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ENT Flashcards

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1
Q

What is otitis externa and sx

A

Acute inflammation of meatal skin
Minimal discharge, pain, itchy
Tragal tenderness

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2
Q

Organisms in otitis externa

A

Pseudomonas

S aureus

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3
Q

RF otitis externa

A

Swimming
Eczema, psoriasis
Trauma

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4
Q

Persistent infection of otitis externa

A

Malignant otitis externa
Temporal bone destruction
CN palsy
Base of skull osteomyelitis

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5
Q

Manage otitis externa

A

Swabs
Aural toilet
Sofradex

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6
Q

Acute otitis media sx

A

Fever, vomiting, ear pain and discharge
Viral UTI
RED bulging tympanic membrane with exudate

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7
Q

3 causes of otitis media

A

Pneumococcus
Haemophilus
Moraxella

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8
Q

Manage otitis media

A

PO CO AMOX

Mastoiditis - IV abx, myringotomy +- definitive mastoidectomy

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9
Q

Complications of otitis media - 5

A 
Mastoiditis- middle ear inflammation leads to destruction of air cells in mastoid abscess and abscess formation - fever, tenderness, swelling, ear forward 
Labyrinthitis
Facial n palsy
Meningitis
Intracranial abscess
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10
Q

What is choleastoma

A

Keratinising squamous epithelium in Middle Ear

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11
Q

Sx of choleastoma

A

Recurrent inf
Foul discharge
Hearing loss
Headache

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12
Q

Manage choleastoma

A

Mastoid surfeyr

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13
Q

Complciatoins choleastoma

A

Mastoiditis
Cerebral abscess
Facial n palsy

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14
Q

Otitis media with effusion ? Finding on otoscope

A

Glue ear
Dull, grey, yello
Bulging, retracting ear drum
Fluid level

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15
Q

Glue ear sx 4

A

Hearing
Language delay
Inattention
Recurrent inf

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16
Q

Glue ear tests 2

A 
audiogram - shows conductive defect
Impedance audiometry (blow air in and monitor what comes back) - flat tympanogram
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17
Q

Manage glue ear

A

Watch and wait - 3m reviews
Surgery with myringotomy and grommet
Hearing aids if bilateral and persistent

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18
Q

Cause of unilateral glue ear in adult

A

Malignancy - nasopharyngeal blocking eustachian tube entrance

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19
Q

4 causes of conductive hearing loss

A

External canal obstruction
Drum perforation
Infection
Problem with ossicular chain

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20
Q

7 causes of sensorineural hearing loss

A 
Genetic
Congenital infection 
Presbyacusis
Ototoxic - gentamicin, furosemide, vancomycin
Post infective
Acoustic neuroma
Ménière disease
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21
Q

Tinnitus what is it

A

Sensation of non verbal sound outside without stimuli in body

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22
Q

Causes of tinnitus

A

Local - presbyacusis, noise injury, head injury, menieres
General - CVS
Drugs - loop
Psychological

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23
Q

Menieres 4 sx

A

Vertigo
Aural fullness
Tinnitus
Sensory neural hearing loss

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24
Q

2 inv Ménière

A

Electrocochleogroahy

MRI

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25
2 manage Ménière
Prochlorperazine | Beta histine
26
Acoustic neuroma sx 3
Ipsilateral tinnitus Sensorineural hearing loss Cerebellar signs if larg e
27
Diagnose acoustic neuroma
MRI head
28
Manage acoustic neuroma
Gamma knife radiotherapy surgery | Monitor
29
Causes of vertigo
Peripheral - menieres, labyrinthitis (long hx), choleastoma Central - acoustic neuroma, head injury Drugs - gentamycin, diuretics
30
What is BPPV
SuDden rotational vertigo for over 30s provoked by head turning Caused by displacement of otoliths in semicircular canals
31
Causes of BPPV
Head injury Middle ear disease Post viral
32
Diagnosis of BPPV
Establish negatives eg hearing loss tinnitus | Hallpike test - test normal side first
33
Treat BPPV 4
Self limiting Epley manoeuvre Vestibular rehab exercise Betahistine, prochlorperazine
34
Where does inferior meatus drain
Nasolacrimal duct
35
Where does middle meatus drain
Maxillary Frontal Anterior ethmoid cells
36
Rhinosinusitis and 2 types
Inflammation of nose and paranasal sinuses with 2 or more of - nasal congestion or discharge - facial pain or pressure - reduced smell - post nasal drip Acute under 12h or chronic 5or more episodes
37
Diagnosis rhinosidinusis
CT sinus
38
Manage rhinusinusitis
``` Acute - bloods Topical corticosteroids PO antibiotics Nasal douches Chronic - FESS ```
39
Where are nose bleeds more common
Kisselbach's area
40
4 vessels in nose
``` LEGS Superior labialise artery Anterior and posterior Ethmoidal Greater palatine Sphenopalatine ```
41
Manage epistaxis
Stop anticoagulation, FBC, cross match Pinch lower of nose while mouth breathing Cautery if small Ongoing - anterior nasal pack or posterior nasal pack (foley catheter) Examine throat May need EUA or ligation Consider causes - trauma, haem
42
Organisms in tonsillitis
Group a strep | Moraxella caterhalis
43
3 differentials tonsillitis
EBV Agranulocytosis Scarlet fever
44
Manage tonsillitis
Paracetamol and difflam Pen v for 10d Recurrent attacks - tonsillectomy
45
Complications tonsillitis (2) and manage
``` Retropharyngeal abscess - extended neck - torticolis - lateral neck X-RAY, CT neck, I&D in theatre Peritonsilar abscess - quinsy - uvula deviation - trismus - muffles coice - antibiotics and aspiration ```
46
Tonsillitis 4 sx
Sore throat Difficulty swallowing Fever Lymphadenopathy
47
Acute epitltotiits sx 4
Sepsis Stridor Dyspnoea Drooling
48
Manage epiglottis 3
Nebulised adrenaline IV dexamethasone IV penicillin and ceftriaxone
49
Midline neck lumps 4
Dermoid cyst (<20yo) Thryoglossal cyst - fluctuant, moves in tongue protrusion, from thyroid migration Thyroid mass - systemic thyroid features, features of mass Chondroma
50
4 lumps in submandibular triangle
Lymphadenopathy Submandibular stone Submandibular tumour Sialadenitis
51
Mass in posterior triangle
Malignancy (parotid) or infectoin - nodes
52
Anterior triangle mass 3
Branchial cyst - on ant border of SCM, from cervical sinus persistence. Squamous epithelium, cholesterol crystals in fluid Cystic hygroma Carotid body tumour - moves side to side, firm, pulsatile, diagnosis on mri
53
Neck lumps inv
USS CT FNA Bloods
54
RF for otitis media
``` URTI Adenoids Malformations eg cleft palate Asthma Bottle feeding, dummy Smoking GORD ```
55
Causes of laryngeal nerve palsy - 4
Cancers - larynx, thyroid, bronchus, oesophagus Iatrogenic - parathyroidectomy, oesophageal or pharyngeal pouch surgery CNS disease Aortic aneurysm
56
Sx of laryngeal nerve palsy - 3
Vocal cord paralysis - innervates adduction and abduction Weak breathy voice, weak cough Exertional dyspnoea - narrow airflow Cough/aspiration
57
Inv recurrent layngeal n palsy
``` If no hx of surgery: CXR CT if clear US thyroid OGD ```
58
Causes of dysphagia
Malignant - oesophageal, pharyngeal, gastric, lung Neuro - bulbar palsy, myasthenia gravis Benign stricture, pharyngeal pouch, systemic sclerosis
59
Complicatiotns of tonsillitis - 4
Otitis media Sinusitis Peritonsillar abscess - quinsy Pharyngeal abscess
60
What is peritonsillar abscess sx
Quinsy - sore throat, dysphagia Peritonsilar bulge, uvular deviation Trismus, muffled voice Abx and aspiration
61
complications of tonsillectomy
Primary haemorrhage - surgery | Secondary haemorrhage - infection of tonsillary fossa - support, surgery, IV abx

Finals (13 decks)

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