Min Criteria Flashcards
(36 cards)
Symptoms of Diffuse Otitis Externa
- Earache
- Ear congestion (+ hearing loss)
- External part of ear is painful (esp tragus)
- Discharge + Itching
- Fever is uncommon
Clinical Findings of Diffuse Otitis Externa
- Swelling + Hyperemia of skin of the Ear Canal
- Serous or Purulent Discharge
- Accumulation of Debris in Ear Canal
- Tympanic Membrane is normal
Symptoms of Acute Otitis Media (Suppurative Form)
- Earache
- Nasal Discharge, Congestion
- Fever + Malaise
- Hearing Loss
- if Perforation –> otorrhea
Clinical Findings of AOM
- Ear Canal Normal
- Hyperemia of Tympanic Membrane
- Marked Bulging of the Tympanic Membrane (spont perforation
Causes of Acute Hearing Loss
CONDUCTIVE TYPE:
- wax/foreign body
- Acute Tubal Occlusin/ Otitis Media
- Trauma (perf of tymapnic membrane)
SENSIONEURAL TYPE:
- Noise induced
- Viral + Vascular
- Toxical Damage (meds/chemical) + Traumas
What to do in case of Acute Sensorineural Hearing Loss
- IV nootropic/vasodilating therapy
- Steroid bolus treatment + hospitilization
- investigate
Recognition of Hearing Loss in Childhood
- New born doesn’t react to sounds
- They cry weirdly
- babbling period doesn’t occur
- speech development is delayed
- articulation diorders
- worse reading + writing skills
Causes of Ear Pain
PRIMARY OTALGIA:
- Otitis
- Tumours
REFERRED EAR PAIN:
- Tumours/Inflmm –> Larynx/Pharynx/Tonsils/Base of Tongue
- Dental Inflmm
- TMJ syndrome
- Neuralgic Pain
Complications of Acute Otitis Media (AOM)
I: EXTRACRANIAL A/ Intratemporal: - Acute Mastoiditis - Zygomaticitis, Petrositis - Labyrinthitis - Facial N Palsy
B/ Extratemporal: - Absecess (subperiosteal/Preauricular/suboccipital) II: INTRACRANIAL - Extradural Absecess/ Subdural/ Brain - Sinus Phlebitis - Meningitis/Encephalitis III: GENERAL: Sepsis
Clinical Features + Symptoms of Acute Mastoiditis
- Pinna outward
- Pulsating, severe pain + Pulsating Otorrhea
- Retroauricular Pain (erythemia)
- Post wall of ear canal is swollen
Causes of Unilateral Otitis Media With Effusion (OME) In Adults and Children
- Chronic Dysfunction of Eustachian Tube (Adenoid/Nasopharyngeal tumour)
- in adults do not forget Nasopharyngeal Tumour
How to diagnose Vertigo caused by Vestibular Disorders
I: PATIENT HISTORY
-type of vertigo (sensation of spinning or falling)
-vegatitive symptoms/ nausea/vomitting
II: EXAMINATION
-deviation, tilting
-spontaneous Nystagmus/provoked by head movement
Causes of Peripheral Facial Palsy
- Bell’s Palsy
- Herpes Zoster Oticus
- Other viral/bacterial infections (HSV/EBV/Lymes)
- Acute + Chronic Middle ear infections
- Tumours of the Pontocerebellar angle, Vestibular Schwannoma
- Cranial Traums/Extratemporal Traumas
- Malignant tumours of the parotid
Primary Management of Epistaxis
- ptnt learn forward with mouth open with pressure on both nasal alae for 10mins
- ephedrine applied to nasal cavity
- cold compress should be applied to the nape of the neck/nasal dorsum
- blood pressure mx (anti-ht if needed)
Management of Epistaxis by ENT professionals
-blood pressure measurement (anti-ht if needed)
-Visible bleeding source:
> chemical cauterization (silver nitrate)
> coagulation (bipolar electrocoag)
- ANT NASAL BLEEDING: ant nasal packing
- POST NASAL Bleeding: post nasal packing (bellocq tamponade)/ Balloon catheter
Management + Complication of Nasal Folliculitis + Furuncles
Circumscript Folliculitis:
- local therapy: Abx/Steroin containing creams + vapour coverage
- *don’t pick or squeeze
Furuncle/Pheegmone: - parentral Abx + vapour coverage
***USUALLY STAPH A
Compications:
- Facial Phlegmone
- Angular Veins Thrombophlebitis
- Cavernous Sinus Thrombosis
Types of Rhinitis
Common infections: Simple Acute Rhinitis/ Purulent
Specific Forms: - TB/ Syphilis/ Sarcoidosis
Allergic rhinitis
Atrophic rhinitis (oezena)
Rhinitis Sicca Anterior
-Other causes:
Idiopathic/vasomotoric/hormona/drug induced
Clinical Features + Management of Angioedema
Symptoms:
- uritcaria + edema in hand/neck region
- dysphagia/ globus feeling of visible swelling in throat - choking
- severe: anaphylaxis
Tx:
- anti his + steroids + adrenaline + maintain freeairways (cricothryotomy/tracheotomy)
Complications of Paranasal Sinus Infections
Extracranial Complications: (POOS)
- Periorbital Cellulitis
- Orbital Phlegmone/Abscess
- Osteomyelitis
- Sepsis
Intracranial:
- Menigitis
- Epi/Subdural/Brain Abscess, Encephelitis
- Cavernous Sinus Thrombosis
Where does the patient localize the pain in the cases of frontal/maxillary/ethmoidal/sphenoidol sinusitis
Frontal - forehead
Maxillary - Face
Ethmoidal - between eyes
Sphenoid - crown of head (occipital area referral)
All cause diffuse Headaches
Causes of Unilateral nasal obstruction and discharge in Childhood and Adulthood
Childhood: (FSNC)
- Foreign Body
- Sinusitis
- Nasopharyngeal Angiofibroma
- Congenital Malformation (choanal atresia, meningoencephalocele)
Adulthood:
- Nasopharyngeal Tumours
- Deviation of Nasal Septum
- Hypertrophy of Septum
- Trauma
- Nasal cavity obstructing diseases (polyps, benign, malignant)
- rhinosinusitis
ENT diseases causes Headache
- Viral Infection of the Upper Airways
- Inflammation of Nasal Sinus/ Benign + Malignant tumours of Nasal Sinuses
- Neuralgias
- Cervical: vertebral disorders/Spondylosis/Myalgia
- Complications of otitis/sinusitis: mastoiditis/meningitis/abscess
- Pain of TMJ
Most Frequent causes of Dyphagia
- GERD
- Globus Feeling (psychogenic disordersÖ
- Inflammation/Tumours in the Mesopharyngeal/Hypopharyngeal/Laryngeal
- Neuralgia (9/10)
- Sensorial/Motor Innervation Disorders (sensorial disorders in supraglottical region)
- Foreign Body (Hypopharnyx + eso)
- Esophageal motility disorders/Achalasia
- Diverticulum (zenker)
- Stenosis
Indications of Tonsillectomy (absolute + relative)
Absolute:
- Rhematic Fever
- Peritonsillar abscess
- Tonsilogenic Sepsis
Relative:
- Chronic/Recurrent Tonsillitis
- Tonsillogenic/Posttonsillitis Focal Symptoms
- Hypertrophy of Tonsils
- Tumour
- Obstructive sleep apnea
- Severe Orofacial/Dental Disorders causing narrow Upper Airways
