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1. 4th year > ENT treatments > Flashcards

ENT treatments Flashcards

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1
Q

cholesteatoma

A

surgery

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2
Q

otosclerosis

A

1st line - hearing aid

stapedectomy, CO2 laser, cochlear implant

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3
Q

treatment of OME (glue ear) in < 3 year olds

A

grommets

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4
Q

treatment of OME (glue ear) in > 3 year olds 1st episode

A

grommets

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5
Q

treatment of OME (glue ear) in > 3 year olds 2nd episode

A

grommets and adenoidectomy

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6
Q

presbycusis

A

hearing aid

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7
Q

ix vestibular schwannoma

A

contrast MRI of cerebellopontine angle

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8
Q

tx vestibular schwannoma

A

watchful waiting
radiotherapy
surgical excision

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9
Q

ix if persistent unilateral otitis externa

A

biopsy - may be maligancy

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10
Q

tx mild otitis externa

A

topical acetic acid (OTC) + topical antibiotic +/- topical steroid

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11
Q

tx moderate otitis externa

A

topical otomize (dexamethasone + neomycin + acetic acid)

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12
Q

are swabs usually taken in otitis externa

A

no - only in non-resolving cases

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13
Q

tx otitis externa that is spreading despite treatment

A

oral flucloxicillin

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14
Q

tx malignant otitis externa

A

refer urgently to ENT and IV ciprofloxacin

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15
Q

1st line treatment in acute otitis media

A

rest analgesia and fluids - usually self limiting

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16
Q

when are antibiotics given in acute otitis media

A

o >4 days or not improving
o Systemically unwell
o Younger than 2 years old with bilateral OM and marked symptoms
o Otitis media with perforation
o Immunocompromise or high risk of complications due to significant heart/lung/kidney/liver/neuromuscular disease

