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FINALS > ENT > Flashcards

ENT Flashcards

1
Q

sensory inputs responsible for maintianing balance and posture are

A
  • vision
  • proprioception
  • signals from vestibular system
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2
Q

vestibular apparatus is located in

A

the inner ear

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3
Q

inner ear patho

A
  • 3 loops = semicircular canals, filled with endolymph
  • head turns and fluid shifts = detected by stereocilia
  • vestibular nerve carries to vestibular nucleus in brainstem and cerebellum
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4
Q

peripheral vs central

A
  • peripheral = affects vestibular system
  • central = brainstem/cerebellar involvement
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5
Q

4 most common causes peripheral vertigo

A
  • BPPV
  • menieres
  • vestibular neuronitis
  • labyrinthitis
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6
Q

4 most common causes central vertigo

A
  • posterior circulation infarct
  • tumour
  • MS
  • vestibular migraine
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7
Q

features peripheral vertigo

A
  • sudden onset
  • short duration
  • hearing loss can be present
  • coordination in tact
  • nausea more severe
    central = opposite
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8
Q

common triggers for BPPV

A
  • turning over in bed
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9
Q

patho of BPPV

A
  • crystals of calcium carbonate = otoconia
  • become displaced in semicircular canals
  • = disrupt normal flow of endolymph
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10
Q

dix hallpike manoevre

A
  • diagnoses bppv
  • sit up, head 45 to one side
  • rapidly lower backwards until hanging off and watch eyes
  • triggers rotational nystagmus and vertigo
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11
Q

epley manoevre

A
  • treat bppv
  • same as DH but when head off bed, rotate 90 degrees past central position and roll on side
  • sit up sidewats
  • flex 45 degrees
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12
Q

peripheral vertigo short term mx

A
  • prochloperazine
  • antihistamines
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13
Q

triad in menieres

A
  • hearing loss
  • vertigo
  • tinnitus
    unilateral episodes
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14
Q

patho menieres

A
  • excessive build up of endolymph in labrynth
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15
Q

what frequency hearing affected in menieres

A
  • low frequency affected first
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16
Q

other sx menieres

A
  • fullness
  • drop attacks
  • imbalance
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17
Q

prophylaxis menieres

A

betahistine

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18
Q

vestibular neuronitis presentation

A
  • recent viral illness (URTI)
  • nausea and vomiting
  • balance problems
  • vertigo
  • no loss of hearing
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19
Q

vestibular neuronitis management

A
  • Severe = buccal/IM prochlorperazine
  • vestibular rehab preferred if chronic
  • Oral prochlorperazine or antihistamine less severe
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20
Q

labyrinthitis sx

A
  • hearing loss
  • tinnitues
  • acute onset vertigo
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21
Q

2 most common bacterial causes otitis externa

A
  • pseudomonas aeruginosa = G-, rod
  • staph aureus
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22
Q

S+S externa

A
  • ear pain
  • discharge
  • itchiness
  • conductive hearing loss
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23
Q

exam externa shows

A
  • erythema and swelling
  • tender canal
  • pus
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24
Q

Mx externa

A
  • mild = acetic acid 2%
  • moderate = top abx and steroid = otomize spray
  • fungal = clotrimazole drops
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25
Q

most common causes media

A
  • strep pneumoniae
  • HI
  • staph aureus
26
Q

S+S media

A
  • ear pain
  • reduced hearing
  • fever
  • upper airway infection
27
Q

normal tympanic membrane looks

A

pearly grey, translucent, slightly shiny

28
Q

tympanic membeane in media

A

bulgin, red, inflamed
- discharge if perforation

29
Q

mx media

A
  • most resolve with no abx
  • immediate abx if systemically unwell
  • delayed prescription if sx not better in 3 days
  • amoxicillin 5-7 days 1st line
30
Q

acoustic neuromas are

A

benign tumours of schwann cells surrounding vestibulocochlear nerve
- usually unilateral
- also called cerebellopontine angle tumours

31
Q

presentation acoustic neuroma

A
  • unilateral sensorineural hearing loss
  • unilateral tinnitus
  • dizziness or imbalance
  • full ear
32
Q

what sort of hearing loss in acoutic neuroma

A

sensorineural hearing loss

33
Q

mx AN

A
  • conservative
  • surgery
  • radiotherapy
34
Q

most likely location of bleeding in epistaxis

A
  • littles area
35
Q

is bleeding in episaxis unilateral or bilateral

A
  • usually unilateral
  • bilateral = bleeding posteriorly in nose
36
Q

mx epistaxis

A
  • > 10 minutes = nasal packing
  • nasal cautery
  • naseptin qds for 10 days if tx
37
Q

features of apnoea

A
  • snoring
  • mornign ehadach e
  • waking up unrefreshed
  • daytime sleepiness
  • concentration problems
    epworth sleepiness scale
38
Q

mx apnoea

A
  • sleep studies
  • correct reversible factors
  • cpap
39
Q

most common cause of bacterial tonsilitis

A

group A strep = strep pyogenes
- 2nd = strep pneumoniae

40
Q

tx bacterial tonsilitis

A

pehenoxymethylpenicillin

41
Q

centor criteria

A
  • fever over 38
  • tonsillar exudates
  • absence of cough
  • tender ln
42
Q

fever pain score

A

fever in 24 hrs
purulence
attented in 3 days sx
inflamed tonsils
no cough

43
Q

prescribe abx in tonsilitis when

A
  • centor >3
  • fever pain >4
44
Q

quinsy is

A

peritonsillar abscess

45
Q

additional sx in quinsy

A
  • trismus
  • change in voice
  • swelling and erythema
46
Q

mx quinsy

A
  • needle aspiration
  • surgical incision drainage
  • dex
  • abx pre and post surgery
47
Q

tinnitus

A
  • ringing in ears
  • primary = with senorineural eharing loss
  • secondary = identifiable cause
48
Q

neck lump red flag referral when

A
  • unexplained neck lump in 45 or more
  • persitent lump at any age
  • USS scan in lump growing in size
49
Q

head and neck cancers are usually

A

squamous cell carcinomas

50
Q

red flags for head and neck cancer

A
  • lump in mouth or on lip
  • ulceration unexplaines 3w
  • erythroplakia
  • persistent neck lump
  • hoarseness
  • unexplained thyroid lump
51
Q

monoclonal antibody in head and neck cancer

A

cetuximab

52
Q

when are nasal polyps concerning

A

when they are unilateral = specialist referral

53
Q

cholesteatoma

A
  • non cancerous growth of squamous epithelium trapped in skull base
  • foul smelling discharge
  • hearing loss, conductive
  • attic crust on otoscopy = uppermost eardrum
  • ent refer
54
Q

glue ear

A
  • OM with effusion
  • Conductive hearing loss
55
Q

Rinne and weber in conductive

A
  • Rinne = negative = bone better than air
  • Weber = localises to affected ear
56
Q

Rinne and weber sensioneural

A
  • Rinne = +ve = Air better than bone
  • Weber = heard in unaffected ear
57
Q

name of LN enlarged in tonsilitis

A

jugulodigastric

58
Q

Barrets is

A

metaplasia from squamous to columnar epithelium in lower oesophagus
- predisposes to adenocarcinoma

59
Q

triad in infectious monomucelosis

A
  • fever
  • pharyngitis
  • lymphadenopathy
    self limiting
60
Q

infectious mono and amoxicillin?

A

itchy maculopapular rash in response to amoxicillin or cefalosporins

61
Q
A

FINALS (31 decks)

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