Conditions Flashcards
1
Q
What must be excluded in a nasal trauma?
A
- exclude septal haematoma
2
Q
When should someone be reviewed in the ENT clinic post nasal fracture?
A
- 5-7 days
3
Q
Complications of a nasal fracture?
A
- Epistaxis
- CSF leak
- Meningitis
- Anosmia
4
Q
Treatment of a severe epistaxis?
A
- resusictate
- lignocaine + adrenaline
- remove clot
5
Q
Systemic treatment for epistaxis?
A
- tranexamic acid
6
Q
Treatment of a pinna haematoma?
A
- aspirate
- incision and drainage
7
Q
Battle sign bruising may appear in what injury?
A
- temporal bone fracture
8
Q
What is the most common classification of temporal bone fractures?
A
- longitudinal
9
Q
What are causes of conductive hearing loss?
A
- fluid
- tympanic membrane perforation
- ossicular problem
10
Q
Treatment of a sudden sensorineural hearing loss?
A
- steroids 1mg/kg
11
Q
Zone 1 neck injury affects what area?
A
- trachea
- oesophagus
- thyroid
- thoracic duct
- subclavian
12
Q
What can cause a deep neck space infection?
A
- extension of infection from tonsil or oropharynx into deeper tissue
13
Q
Symptoms of a deep neck space infection?
A
- sore throat
- unwell
- previous URTI
- limited neck movement
14
Q
Treatment of a deep neck space infection?
A
- Fluids
- IV antibiotics
- incision and drainage
15
Q
Complication of a deep neck space infection?
A
- enters mediastinum
16
Q
What sign will be seen on CT of sinuses during a facial trauma?
A
- tear drop sign
17
Q
What is the most common LeFort fracture?
A
- Le Fort 1
18
Q
What comprises Waldeyer’s ring?
A
- palatine tonsils
- adenoids
- inguinal tonsils
19
Q
Histology of tonsil tissue?
A
- specialised squamous
20
Q
Histology of adenoid tissue?
A
- ciliated pseudostratified columnar stratified squamous
- deep folds
21
Q
Viral causes of acute tonsillitis?
A
- EBV
- Rhinovirus
- adenovirus
22
Q
Bacterial causes of acute tonsillitis?
A
- s.pyogenes
- h. influenza
23
Q
Bacterial symptoms of acute tonsillitis?
A
- systemic upset
- fever
- odynophagia
- lasts 1 week
24
Q
Viral symptoms of acute tonsillitis?
A
- malaise
- sore throat
- 3-4days
25
High FEVERPAIN score treatment?
- penicillin 500mg 4 times daily for 10 days
26
When is tonsillectomy recommended?
- 7 or more infections a year
27
Peritonsillar abscess is also known as?
- quinsy
28
What causes a peritonsilar abscess?
- bacteria between muscle and tonsil and production of pus
29
Treatment of quinsy?
- aspiration and antibiotics
30
Glandular fever is also known as?
- infectious mononucleosis
31
What causes glandular fever?
- ebstein-barr virus
32
Signs of glandular fever?
- gross tonsillar enlargement
| - cervical lymphadenopathy
33
Diagnosis of glandular fever?
- EBV IgM
| - Low CRP
34
Management of glandular fever?
- antibitotics
| - steroids
35
Signs of adenoid hyperplasia?
- mouth breathing
36
What is otitis media with effusion also known as?
- glue ear
37
What age group is most commonly affected by glue ear?
- children
38
What is glue ear?
- inflammation of the middle ear, fluid without the signs or symptoms of acute inflammation
39
Symptoms of glue ear?
- deafness
- speech delay
- behavioural changes
40
What would a tympanometry graph look in glue ear?
- flat
| - bone conduction > air conduction
41
Treatment of glue ear?
- wait 3 months
- grommets
- adenoidectomy
- hearing aids
42
Glue ear is a __conductive/sensorineural__ hearing loss?
- conductive
43
Types of hearing loss?
