevent attacks with beta histine
50
Drugs causing hearing loss
Quinine Furosemide Gentamicin Aspirin Chemo
51
2WW referral for laryngeal cancer
aged 45 and over with: persistent unexplained hoarseness or an unexplained lump in the neck
52
2WW referral for oral cancer
unexplained ulceration in the oral cavity lasting for more than 3 weeks or a persistent and unexplained lump in the neck.
53
Sialolithiasis vs Sialadenitis
Sialothiasis- stone- colicky pain and post prandial swelling of the gland Sialadenitis Staphylococcus aureus infection Pus may be seen leaking from the duct, erythema may also be note
54
Mx of glue ear
No cormibidities- observe 6-12 weeks Downs/cleft plate- ENT
55
Positive Rinne test
AC>BC
56
Perf eardrum feature and rinne and webers
Trauma, muffled sound Rinne negative, Weber localise to affected side
57
Bleeding after tonsillectomy
Referral to ENT
58
Auricular haematoma mx
referral to ENT
59
Conductive vs SN loss
Conductive- outer ear to round window(inner ear) - wax, perforation, ossicle defect SN- inner ear- cochlea, nerve or brain- drugs, infection, meunière, MS
60
Mx of vestibular neuritis
prochlorperazine- rapid relief - short course vestibular rehabilitation exercises are the preferred treatment for patients who experience chronic symptoms
61
Mx of mastoiditis
IV ABx
62
Otosclerosis sx
Conductive deafness Tinnitus Flamingo tinge- tympanic membrane Bilateral
63
Presbycusis sx
Age related SN loss Audiometry shows bilateral high-frequency hearing loss
64
Mx of nasal polyp
Large unilateral- urgent referral to ENT Most drink with CS
65
Sudden SN hearing loss mx
Urgent referral and CS
66
Nasopharyngeal carcinoma sx
Otalgia Unilateral serous otitis media Nasal obstruction- epistaxis CN palsies
67
Light reflex
Reflexting off surface of eardrum Loss in otitis media
68
Nasal haematoma mx
Urgent referral for drainage
69
Peripheral vs central nystagmus tests
Nystagmus- unidirectional peripheral, bidirectional central Abnormal head impusle- peripheral Skew- Vertical central
70
Nystagmus direction for labyrinth causes vs central
Central- towards and worse towards lesion Labyrinth- away Fast phase- saccade side named nystagmus So left labyrinth cause- right beating nystagmus Right cerebellar- right beating nystagmus
71
Most common cause of laryngeal cancer
HPV
72
Cause and tx of sudden onset SN hearing loss
Idiopathic Treat with steroids
73
Important part of ear to visualise in chronic discharge
Attic- for cholestoma
74
Malodourous chronic discharge mx
Refer to ENT since could be cholestolema

Year 6 (28 decks)

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