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Flashcards in ENT Passmedicine Deck (267)
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1

What is otosclerosis?

Replacement of normal bone by vascular spongy bone

2

What kind of deafness does otosclerosis cause?

Progressive conductive deafness

3

Why do you get deafness in otosclerosis?

The stapes becomes fixed at the oval window

4

How is otosclerosis inherited?

Autosomal dominantly

5

When is the typical onset of otosclerosis?

20-40y

6

What are the clinical features of otosclerosis?

Conductive deafness
Tinnitus
Normal tympanic membrane (10% have flamingo tinge caused by hyperaemia)
+ve FH

7

How do you manage otosclerosis?

Hearing aid
Stapedectomy

8

What is Meniere's disease?

Disorder of the inner ear of unknown cause

9

What is Meniere's characterised by?

Excessive pressure and progressive dilation of the endolymphatic system

10

In which age group is Meniere's most common?

Middle aged

11

What are the features of Meniere's?

Recurrent episodes of vertigo, tinnitus and sensorineural hearing loss
Sensation of aural fullness/pressure
Nystagmus
Positive Romberg test

12

How long do the symptoms last in episodes of Meniere's?

minutes to hours

13

Are symptoms of Meniere's typically bilateral or unilateral?

Unilateral usually

14

What is the natural history of Meniere's?

Symptoms tend to resolve after 5-10 years
Majority are left with hearing loss

15

What is involved in the management of Meniere's?

ENT assessment req. for diagnosis
Inform DVLA (cease driving until adequate control of sx)
Rx of acute attacks and prevention

16

How do you treat acute attacks in Meniere's?

Buccal/IM prochlorperazine

17

How do you prevent attacks in Meniere's?

Betahistine and vestibular rehabilitation exercises

18

What drugs can cause gingival hyperplasia?

Phenytoin
Ciclosporin
CCB, esp nifedipine

19

What conditions can cause gingival hyperplasia?

AML

20

What are complications of tonsillitis?

Otitis media
Quinsy/peritonsillar abscess
Rheumatic fever + GN very rarely

21

When do NICE recommend tonsillectomy should be considered?

If they meet all of the following:
1. Sore throats are due to tonsillitis
2. Person has 5+ episodes pa
3. Symptoms been occurring for at least 1 year
4. Episodes of sore throat are disabling + prevent normal functioning

22

What are some established indications for a tonsillectomy?

Recurrent febrile convulsions 2ndary to tonsillitis
Obstructive sleep apnoea/stridor/dysphagia due to enlarged tonsils
Quinsy unresponsive to standard Rx

23

What are the primary complications of tonsillectomy?

Occur within 24h:
1. Haemorrhage
2. Pain

24

What are the secondary complications of tonsillitis?

Occur after 24h:
1. Haemorrhage (mostly due to infection)
2. Pain

25

Define vertigo

False sensation that the body/environment is moving

26

List 10 causes of vertigo

Meniere's disease
BPPV
Acoustic neuroma
Viral labyrinthitis
Vestibular neuronitis
Vertebrobasilar ischaemia
Posterior circulation stroke
Trauma
Otoxoticity
MS

27

What are the things that should stand out in a history that point towards a diagnosis of viral labyrinthitis?

Recent viral infection
Sudden onset
NV
Hearing affected

28

What are the things that should stand out in a history that point towards a diagnosis of vestibular neuronitis?

Recent viral infection
Recurrent vertigo attacks lasting hours/days
No hearing loss

29

What are the things that should stand out in a history that point towards a diagnosis of BPPV?

Gradual onset
Triggered by change in head position
Episodes last 10-20s

30

What are the things that should stand out in a history that point towards a diagnosis of Meniere's?

Hearing loss
Tinnitus
Vertigo
Sensation of fullness/pressure in one/both ears