ENT Flashcards
(34 cards)
in what condition is there a loss of high pitched sounds before lower pitched sounds?
presbycusis
in which condition is there a loss of lower pitched sounds before higher pitched?
otosclerosis
what is a cholesteatoma?
- retraction of the pars flaccida of the tympanic membrane due to Eustachian tube dysfunction, leading to the formation of a sac/pocket.
- stratified squamous epithelium and keratin proliferate here and forma cholesteatoma
classical sign of carotid body tumour?
Lyre sign - splaying of the ICA and ECA
what is a branchial cyst?
- congenital abnormality when the second branchial cleft fails to form properly during fetal development
- it leaves a space surrounded by epithelial tissue in the lateral neck which can fill with fluid and form a cyst
what is a carotid body tumour and how do they present?
- excessive growth of glomus cells (paragangliomas)
- slow growing lump
- in the upper anterior triangle of the neck
- painless
- pulsatile
- associated with bruit
how can infectious mononucleosis present on examination?
intensely itchy maculopapular rash in response to amoxicillin or cephalosporins
what is the centor criteria?
- fever over 38 degrees
- tonsillar exudate
- absence of cough
- tender anterior cervical lymph nodes
what is the feverPAIN score?
- Fever during the previous 24 hours
- Purulence (pus on tonsils)
- Attendance within 3 days of onset of symptoms
- Inflamed tonsils
- No cough or coryza
how many episodes of tonsillitis are needed to have a tonsillectomy?
- 7 or more for 1 year
- 5 per year for 2 years
- 3 per year for 3 years
what can be used for less severe bleeds post tonsillectomy?
- hydrogen peroxide gargle (antiseptic and promotes clotting)
- adrenaline soaked swab (vasoconstriction)
management of severe otitis external?
oral antibiotics - flucloxacillon or clarithyromycin
first line antibiotics for acute otitis media?
- amoxicillin (5-7 days)
- clarithryomycin (penicillin allergy)
- erythromycin (pregnant women who are allergic to penicillin)
what is the most common bacterial cause of acute otitis media?
streptococcus pneumonia
what is it called when you get an accumulation of fluid inside the middle ear?
otitis media with effusion
how does a grommet work?
- tiny tube inserted into the tympanic membrane
- allows fluid to flow from the middle ear through the TM to the ear canal
- acts to maintain equilibrium of pressures
what is FESS procedure and when is it used?
- Functional endoscopic sinus surgery
- small endoscope inserted through the nostrils and sinuses
- obstruction may be caused by swollen mucosa, bone, polyps
- balloons may be inflated to dilate the opening of the sinuses
- CT needed before procedure to confirm diagnosis and assess structures
- chronic sinusitis
how does sinusitis present?
- facial pain/pressure, worse on leaning forwards
- nasal congestion
- nasal discharge
- anosmia
- facial swelling
what is samter’s triad?
- nasal polyps
- asthma
- aspirin intolerance/allergy
how are nasal polyps medically managed?
intranasal topical steroid drops or sprays
risk factors for head and neck cancer?
- smoking
- chewing tobacco or betel quid
- alcohol
- HPV
- EBV
red flags for head and neck cancer?
- mouth or lip lump
- unexplained ulceration lasting more than 3 weeks
- persistent neck lump
- hoarseness of voice
- erythroplakia
- unexplained thyroid lump
- persistent sore throat
pathophysiology of BPPV?
- caused by crystals called otoconia, becoming displaced from the utricle and saccule, into the semicircular canals (usually posterior)
- they may be displaced by a viral infection, head trauma, ageing or without a cause
- the crystals disrupt the normal flow of endolymph through the canals -> this moves the stereocilia -> creating action potentials and confusing the vestibular system -> signalling to the brain that we’re moving when we’re not
-> head movement creates the flow of endolymph in the canals, triggering episodes of vertigo
a 55 year old man presents with vertigo and dizziness after turning their head. His symptoms last 20-60 seconds and then go away. there is no symptoms of hearing loss or tinnitus. what is this?
BPPV
