Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Finals: Speciality Blocks > ENT > Flashcards

ENT Flashcards

(94 cards)

Start Studying
1
Q

What is the criteria used as a clinical scoring tool that is used to decide whether antibiotics are warranted to treat a possible streptococcal tonsillitis

A

Centor criteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the components of the Centor criteria

A

Tonsillar exudate
Tender anterior cervical lymphadenopathy
Temperature >38
Absence of cough

Centor criteria is a clinical scoring tool that can be used to decide whether antibiotics are warranted to treat a possible streptococcal tonsillitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Name a rare but serious complications of strep throat

A

Scarlet fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name 3 common complications of acute tonsillitis

A

1) Recurrent tonsillitis (most common)
2) Retropharyngeal Abscess
3) Peritonsillar Abscess (Quinsy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Likely Dx
Sore throat, dysphagia, peritonsillar bulge, uvular deviation, trismus and muffled voice

A

Peritonsillar Abscess (Quinsy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Management of peritonsillar abscess (quinsy)

A

Antibiotics and aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Likely Dx:

Elderly patient
Gradual symmetrical bilateral hearing loss which is most noticeable at higher frequencies

A

Presbycusis
Due to natural ageing of the auditory system: cochlear hair cells and auditory nerve fibres damaged symmetrically over time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the most appropriate management for proliferative diabetic retinopathy

A

Urgent laser photocoagulation (within 72h to prevent further neovascularisation)

You sacrifice the peripheral retina to reduce the production of vascular endothelial growth factor produced by this ischaemic retina and thus prevent neovascularisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What do you prevent from happening by urgently doing laser photocoagulation for proliferative diabetic retinopathy

A

Blindness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Recurrent otitis media is a key characteristic of which inherit condition?

A

Turner’s Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the first line antibiotic used in the treatment of bacterial tonsillitis

A

Phenoxymethylpenicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the first line antibiotic used in the treatment of bacterial tonsillitis with a penicillin allergy

A

Clarithromycin or Erythromycin for 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Name an extra-cranial complication of otitis media

A

1) Facial nerve palsy (CN VII)

2) Mastoiditis (infection spread to cause abscess formation in the mastoid air spaces of the temporal bone)

3) Petrositis

4) Labrynthtitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Name an intra-cranial complication of otitis media

A

1) Meningitis
2) Sigmoid sinus thrombosis
3) Brain abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hoarseness is a red flag for which kind of head and neck cancer?

A

Laryngeal cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Name a cause of hoarseness

A

1) Laryngeal cancer
2) Chronic Laryngitis (most commonly hoarseness in the morning)
3) Laryngitis (inflammation of the larynx i.e. voice box)
4) Reinke’s Oedema (caused by enlargement of the vocal cords and is associated with hypothyroidism it leads to prolonged and persistent hoarseness)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tonsillectomy is considered if a patient suffers more than how many episodes of tonsillitis per year for 2 years and if the episodes interfere with daily life

A

5 episodes of tonsillitis per year for 2 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the inheritance pattern of Hereditary Hemorrhagic Telangiectasia (Osler-Weber-Rendu Syndrome)

A

Autosomal dominant

This condition should be suspected in a patient with recurrent epistaxis, telangiectasia, and arteriovenous (AV) malformations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What medication should be started immediately if novel sensorineural hearing loss

A

ENT emergency
High dose steroids as are highly effective if started early

Immediate referral to ENT for assessment within 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Likely Dx:

Sudden, unpredictable attacks of vertigo lasting between 20 minutes and 12 hours

Associated sensorineural hearing loss and tinnitus

A

Ménière’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What medication is used prophylactic to reduce the frequency of attacks of vertigo in Ménière’s disease

A

Betahistine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What medication is used acutely when a patient experiences an attack of vertigo in Ménière’s disease

A

Prochlorperazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

A single nasal polyp unilaterally should be investigated with an urgent ENT referral as it suspicious for what kind of cancer?

