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Flashcards in ENT Deck (64):
1

Management of septal haematoma of nose

Urgent drainage to prevent AVN of septal cartilage

2

Management of fractured nose

Analgesia
Exclude septal haematoma
Review in ENT clinic in 5-7d

3

What cell type is hypo-pharyngeal ca?

Squamous cell carcinoma
Arises from pharyngeal walls, epiglottis, pyro form fossa or upper oesophagus

4

What is Patterson-Brown-Kelly syndrome (Plummer-Vinson synd)

Triad of
- dysphasia
- glossitis
- iron deficiency anaemia

5

Causes of lymphadenopathy

Bacterial - pyogenic infection, TB, brucellosis
Viral- EBV, CMV, HIV
Protozoa - toxoplasmosis
Lymphoma
Metastases
Collagen disease
Sarcoidosis
Amyloidosis

6

Causes of dysphagia

Neurological - MG, MND, MS
foreign body
Pharyngeal pouch
Post-cricoid web
Globus pharyngis

7

Cell type of laryngeal carcinoma

Squamous cell carcinoma

8

Features of laryngeal carcinoma

Hoarse voice
Airway obstruction
Hemoptysis

9

What is a thyroglossal cyst

Develops from thyroglossal ducts which usually disappear on development
Mid-line swelling
Above upper border of thyroid cartilage
Moves on swallowing and tongue protrusion

10

Causes of nasal obstruction

Rhinitis
Septal deviation
Nasal polyps
Foreign body
Sinonasal malignancy

11

What are nasal polyps

Oedematous paranasal sinus mucosa protruding through sinus ostia.
Single or multiple
Temporary improvement with steroids
Surgical removal

12

Causes of anosmia

URTI
Nasal polyps
Sinonasal disease
Old age
Drug tx
Head injury / trauma

13

What is sinusitis + causative organisms

Infection of a sinus causing facial pain

Strep pneumonia
H. Influenzae
Infection from dental abscess

14

Types of sinus tumour

Squamous cell
Adenocarcinoma in furniture of workers
Maxillary and ethmoid most commonly

15

Most common site of epistaxis

Littles area

16

Management of anterior nose bleed

Pressure on anterior septum
+/- adrenaline application

17

What is a common cause of nosebleeds in older patients

Arteriosclerotic vessel further back
Use balloon compression or packing

18

What is otorrhoea

Ear discharge
Usually from infection of outer or middle ear

19

What is otitis externa + how do you tx it

Inflammation of skin of ear canal
Bacterial, viral or fungal

Tx = remove debris, regular cleansing + antibiotic ear drops

20

Define cholesteatoma

Keratinising squamous epithelium of middle ear
Tympanic membrane defect containing white material - can erode local structures.
Surgery to remove the sac.

21

Causes of perforated tympanic membrane

Trauma
Chronic middle ear disease

22

Symptoms of perforated tympanic membrane

Decreased hearing
Whistling sound

23

What is otitis media + common organisms

Bacterial infection of middle ear
H. Influenzae
Strep pneumoniae

24

Symptoms of otitis media

Otalgia
Fever
Malaise

25

What is OME (glue ear)

Fluid in middle ear
Common in children
Syx = hearing loss, interference of language acquisition

26

What is Otosclerosis

Stapes becomes fixed by new bone formation
F>M
Surgical tx

27

Features of vocal cord nodule

Bilateral
Free edge of vocal cord
Prevents full closure
Breathy harsh voice

28

What is Reinke's oedema

Oedema of the vocal cord
Caused by irritation
Causes = Smoking, voice abuse, acid reflux, hypothyroidism

29

Risk factors for larangeal carcinoma

SMOKING
Excess alcohol
Male
Low socio-economic status
>55 yo

30

Symptoms of laryngeal carcinoma

Hoarseness / voice change
Neck lump
Sore throat
Persistent cough
Stridor
Halitosis
Otalgia

31

Common organisms of tonsillitis

Bacterial - beta-haemolytic streptococcus
Viral - adeno, rhino, flu, resp syncytial virus

32

Symptoms of tonsillitis

Fever
Sore throat
Dysphagia
Lymphadenopathy
Malaise

33

Symptoms of glandular fever

Sore throat
Fever
Fatigue
Weight loss
Malaise
Vomiting
Petechiae
Decreased appetite

