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ENT emergencies Flashcards

(53 cards)

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1
Q

Damage to cartilage is an…

A

ENT emergency

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2
Q

What can cause a haematoma?

A

Cartilaginous necrosis

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3
Q

How do you treat a haematoma?

A

Drain
Abx
Bulky dressing

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4
Q

Ear anaesthesis?

A

Block great auricular nerve in post-auricular region

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5
Q

Treatment of chondritis (cellulitis):

A

Difficult to treat due to poor blood supply
Cover S. Aureus and Pseudomonas
Extra care in diabetes

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6
Q

Differential of chondritis?

A

Inflammation from sero-ve arthritis

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7
Q

Features of otitis externa:

A

Ear canal infection and inflammation
Bacteria (pseudomonas and staph) and funghi
Treat with Abx-steroid drops
Use wick for tight canals

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8
Q

ENT diabetic complication:

A

Malignant otitis externa - granulation tissue

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9
Q

Management of FB in ear canal:

A

Kill bugs with mineral oil/lidocaine
Suction/tissue adhesive
Involve ENT specialist

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10
Q

What in the history can indicate tympanic membrane perforation?

A

History of drainage

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11
Q

When does perforation of the tympanic membrane warrant immediate referral?

A

Perforation with vertigo and facial nerve involvement

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12
Q

What causes tympanic membrane perforation?

A

Middle ear pressure

Fluid or barotrauma

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13
Q

Management of tympanic membrane perforation?

A

Oral Abx - drops for purulent but avoid gentamicin

Most heal but all need ENT follow up

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14
Q

Name 3 significant middle ear conditions:

A

Serous otitis media
Otitis media
Mastoiditis

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15
Q

Sign of mastoiditis?

A

Mastoid bulging and tenderness

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16
Q

What is serous otitis media and how do you manage it?

A

Eustachian tube dysfunction

Manage with decongestants and decompression

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17
Q

Sign of otitis media:

A

Fluid behind the tympanic membrane

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18
Q

Risk with mastoiditis:

A

Can lead to brain abscess/meningitis due to the venous connection with the brain

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19
Q

Name 2 types of vestibulopathy (peripheral vertigo):

A

BPPV

Labyrinthitis

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20
Q

Signs of vestibulopathy (peripheral vertigo):

A

Acute onset
No central signs
Young patient
Horizontal nystagmus

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21
Q

Symptoms of Meniere’s disease:

A

Vertigo
Sensorineural hearing loss
Tinnitus

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22
Q

Differential between Meniere’s and peripheral vertigo?

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A

Meniere’s causes sensorineural hearing loss and tinnitus

23
Q

How do you treat Meniere’s disease?

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A

Antihistamine
Prochlorpenazine
Fluids and rest
Epley manoeuvre

24
Q

What is the arterial supply to the anterior nose?

Study These Flashcards
A

Internal carotid

25
What is the arterial supply to the posterior nose?
Distal branches of the external carotid
26
Where does anterior epistaxis originate 90% of the time?
Kisselbach's plexus (Little's area)
27
What does anterior epistaxis require?
Abx prophylaxis, pressure +/- tamponade
28
What may cause CNVII palsy?
Lyme disease | HSV
29
Management of CNVII palsy?
60-80mg prednisone and antivirals | Surgical decompression if not improving by 2 weeks and electroneurography
30
Treatment for sinusitis:
Amoxicillin, doxycycline | Decongestants and analgesia
31
Complications of sinusitis:
Ethmoid sinusitis leading to orbital cellulitis and abscess | Frontal sinusitis may erode bone (Pott's puffy tumour and brain abscess)
32
Features of parotiditis:
Usually viral (paramyxovirus) Bacterial in elderly and immunocompromised Assoc with dehydration Cover staph and anaerobes
33
What organisms can cause pharyngitis?
Viruses: EBV, adenovirus, rhinovirus Bacteria: Group A-beta haemolytic strep, mycoplasma, gonorrhoea, diphtheria
34
What is a complication of suppurative tonsilitis?
Peritonsillar abscess
35
Signs of peritonsillar abscess:
Inferior-medial displacement if tonsils and uvula
36
Symptoms of peritonsillar abscess:
``` Dysphagia Ear pain Muffled voice Fever Trismus ```
37
Treatment of peritonsillar abscess?
Abx I and D +/- steroids
38
Signs and symptoms of epiglottitis:
``` Rapid onset, looks toxic Prefer to sit Muffled voice Dysphagia Drooling Restlessness Thumbprint of Vallecula sign Epiglottis >8mm in adults for acute epiglottitis ```
39
Treatment of epiglottitis?
Prepare for emergent airway IV cefotaxime +/- steroids Adrenaline nebulisers
40
What causes breathing problems in retropharyngeal abscess?
Swelling in the retropharyngeal anterior to pre-vertebral space
41
Why can retropharyngeal abscess occur in children <4?
Lymphoid tissue occupies the space
42
Symptoms of retropharyngeal abscess:
Pain Dysphagia Dyspnoea Fever
43
Management of retropharyngeal abscess:
Lateral neck X-ray | CT with contrast
44
Complication of retropharyngeal abscess?
Mediastinitis
45
What is Ludwig's angina?
Rapidly growing cellulitis on the floor of the mouth causing airway obstruction History of dental procedures Caused be strep. viridans and happens in the elderly
46
Treatment of Ludwig's angina?
Intubation/tracheostomy/airway-compromised-ICU admission | Abx
47
What can cause angioedema?
Hereditary | ACE inhibitors
48
Management of angioedema:
Antihistamines and steroids | Observe every 4-6 hours
49
What does aphonia suggest?
Complete upper airway obstruction
50
What does stridor suggest?
Incomplete upper airway obstruction
51
What does wheezing suggest?
Incomplete lower airway obstruction
52
Management of wheezing?
Salbutamol + ipratropium/steroids
53
What does loss of breath sounds indicate?
Complete lower airway obstruction e.g. from fluid in the bronchus

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