- conductive
- sensorineural
- mixed
44
When would an adenoidectomy be considered in glue ear?
- having had 2 or 3 grommets
45
On audiometry the circles are what ear?
- right ear
46
On audiometer the crosses are what ear?
- left war
47
Otitis externa can present with __conductive/sensorineural__ hearing loss?
- conductive
48
Causes of otitis externa?
- water
- cotton buds
- skin conditions
49
Acute otitis media can present with __conductive/sensorineural__ hearing loss?
- conductive
50
Acute otitis media treatment?
- wait 3 or 4 days
| - fail to resolve --> amoxicillin
51
Causes of chronic otitis media?
- cholesteatoma
| - perforation
52
What is done prior to a grommet insertion?
- myringotomy
53
Treatment of perforation of the tympanic membrane?
- usually spontaneous recovery
54
Describe cholesteatoma?
- presence of keratin within the middle ear
| - may erode surrounding bone
55
Cholesteatoma can present with __conductive/sensorineural__ hearing loss?
- conductive
56
Symptoms of cholesteatoma?
- conductive hearing loss
| - discharge
57
Treatment of cholesteatoma?
- surgical excision
58
If cholesteatoma spreads superiorly it may cause?-
- brain abscess
| - meningitis
59
Describe otosclerosis?
- genetic condition
- conductive hearing loss
- gradual fixation of the stapes foot plate
60
When is otosclerosis most prevalent?
- pregnancy
| - HRT therapy
61
Treatment of otosclerosis?
- stapedectomy
62
Presbycusis an present with __conductive/sensorineural__ hearing loss?
- sensorineural
63
In presbycusis what frequency of soun is lost?
- high frequency
64
In presbycusis there is not a difference between bone and air conduction?
- true
65
Vestibular schwannoma can present with __conductive/sensorineural__ hearing loss?
- sensorineural hearing loss
66
What is vestibular schwannoma?
-Benign tumour arising in internal auditory meatus
67
Symptoms of vestibular schwannoma?
o Hearing loss (asymmetrical)
o Tinnitus
o Imbalance
68
Diagnosis of vestibular schwannoma?
- MRI
69
Symptom of vertigo?
-Sensation of movement, usually spinning, failing, being pushed
70
Verigo lasting seconds may indicate?
BPPV (Benign , paroxysmal positional vertigo)
71
Vertigo lasting hours may suggest?
- Meniere’s
72
Vertigo lasting days may suggest?
- vestibular neuritis
73
Semi-circular canals sense?
-Rotational acceleration
74
Saccule and utricle sense?
- linear acceleration
75
Head impulse test used to diagnose?
- vestibulo-ocular reflex
76
What causes bening paroxysmal positional vertigo?
-Otoconia from utricle are displaced into semicircular canals (typically the posterior)
77
Otoconia tends to fall into what semi-circular canal?
- posterior
78
When is Benign positional paroxysmal vertigo present?
- looking up
| - rolling over in bed
79
What diagnoses BPPV?
- Dix Hallpike test
80
Treatment of BPPV?
- Epley manoeuvre
81
What is the name of the at home exercises a patient with BPPV can do?
- Brandt-daroff exercises
82
Vestibular neuronitis/labyrinthitis is vertigo lasting___
- days
83
Treatment of vestibular neuronitis
- Self-limiting
- Vestibular sedatives
- 3 days in bed, 3 weeks off work, off-balance for 3 months
84
Describe Meniere’s disease
- Endolymphatic hydrops
- Recurrent, spontaneous rotational vertigo
- 2 episodes >20mins
- New tinnitus
- Usually affects only one side
85
Hearing loss in Meniere’s disease?
- sensioneural
| - affects low frequency hearing
86
Treatment of Meniere’s disease?
- Supportive during episodes
- Tinnitus therapy
- Hearing aids
- Salt restriction/ caffeine/alcohol stress
87
First line facial surgery healing technique?
-Healing by secondary intention
88
Low frequency hearing loss, fullness and tinnitus?