A

Nasopharyngeal cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

HINTS examination is used to determine if the vertigo is peripheral or central in origin.

What does HINTS stand for?

A

Head Impulse
Nystagmus
Test of Skew

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
HINTS examination: negative head impulse, bidirectional/vertical nystagmus and abnormal test of skew Is the vertigo central or peripheral in origin?
The vertigo is central in origin e.g. posterior circulation strokes. The nystagmus would be bidirectional or vertical
26
HINTS examination: positive head impulse, no or unidirectional nystagmus and normal test of skew Is the vertigo central or peripheral in origin?
The vertigo is peripheral in origin They may have nystagmus but it would be unidirectional rather than bidirectional or vertical which is the case for central origin vertigo
27
Name 3 common causes of peripheral vertigo
1) Benign paroxysmal positional vertigo (BPPV) 2) Vestibular neuronitis (or labyrinthitis) 3) Ménière’s disease
28
What is the diagnostic test for Benign positional paroxysmal vertigo (BPPV)
Dix-Hallpike manoeuvre is diagnostic, where certain movements of the head causes fatiguable nystagmus.
29
What is the treatment manoeuvres for Benign positional paroxysmal vertigo (BPPV)
Epley manoeuvres
30
Peripheral vertigo after a recent viral illness is a pathognomonic presentation of what condition
Vestibular neuronitis Characterised by inflammation of the vestibular nerve, often after a viral infection
31
What is the first line symptomatic treatment of Vestibular neuronitis
Prochlorperazine (anti-sickness medication)
32
Recurrent episodes of vertigo, sensorineural hearing loss, tinnitus are cardinal features of what condition?
Ménière's disease Patients may also experience a feeling of aural fullness however it is not a cardinal feature of MD
33
Presence of Reed-Sternberg cells on biopsy is a pathognomonic finding of what type of lymphoma
Hodgkin's lymphoma
34
Likely Dx: 20 year or 70 year old Non-tender and “rubbery” lymph nodes Presence of B symptoms (fever, night sweats and weight loss)
Hodgkin’s lymphoma
35
Midline neck lump, ascends on swallowing but not on protrusion of the tongue is what: A) Thyroid lump B) Thyroglossal lump
A) Thyroid lump Voice hoarseness due to hypothyroidism is secondary to laryngeal oedema, which varies in intensity over time; therefore this type of hoarseness is intermittent. In contrast, permanent hoarseness in the setting of a thyroid lump is likely due to malignant infiltration of the recurrent laryngeal nerve. Additional features of thyroid malignancy include those of local mass effect (difficulty swallowing i.e. dysphagia, painful swallow i.e. odynophagia, airway compromise or stridor), constitutional (unexplained significant weight loss, low-grade fever), or metastasis (enlarged rubbery painless cervical lymphadenopathy, and rarely bone or lung metastasis)
36
Midline neck lump, ascends both on swallowing and tongue protrusion is what: A) Thyroid lump B) Thyroglossal lump
B) Thyroglossal lump
37
How can you differentiate between voice hoarseness secondary to hypothyroidism and malignant infiltration of the recurrent laryngeal nerve (the patient also has a thyroid lump (a feature of both conditions))
In hypothyroidism - it is due to laryngeal oedema and hence the hoarseness is intermittent In malignant infiltration of the recurrent laryngeal nerve the hoarseness is permanent
38
Name some of the features of thyroid malignancy
Thyroid lump Permanent voice hoarseness Difficulty swallowing i.e. dysphagia Painful swallow i.e. odynophagia Stridor Constitutional symptoms (unexplained significant weight loss, low-grade fever)
39
What type of imaging is required to determine the type of stroke
Non-contrast CT head
40
What is the thrombolysis interval for a stroke?
4.5 hours
41
What are the three classic signs of Horner's syndrome
Miosis (constricted pupil) Ptosis (weak droopy eyelid) Anhydrosis (reduced sweating)
42
Cholesteatoma is a serious and rare complication of what condition
Chronic otitis media
43
Likely Dx: Persistent foul smelling discharge Conductive hearing loss
