Basics of ENT first Flashcards
What does the vastibular system do?
It maintains equilibrium or balance in the ear by detecting angular and linear accelerations of the head
Angular rotation is detected by semicircular canals
Linear accelerations is detected by the ottolothic organs
Where does Otitis externa take place? What is it caused by?
The outer ear.
It’s caused by bacterial (staphylococcus aureus) or fungal (candida)
What’s the treatment for acute otitis externa? (5)
By through cleaning with:
- Anti-inflammatory corticosteroid ear drops, or
- Anti-effective chloramphenicol ear drops, or
- An astrigent such as aluminium acetate, or
- 2% Acetate acid solution (EarCalm spray)
- Topical antibiotics plus glucocorticoid: Neomycin./ polymyxin plus dexamethasone/ hydrocortisone (e.g. Otomize spray)
What’s the treatment for chronic otitis externa? (2)
- Oral flucloxacillin (or clarithromycin if penicillin-allergic)
- Antifungal agent e.g. nystatin
Name some mixtures that can be used to remove ear wax (3) and what do they do?
- Olive oil
- Almond oil
- Sodium bicarbonate
Cerumenolytic products act by softening the ear wax (cerumen)
Where is otitis media located (1) and what are the symptoms of acute otitis media? (4)
Otitis media is located in the middle ear
- Sudden onset of ear ache
- fever
- hearing loss
- preceded by an upper respiratory tract infection lasting for several days
What are the available treatments for acute otitis media? (2)
- local cleansing
- anti-effective (antibiotics); a systemic antibacterial is used such as oral amoxicillin (or clarithromycin if penicillin-allergic)
What are the available treatments for chronic otitis media? (2)
- Oral amoxicillin
2. IV cephalosporin
Where does labyrinthitis occur?
In the inner ear
What are some of the symptoms of labyrinthitis? (4)
- Vertigo
- Balance disorder
- Tinnitus
- Hearing loss
What are the available treatments for labyrinthitis? (3)
- anti-effective (antibiotics); a systemic antibacterial is used such as oral amoxicillin (or clarithromycin if penicillin-allergic)
- Anti-viral agents e.g. valacyclovir
- Vestibular rehabilitation therapy (VRT)
N.B. Treatment of vertigo and nausea: prochlorperizine and treatment of anxiety symptoms: benzodiazepines and/or depression: SSRIs
Define rhinitis
An allergic acute or chronic inflammation of the nasal mucosa e.g. hay fever
Define rhinorrhea
The production of excessive watery nasal secretions by the nasal mucosa
Name the available treatments of rhinitis and rhinorrhea (4) include their target and also MoA
- Sympathomimetic agents (e.g. ephedrine). These target nasal blood flow. MoA: Vasoconstriction (to limit histamine effects)
- Glucocorticoids (e.g. Beclomethasone mometasone). These target anti-inflammatory. MoA: Anti-inflammatory steroid
- Cromolyn sodium and Omalizumab. These target the suppression of mediator release. MoA: Inhibits histamine release and prevents IgE interaction
- H1-receptor antagonists (e.g. Azelastine), Leuokitriene (E.g. Montelukast). These target mediator receptor blockade. MoA: They block vasodilation and inflammation
What’s the treatment for non-allergic watery rhinorrhoea?
Treated with the antimuscarinic; ipratroprium nasal spray
What are the available treatments for nasal congestion? (2)
- Ephedrine or systemic pseudoephedrine (Sudafed)
2. Sodium chloride (0.9%)
What’s the available treatment of nasal staphylococci?`
Mupirocin
N.B. To avoid the development of resistance, if the MRSA strain is mupirocin-resistant, alternatives such as chlorhexidine or neomycin cream should be used
Within the oropharynx, the main fungal infection is thrush. What treatments are predominantly used? (3)
Thrush: Nystatin or miconazole antibiotic oral suspension/gel/tablet or,
fluconazole capsules or IV
Severe invasive candidiasis: amphoteracin
Within the oropharynx, the main viral infection is herpes s. What treatments are predominantly used? (3)
Primary herpetic gingivostomatitis:
- Benzydamine
- Chlorhexidine mouthwash
Herpetic stomastis: a systemic antiviral such as aciclovir
Herpes simplex: Aciclovir, valaciclovir and doxycycline
Treatments available for oral ulceration and inflammation in the oropharynx? (4)
- Benzydamine (NSAID oromucosal spray)
- Choline salicyclate gel e.g. Bonjela (not for under 16)
- Carmellose gelatin paste
N.B. Inflammation treated by hydrocortisone and betamethasone
Ulceration occurs predominately in the oropharynx
What mouthwashes contain for someone with oral candidiasis?
- Compound sodium chloride
2. Chlorhexidine mouthwash e.g. Corsodyl
What type of drugs can cause dry mouth? (2)
- anti-muscarinic drugs
- diuretic drugs
