ENT Emergencies

Question 1

Which parts of the body can lose loads of blood?

Answer 1

Pelvic cavity
Abdominal cavity
Long bones e.g. femur
Chest cavity

Question 2

What % of blood can be lost and you can still be physiologically fine?

Answer 2

0 - 15%

Question 3

What % of blood can be lost and you become hypotensive, your breathing changes etc?

Answer 3

15 - 30%

Question 4

Types of stridor

Answer 4

Inspiratory
Expiratory
Biphasic

Question 5

Features of croup

Answer 5

Stridor - hoarse and biphasic

Characteristic cough - barking

Question 6

What is a laryngeal papilloma?

Answer 6

Viral tumour growth like a wart

Question 7

Causes of SIRS

Answer 7

Trauma
Burns
Anaphylaxis
Infection

Question 8

What is septic shock?

Answer 8

Hypoperfused / hypotensive despite adequate fluid replacement

Question 9

How does the ear classically point in mastoiditis?

Answer 9

Forward

Down

Question 10

What % of epistaxis occurs from littles area?

Answer 10

95%

Question 11

How are you meant to put pressure on the nose to treat epistaxis?

Answer 11

Pinch top part of soft part and lean forwards

Question 12

Treatment of epistaxis

Answer 12

1st aid
Naseptin cream (heels the area)
Silver nitrate cautery (superficial burn)
Nasal packing 
Surgery or embolization of arteries

Question 13

What is usually the causative organism of tonsillitis?

Answer 13

Virus

Question 14

What causes glandular fever?

Answer 14

EBV

Question 15

Another name for glandular fever

Answer 15

Infectious mononucleosis

Question 16

After glandular fever, what is usually not allowed for 6 weeks?

Answer 16

Contact sports

Alcohol

Question 17

Who gets croup?

Answer 17

6 months - 3 y/o

Question 18

Treatment for croup

Answer 18

No treatment
Supportive
- humidification
- adrenaline / neb steroids

Question 19

Causative organisms of croup

Answer 19

RSV
Flu
Paraflu

Question 20

What do children get now that prevents epiglottitis?

Answer 20

HIB vaccine

Question 21

Who gets epiglottitis?

Answer 21

Age 1 - 5 y/o

Question 22

Presentation of epiglottitis

Answer 22

Red + flushed 
Drooling (cant swallow)
Tripoding 
Dysphagia 
Sore throat 
Muffled voice

Question 23

What is tripoding?

Answer 23

Propping airway forwards
Leaning forwards
Leaning on something

Question 24

Treatment of epiglottitis

Answer 24

Intubate
IV access
Antibiotics
Steroids

Question 25

Treatment of airway obstruction

Answer 25

``` ABCDE Oxygen / heliox Nebulised adrenaline IV dexamethasone IV antibiotics ```

Question 26

What do adrenaline neb and IV dex do in the treatment of airway obstruction?

Answer 26

Reduce swelling

Question 27

What is a tracheostomy?

Answer 27

A stoma / hole in the trachea

Question 28

Does a tracheostomy change the anatomy?

Answer 28

No

Question 29

What are the anatomical changes with a laryngectomy?

Answer 29

Taken everything out above | The mouth is not connected to the lungs

Question 30

Where can infection easily spread from to give periorbital cellulitis?

Answer 30

Sinuses

Question 31

Complications of periorbital cellulitis

Answer 31

Abscess | Compromised nerves and blood supply

Question 32

What is tonsillar SSC associated with?

Answer 32

HPV infection

Question 33

Where is the most common site for SCC in the oropharynx?

Answer 33

Tonsils

Question 34

Risk factors for tonsillar SCC

Answer 34

Smoking High levels of alcohol intake Poor oral hygiene HPV (HPV-16)

Question 35

What is the HTLV1 (human T cell lymphotropic virus) associated with?

Answer 35

Adult T cell leukaemia

Question 36

Complications of thyroid surgery

Answer 36

Recurrent laryngeal nerve damage Bleeding Damage to the parathyroid glands resulting in hypocalcaemia

Question 37

How can bleeding after thyroid surgery lead to respiratory compromise?

Answer 37

Venous return impaired | Resulting in laryngeal oedema and resp compromise

Question 38

What is otalgia in the absence of ear signs a red flag for?

Answer 38

Head and neck malignancy

Question 39

Any patient presenting with hoarseness who are being referred down the suspected cancer pathway should have what test and to exclude what?

Answer 39

CXR | Apical lung pathology

Question 40

What should persistent hoarseness in a smoker indicate?

Answer 40

Lung cancer | Laryngeal cancer