Cholesteatoma Non-cancerous growth of squamous epithelium that is 'trapped' within the skull base causing local destruction
44
How is Cholesteatoma managed
Referred to ENT for consideration of surgical removal
45
Likely Dx: Midline neck lump Moves on tongue protrusion and swallowing
Thyroglossal cyst
46
How are thyroglossal cyst managed?
Reassurance Can be surgically removed for cosmetic reasons
47
What is the first line treatment for mild symptoms of allergic rhinitis
Oral antihistamine
48
What is the first line treatment for moderate or severe symptoms of allergic rhinitis
Intranasal corticosteroids (most effective class of medication)
49
Likely Dx: Early adult patient Conductive hearing loss which is characteristically better when there is background noise Patients speaking quietly as their voice sounds louder in their head
Otosclerosis caused by the thickening of the trabecular part of the bone. This causes hearing loss as the stapes bone (which transmits sound through the oval window) becomes fused with the surrounding bone removing its ability to move
50
How is otosclerosis managed
Treated with hearing aids or surgery to replace the stapes bone with a metal version
51
Acoustic neuromas are benign tumours that grow on what cranial nerves?
Vestibular or cochlear nerves
52
Likely Dx: Sudden onset severe vertigo Vomiting Nystagmus Recent Hx of viral infection
Vestibular neuritis NOTE: No hearing loss in vestibular neuritis
53
What are the two most common causes of episodic vertigo and vomiting
Meniere's disease Benign Paroxysmal Positional Vertigo (BPPV)
54
What severity is this description of otitis externa: Complete occlusion of the external auditory meatus and inability to view the tympanic membrane
Severe otitis externa
55
What severity is this description of otitis externa: Ear pain and discharge and partially occludes the external auditory meatus
Moderate otitis externa
56
What severity is this description of otitis externa: Itch with scanty discharge. There is no pain and no occlusion of the external auditory meatus
Mild otitis externa
57
What is the most common cause of hearing impairment post head injury
Perforated tympanic membrane
58
Weber's test lateralises to the which side of a sensorineural hearing loss
Contralateral side i.e. if Weber's test lateralises to the left the sensorineural hearing loss is in the right
59
How is acute otitis media managed in those with no acute complications or systemic illness
Symptomatic relief such as regular analgesia
60
Conductive hearing loss and otoscope shows chalky white patches on the tympanic membrane is pathognomonic of what condition
Tympanosclerosis Characterised by chronic inflammation and scarring of the tympanic membrane leading to subsequent calcification of the tympanic membrane and associated structures Often patients have a background childhood history of recurrent otitis media and grommet insertion is
61
How is septal haematoma managed?
Immediate referral to ENT for emergency incision and drainage as if left untreated there can be damage to the septal cartilage leading to irreversible septal perforation and necrosis
62
Bilateral cherry-red swelling arising from the nasal septum after a nasal injury is pathognomonic of what condition
Septal Haematoma
63
What is the most common tumour of the parotid gland?
Pleomorphic adenoma
64
Likely Dx: Sudden onset unilateral constant vertigo Tinnitus Recent viral infection
Acute (viral) labrynthitis
65
Child with tender mass over the mastoid process with ear pain (or tugging at their ear) is pathognomonic of what condition?
Acute mastoiditis
66
What is the first-line management for epistaxis
Direct compression of the nasal alae (cartilaginous part) for at least 10-15 minutes This is because most anterior bleeds resolve after 10-15 minutes of compression without interruption
67
If direct compression of the nasal alae for 10-15 minutes does not resolve epistaxis, what is the next most appropriate management step if the bleeding site is visible
Nasal cautery
68
If direct compression of the nasal alae for 10-15 minutes does not resolve epistaxis, what is the next most appropriate management step if the bleeding site is not visible