- Meniere’s disease
89
Vestibular schwannoma affects what nerve sheath?
- CN VIII
| - Vestibulocochlear
90
Treatment of migraines?
- Lifestyle modification
- Triptans
- Propranolol or amitriptyline as prophylaxis
91
What drugs can be used in the prevention of migranes?
- propanolol or amitriptyling
92
Explain a type I hypersensitivity reaction?
- protein allergen in sensitied patient
- IgE on mast cell
- release of histamine and leukotrienes
93
Treatment of a stuffy nose?
- topical corticosteroids
- anti--histamine
- decongestant
- anti-cholinergic
- LTR blocker
94
Name an anti-cholinergic drug and its affect on the nose?
- ipratropium
| - reduces nasal mucus
95
Symptoms of a blocked nose?
- blockages
- loss of smell
- discharge
- facial pain
96
What are the 2 broad causes of rhinitis?
- infective
| - non-infective
97
What is the most common infective cause of rhinitis?
- viral
98
Non-infective causes of rhinitis?
- allergic
| - non-allergic
99
What are intermittent causes of allergic rhinitis?
- grass pollen
- tree pollen
- fungal spores
100
What defines persistent allergic rhinitis?
- symptoms > 4 days per week
101
Treatment of allergic rhinitis?
- allergen avoidance
- nasal steroids
- antihistamines
- immunotherapy
102
What examinations may be conducted for allergic rhinitis?
- IgE bloods
| - skin prick test
103
Treatment of nasal polyps?
- oral then topic steroids
| - surgery
104
What is vasomotor rhinitis?
- drippy nose
- over 50s
- parasympathetic overdrive
105
Treatment of vasomotor rhinitis?
- ipratropium
106
Treatment of infective rhinitis?
- analgesics
| - persistance > 10days --> antibiotics
107
Complications of sinusitis?
- orbital cellulitis
| - meningitis
108
Complication of nasal trauma?
- septal haematoma
109
Causes of nasal blockage, non-infective?
- adenoid hypertrophy
- foreign body
- tumour
110
Causes of airway obstruction?
- inflammation
- foreign bodies
- trauma
- neoplastic
111
Why are children more prone to airway obstruction?
- large heads
- small nares
- neonates are nasal breathers
- narrow subglottis
112
Define stridor?
- high pitch harsh inspiratory noise
113
Define stertor?
- low pitch
| - snoring sound
114
Causes of obstructive sleep apnoea in children?
- adenoid hypertrophy
| - enlarged tonsils
115
Causes of epiglottitis?
- Influenza bacteria
116
Management of airway obstruction?
- resuscitation
- oxygen
- heliox
- steroid
- adrenaline
117
What is the most common cell type in head and neck cancer?
- squamous cell carcinoma
118
Most common site of head and neck cancer?
- larynx
119
Risk factors for head and neck cancer
- tobacco
- alcohol
- viruses (HPV and EBV)
120
Commonest head and neck cancer in south china?
- nasopharyngeal
| - link to EBV
121
Symptoms of nasopharyngeal cancer due to EBV?
- Hearing changes due to glue ear
| - lump in neck
122
Symptoms of head and neck cancer?
- dysphonia
- dysphagia
- odynophagia
123
Supra-glottic tumour may spread where?
- superior deep cervical nodes
124
Glottic tumours spread where?
- 95% stay on vocal cords
| - minimum lymphatic drainage
125
Sub-glottic tumours spread where?
- paratracheal nodes
126
Diagnosis of head and neck tumours?
- USS/ FNA
- CT
- MRI
- PET
127
Treatment of early laryngeal cancer?
- transoral laser surgery
| - radiotherapy
128
Treatment of late and advanced laryngeal cancers?
- partial or total laryngectomy
| - chemo and radiotherapy
129
Malignant salivary gland pathology is associated with what size of gland?
- smaller glands = more chance of malignancy
130
Most common arterial branch to bleed in epistaxis?
- sphenopalatine
| - branch of the external carotid
