ENT Emergencies

Question 1

Causes of emergency airway obstruction

Answer 1

Epiglotitis
Retropharyngeal abscess (complication - mediastinitis)
Ludwigs angina - cellulitis of floor of mouth
Angiodema - hereditary, ACEi, hypersensitivity

Question 2

How does mastoiditis develop

Answer 2

2ndry to AOM
Direct spread to bone or
Indirect via emissary vein of mastoid

Question 3

Management of mastoiditis

Answer 3

CT brain
Abx
+- surgery

Question 4

Diff for mastoiditis

Answer 4

Post auricular lymphadenitis

Question 5

Common site for epistaxis

Answer 5

kieselbachs plexus (anterior)
Littles area

Question 6

Rx for anterior bleeds

Answer 6

Abc 
Compression
Cautery (silver nitrate)
Decongestants
Topical Abx
Bed rest

In posterior add nasal packing and spa ligation if needed

Question 7

When to manipulate nasal fracture deformity

Answer 7

5 days to 2 weeks

Question 8

Sign for oesophageal perf form foreign body

Answer 8

Para vertebral air

Question 9

Acute management of stridor

Answer 9

Abc
Adrenalin neb
Oxygen
Calm
Refer
Est diagnosis

Question 10

Common causes for upper airway obstruction in children

Answer 10

• adenotonsillar hypertrophy
• retropharyngeal abscess
• epiglottitis
• foreign body

Question 11

Procedure for long uvula

Answer 11

• partial uvulectomy

- uvulapalatopharyngoplasty

Question 12

Features of Ramsy-Hunt syndrome

Answer 12

• pain
• CN VII palsy
• sensorineural hearing loss

Question 13

Complications of a quinsy

Answer 13

• airway obstruction

- deep neck space abscess

Question 14

Complications of EBV

Answer 14

• bacterial superinfection
• hepatitis
• thrombocytopaenia

Question 15

Complications of diptheria

Answer 15

• airway obstruction

- myocarditis

Question 16

Where are papillomas found?

Answer 16

• nostrils

- larynx

Question 17

Stridor

Answer 17

Noisy breathing due to air flow changes within larynx, trachea or bronchi

Question 18

Stertor

Answer 18

Noisy breathing due to obstruction of airway above larynx, produced by vibrations of tissue of nasopharynx, pharynx or soft palate

Question 19

Treatment of stridor

Answer 19

• nebulised adrenalise
• oxygen
• calm environment
• emergency referral
• establish diagnosis

Question 20

Symptoms of epiglottitis

Answer 20

• prefer to sit
• muffled voice
• dysphagia
• drooling
• restlessness

Question 21

Symptoms of retropharyngeal abscess

Answer 21

• pain
• dysphagia
• dyspnoea
• fever

Question 22

Complication of retropharyngeal abscess

Answer 22

Mediastinitis

Question 23

What is Ludwig’s angina?

Answer 23

• rapidly progressive cellulitis of floor of the mouth
• usually in elderly debilitated patients
• precipitated by dental procedures

Question 24

Treatment of Ludwig’s angina

Answer 24

• ICU
• antibiotics
• airway management

Question 25

Definition of mastoiditis

Answer 25

Inflammation and osteitis within the mastoid air cell system or periosteitis of the mastoid process

Question 26

How does the mastoid become infected?

Answer 26

- direct bone erosion through the cortex | - indirectly through the emissary vein of the mastoid

Question 27

Symptoms of mastoiditis

Answer 27

- otaliga - otorrhoea - fever - irritability - post-auricular swelling

Question 28

Places where facial nerve palsies can originate

Answer 28

- ear - parotid gland - parapharyngeal - skull base - temporal bone trauma

Question 29

Treatment of idiopathic facial nerve palsy

Answer 29

- consider steroids - eye care - ENT OPD appointment

Question 30

Organisms responsible for chondritis

Answer 30

- S. aureus - pseudomonas (inflammatory causes related to seronegative arthritis may be indistinguishable from infection - ear lobe usually spared)

Question 31

Arteries making up Keiselbachs plexus

Answer 31

- anterior ethmoid artery - posterior ethmoid artery - spheno-palatine artery - greated palatine artery - septal branch of superior labial artery

Question 32

What to do if you suspect large foreign body

Answer 32

- barium swallow