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Y3 > ENT & Ophthal & Derm > Flashcards

ENT & Ophthal & Derm Flashcards

1
Q

BPPV signs and symptoms

A

Vertigo lasting a minute
Dizziness after changing head position

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2
Q

BPPV investigations

A

Hallpike test

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3
Q

BPPV management

A
  1. Epley manoeuvre
  2. Vestibular rehabilitation (Cawthorne-Cooksey exercises)
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4
Q

Ménière’s disease signs and symptoms

A

Vertigo lasting hours
Unilateral hearing loss with aural fullness and tinnitus
N+V

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5
Q

Ménière’s disease management

A

Acute:
Vestibular sedatives e.g. prochlorperazine
Antihistamine e.g. cinnarizine

Long term:
Stress avoidance
Betahistine (reduces frequency and length of episodes)
Diuretics

Dont drive!
2nd line:
Grommet
Hearing aid
Intratympanic gentamicin/steroid injection

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6
Q

Epistaxis management

A

Firm pressure on soft anterior nose for 15 min
Patient should sit forward

bleed is visible:
Cautery with silver nitrate

bleed isn’t visible:
nasal packing

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7
Q

Infectious mononucleosis signs and symptoms

A

Triad:
Sore throat
Lymphadenopathy
Fever

Tonsillar enlargement
Splenomegaly (important)

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8
Q

Infectious mononucleosis investigations

A

Gold standard: Heterophil antibody test (monospot test)

FBC: leukocytosis/lymphocytosis
Blood film: atypical lymphocytes

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9
Q

Infectious mononucleosis management

A

Physical isolation
Avoid alcohol
Analgesia, hydration
Steroids if symptoms are severe

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10
Q

Obstructive sleep apnoea signs and symptoms

A

Snoring
Sleep disruption/fragmentation

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11
Q

Obstructive sleep apnoea management

A

Mild:
Lifestyle and sleep advice

Moderate/severe:
Lifestyle and sleep advice
Fixed level CPAP, auto CPAP if not working

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12
Q

Rhinosinusitis signs and symptoms

A

Headache
Facial pain, worse when bending over/lying down
Thick nasal discharge (green/blood/pus)

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13
Q

Rhinosinusitis management

A

Nasal congestion:
Nasal irrigation
Hydration

Allergic:
Antihistamine
Mometasone/fluticasone

Viral:
Will get better over 10 days

Bacterial:
Co-amoxiclav 500mg TDS 5/7
Penicillin allergy -> clarithromycin/doxycycline

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14
Q

Tonsillitis signs and symptoms

A

Common cold: rhinorrhoea, nasal congestion, cough

Influenza: headache, weakness, fatigue, myalgia, fever, dry cough

Streptococcal: acute onset, fever, tonsil exudate, no cough

Glandular fever (inf mononucleosis): >7d sore throat, adenopathy, splenomegaly

Haem malignancy (rare): fatigue, weight loss, petechial rash, bruising, adenopathy, fever

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15
Q

Tonsillitis indications for hospital admission

A

Drooling with respiratory distress
Severe dehydration
Per-tonsillitis abscess
Suspected Kawasaki disease

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16
Q

Tonsillitis management

A

Calculate feverPAIN score:
2-3 -> delayed penicillin V 500mg QDS 10/7
4-5 -> immediate penicillin V 500mg QDS 10/7

Peri-tonsillar abscess:
Intraoral incision and drainage
Needle aspiration

> 7 well-documented episodes of tonsillitis in a year: tonsillectomy

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17
Q

Optic neuritis signs and symptoms

A

Eye pain, worse on eye movement
Blurry vision and colour may be affected(red desaturation)
Related to MS

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18
Q

Causes of abnormally large/small pupil

A

Large:
Third nerve palsy
Acute glaucoma
Pharmacological

Small:
Horner’s syndrome
Opioid overdose

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19
Q

Optic neuritis investigations

A

MRI to rule out MS
Lumbar puncture to check for MS

20
Q

Optic neuritis management

A

High dose steroids

21
Q

Scleritis signs and symptoms

A

Severe eye pain, worse at night
Photophobia
Tearing
Visual acuity affected

Associations:
RA
SLE
Sarcoidosis
Granulomatosis with polyangiitis

22
Q

Uveitis signs and symptoms

A

Pain and redness
Photophobia
Blurred vision
anterior uveitis associated with ankylosing spondylitis

