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Flashcards in Surgery Deck (24)
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1
Q

Top 3 causes of hearing loss

A
  1. ear Wax
  2. otitis media
  3. otitis externa
2
Q

Presbyacusis

A

Age related hearing loss.
Sensorineural
Audiometry: high frequency hearing loss

3
Q

Otosclerosis

A

AD (+ FH)
Conductive
Tinnitus

4
Q

Glue Ear/Otitis media with effusion

A
  • Approx 2yrs old
  • Hearing loss +/- seondary problems relating to loss of hearing eg. SALT
  • Painful!
  • Complications: ruptured membrane- once ruptured pain gone and gunk on pillow.
  • Rx: Abx and r/v in 2/52 (Amoxicillin)
5
Q

Menieres disease

A
  • Idiopathic
  • mins:hours recurrent
  • Sensorineural
  • vertigo, tinnitus, aural fullness
  • (nystagmus and + romberg)
6
Q

Noise damage

A

Bilateral

Audiometry: hearing worse at 3000-6000Hz

7
Q

Acoustic Neuroma

A

CN specific

  • VIII: hearing loss, vertigo, tinnitus
  • V: No corneal reflec
  • VII: facial palsy

if bilateral: think NEUROFIBROMATOSIS TYPE II

8
Q

Trigeminal Neuralgia

A

Unilateral electric shocks in >=1 of V1-3
triggers: light touch, smoking, talking
Rx: Carbemazepine (stabilises VG Na channels)

9
Q

criteria for Tonsillectomy

A
  • > 5 sore throats (tonsillitis/1year)

- significant imapact on daily life

10
Q

Centor Score

A

Likelihood of adults w/sore throat caused by group A B haemolytic Strep.

  1. Fever
  2. exudates
  3. adenopathy
  4. No cough

> =3: 40-60% chance

Rx: Penicillin V (erythromycin)

11
Q

NICE guidelines for ABx in tonsillitis

A
  • systemic upset 2ary to sore throat
  • unilateral peritonsillitis
  • Hx of rheumatic fever
  • increased risk of infection (child with DM, immunosuppression)
  • acute sore throat + >=3 centor criteria
12
Q

Cholesteatoma

A
Squamous epithelium shed --> stuck in skull --> local destruction.
ATTIC CRUST
foul smelling DC
hearing loss
Rx: surgery- mastoidectomy
13
Q

Otitis Externa

A

Rx:
first line- steroid and Abx spray
second line - oral fluclox/cipro

14
Q

Bells Palsy

A

Acute idiopathic Facial Nerve Palsy

LMN

15
Q

Viral Labyrinthitis

A

Sudden onset
hearing loss
Nausea and vertigo
Preceeding coryza

16
Q

Otitis media

A

Bulging membrane

Rx: None unless <2years old or bilateral and otorrhoea.

17
Q

Vestibular Neuritis

A

recent viral infection
recurrent vertigo
No hearing loss

18
Q

BPPV

A

Gradual onset
Triggered by change in head position
Lasts 10-20 seconds

19
Q

Diagnosing BPPV

A

Modified Dix-Hallpike:

  • determines posterior semicircular canal involvement.
  • reproduced vertigo and nystagmus
  • Patient sitting
  • Swiftly move patient to side lying and head rotated 45 degrees away from side being tested.
  • look for nystagmus

Roll test: horizonal semicircular canal:

  • lie supine with head 20degrees flexion
  • roll head 90 degrees to left
  • look for vertgio and nystagmus
20
Q

Treating EPPV with the Epley Manouvre

A

tbc

21
Q

Vertebrobasilar Ischaemia

A

Elderly Patient

Dizziness on neck extension

22
Q
  • Sudden onset backpain leaning forwards
  • tenderness on lumbar spine
  • Neuro exam NAD
  • Straight leg raise NAD
A

Facet Joint Pain

- normal straight leg raise means this is unlikely to be disc prolapse.

23
Q
  • Progressively severe lower back pain (no trigger)
  • hypotensive 90/60
  • HR 120
A

Leaking AAA

24
Q

Indications for an ankle XRAY: THE OTTOWA RULES

A
  • Pain in the malleolar zone plus any one of…
    1. bony tenderness at he lateral malleolar zone (includes lower 6cm fibula)
    2. bony tenderness of the medialmalleolar zone (lower 6cm of tibia)
    3. inability to walk 4 weight bearing steps immediately after injusty and in ED