Corrections 2 Flashcards
What are some associations with nasal polyps?
- asthma (particularly late-onset asthma)
- aspirin sensitivity
- infective sinusitis
- CF
- Kartagener’s syndrome
- Churg-Strauss syndrome
What medication is it important to avoid in a patient with nasal polyps?
Aspirin - association with aspirin sensitivity
What is Samter’s triad?
1) aspirin sensitivity
2) asthma
3) nasal polyposis
Mx of ALL nasal polyps?
all patients with suspected nasal polyps should be referred to ENT for a full examination
What medication can be used to shrink nasal polyps?
Steroids
Hearing loss in labyrinthitis vs neuronitis?
No hearing loss in vestibular neuronitis
Mx of vestibular neuronitis?
A short oral course of prochlorperazine in the acute phase only.
Why is prochlorperazine only used in the acute phase in the mx of vestibular neuronitis?
It should be stopped after a few days as it delays recovery by interfering with central compensatory mechanisms
Criteria for a tonsillectomy?
Patients would need to have had it 7 times in the last year or 5 times a year for two consecutive years.
What drugs can cause tinnitus?
1) aspirin/NSAIDs
2) aminoglycosides
3) loop diuretics
4) quinine
Give some causes of tinnitus
1) idiopathic
2) Meniere’s disease
3) otosclerosis
4) sudden onset sensorineural hearing loss (SSNHL)
5) acoustic neuroma
6) hearing loss e.g. excessive loud noise and presbycusis
7) drugs
8) impacted ear wax
Referral for laryngeal cancer?
A suspected cancer pathway referral for laryngeal cancer (appointment within 2 weeks) should be considered in people aged 45 and over with persistent unexplained hoarseness or an unexplained lump in the neck.
Mx of child with a first presentation of otitis media with effusion?
Active observation for 3 months
What is the preferred treatment for chronic symptoms in vestibular neuronitis?
Vestibular rehabilitation exercises
1st line mx of vestibular neuronitis?
3 day course of prochlorperazine
When is an US necessary in a lipoma?
> 5cm
What can be used to distinguish vestibular neuronitis from posterior circulation stroke?
HiNTs exam
What is the most common malignancy in the lower lip?
SCC
What antiepileptic can cause toxic epidermal necrolysis (TEN)?
Phenytoin
Mx of Ramsay Hunt syndrome?
Oral steroids, aciclovir & eye protection
What is Ramsay Hunt syndrome?
reactivation of the varicella zoster virus in the geniculate ganglion of the seventh cranial nerve.
What is often the first feature of Ramsay Hunt syndrome?
Auricular pain
Mx of otitis externa in diabetics?
Ciprofloxacin to cover Pseudomonas
What is malignant otitis externa?
Uncommon type of otitis externa that is found in immunocompromised individuals (90% cases found in diabetics)
What organism most commonly causes malignant otitis externa?
Pseudomonas aeruginosa
What can malignant otitis externa progress to?
Temporal bone osteomyelitis
Describe nystagmus seen in BPPV
Rotatory
