ENT Flashcards
(21 cards)
How do you treat meatal swelling?
Ribbon gauze soaked in magnesium sulphate
or pope wick changed daily then gentamicin or neomycin
What causes mastoiditis?
Breakdown of bony partitions (trabeculae) between mastoid air cells
When should mastoiditis be suspected?
Continuous discharge for >10 days
If systemically unwell
Other causes of ear pain
Referred pain from CN9 (tonsillitis)
CN10 - carcinoma of pyriform fossa
CN5 mandibular division (upper molars or TMJ)
C2/C3 pain due to posture
Causes of otorrhea
Acute = OM or OE
Chronic inflammatory disease
In acute, pain is dominant before discharge
Subacute suppurative OM
Continuous discharge from ear >3 weeks after OM
Due to mucosal infection or infection of nasopharynx
Chronic suppurative OM
Safe and unsafe
Both present with conductive deafness and painless discharge
Safe chronic suppurative OM
Active mucosal chronic OM
Perforation is central so there is always a rim of ear drum
Involves pars tensa
Discharge arises from secreting mucosa
Unsafe chronic suppurative OM
Active chronic with cholesteatoma May spread intra cranially due to erosion of bone Atticantral Discharge is foul smelling May need radical mastoidectomy
Causes of conductive hearing loss
Obstruction due to wax, foreign body, debris
Perforation causing reduction in SA of TM - also allows incident sound pressure which causes distortion of sound waves
Discontinuity of ossicular chain - usually due to infection (particularly of long process of incus)
Fixation of ossicular chain due to otosclerosis which immobilises foot of stapes
Eustachian tube blockage (glue ear) - progressive deafness due to accumulation of viscous material
MUST EXCLUDE CARCINOMA OF NP as this can present as conductive hearing loss
Causes of sensorineural hearing loss
Bilateral progressive = age, noise damage, drug ototoxicity
Unilateral progressive = meniere’s or acoustic neuroma
Sudden loss = mumps, measles, chicken pox, trauma
How can ENT conditions cause ABC problems?
A = inhaled FB, epiglottitis, quinsy, anaphylaxis, croup B = croup, inhaled FB C = haemorrhage eg epistaxis or post tonsillectomy
What are sore throat red flags?
Agranulocytosis
Stevens Johnson syndrome
Trismus
What is trismus?
Spasm of pterygoid muscles preventing opening of mouth
Seen in quinsy
What is peritonsillar cellulitis?
Presuppurative stage of quinsy
Ipsilateral ear pain, pain on movement of neck (due to lymphadenopathy), uvula pushed to one side
Steven johnsons syndrome
Vesiculobullous lesions and erosions on mucous membranes associated with erythema multiforme
2x more common in males
Causes: allopurinol, mycoplasma, HSV, abx and anti-convulsants
Non ENT causes of sore throat
Angina
Reflux (sore throat and persistent cough, may have pharyngitis)
Epiglottitis
Caused by H influenza
High fever + sore throat then stridor and muffled voice
Sit up right and lean forward
Croup
Laryngotracheobronchitis
Fever, painful barking cough, stridor
Bacterial tracheitis
Stridor, hoarse voice, cough, high fever, toxic ill looking child without swallowing difficulties
Meniere’s
Fluctuating hearing levels and recurrent episodes of vertigo
