ENT Flashcards
(25 cards)
What is Ludwig’s angina
Rapidly spreading bacterial infection of the floor of the mouth - often due to dental infection
Which neck spaces does Ludwig’s angina affect
Submandibular and sublingual
Common organisms involved in Ludwig’s angina
Group A streptococcus, staphylococcus, fusobacterium, bacteroides
Abx for Ludwig’s angiina
- benzylpenicillin intravenously
- amoxicillin+clavulanate intravenously
mnost appropriate initial step for sudden sensorineural hearing loss
high dose PO corticosteroid 1mg/kg/d - max of 60mg/day for 5 day then reduced daily by 10mg consecutively in the next 5 days
def SSNHL
hearing loss of 30 dB or more over at least three contiguous frequencies, over a period of 72 hours or less’.
first line tx for symptomatic ear wax accumulation
docusate sodium ear drops
when would you perform audiometry/ pure tone audiometric testing in ? SSNHL
When clinical picture is unclear
When are intratympanic CS used in SSNHL
s usually reserved for patients with SSNHL who respond poorly to oral steroids and recurrence with previous oral steroid therapy. It can also be first-line if there is contraindication to oral steroids such as brittle diabetes.
First line imaging ix for thyroid masses to assess characteristics and guide further management
US
What are the two main systems responsible for allowing us to percieve sounds
- Sound conducting system
- Sound transducing system
Sound conducting system
This is composed of the outer ear (pinna, external auditory canal) and the middle ear (ossicles, tympanic membrane). Vibration is the main manner in which these signals are transmitted.
Sound transducing system
This is composed of the cochlear, the auditory nerve and central processing centres. Vibration signals are transmitted as nerve impulses, and processed so we can appreciate them as sound.
WHich patient demographic are nasopharyngeal carcinomas commonly seen in
Southeast asians
Clinf of nasopharyngeal carcinoma
Increasing deafness - obstruciton or d/c
Tinnitus - due to obstruction of eustachian tube
Which lymph nodes can nasopharyngeal carcinoma involve
Jugulodigastic nodes- those in the apex of the posterior triangle of the neck
Next step in patient with symptoms sus of nasopharyngeal carcinoma
Examination of nasal cavity
Risk factors for nasopharyngeal carcinoma
EBV
Southeast asian
FH, HLA 2
Foods high in nitrosamines- salted fish and preserved foods
SMoking, chronic nasal inflammation, occupational exposure (wood dust, formaldehyde)
HINTS finsings for central vertigo
Bidirectional or vertical nystagmus
impaired gait and balance
positive test of skew
normal head impulse
Clin F of laryngeal ca
Chronic cough
Hemoptysis
Dysphagia
sialolithiasis
stone within salivary gland or duct system
diagnostic features of sialolithiasis
Painful submandibular swelling that worsens after meals
Management of submandibular duct calculi
Hydration
Sialogogues
Analgesia
+/- ABx
Definitive: removal of stone via sialendoscopy
Why is the submanidubular duct the most common site for salivary stones
tortuous duct, alkaline saliva, and high mucin and calcium content.