34

Signs of glandular fever

Fever
Lymphadenopathy
Splenomegally
Hepatitis
Haemolysis

35

Define Trismus

Inability to normally open the mouth

36

Define quinsy

Collection of pus outside of the capsule of the tonsil.
Pushes the uvula across
Needs urgent ENT referral

37

Indications for tonsillectomy

Suspected malignancy
OSA due to tonsilar hypertrophy
Recurrent tonsillitis (5/yr for 2yrs)
Quinsy + recurrent tonsillitis

38

What are adenoids

Lymphoid tissue in the nasopharynx of children.
Increase in size until 4 then disappear in adulthood.

39

Cell types of tonsil tumours

Younger pts - lymphoma (smooth)
Older pts - squamous cell ca. (Ulcerated)

40

What is a pharyngeal pouch

Mucosal herniation through the pharyngeal musculature because cricopharyngeus doesn't relax.
Dysphagia for solids + regurgitation

41

What causes Ménière's disease

Distension of the membranous labyrinth by accumulation of endolymph

42

What is benign paroxysmal positional vertigo

Secondary to degeneration of utricular neuroepithelium in semicircular canals.
Spontaneous or after head injury.
Free floating material affects endolymph flow

43

Symptoms of benign paroxysmal positional vertigo

Attacks of vertigo - precipitated by head movement

44

Management of benign paroxysmal positional vertigo

Steady resolution over weeks

Most cases can be treated by - Epley manouvre

45

What drugs can cause ototoxicity

Gentamicin
Streptomycin
Quinine
High dose aspirin

46

What is Ramsay hunt syndrome and what are its symptoms

Herpes zoster infection of the geniculate ganglion
Affects facial nerve and vestibulocochlear nerve

Facial muscle paralysis
Herpetic eruption on ear canal (shingles)
+/- tinnitus, hearing loss, vertigo

47

What is labyrinthitis and what causes it

AKA vestibular neuronitis
Most common cause of vertigo

Sudden severe vertigo, vomiting and ataxia
No tinnitus, no hearing loss

May be viral in origin

48

Management of labyrinthitis

Antiemetics - often prochlorperazine

Syx settle over few days

49

Symptoms of vestibular neuronitis

unsteadiness,
nausea and vomiting.
Feels like room is rotating.
Moving the head aggravates symptoms.

50

Examination findings in vestibular neuronitis

Spontaneous, unidirectional, horizontal nystagmus
fast direction towards the healthy ear.

On walking / in Romberg's test, the patient tends to fall towards the affected side.

51

Management of vestibular neuronitis

antiemetic
prochlorperazine (vestibular suppressant) may be useful short term.
Promethazine and domperidone may be useful.
3 days steroids
Early activity encouraged - promote vestibular compensation.

52

What is an acoustic neuroma

tumour of the vestibulocochlear nerve
Schwannoma
benign and slow growing
symptoms due to mass effect

53

Risk factors for acoustic neuroma

Neurofibromatosis.
High-dose ionising radiation to head and neck

54

Presentation of acoustic neuroma

unilateral sensorineural hearing loss is an acoustic neuroma until proven otherwise.

Unilateral tinnitus.
Impaired facial sensation.
Balance problems without other explanation.

55

What is a quinsy

Collection of pus outside the capsule of the tonsil
Deviates the uvula
Needs urgent ENT referal

56

What is trismus

Inability to normally open mouth

57

Symptoms of tonsillitis

Fever
Sore throat
Dysphagia
Lymphadenopathy
Malaise

58

Common organisms of tonsillitis

Viruses - adeno / rhino / influenza / resp syncytial
Bacterial - beta-haemolytic / streptococcus

59

Symptoms of layngeal cancer

Hoarseness
Voice change
Neck lump
Odynophagia
Persistent cough
Stridor
Halitosis
Otalgia

60

Risk factors for laryngeal carcinoma

**Smoking**
Excess alcohol
Male
Low socio-economic status
>55yo

61

What is reinke's oedema

Oedema of the vocal cord

62

Treatment of epistaxis from littles area

Apply pressure to lower nose
Lean head forward

63

What makes sinusitis pain worse

Bending
Coughing

64

What is swimmers ear

Acute otitis externa