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Year 2 MBChB > ENT > Flashcards

ENT Flashcards

(92 cards)

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1
Q

What is sinusitis?

A

Inflamm of lining of paranasal sinuses

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2
Q

What is the presentation of sinusitis?

A

Pain over cheek that increases with straining/bending down
Discharge
Blocked nose
Hyposmia

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3
Q

What is the management of sinusitis?

A

Phenylnedhrine

Drainage

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4
Q

What are the causes of airway obstruction?

A 
Inflamm/allergy 
Foreign bodies 
Compression 
Trauma 
Neuro 
Burn 
Cancer 
Congenital
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5
Q

What are the signs and symptoms of airway obstruction?

A 
SOBOE 
Choking 
Stridor 
Coughing 
Tracheal tug 
Cyanosis 
Pyrexia
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6
Q

How is airway obstruction assessed?

A

Appearance
Skin circulation
Work of breathing
Flexible endoscopy

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7
Q

How is airway obstruction managed?

A 
ABC 
O2 
Heliox 
Steroid 
Adrenaline 
Tracheostomy (avoid if poss) 
Removal of thing causing
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8
Q

What are complications of nasal trauma?

A

Epistaxis
CSF leak
Anosmia

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9
Q

Which arteries are likely to be responsible in epistaxis?

A

Spenopalatine artery anastomosis
Ethmoid artery anastomosis
Greater palatine artery

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10
Q

What is the management of epistaxis?

A 
Rhesus if necessary 
Pressure, ice 
Suction to remove clots 
Nasal pack 
Cautery 
Surgery
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11
Q

What are the causes of rhinitis?

A

Viral URTI
Allergic
Non-allergic or infective

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12
Q

What causes intermittent allergic rhinitis?

A

Grass
Trees
Fungal spores

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13
Q

What causes persistent allergic rhinitis?

A

Dust mite
Cats
Dogs

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14
Q

How is persistent allergic rhinitis classified?

A

Symptoms for more than 4 days of the week or lasting longer than four weeks

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15
Q

How is intermittent allergic rhinitis classified?

A

Symptoms for less than 4 days of the week or lasting less than four weeks

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16
Q

What is the management of allergic rhinitis?

A

Antihistamines > topical steroids > both

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17
Q

What are nasal polyps?

A

Benign tear shaped growths in nose or sinuses

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18
Q

What are nasal polyps associated with?

A

Non-allergic rhinitis

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19
Q

What is the presentation of nasal polyps?

A 
Nasal obstruction 
Drip 
Sneezing 
Facial pain 
Changes in smell
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20
Q

How are nasal polyps diagnosed?

A

Nasal endoscopy

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21
Q

What is the management of nasal polyps?

A

Oral steroids > topical steroids > surgery

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22
Q

How does acute infective rhino sinusitis present?

A

Facial pain
Discharge
Nasal blockage

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23
Q

How is acute infective rhinosinusitis managed?

A

Analgesics

Decongestants

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24
Q

What is Meniere’s disease?

