ENT Flashcards
(23 cards)
What scoring system is used for assessing risk of streptococcal infection in acute sore throat?
FEVER criteria
Scoring ranges from 0 to 5, with different recommendations for antibiotic treatment.
Can also use CENTOR but slightly less accurate in primary care
What are the criteria for scoring in the FeverPAIN system?
- Fever during last 24 hours
- Purulence on tonsils
- Attends rapidly (within 3 days of symptoms onset)
- Severely inflamed tonsils
- No cough or coryza
What does the CENTOR criteria assess?
- Cough
- Exudate
- Nodes
- Temperature
Adjusts the score based on age.
What is the antibiotic choice for non-allergic patients?
Pen V 500mg QDS or 100mg BD for 5-10 days
Alternative options exist for those with penicillin allergies.
What is the recommended antibiotic for patients with a penicillin allergy?
- Clarithromycin 250-500mg BD for 5 days
- Erythromycin 250-500mg QDS or 500-1000mg BD for 5 days
What is the first-line treatment for oral candidiasis in immunocompetent adults?
Miconazole 2.5mL (24mg/mL) QDS after food for 7 days, and continue 7 days after resolution.
When would you use fluconazole 100mg for oral candidiasis?
In extensive or severe candidiasis, especially in immunocompromised patients such as those with HIV.
How is recurrent vaginal candidiasis managed?
Fluconazole 150mg every 72 hours for 3 doses, followed by one dose weekly for 6 months.
When should antibiotics be offered immediately for acute otitis media (AOM)?
<2 years with bilateral AOM or presence of otorrhoea, or if systemically unwell.
What is the second-line treatment for acute otitis externa?
Topical acetic acid spray or antibiotic/steroid drops (e.g., neomycin + corticosteroid) for 7–14 days.
What are first-line antibiotics for acute bacterial sinusitis?
Phenoxymethylpenicillin (Pen V) 500mg QDS for 5 days.
If failed or severe then co-amox
When should intranasal corticosteroids for allergic rhinitis be started?
Two weeks before predicted onset of symptoms.
What are red flags for urgent tinnitus referral?
Sudden neuro signs, suicidal ideation, acute vestibular symptoms, or pulsatile tinnitus.
What is the typical presentation of an acoustic neuroma?
Gradual unilateral sensorineural hearing loss and tinnitus.
How is sudden sensorineural hearing loss managed?
Urgent ENT referral within 24 hours for possible steroid treatment.
When should a child with glue ear be referred?
If it persists for more than 3 months or affects speech/hearing.
What developmental red flags require speech and language referral?
No babble by 12 months, no words by 18 months, no phrases by 2.5 years.
Which do the first line treatment for acute otitis externa?
Analgesia for pain relief and apply localised heat (such as a warm flannel)
Sinusitis for 9 days what do you do?
Symptoms for 10 days - no antibiotics
What is the antibiotic choice in AOM if needed
Amoxicillin 500mg TDS (250mg in <10mg) for 5 years
In ottitis externa is signs of spreading cellulitis/systemic signs what AB
Oral flucloxacillin 500mg QDS x 7 days
(If malignant OE suspected esp diabetic, immunocompromised) then urgent ENT referral
What is oral allergy syndrome?
Corsa reaction of pollen with foods esp tree pollen. Raw fruit, veg and tree nuts.
Similar symptoms but around mouth
What are the seasonal allergens by months
Tree: Feb-June
Grass: May-July
Weeds (nettles,dock etc): June-Sept
Mould: Sept-Oct (+damp conditions)
