Misc Flashcards
dysphagia
ADD
dysphonia causes
inflammation
muscle tension imbalance
structural/neoplastic
neuromuscular: over/underuse
dysphonia assessment
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voice therapy
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laryngectomy
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swallowing phsyiology
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SALT investigations
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tonsillectomy complicatiosn
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grommet complications
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otalgia
often with otorhoea
local (ext/mid ear) or referred (TMJ, throat, mouth, dental)
>1/12 with no Dx (check tongue/retromolar) = refer (ENT endoscopy)
*TMJ: dysfunction/arthritis; pain on movement/palpation
otorrhoea
often with otalgia
OM: severe pain then d/c, then pain lessens; purulent
cholesteatom: foul-smelling unilateral; check par flaccida
saliva functions
lubricate/moist/friction/prevent sticking bolus formation/softening speech articulation digestion, taste, solvent, buffer immune (lysozymes, IgA, washing)
changed voice
polyps, nodules, paralysis/movement, inflammation/infection/irritative laryngitis (smoke/reflux/allergy)
regional paralysis: nerve, tumour, NMJ/mm/nn, AI
hypothyroid hoarseness
lost voice
no phonation
articulation
infection
psychological (can cough)
UAO emergencies
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nasal polyps
allergic: commonest;
obstruction, rhinitis, multiple white/silver polyps
Rx: steroids (shrink), surgery if fails (can recur)
non-allergic:
inverted papilloma/antrochoanal polyp; from sinus into cavity
solitary polyp
Mx: imaging CT >MRI; surgery
sore throat DDx
duration, triggers, occupation, smoking and alcohol, acid reflex, ‘lump’
tonsilitis/viral infection/bacterial
-bacterial: centor score, worse >3/d; diphtheria (membrane), staph, strep, myco, clap, pertussis
-glandular fever (EBV), mono
intra-oral lesions/ulcers
neck lumps: 1o cancer, 2o mets, cervical LA
RED FLAGS!
hoarse voice >3/52 (tumour) foul smelling otorrhoea (cholesteatoma) unilateral foul nasal d/c (foreign body) unilateral polyp/bloody rhinorrhoea (tumour) unilateral deafness (tumour) persistent lump in throat (tumour)
tinnitus
can be caused by any hearing loss
Rx: supportive/distraction
common; psych effect (sleep, conc, coping)
history: duration, ‘SOCRATES’, nature (?pulsitile), triggers, RF, impact
bilateral pulsitile: HTN spikes; unilateral: ?glomus tumour (sunset TM)
middle ear pathology: low frequency
Meniere’s: low frequencies
Presbycusis/idiopathic: high frequencies
Sore throat - ABx indications
systemic upset unilateral peritonsilitis PMH Rheumatic fever increased infection risk (DM, IC) 3+ Centor criteria (tonsil exudate, fever, no cough, tender cervical LA)