23
Q

Types of visual field defects and where are the lesions

A

Bitemporal hemianopia: optic chiasm
Homonymous hemianopia: optic tract contra
Unilateral vision loss: optic nerve ipsi
Homonymous superior quadrantanopia: temporal lobe contra
Homonymous inferior quadrantanopia: parietal lobe contra

24
Q

Conjunctivitis signs and symptoms

A

Red eye, swelling, watering
Normal vision and reflexes
Viral conjunctivitis associated with URTI
Sticky discharge if bacterial

25
Q

Conjunctivitis investigations

A

Swab if bacterial and not improving with topical antibiotics
Patch test for allergen

26
Q

Conjunctivitis management

A

Antihistamines
Artificial tears
Bacterial: topical chloramphenicol, topical fusidic acid if pregnant

27
Q

Scleritis management

A

NSAIDs e.g. ibuprofen
Prednisolone if NSAIDs contraindicated or scleritis is posterior/necrotising
Immunosuppressants e.g. azathioprine/methotrexate
Antibiotics if bacterial

28
Q

Uveitis management

A

Topical/oral steroids
Rule out corneal ulcers
DMARDs if caused by RA

29
Q

Eczema Signs and symptoms

A

Thickened and scaly skin on flexor surfaces

30
Q

Eczema management

A

Reduce exposure to irritant
emollient
Moisturise

Mild: hydrocortisone

Moderate: betamethasone(betnovate)/clobetasone(eumovate)

Potent: fluticasone(cutivate)

Very potent: clobetasol(dermovate)

31
Q

Cellulitis management

A

Flucloxacillin 1g QDS 7/7

32
Q

Cellulitis signs and symptoms

A

Pain and swelling
Blanching erythema

33
Q

Psoriasis signs and symptoms

A

Scaly erythematous plaques on extensor surfaces
Joint pain

Exacerbations:
Smoking/alcohol
Stress
Infection
Medication
Skin injury

34
Q

Psoriasis management

A
  1. emollients
  2. potent corticosteroid + vit D
  3. step up vit D
  4. step up steroids
  5. dithranol

phototherapy
methotrexate
etanercept

35
Q

Candidiasis signs and symptoms

A

Oral:
White patches on tongue

Vagina:
Itching, burning
White discharge

36
Q

Candidiasis management

A

Oral:
Topical nystatin
Topical clotrimazole

Vaginal:
Topical clotrimazole

37
Q

Necrotising fasciitis signs and symptoms

A

Red/purple skin in affected area
Fever
Pain
Usually limbs or perineum

38
Q

Necrotising fasciitis investigations

A

Surgical exploration (gold standard)
FBC, CRP, U&E, glucose

39
Q

Necrotising fasciitis management

A

Aggressive surgical debridement
Co-amoxiclav
IV fluid
Analgesia

40
Q

HSV signs and symptoms

A

Urinary retention
Burning/tingling
Lymphadenopathy, malaise, anorexia
Painful vesicles on erythematous base

41
Q

HSV diagnosis and management

A

Diagnosis: PCR

Acyclovir
IV antivirals

42
Q

Orbital cellulitis signs and symptoms

A

Painful, limited eye movement
Sudden vision loss
Bulging eyes (proptosis)
Eyelid redness, swelling

43
Q

Orbital cellulitis management

A

IV Penicillins/vancomycin/clindamycin/doxycyline
Surgical drainage of sinuses

44
Q

Urticaria signs and symptoms

A

Red, raised itchy bumps
Caused by medication, insect bites, food
RF: asthma, hay fever

45
Q

Urticaria management

A

Antihistamines (fexofenadine)
Omalizumab

46
Q

Viral exanthema signs and symptoms and causative organisms

A

Widespread rash, usually children

Measles
Rubella
Parvovirus B19
HHV6

47
Q

strawberry tongue presentation

A

kawasaki disease

Y3 (9 decks)

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