Corrections 2 Flashcards
1st line mx of epistaxis (pt is stable)?
1) Asking the patient to sit with their torso forward and their mouth open
2) Pinch the cartilaginous (soft) area of the nose firmly for at least 20 minutes
2nd line mx of epistaxis?
1) consider using a topical antiseptic such as Naseptin (chlorhexidine and neomycin)
2) consider silver nitrate cautery (if bleeding source is visible)
3) packing may be used if cautery is not viable or the bleeding point cannot be visualised
Mx of epistaxis that has failed all emergency management?
may require sphenopalatine ligation in theatre
What needs to be excluded in SSNHL?
An MRI scan is usually performed to exclude a vestibular schwannoma.
What imaging is indicated in SSNHL?
MRI - exclude a vestibular schwannoma.
Time of ENT assessment in SSNHL?
24h
What is the main duct that sialolithiasis occurs in?
Wharton’s duct in the submandibular gland
When can patients be offered a cochlear implant in hearing loss?
In adults, patients should have completed a trial of appropriate hearing aids for at least 3 months which they have been objectively demonstrated to receive limited or no benefit from.
What abx drops are indicated in otitis externa in diabetics?
Ciprofloxacin to cover Pseudomonas
What is sialadenitis?
Inflammation of the salivary gland likely 2ary to obstruction by a stone impacted in the duct.
Mx of unilateral nasal polyps?
Red flag –> urgent ENT referral
Mx of acute attacks of Meniere’s?
Buccal or IM prochlorperazine
What can be used to help prevent attacks of Meniere’s?
Betahistine & vestibular rehabilitation exercises
Give 4 causes of gingival hyperplasia?
1) phenytoin
2) ciclosporin
3) CCBs
4) AML
Which leukaemia can cause gingival hyperplasia?
AML
Routine vs urgent referral in nasal polyps?
Routine –> All patients with suspected nasal polyps should be referred routinely to the ENT team
Urgent –> Unilateral symptoms or blood-stained discharge
What can be used to shrink nasal polyps?
Topical steroids
Imaging investigation of choice in mastoiditis?
CT temporal bone
What operation can be performed in cases of tympanic membrane rupture where spontaneous healing has failed to occur?
Myringoplasty
What is double sickening?
What is it typically seen in?
An initial period of recovery followed by a sudden worsening of symptoms.
Typically seen in bacterial sinusitis.
Key features of Meniere’s?
- tinnitus
- vertigo (minutes to hours)
- hearing loss (sensorineural)
- nystagmus
- aural fullness
- +ve Romberg’s
Acute mx of Meniere’s?
IM or buccal prochlorperazine
Prevention of Meniere’s?
Betahistine
How long do symptoms take to resolve in Meniere’s?
5-10y
Timeline of acute vs chronic sinusitis?
Acute: <4 weeks
Chronic: ≥12 weeks
1st line abx in sinusitis when indicated?
Penicillin V
When can nasal steroids be offered in sinusitis?
> 10 days
If 1st aid measures are successful in epistaxis, what can the patient be given on discharge?
Topical antiseptic e.g. naseptin (chlorhexidine & neomycin) –> to reduce crusting and risk of vestibulitis
