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SAQ for finals > ENT > Flashcards

ENT Flashcards

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1
Q

What is the commonest cause of epistaxis?

A

Trauma

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2
Q

What is the name of the area on the anterior nasal septum where epistaxis commonly originates?

A

Little’s area/Kiesselbach’s plexus

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3
Q

Give 2 reasons why it is appropriate to do an FBC for epistaxis

A

Hb may have dropped due to epistaxis
Thrombocytopenia may be the cause

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4
Q

Apart from FBC, name 2 other blood tests which may be performed

A

INR (if on warfarin)
LFTs (deranged liver function may lead to insufficient synthesis of clotting factors)
Group and save (in case transfusion is necessary)

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5
Q

Give 2 simple initial management steps for epistaxis

A

Sit upright
Tilt forward
Squeeze soft part of nose
Apply ice pack to bridge of nose
Spit out any blood
Monitor pulse and blood pressure

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6
Q

Give 2 methods to stop epistaxis

A

Cauterisation (Silver nitrate stick)
Nasal packing

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7
Q

Medical term for pain on swallowing

A

Odynophagia

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8
Q

Name 2 symptoms of acute tonsilitis, other than sore throat and pain on swallowing

A

Fever
Anorexia
Headache
Otalgia
Change in voice
Abdo pain

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9
Q

What is the name for the lymph node commonly found to be enlarged in tonsillitis?

A

Jugulodigastric lymph node

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10
Q

Give 2 differentials for tonsillitis

A

Infectious mononucleosis
Angranulocytosis
Scarlet fever

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11
Q

Why is penicillin V given as apposed to amoxicillin in tonsillitis?

A

Amoxicillin will give a maculopapular rash if the cause of symptoms is infectious mono

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12
Q

Give 2 conservative management options which the parents should be advised about in tonsilitis

A

Analgesia and antipyretics
Adequate hydration

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13
Q

What is the other name of peritonsillar abscess?

A

Quinsy

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14
Q

What is the significance of swallowing fluid being normal but swallowing solids being difficult?

A

Points towards a structure as the cause

Fluids more difficult than solids points towards a motility disorder

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15
Q

What type of oesophageal carcinoma does Barrett’s oesophagus predispose somebody to?

A

Adenocarcinoma

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16
Q

apart from Barrett’s oesophagus, give 2 risk factors for oesophageal carcinoma

A

Smoking
Alcohol
Obesity
Achalasia

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17
Q

what staging system is used to stage oesophageal carcinoma

A

TNM

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18
Q

Give 2 possible treatment options for oesophageal carcinoma

A

Surgery
Chemoradio
Palliation

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19
Q

Which cranial nerve is the recurrent laryngeal nerve a branch of?

A

Vagus nerve

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20
Q

Which side is recurrent laryngeal nerve palsy commoner on and why?

A

Left, longer course than right so more susceptible to damage

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21
Q

What is the only laryngeal muscle not supplied by the recurrent laryngeal nerve, and what nerve is this muscle supplied by?

A

Cricothyroid, superior laryngeal nerve

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22
Q

Give 2 possible causes of recurrent laryngeal nerve palsy

A

Thyroid or oesophageal tumour Thyroid or oesophageal surgery

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23
Q

Give other symptoms of vocal cord palsy other than hoarseness

A

Vocal fatigue
Reduced volume
SOB
Cough

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24
Q

What procedure is used in the ENT outpatient setting to visualise the vocal cords?

