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ENT > Conditions > Flashcards

Conditions Flashcards

1
Q

When can you refer for grommets?

A 
It OME for more than 3 months
Speech/language problems
Deafness
CHL >25db
Developmental behavioural problems
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2
Q

Peritonsillar abscess?

A

Classic picture:
Unilateral throat pain and odynophagia
TRISMUS!!
3-7 days preceding of acute tonsillitis

Medial displacement of tonsil and uvula
Concavity of palate lost

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3
Q

Treatment for peritonsillar abscess?

A

Aspiration and antibiotics

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4
Q

Tonsil histology

A

Specialised squamous
Deep crypts
Lymphoid follicles

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5
Q

Adenoid histology

A

Ciliated pseudostratified columinal
Stratified squamous
Transitional
Deep folds

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6
Q

Viral vs. Bacterial Tonsillitis

A 
Viral
Malaise
Sore throat, mild analgesia requirement
Temperature
Able to undertake near normal activity
Possible lymphadenopathy
Lasts 3-4 days
Bacterial
Systemic upset,
Fever
Odynophagia
Halitosis
Unable to work / school
Lymphadenopathy
Lasts ~1 week, requires antibiotics to settle
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7
Q

Centor criteria?

Differentiates between bacterial and viral tonsillits

A 
Differentiating Bacterial from Viral
History of fever
Tonsillar exudates
Tender anterior cervical adenopathy
Absence of cough

0 or 1 points - No antibiotic (risk of bacterial infection <10%)
2 or 3 points - Should receive an antibiotic if symptoms progress (Risk of infection 32% if 3 criteria, 15% if 2)
4 or 5 points - Treat empirically with an antibiotic (Risk of infection 56%)

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8
Q

Treatment for tonsillitis

A 
Eat & Drink
Rest
OTC analgesia
Paracetamol, NSAID
Antibiotic
Penicillin 500mg qid for 10 days
Clarithromycin if allergic
Hospital
IV Fluids
IV antibiotics
Steroids
Surgery
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9
Q 
Gross tonsillar enlargement with membranous exudate
Marked cervical lymphadenopathy
Palatal petechial haemorrhages
Generalised lymphadenopathy
Hepatosplenomegaly
A

Glandular fever

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10
Q

Diagnosis of glandular fever

A

Atypical lymphocytes in peripheral blood
+ve Monospot or Paul-Bunnell test
Low CRP (<100)

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11
Q

Management of glandular fever?

A 
Symptomatic treatment
Do NOT prescribe ampicillin
diagnostic generalised macular rash will result!
Antibiotics 
Steroids
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12
Q

Chronic tonsillitis

A 
Chronic “sore throat”
“Malodorous breath”
Presence of tonsilliths
Peritonsillar erythema
Persistent tender cervical lymphadenopathy
Surgery has controversial role
Rarely offered
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13
Q

Obstructive hyerplasia (adenoids)

A 
Adenoid
Obligate mouth breathing
Hyponasal voice
Snoring and other signs of sleep disturbance
AOM / OME
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14
Q

Obstructive hyperplasia (tonsil)

A

Tonsil
Snoring and other symptoms of sleep disturbance
Muffled voice
?Dysphagia

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15
Q

Glue ear vs. acute otitis media

A

Inflammation of the middle ear accompanied by accumulation of fluid without the symptoms and signs of acute inflammation

Inflammation of the middle ear accompanied by the symptoms and signs of acute inflammation with / without an accumulation of fluid

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16
Q

What increases the incidence of OME?

A

Day care
Older siblings
Smoking household
Recurrent URTI

17
Q

Signs of OME?

A 
TM retraction
Reduced TM mobility
Altered TM colour
Visible ME fluid/bubbles
CHL tuning fork tests
18
Q

What can be used to check vestibular function

A

Nystagmus

19
Q

History of recurrent, spontaneous, rotational vertigo with at least two episodes >20mins (often lasting hours)
Occurrence of or worsening of tinnitus on the affected side
Occurrence of aural fullness on the affected side
Documented SNHL on at least one occasion
Other causes excluded

A

Menieres

20
Q

Menieres

A

History of recurrent, spontaneous, rotational vertigo with at least two episodes >20mins (often lasting hours)
Occurrence of or worsening of tinnitus on the affected side
Occurrence of aural fullness on the affected side
Documented SNHL on at least one occasion
Other causes excluded

21
Q

Management of Meniere’s disease?

A 
Management:
Supportive treatment during episodes
Tinnitus therapy
Hearing Aids
Prevention
Salt restriction / Betahistine / caffeine / alcohol / stress
Grommet insertion
Intra-tympanic GENTAMICIN/steroids
Surgery
22
Q 
Vertigo on:
looking up
turning in bed - often worse to one side
first lying down in bed at night 
on first getting out of bed in the morning
bending forward
rising from bending
moving head quickly – often only in one direction
A

BPPV

23
Q

Hallpike’s Test
Epley Manoeuvre
Semont Manoeuvre
Brandt-Daroff Exercises

A

Used to treat BPPV

24
Q

BPPV and vertebrobasilar insufficiency?

A

BPPV and vertibrobasilar insufficiency are similar however vertebrobasilar insufficiency will have other symptoms of impaired circulation e.g:

  • visual disturbance
  • numbness
  • weakness

ENT (14 decks)

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