Nasal Packing
69
What age group would you consider amoxicillin immediately as the most appropriate management for otitis media
< 2 years old Ten day course of amoxicillin In an older child it could be acceptable to hold off antibiotics for 48 hours to see if symptoms improve spontaneously
70
Likely Dx - Child - Slow growing painless neck lump in the anterior triangle of the neck - Does not move on tongue protrusion or on swallowing
Branchial cyst Formed due to the failure of obliteration of the second, third, and fourth branchial cleft. Typically undetectable until the cyst swells in size, commonly due to infection
71
Likely Dx Watery nasal discharge worsen on bending forwards Recent Hx of nasal trauma
CSF rhinorrhoea
72
Gold standard investigation for anterior skull base fracture
CT Head
73
What time after gentamicin dose should a patient have a gentamicin level taken at?
6 -12 hours
74
A Centor criteria score of what warrants antibiotics for acute tonsillitis
3 out of 4
75
What is the first line antibiotics used in the treatment of acute tonsillitis
Penicillin V 500mg PO QDS for 5-10 days
76
What is the first line antibiotics used in the treatment of acute tonsillitis if patient has a penicillin allergy
Clarithromycin/Erythromycin 250-500mg PO BD for 5 days
77
Patients with a penicillin allergy cannot have penicillin based antibiotics as well as what other kind of antibiotics
Cephalosporins because of cross-reactivity
78
In patients with chronic or recurrent ear discharge what part of the tympanic membrane to important visualise?
The attic is visualised to exclude cholesteatoma
79
What is the treatment of Ramsay Hunt syndrome
Oral aciclovir and corticosteroids
80
Following referral to ENT, patients with sudden-onset sensorineural hearing loss are treated with what?
High-dose oral corticosteroids
81
What feature is used to distinguish between vestibular neuronitis from labyrinthitis
In vestibular neuronitis the hearing is unaffected Remember: Neuronitis = No hearing loss Labyrinthitis = Loss of hearing
82
Likely Dx: - Recently developed an upper respiratory tract infection - Sudden onset of symptoms - Vertigo and associated vomiting - Sensorineural hearing loss
Viral labyrinthitis
83
In benign paroxysmal positional vertigo, if patient declines the Epley manoeuvre, what is the next best management option?
Brandt-Daroff exercises
84
What is the 1st line treatment for uncomplicated acute otitis externa
Topical antibiotics +/- topical steroid
85
What type of nystagmus is indicative of a positive Dix-Hallpike manoeuvre
Rotatory nystagmus
86
What type of stroke presents with vertigo, nystagmus, ipsilateral facial pain, and contralateral loss in temperature sensation
Posterior circulation stroke
87
What is the first line management option for patients with acute otitis media with a perforated tympanic membrane
A 5-7 day course of oral amoxicillin
88
What is the most common causative organisms for bacterial otitis media
Haemophilus influenzae
89
How is peritonsillar abscess (quinsy) managed
IV antibiotics and surgical drainage and a tonsillectomy should be considered in 6 weeks.
90
NICE recommends that unexplained and persistent (>3 weeks) oral ulcers warrant what kind of referral
Urgent referral to secondary care due to the likelihood of malignancy.
91
Elderly patient dizzy on extending neck is pathognomonic of what condition
Vertebrobasilar ischaemia BPPV does causes vertigo upon head movement but the characteristic production of symptoms on neck extension makes this a less likely diagnosis than vertebrobasilar ischaemia
92
What is the Samters triad
1. Nasal polyp/s 2. Asthma 3. Aspirin hypersensitivity
93
What is the most appropriate next step in managing a perforated tympanic membrane does not heal by itself
Myringoplasty
94
Likely Dx: Swollen salvia gland, which is often most painful when eating or thinking about food
Parotid sialolithiasis Presence of calculus (stone) within the parotid gland obstructing the flow of salvia through the gland

Finals: Speciality Blocks (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions