ENT Clinical Flashcards
(45 cards)
What additional checks should be done if a baby has external ear abnormalities?
Chromosomal check
What is the most common bacterial cause of sore throat?
Streptococcus progenies (Group A haemolytic strep)
Which bacteria causes diphtheria?
Corynebacterium diphtheria
Which bacteria causes oral candida?
Candida albicans
What conditions does coxsackie virus cause?
Hand, foot and mouth, and herpangina
What is Rinne’s test?
Strike a tuning fork against an object, then press the vibrating fork on the pt’s mastoid bone. Normally, air conduction is better than bone conduction, however if there is a blockage then this will be reversed
What is Weber’s test?
Place the vibrating fork on the patients forehead and ask them where they hear it Normal: they hear it in the middle Abnormal: they hear it more on one side
What test findings will be found with conductive hearing loss?
- Rinne’s: bone conduction > air
- Weber’s: sound localises to affected ear
- Tympanometry
- Flat may indicate OME or fluid in the middle ear
- High peak may indicate perforation
- PTA – significant air-bone gap
What test findings can be expected with sensorineural hearing loss?
- Weber test: sound localises to normal ear
- Rinne test: air and bone conduction equally diminished
- PTA - No difference between bone and air conduction
What is Carhart’s Notch and what does it indicate?
Dip in PTA at 2K Hz, and indicatres ostersclerosis
What are the different criteria for normal hearing and loss in PTA?
- Normal: 0-25db
- Mild: 25-45db
- Moderate: 45-65dp
- Severe: 65-85db
- Profound: >85db
What is a tympanogram?
Put some sound in the ear then monitor the movement of the ear drum
What are the 6 D’s for symptoms of ear disease?
- Deafness
- Discomfort
- Dizziness
- Discharge
- Din din (tinnitus)
- Defective movement of face
What nerves can be involved in earache?
- CN V
- CN VII
- CN IX
- CN X
- C2 C3
What causes the pain in acute otitis media?
Pus coming from the eustachian tube which applied pressure on tympanic membrane, sometimes causing perforation
What two things can cause a CSF leak from the ear?
May occur due to congenital causes (walls of the ear haven’t come together) or a head injury (eg. a fracture)
What are the 2 types of cholesteatoma?
- Aquired
- Congenital (Derlacki)
- White mass behind an intact ear drum,
- is an embryological remnant which should have cleared at 20weeks
What are important differences with peadiatrics to know for airway obstruction?
- Floppy epiglottis
- Large head
- Neonates are obligate nasal breathers
- If you block their nose, they cant breath
- Relatively large tongue
- Small, soft larynx in higher position (C1)
- Weak neck muscles; floppy head
- Narrow subglottis (3.5 mm at the cricoid
What is the differences between stridora and stretor?
- Stridor: High pitched harsh noise due to turbulent airflow resulting from airway obstructions
- Lower that stretor
- Can occur on inspiration or expiration.
- Stretor: Low pitched sonorous sound arising from nasopharyngeal airway (like snoring)
- Upper respiratory tract
What is heliox?
Combination of helium and oxygen – which makes the air thinner and therefore easier to breath
What is the managment for paedtriatic airway obsrtuction?
- ABC: Resuscitation
- Oxygen
- Heliox
- Steroi
- Adrenalin
- Flexible fibre-optic endoscopy
- Secure airway with ET Tube/Tracheostomy
- Secure airway before anything else
- Treat underlying pathology
What is the difference between dizziness and vertigo?
- Dizziness: Non-specific term, which may cover vertigo, pre-syncope, disequilibrium, etc.
- Vertigo: a sensation of movement, usually spinning.
What is the main symptom for vestibular pathology?
Nystagmus