A

Disorder of inner ear

Increased hydraulic pressure in endolymphatic system

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25
How does Meniere's disease present?
``` Vertigo: >2 20 min episodes Tinnitus Sensorineural HL Sensation of aural fullness Nystagmus ```
26
How is Meniere's disease investigated?
Audiometry ECOG ENG Otoscopy
27
How is Meniere's disease managed?
Lifestyle and diet Meclizine Prochlorperazine
28
What are the key features of presbycusis?
Age related sensorineural HL | Bilateral high frequency HL
29
What is otosclerosis?
Autosomal dominant replacement of normal bone by vascular spongy bones
30
What are the key features of otosclerosis?
Onset: 20-40 y/o Tinnitus Conductive HL +ve FH
31
What is the peak age of OME?
2 y/o
32
How does OME present?
HL Speech and language delay Behaviour/balance probs
33
What drugs causes ototoxicity?
Gent Aspirin Furosemide
34
What are the features of vestibular schwanomma?
HL, vertigo, tinnitus Absent corneal reflex (CN V) Facial palsy (CN VII)
35
What are the features of viral labrynthitis?
Vertigo N&V May be HL
36
What are the features of vestibular neuritis?
Recurrent vertigo attacks lasting hours - days | No HL
37
What are the features of BPPV?
Gradual onset Triggered by position Lasts seconds
38
What are the features of an acoustic neuroma?
HL Tinnitus Vertigo Absent corneal reflex
39
What is otitis media?
Inflamm of the middle ear
40
What causes otitis media?
Usually viral
41
What is a complication of otitis media?
Mastoiditis
42
What are the common organisms in otitis media?
H influenza Strep pneumonia Catarrhalis Strep pyogenes
43
How does otitis media present?
``` Otalgia Malaise Fever Rhinorrhoea Vomiting ```
44
What is seen on examination in otitis media?
Bulging TM Air fluid level Red/yellow/cloudy TM
45
How is otitis media managed?
Analgesia | Abx if systemically unwell
46
What is the management of vestibular neuritis?
Self-limiting Prochlorperazine Anti-emetic
47
How does OME present?
``` Mild conductive HL Intermittent otalgia 'popping' sensation Balance problems AOM history ```
48
What is seen on examination in OME?
Retracted TM Immobile TM Loss of light reflex
49
What is the management of OME?
Observe (3m) Grommets Adenoidectomy
50
What is the management of vestibular schwannoma?
Surgery
51
How does otitis externa present?
Itch Pain Otorrhoea Temporary dulled hearing
52
What are the causes of otitis externa?
Swimming Skin problems Otitis media
53
What is the management of otitis externa?
Acetic acid spray | Abx + steroid drops
54
What HL is it when there is an air bone gap and the bone is normal?
Conductive
55
What HL is it when there is no difference between air and bone conduction?
Sensorineural
56
What HL is it when there is an air bone gap but both are abnormal?
Mixed
57
What is a cholesteatoma?
Abnormal squamous cells in the middle ear
58
What are RFs for a cholesteatoma?
Cleft palate | Grommets
59
How does a cholesteatoma present?
Progressive conductive HL Vertigo Headache Facial nerve palsy
60
How is a cholesteatoma managed?
Tympanomastoidectomy | Tympanoplasty
61
What is the first line management of epistaxis?
First aid measures + stop anticoagulants
62
What is the second line management of epistaxis?
Chemical cautery of visibly bleeding vessels
63
What is the third line management of epistaxis?
Nasal packing
64
What is the fourth line management of epistaxis?
Endoscopic cautery
65
What is the fifth line management of epistaxis?
Ligation of arteries; local arteries then external carotid
66
What is the last management of epistaxis?
Arterial embolisation
67
What is the common site of epistaxis?
Kiesselbach's plexus
68
What are features of lymphoma?
Rubbery, painless lymphadenopathy, may be associated night sweats or splenomegaly
69
What are the features of a thyroid swelling?
Moves upwards on swallowing
70
What are the features of thyroglossal cyst?
Usually midline, moves upwards on protrusion of tongue
71
What is a pharyngeal pouch?
Posteromedial herniation between thyropharyngeus and cricopharynxgeus muscles
72
What are the features of a pharyngeal pouch?
Midline lump that gurgles on palpation, dysphagia, regurgitation, aspiration, chronic cough
73
What are the features of a cystic hygroma?
Congenital, classically on the left side
74
What is a branchial cyst?
Remnant of the second branchial cleft in embryonic development
75
What are the features of a branchial cyst?
Present in early adulthood, oval, mobile cystic mass
76
How is sleepiness assessed?
Epworth scale
77
How is sleep apnoea diagnosed?
Sleep studies
78
How is sleep apnoea managed?
Weight loss, CPAP
79
What are predisposing factors for sleep apnoea?
Obesity, macroglossia, large tonsils, Marfan's
80
What are the consequences of sleep apnoea?
Daytime somnolence, hypertension
81
What are the features of FeverPAIN score?
``` Fever in last 24 hours Purulence Acute: last 3 days Inflamed tonsils No cough ```
82
When should someone be referred for a tonsillectomy?
7 well documented episodes of tonsillitis in the last year, 5 in the last 2 years, 3 in the last three years
83
What is the most common organism in tonsillitis?
Strep pyogenes
84
What is the management of tonsillitis (able to swallow)?
Penicillin V oral 500mg qds for 10 days
85
What is the management of tonsillitis (unable to swallow)?
Benzylpenicillin IV 1.2g qds
86
What is the investigation of choice for glandular fever?
Monospot test
87
What is the management of glandular fever?
Rest, fluids, analgesia, AVOID CONTACT SPORTS in first 8 weeks to prevent splenic rupture
88
What is the normal dB for hearing?
0-20
89
What is black hairy tongue due to?
Defective desquamation of the filiform papillae
90
What drugs cause gingival hyperplasia?
Phenytoin, ciclosporin, CCBs
91
What organism is common in malignant OE?
Pseudomonas
92
What are the key features in the history for malignant OE?
Diabetes/immunosuppression | Severe, unrelenting, deep-seated otalgia, temporal headaches, purulent otorrhoea

Year 2 MBChB (8 decks)

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