Vertigo Flashcards
(47 cards)
Acute sinusitis
1) what is it
2) commonest infectious agents
3) predisposing factors?
1) inflammation of the mucous membranes of the paranasal sinuses
2) Strep pneumonaie, Haemophilis influenza and rhinoviruses
3) nasal obstruction (polyps, septal deviation), recurrent local infection (rhinitis, dental extraction), swimming, smoking
T/F: the sinuses are usually sterile
T
features of acute sinusitis?
nasal d/c (thick and purulent)
facial pain: frontal, worse on bending forwards
nasal obstruction
Rx of acute sinusitis?
analgesia
intranasal corticosteroids if symptoms >10 days
antibiotics only if severe
T/F: antibiotics are routinely used in acute sinusitis
false - only for severe presentations
when might intranasal corticosteroids be used in acute sinusitis
if symptoms persist >10 days
T/F: vast majority of cases of acute tonsillitis are viral
false - over 50% bacterial
commonest organism in acute tonsillitis?
Strep pyogenes
CENTOR criteria?
What merits antibiotics?
Fever (>38)
Tender anterior cervical lymphadenopathy
Tonsillar exudate
Absence of a cough
complications of tonsillitis?
Peritonsillar abscess (Quinsy)
Otitis media
Rheumatic fever and glomerulonephritis (rare)
indications for tonsillectomy?
Must meet ALL of the following: ≥5 episodes/ year Symptoms for at least 1 year Interfering with normal functioning Sore throat is due to tonsillitis
complications post-tonsillectomy?
management?
primary haemorrhage (<24h): usually inadequate haemostasis»_space; immediate return to theatre
secondary haemorrhage (1-10 days): usually due to infection»_space; admission and antibiotics (surgery if severe)
ALL cases require ENT referral (even if resolved by time of presentation).
peritonsillar abscess (quinsy)
1) features
2) treatment?
1) tonsillar deviation away from affected side, voice changes, severe unilateral throat pain
2) IV Abx and drainage
peritonsillar abscess (quinsy)
1) features
2) treatment?
1) uvular deviation away from affected side, severe throat pain lateralising to one side, trismus, reduced neck mobility
2) urgent ENT review, IV Abx + drainage (tonsillectomy considered after 6 weeks)
T/F: most cases of acute otitis media are viral in origin
false- although typically preceded by viral URTI, mainly caused by bacteria esp S. pneumoniae, H. influenza and Moraxella catarrhalis
(viral URTIs are thought to disturb the normal nasopharyngeal microbiome, allowing bacteria to infect the middle ear via the Eustachian tube)
acute otitis media
1) features
2) otoscopy findings
3) if using pneumatic otoscopy
1) otalgia (may pull at ear), fever in 50%, hear loss, recent viral URTI, ear d/c if perforates
2) bulging TM > loss of light reflex, opacification or erythema of TM, purulent otorrhoea (perforation)
3) reduced mobility
Treatment of acute otitis media?
Analgesia, most self resolve. Seek help if not resolved after 3 days.
Antibiotics if
- <2 and b/l
- perforated/ dc in canal
- systemically unwell
- immunocompromised/ high risk of complications
- > 4 days symptoms
1st line antibiotic in acute otitis media?
if pen allergic?
amoxicillin (5-7 days)
erythromycin/ clarithromycin if pen allergic
define chronic suppurative otitis media? (CSOM)
ear pain with otorrhoea for >12 weeks
define chronic suppurative otitis media? (CSOM)
ear pain with otorrhoea for >6 weeks
common sequelae of acute otitis media?
perforation > CSOM
learing loss
labyrinthitis
causes of otitis externa?
infection: bacteria (S aureus, Pseudomonas) or fungal
Seborrhoeic dermatitis
Contact dermatitis
features of otitis externa?
otoscopy findings?
particularly common in which athletes?
ear pain, itch, discharge
otoscopy: red, swollen, or eczematous canal
swimming - ‘swimmers ear’
1st line Rx of otitis externa?
topical antibiotic/ combined topical antibiotic + steroid
ear wick sometimes used if canal extensively swollen