A

Laryngoscopy

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25
List 5 causes of unilateral facial weakness
Stroke Bell's palsy Ramsay hunt syndrome MS
26
How can you discriminate an UMN lesion from LMN lesion affecting the face?
Forehead sparing - not spared in LMN
27
Name the 5 major branches of the facial nerve
Zygomatic Mandibular Buccal Temporal Cervical
28
What treatment may you start for Bell's palsy?
Prednisolone (within 72 h)
29
Give 2 long-term consequences of Bell's palsy
Damage to eye (due to reduced lacrimation) Altered taste Psychological impact
30
What is vertigo?
The illusion of movement - in true vertigo the patient should be able to tell you in which direction the movement is occuring
31
Give 4 causes of vertigo
BPPV Menieres disease Vestibular neuronitis Acoustic neuroma MS Cholesteatoma
32
Describe the pathogenesis of BPPV
Displacement of an otoconia within the semicircular canals - the heavier otoconia causes abnormal movement in the endolymph
33
What test is diagnostic of this condition
Dix-Hallpike
34
What manoeuvre can be used to treat this condition
Epley manoeuvre
35
Other than Epley manoeuvre, management of BPPV?
Reassurance Reduce alcohol intake Betahistine
36
Name 2 common bacterial causes of otitis media
Strep pneumoniae (most common) Haem influenzae Moraxella catarrhalis
37
What is the consequence of children's shorter Eustachian tube?
Poor drainage, more likely to suffer middle ear infections
38
Name the two portions of the ear drum
Pars flaccida, pars tensa
39
What might you find on otoscopy in otitis media?
Bulging eardrum Erythema Prominent blood vessels +/- perforation
40
What medication will you prescribe to manage otitis media
Analgesia Amoxicillin
41
Sensorineural hearing loss in the right ear a) Rinne's test b) Weber's test
a) Rinne's test positive in both ears (not an air conductive problem) b) Weber's test loudest in left ear (sensorineural loss)
42
What tuning fork should be used to test hearing
256 - 512 Hz
43
Where is the tuning fork placed to elicit bone conduction in Rinne's test
Mastoid process
44
What is a positive Rinne's test
Air conduction louder than bone conduction
45
What 2 possible consequences give a positive Rinne's test
Normal hearing Unilateral sensorineural hearing loss
46
How do you perform Weber's test
Tuning fork placed in middle of forehead
47
Is an acoustic neuroma benign or malignant
Benign
48
How do you confirm the diagnosis of acoustic neuroma
MRI
49
What is the main differential diagnosis of acoustic neuroma
Meningioma
50
What potential treatment option is available for acoustic neuroma
Surgical removal
51
What is a paranasal sinus?
Air-filled cavity in the facial bones with connection to the nasal cavity
52
Name the paranasal sinuses
Maxillary Ethmoidal Sphenoid Frontal
53
What epithelium lines the paranasal sinuses?
Ciliated pseudostratified columnar epithelium
54
Give 2 causes of maxillary sinusitis
Secondary to bacterial infection (most common) Dental root infection
55
How would you manage acute sinusitis?
Decongestants Analgesia
56
Cranial nerve in parotid gland enlargement
Facial nerve
57
What are the pairs of salivary glands called
Parotid Submandibular Sublingual
58
What percentage of tumours within the salivary gland are found in the parotid gland
80%
59
What is the commonest tumour of the parotid gland
Pleomorphic adenoma
60
What features would lead you to expect a carcinoma of the parotid gland
Pain fast growth fixed to other structures facial nerve palsy
61
Where does the parotid duct enter the mouth
next to the second maxillary molar tooth
62
Excluding tumours, what other conditions can lead to unilateral swelling of the parotid gland?
parotitis mumps (more commonly bilateral) duct blockage
63
3 main structures in the inner ear
Semicircular canals Vestibule Cochlea
64
How can labyrinthitis and vestibular neuronitis be differentiated clinically
Tinnitus and hearing loss in labyrinthitis
65
Pathological basis of menieres disease
Excessive buildup of endolymph in the labyrinth of the inner ear Increasing the pressure and disrupting sensory signals
66
Menieres disease prophylaxis
Betahistine
67
4 features to ask about in a hearing loss presentation
FH Noise exposure Drug history e.g. chemo, aminoglyclosides Tinnitus Vertigo Ear discharge Head injury
68
Further investigation bilateral sensorineural hearing loss
MRI inner ear

SAQ for finals (20 decks)

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