Facts Flashcards
(20 cards)
What is the treatment for acute otitis externa?
Topical abx + steroid drops - Gentisone or Sofradex for one week
Don’t use aminoglycosides (Gentamicin) in tympanic membrane perforation
Advice about keeping the ear dry and not swimming
What are the complications of otitis externa?
Perichondritis
Malignant otitis externa (spread to the skull base - more likely in diabetics or immunocompromised)
Facial cellulitis
What advice would you give to someone about how to use ear drops?
Ideally use a soaked ribbon gauze but this may not be possible so instead drop in the drops and lie flat on your side (not the side you’ve put the drops in) for 10 minutes after the canal has been filled with a liberal quantity
What is the centor criteria?
Absence of cough Cervical lymphadenopathy Fever >38 degrees Bilateral purulent tonsillar exudates Need to have >2/4 for abx
How do you treat bacterial tonsillitis?
Penicillin V for 7-10 days
Differentials for tonsillitis?
Bacterial tonsillitis
Viral tonsillitis
Quinsy
Glandular Fever
Indications for tonsillectomy?
> 7 episodes in 1 year
5 episodes per year in past 2 years
3 episodes per year in past 3 years
What can cause a conductive hearing loss?
Tympanic membrane perforation Wax Otosclerosis Otitis Media with Effusion Otitis Externa Foreign body Acute Otitis Media Choleasteatoma
What does a lateralising Weber’s Test indicate?
Conductive deafness in that ear
Sensorineural deafness in the opposite ear
What does a positive bilateral Rinne’s Test indicate?
Normal
OR
Sensorineural hearing loss
Why do you get a false negative Rinne’s Test?
When there is a dead ear (severe sensorineural hearing loss)
This is because bone conduction to the contralateral ear is quicker than air conduction to the affected ear, so bone conduction is better than air conduction although it’s being heard in the opposite ear
What is the treatment for acute otitis media?
Delayed prescription for oral Amoxicillin if persisting for longer than 3 days (usually viral)
Analgesia
What is Ramsay Hunt syndrome?
Reactivation of the VZV in geniculate ganglion
How does Ramsay Hunt syndrome present?
Unilateral facial nerve palsy
Discharge and crusting of the affected ear
Ear pain
Dry mouth and eyes
Affected taste
Erythematous vesicular rash of the ear canal
? Tinnitus, hearing loss, vertigo
How do you investigate a neck lump?
History and examination Observations Ultrasound guided FNA Core Biopsy Discussion with MDT CXR Blood tests TFTs
What is a branchial cyst?
Mobile mass between the sternocleidomastoid muscle and the pharynx
Caused by failure to obliterate the 2nd branchial cleft
What symptoms do people with BPPV have?
Vertigo lasting seconds
No hearing loss
Nausea and vomiting
No tinnitus
What symptoms do people with Labyrinthitis have?
Vertigo lasting for a few days
Nausea and vomiting
No hearing loss
No tinnitus
What symptoms do people with Meniere’s Disease have?
Vertigo lasting hours at a time
Sensorineural Hearing Loss
Tinnitus
Feeling of fullness in the ear
What symptoms do people with Vestibular Schwannoma have?
Vertigo of gradual onset
Sensorineural hearing loss
Tinnitus
May have a facial nerve palsy
