Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MIND AND MOVEMENT > ENT > Flashcards

ENT Flashcards

1
Q

Questions about neck lumps

A 
Duration
Change in size
Associated features- pain, redness, discharge
Lumps elsewhere 
Preceding symptoms 
Recent travel esp TB
occupation 
Cat scratch 
Radiation exposure 
Red flags- persistent sore throat, hoarseness, dysphagia, odynophagia, Weight Loss, fevers, night sweats
Smoking 
Alcohol consumption 
HIV status 
Dental problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Investigations of a neck lump

A

USS with fine needle aspiration

CT can be useful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Red flags in neck lump

A

persistent sore throat, hoarseness, dysphagia, odynophagia, Weight Loss, fevers, night sweats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q 
Elderly male
Neck lump for three months 
Increasing in size
Persistent sore throat
Change in voice 
Heavy smoker 
Heavy drinker

Next steps
Diagnosis?

A

Do full exam
Flexible nasopharynolaryngoscopy
If lump going do USS and FNAC
Discuss at MDT

Neck cancer eg SCC mets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Risk factors for SCC if head and neck

A 
Betel nut chewing 
Smoking 
HPV
EBV
Alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Elderly man

Hoarse voice

A

Head and neck cancer

Spreading to larynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Other questions to ask when hoarseness present

A 
Dysphagia
Odynophagia
Weight loss
Heart burn or indigestion 
Post nasal drip 
Systemic upset
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Urgent referral needed for throat when

A 
Hoarseness for more than six weeks
Oral swellings for more than six weeks 
Dysphagia got more than three weeks
Unresolving neck masses for more than three weeks 
Cranial neuropathies
Orbital masses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Causes of hoarseness

A 
Overuse of larynx 
Acute laryngitis
Chronic laryngitis secondary to reflux 
Use of asthma inhaler
Smoking
SCC of larynx 
Vocal cord Palsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Treat for SCC mets

A

Radiotherapy- multiple small doses, can be curative or palliative
Surgical resection
Chemo- not curative but can be used to shrink
Then if unsuccessful look at palliative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Middle aged female. Non smoker. Neck lump. Differentials

A 
Thyroid lump (follicular adenoma, hyperplastic nodules, thyroid cysts, malignancy- papillary carcinoma, follicular carcinoma, etc)
Goitre
Thyroglossal cyst
Cervical lymphadenopathy 
Dermoid cyst
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Signs that thyroid lump seem more likely

A 
Enlarged cervical lymph nodes
Unexplained hoarseness
Stridor- indicates narrowing of airway
Rapidly enlarging painless mass
Thyroid nodule in child
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Key investigations for neck lumps

A

Ultrasound and FNAC

If can we then need staging scans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Three broad categories for nasal Blockage

A

Structural
Inflammatory
Infective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Nasal blockage questions

A 
Both sides or just one 
How long has it felt blocked
Intermittent or constant
Is it ever clear
Any trauma to nose recently or in past
Previous nasal surgery
Other nasal symptoms- sneezing, rhinorrhoea, facial pain, post nasal drip, epistaxis
What meds does pt take
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If nasal blockage and history of trauma- what is wrong and next step?

A

Probably a deviated septum but still good to rule out the other causes as blockage may be mulitfactorial.

If deviated septum that is symptomatic - septoplasty

17
Q

Risks of septoplasty

A 
The need for future surgeries
Failure to improve symptoms
Altered appearance
Septal perforation
Numbness of upper teeth
Anosmia or hyposmia- rare and often transient 
Numbness of the nose
Bleeding and infection
18
Q

Middle aged woman. Nasal obstruction. 15 year history of symptoms. Worse in past four months. Associated with sneezing and rhinorrhea. Asthma and eczema in Hx

Further questions, further investigations and likely diagnosis

A

Worse at any time of year
Sense of smell
Tried any meds
Allergies?

Examine the nose.

Probably a chronic rhinosinusitis. With or without polyps as would need to scope to visualise

19
Q

Further testing after a chronic rhinosinusitis diagnosis

A

Scope to look for polyps

RAST testing to identify allergies and antigens through blood

20
Q

Management of chronic rhinosinusitis

A

Saline nasal irrigation, antihistamines (only when clear evidence of allergies), advise to avoid allergens, topical nasal steroids

21
Q

Lumps and bumps in the nose

A

Polyps
Septal haematoma
Nasaopharyngeal carcinoma - typical unilateral symptoms
Inferior turbinates

22
Q

If suspecting polyps what is the next step

A

CT scan of sinuses if surgery required and need to see extent of disease
Short course pred to shrink polyps and provide some relief of symptoms
Topical nasal steroids

23
Q

Purulant nasal discharge
Nasal obstruction
Facial pain and fullness
Up to four weeks of symptoms

A

Acute rhinosinusitis

24
Q

Clear nasal discharge- what could it be

A

Viral rhinosinusitis secretions
Allergic rhinosinusitis
Could be CSF! Check for glucose. If glucose present then is CSF

25
Q

Purulent discharge with other signs of rhinosinusitis- differential and treatment

A

Bacterial rhinosinusitis

Treat with clarithromycin

26
Q

Epistaxis - Questions to ask in history

A 
Frequency 
Duration
Which side of nose
Is blood dripping out or down throat
History of previous bleeds including easy bruising 
Previous treatment
PMH- GPA, bleeding disorders, rhinitis
Drug history- clopidogrel, warfarin, aspirin
Trauma including digital trauma
27
Q

Examination of nose in epistaxis

A

External nose for signs of trauma, surgery or deformities eg saddle nose deformities
Anterior rhinoscopy
Posterior rhinoscopy
Use a Thuddicum’s speculum or an otoscope

28
Q

Most likely source of epistaxis

A

Little’s area - highly vascular and quite exposed

Kiesselbach’s plexus lies within little’s area

29
Q

Treatment and advice for epistaxis

A
  1. Advise do not blow nose for a week, do not clean the nose, avoid hot baths, do not drink hot tea or coffee for 72 hours, no strenuous exercise for a week
  2. Naseptin ointment - reduces crusting in nose (contains peanuts so check allergies)
  3. Silver nitrate cautery
  4. If epistaxis recurs then apply firm pressure for 15 minutes . If this fails go to A&E
30
Q

Young male. Punched in face yesterday, initially stopped bleeding but started again. Prolonged episode and big clots evident. No meds. What do you do?

A

ABCDE!!!
Get IV access for cannulation
Examine the nose and get adequate protection as blood may spray. Suction may be used to visualise the area.
If origin found then cauterise. If not then need to move on to nasal packing and admit to ENT and get help.

Test- FBC, Coag profile, group and save

31
Q

Factors that could cause epistaxis in adults

A 
Trauma including digital trauma
HTN
Coagulopathies
Meds eg aspirin, warfarin, clopidogrel
Inflammation 
Rare- malignancy eg SCC.
32
Q

Epistaxis in child- usual cause and next steps

A

Usually from Little’s area from digital trauma.
Treat Using naseptin (check allergies) or bactroben. These have antibacterial properties
Discourage digital trauma

MIND AND MOVEMENT (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions