Viral labyrinthitis; Neck Lumps Flashcards
(10 cards)
Describe what is meant by viral labyrinthitis? [1]
What are the characteristics? [+]
Viral labyrinthitis is an inflammatory condition of the inner ear, specifically affecting the labyrinth, which comprises the vestibular system and the cochlea. It is characterized by a sudden onset of vertigo, hearing loss, and tinnitus, typically following a viral infection.
What are the key clinical features of viral labyrinthitis? [+]
Vertigo: Patients typically experience a sudden, severe vertigo that can last for days to weeks. The vertigo may be accompanied by nausea, vomiting, and difficulties in maintaining balance.
Hearing loss: Sensorineural hearing loss is commonly observed, which may be unilateral or bilateral. The degree of hearing loss can range from mild to severe.
Tinnitus: Patients often report a persistent ringing or buzzing sound in the affected ear(s)
There may also be preceding or concurrent symptoms of upper respiratory tract infection.
What are the signs of labyrinthitis? [4]
spontaneous unidirectional horizontal nystagmus towards the unaffected side
sensorineural hearing loss: shown by Rinne’s test and Weber test
abnormal head impulse test: signifies an impaired vestibulo-ocular reflex
gait disturbance: the patient may fall towards the affected side
Mx of labyrinthitis? [2]
episodes are usually self-limiting
prochlorperazine or antihistamines may help reduce the sensation of dizziness
The SIGN guidelines (2010) give the indications for tonsillectomy. The number of episodes of acute sore throat they specify for a tonsillectomy are: [3]
Other indications are: [2]
7 or more in 1 year
5 per year for 2 years
3 per year for 3 years
Also
Recurrent tonsillar abscesses (2 episodes)
Enlarged tonsils causing difficulty breathing, swallowing or snoring
Describe the risk from post tonsillectomy bleeding? [2]
Post tonsillectomy bleeding is the main significant complication after a tonsillectomy. Significant bleeding can occur in up to 5% of patients who have had a tonsillectomy requiring urgent management. This can happen up to 2 weeks after the operation.
Bleeding can be severe and, in rare cases, life-threatening due to aspiration of blood.
Post Tonsillectomy Bleeding:
Before going back to theatre there are two options for stopping less severe bleeds:
If there is severe bleeding or airway compromise, call an anaesthetist. Intubation may be required.
Before going back to theatre there are two options for stopping less severe bleeds:
- Hydrogen peroxide gargle
- Adrenalin soaked swab applied topically
[] is an example of a monoclonal antibody used in treating squamous cell carcinomas of the head and neck.
Cetuximab is an example of a monoclonal antibody used in treating squamous cell carcinomas of the head and neck. It may also be used to treat bowel cancer. It targets epidermal growth factor receptor, blocking the activation of this receptor and inhibiting the growth and metastasis of the tumour.
There are three descriptions to note the location of a neck lump.
What are they and describe the borders of them [+]
There are three descriptions to note the location of a neck lump:
* Anterior triangle
* Posterior triangle
* Midline (vertically along the centre of the neck)
These two triangles are on either side of the sternocleidomastoid muscle.
The borders of the anterior triangle are:
* Mandible forms the superior border
* Midline of the neck forms the medial border
* Sternocleidomastoid forms the lateral border
The borders of the posterior triangle are:
* Clavicle forms the inferior border
* Trapezius forms the posterior border
* Sternocleidomastoid forms the lateral border
TOM TIP: It is not uncommon for patients to present worried about a normal bony prominence in the neck. Common areas of concern are the [3]
TOM TIP: It is not uncommon for patients to present worried about a normal bony prominence in the neck. Common areas of concern are the hyoid bone, mastoid process and transverse processes of C1.