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17
Q

antibiotic of choice in acute otitis media if being given

A

500mg Amoxicillin TDS 5-7 days

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18
Q

2nd line antibiotic of choice in acute otitis media if being given

A

500mg Clarithromycin or erythromycin TDS 5 days

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19
Q

tx ruptured tympanic membrane

A

majority heal on own, review in 6-8 weeks

if fails to heal - myringoplasty

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20
Q

tx mastoiditis

A

IV tazocin +/- mastoidectomy

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21
Q

tx epiglottitis/supraglottitis

A

IV ceftriaxone

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22
Q

tx acute attack menieres

A

buccal or IM prochlorperazine

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23
Q

tx preventing menieres

A

beta histine and vestibular rehabilitation exercises

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24
Q

life style advice for menieres

A

reduce salt, alcohol, caffeine and stress

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25
dx BPPV
dix hallpike - rotational nystagmus
26
tx BPPV
epley | teach patient exercises to do at home
27
tx vestibular neuronitis
- buccal or IM prochlorperazine for rapid relief | - short course oral prochlorperazine or antihistamine
28
tx chronic vestibular neuronitis
vestibular rehab exercises
29
tx labyrinthitis
prochlorperazine or antihistamine may help
30
what nystagmus is seen in labyrinthitis and vestibular neuronitis
horizontal
31
1st line nose bleed treatment haemodynamically stable
first aid measures: sit forward and mouth open pinch cartilaginous area of nose firmly for 20 mins breath through mouth o Avoid blowing or picking the nose, heavy lifting, exercise, lying flat, drinking alcohol or hot drinks
32
2nd line nose bleed treatment
naseptin cream (chlorhexidine and neomycin)
33
when is naseptin contraindicated
peanut soy or neomycin allergy
34
what is an alternative to naseptin cream in peanut allergy
mupirocin
35
treatment nosebleed rhyme
``` NCP-SLE naseptin cautery packing sphenopalatine ligation embolisation ```
36
treatment nosebleed after naseptin/bleeding continuing after 10-15 mins
cautery - if source of bleed is visible
37
do you cauterise both sides of septum
no just one - risk of perforation
38
treatment nosebleed after cautery or if bleeding source not visible
admit to hospital and packing | - anterior then posterior
39
how long does anterior packing stay in for
24 hours
40
how long does posterior packing stay in for
48 hours
41
treatment nosebleed if haemodynamically unstable
admit to A+E
42
treatment nosebleed after packing / all other treatment failed
sphenopalatine artery ligation
43
treatment nosebleed after sphenopalatine ligation
ligation of ECA
44
treatment nosebleed after ligation of ECA
embolisation
45
symptomatic tx rhinosinusitis
analgesia intranasal corticosteroids nasal irrigation with saline decongestants - pseudophedrine,oxymetazoline
46
tx rhinosinusitis if symptoms last longer than 10 days
inhaled steroids
47
what is the problem with use of decongestants e.g. pseudophedrine, oxymetazoline
cause rebound congestion and necrosis of septum if used LT (rhinitis medicamentosa)
48
treatment chronic rhinosinusitis
avoid allergens intranasal corticosteroids nasal irrigation
49
1st line treatment allergic rhinitis
allergen avoidance
50
treatment mild/moderate allergic rhinitis
oral or intranasal antihistamine
51
treatment severe allergic rhinitis
intranasal steroids
52
treatment allergic rhinitis if important life event coming up
short course oral steriod
53
when should antibiotics be used in sinusitis
symptoms persist / worsening after 7-10 days
54
1st line treatment of infective sinusitis
penicillin V 500mg TDS 7 days
55
2nd line treatment infective sinusitis
doxycycline 100mg
56
tx infective sinusitis if high risk of comps or very serious illness
co-amox
57
tx vasomotor rhinosinusitis
inhaled ipratropium
58
tx nasal polyps 1st line
topical steroid +/- montelukast
59
2nd line tx nasal polyps
endoscopic polypectomy
60
tx viral tonsillitis
paracetamol bed rest | difflam analgesic spray can help
61
tx bacterial tonsillitis
penicillin V 10 days
62
2nd line treatment bacterial tonsillitis
clarithromycin 5 days
63
tx quinsy
needle aspiration and drainage and IV antibiotics
64
cause of infectious mononucleosis
EBV
65
scoring system for bacterial tonsillitis
centor - tender anterior lymphadenopathy - absence of cough - fever - enlarged tonsils with exudate
66
tx of infective mononucleosis
supportive | avoid contact sport for 4 weeks
67
white pseudomembrane systemically very unwell bull neck appearance
diphtheria
68
ix diphtheria
throat swab for culture - tellurite agar or loefflers media
69
tx diphtheria
diphtheria antitoxin + IM penicillin
70
salivary gland infection
flucloxicillin + metronidazole if bacterial
71
ix parotid gland tumour
plain x-ray - exclude calculi FNAC superficial parotidectomy - diagnostic and therapeutic CT/MRI staging in cases of malignancy
72
ix submandibular tumour
FNAC CT and MRI all should be excised
73
RF for nasopharyngeal (SCC) cancer
EBV | asian populations
74
RF for oral, oropharyngeal and oesophageal cancer
HPV
75
IX for nasal and nasopharyngeal cancers
combined CT and MRI
76
tx nasopharyngeal cancers
radiotherapy
77
ix oropharyngeal cancer
biopsy
78
tx oropharyngeal cancer
o Early, small: radical radiotherapy or surgery. o Locally advanced but resectable: surgery + post op radiotherapy. o Locally advanced but not resectable: chemo-radiotherapy.
79
ix for laryngeal cancer
laryngoscopy and biopsy
80
tx largyneal cancer
surgery - laryngeal sparing (T1 or T2) - total or partial laryngectomy chemo-radiotherapy can be used as an alternative to surgery in advanced disease
81
tx motion sickness and vertigo
prochlorperazine
82
SE of LT use of prochlorperazine
EPSEs
83
auricular haematoma
urgent incision and drainage - same day ENT assessment
84
ear wax impaction treatment
ear drops - olive oil, sodium bicarb | syringing
85
tx ramsay hunt
oral aciclovir and steroids
86
tx bells palsy
< 72 hours - oral prednisolone

1. 4th year (23 decks)

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