Conditions summary Flashcards by Jay Slater

kid
URTI last week - haem influenzae, strep 
sore ear with discharge 
fever 
been off his food

acute otitis media

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acute otitis media treatment

self limiting <4 days, paracetemol for pain

amoxicillin PO if >4days

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age 2/5/6 
poor school performance
listens to TV v loudly 
conductive hearing loss on examination 
 no ear pain

otitis media with effusion (glue ear)

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otitis media with effusion (glue ear) treatment

self limiting <3 months (see back)

grommets

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swimmer 
discharge
itchy ear
sore ear
red and swollen external acoustic meatus on examination

otitis externa

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otitis externa treatment (3)

clean and DRY ear
severe fungal - topical clotrimazole
severe bacterial - gentamicin drops

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previous otitis externa 
pseudomonas in ear 
bells palsy (CN VII palsy) 
pain 
headache

malignant otitis

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malignant otitis treatment

surgical debridement

antibiotics

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perforated ear drum 
v painful ear 
cheesy, foul smelling discharge 
vertigo 
pearly white tympanic membrane on otoscopy

cholesteatoma

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cholesteatoma treatment

mastoid surgery

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unilateral sensorineural hearing loss
vertigo
tinnitus
‘golf ball’ on MRI

vestibular schwannoma

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bilateral sensorineural hearing loss 
café au lait spots 
child 
tinnitus 
vertigo 
'golf ball' on MRI

vestibular schwannoma

associated with neurofibromatosis type 2

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‘battle sign’ bruise on mastoid process of temporal bone
sensorineural hearing loss

be specific!

transverse temporal fracture

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‘battle sign’ bruise on mastoid process of temporal bone
conductive hearing loss

be specific!

longitudinal temporal fracture

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infection in early pregnancy

kid has sensorineural hearing loss age 2

cytomegalovirus

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vertigo 30-60 seconds after position change

no hearing loss/tinnitus

benign positional paroxysmal vertigo (BPPV)

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benign positional paroxysmal vertigo (BPPV) treatment (2)

epley manoeuvre

brandt daroff exercises at home

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recent viral cold 
vertigo <3 weeks, worst on day 1
severe spinning, vomiting on day 1 
nystagmus to other side 
no hearing loss/tinnitus

vestibular neuronitis

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vestibular neuronitis treatment (2)

self limiting

buccastem for vomiting in future episodes

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recent viral cold 
vertigo <3 weeks, worst on day 2
severe spinning and vomiting on day 1 
nystagmus to other side 
hearing loss and/or tinnitus

labyrinthitis

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labyrinthitis treatment (2)

self limiting

buccastem for vomiting in future episodes

worsening of tinnitus/hearing loss then vertigo for >20 mins (hours)
feeling of fullness in ears vomiting

menieres disease

menieres disease treatment (3 + lifestyle advice (4))

buccastem for vomiting in future episodes
life style advice - decrease salt, decrease alcohol, decrease caffeine, decrease stress
intra tympanic gentamicin
intra tympanic steroids

recent URTI (viral) 
tender sinuses

acute sinusitis

acute sinusitis treatment

``` self limiting (most likely viral) antibiotics (penicillin V) if it doesnt clear up in 2.5 weeks ```

oedematous, fluid filled bulge in nose runny nose chronic blocked nose allergic crease (line on nose)

rhinitis caused by polyp

``` runny nose sneezing itchy nose allergic crease ( line on nose) eczema ```

allergic rhinitis

treatment of allergic rhinitis (3)

avoid allergen antihistamines topical steroids

treatment of infective rhinitis (3)

analgesia nasal decongestant antibiotics (rarely)

lump in nose decreased smell chronic blocked nose painless

nasal polyp

nasal poly treatment (2)

steroids PO or topical | surgery

saddle nose

GPA vasculitis

infectious mononucleosis diagnosis with nasal symptoms (unilateral blocked nose, runny nose)

nasopharyngeal carcinoma associated with EBV

home treatment of nose bleeds (epistaxis) (3)

pinch front of nose for 20 mins ice blow out blood clots

emergency treatment of nose bleeds (epistaxis) in hospital if >20mins (3)

``` topical vasoconstrictor eg adrenaline in cotton wool cauterisation of vessel (silver nitrate) anterior rhinoscopy (looks like a tampon) ```

nose trauma | red asymmetrical bulge when you look up nose

septal haematoma

investigation and treatment of nasal facture

NOTHING! | ice and pain relief

``` painful swallowing fever lymphadenopathy no cough age 15-25 ```

throat infection (tonsillitis or pharyngitis)

tonsillitis/pharyngitis treatment

self limiting 3-7 days if >7 days check EBV for infectious mononucleosis penicillin V 500mg QDS 10 days if bacterial cause

``` exotoxin toxic to heart and brain v sore through swelling = obstruction white/grey membrane across pharynx unvaccinated ```

diphtheria

diphtheria treatment (2)

antitoxin and antibiotic (penicillin) VACCINATION IS PREVENTION!

white patches in mouth/throat

oral thrush/candida

``` aged 15-25 enlarged B lymphocytes on histology fever lymphadenopathy sore throat splenomegaly ``` get a nasopharyngeal carcinoma in the next couple weeks (you can just feel it in the air)

infectious mononucleosis (glandular fever)

infectious mononucleosis treatment think about cause

self limiting 3 weeks | paracetamol for pain

``` child unvaccinated drooling severe croup/stridor thumbprint sign on xray ```

acute epiglottitis

epiglottitis treatment

ceftriaxone IV | Ceftriaxone bc Children get epiglottitis

``` 20-50 year old non smoker or drinker koilocytes on histology weight loss fatigue otalgia feels like a lump in neck (no pain) ```

HPV oropharynx squamous cell carcinoma

HPV oropharynx squamous cell carcinoma treatment

chemoradiotherapy

``` >50 year old male smokes and drinks otalgia hoarseness feels like a lump in neck (no pain) fatigue weight loss ```

smoking/drinking associated throat squamous cell carcinoma

smoking/drinking associated throat squamous cell carcinoma treatment (2)

laryngectomy with post op radiotherapy (need to learn to speak) OR chemo (bad side effects) patients choice