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MB2 Ear, Nose and Throat > Ear and throat disease > Flashcards

Ear and throat disease Flashcards

1
Q

cause of dizzy patient

A 
ENT
cardiovascular 
metabolic 
anxiety 
neurological 
trauma 
migraine 
drug side effects
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2
Q

define dizziness

A

non specific feeling of vertigo, pre-syncope, disequilibrium

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3
Q

features of cardiac dizziness

A

lightheaded
palpitations
syncope

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4
Q

features of neurological dizziness

A 
blackout 
visual disturbance 
paraesthesia 
weakness 
speech/swallow issues
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5
Q

features of vestibular dizziness

A

motion

spinning, fall, pushed

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6
Q

assoaicted symptoms with vertigo

A 
hearing loss 
tinnitus 
aural pressure 
migraines 
sound/pressure indiced symptoms
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7
Q

dizzy rolling in bed?

A

BPPV

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8
Q

severe attack of dizziness lasting for hours with nausea and vomiting

A

vestibular neuritis

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9
Q

light sensitive and dizzy?

A

migraine

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10
Q

one ear feeling full and dizzy?

A

meniere’s disease

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11
Q

investigations to take for dizziness and vertigo?

A 
blood pressure 
otoscopy 
neurological examination 
balance 
audiometry
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12
Q

what is the vestibulo-ocular reflex

A

focus eyes in distance, turning head causes deflection to allow eye focus
fluid shift in the horizontal VC deflects cupula to opposite side of turn and stimulates the left or right semi circular canal
leads to deflected eye movement

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13
Q

when the head turns right, the ___ horizontal canal is stimulated and the ___ is inhibited leading to eye movement on the ___ side

A

right
left
left

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14
Q

when the head turns left, the ___ horizontal canal is stimulated and the ___ is inhibited leading to eye movement on the ___ side

A

left
right
right

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15
Q

describe how nystagmus may occur in vestibular pathology

A

firing potential is lost on the affected side, with the other side being dominant. this leads to one side being the dominant in vestibulo-ocular reflex
this leads to nystagmus

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16
Q

what is the head impulse test

A

test vestibular-ocular reflex by rotating head and observing eye movement
use goggles to determine delay

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17
Q

cause of BPPV

A

trauma
ear surgery
idiopathic

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18
Q

pathophysiology of BPPV

A

otoconia from utricle is displaced into semicircular canal, usually posterior

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19
Q

presenting features of BPPV

A

vertigo on looking up, turning in bed, lying down, bending, rising, moving head quickly

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20
Q

how can BPPV be distinguished from vertebrobasillar insuffiency

A

difficulty speaking, swallow, weakness, numbness, visual disturbance

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21
Q

diagnostic test for BPPV

A 
dix hallpike test 
sit up with enough room to lay down 
vertical/torsional geotropic nystagmus
vertigo 
sick
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22
Q

best treatment for BPPV

A

epley manoeuvre

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23
Q

other management for BPPV

A

semont manoeuvre

brant-daroff exercises - 10 reps 3x a day for 1 weeek

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24
Q

features of vestibular neuronitis/labyrinthitis

A

prolonged vertigo for days
associated tinnitus
prodromal viral symptoms

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25
Q

management of vestibular neuronitis/labyrinthitis

A

self limiting
if prolonged then investigate
rehabilitate
3 days in bed, 3 weeks off work, 3 months off balance

26
Q

features of meniere’s disease

A

fecurrent, spontaneous and rotational vertigo with 2 episodes >20 mins
new tinnitus
aural fullness
SNHL, low freq

27
Q

management of meniere’s disease

A

supportive, intratympanic steroids, gentamicin, surgery, diuretics
tinnitus therapy
hearing aids
salt restriction, alcohol, caffeine, stress

28
Q

what is a vestibular schwannoma, what symptoms may it cause and how is it diagnosed

A

rare, benign tumour of VIII sheath
imbalance, hearing loss with tinnitus
asymmetric hearing loss by MRI

29
Q

management of migraine and vertigo

A

lifestyle - alcohol, caffeine, stress, citrus fruit, sleep
triptans
propranolol, amitriptyline

30
Q

features associated wth migraine and vertigo?

A 
ataxia 
vertigo 
phonophobia 
motion sickness 
hearing loss
31
Q

what is otitis externa and what causes it

A

inflammation fo skin of ear canal
almost always infectrive - bacterial/fungal
caused by water, cotton buds, hearing aids, skin issues

32
Q

in who is acuite otitis media more common

A

children

33
Q

causes of OME in children

A

eustachian tube block or dysfunction

34
Q

causes of OME in adults

A

nasopharyngeal carcinoma/lymphoma

rhinosinusitis

35
Q

what is cholesteatoma, is it congenital or acquired, features

A

keratin in middle ear
hearing loss and discharge
usually acquired but can be congenital

36
Q

complications of acuite otitis media/cholesteatoma

A

sensorineural hearing loss, tinnitus, vertigo, facial palsy
brain abscess or meningitis
venous sinus thrombosis

37
Q

what is presbycusis and what frequency is the hearing loss

A

age related sensorineural hearing loss

high frequency

38
Q

in who is otosclerosis more common

A

young women
pregnancy
familial

39
Q

common cause of acute otitis media

A

preceding URTI in children

40
Q

what makes up waldeyer’s ring

A

palatine tonsils
adenoid tonsils
lingual tonsil

41
Q

histology of the tonsils

A

stratified squamous
crypts
adenoids formed of ciliated pseudostratified columnar

42
Q

upper aerodigestive histology?

A

ciliated columnar respiratory type

squamous

43
Q

histology of oral cavity, pharynx, vocal cords and oesophagus

A

squamous

44
Q

pathogens in acute tonsillitis

A 
EBV 
adenovirus 
rhinovirus
enterovirus 
influenza and parainfluenza 
GAS , haemophilus influenzae, s aureus, strep pneumoniae
45
Q

symptoms of viral tonsilitis

A

malise
sore throat
fever
possible lymphadenopathy <4days

46
Q

symptoms of bacterial tonsilitis

A 
around a week 
systemic upset 
fever
lymphadenopathy 
odonophagia 
halitosis
47
Q

management of tonsillitis

A 
eat and drink
rest
OTC analgesia 
penicillin
consider tonsillectomy 
steroids 
fluids
48
Q

what is a peritonsillar abscess, what are the symptoms and management

A

pus production between tonsil and muscle
unolateral throat pain, odynophagia, medially displaced tonsil and uvula, trismus
aspirate, abx

49
Q

signs of infectious mononucleosis

A

tonsillar enlargemnt with membranous exudate
cervical lymphadenopathy
palatal petechial haemorrhage
hepatosplenomegaly

50
Q

disgnosis of infectious mononucleosis

A 
atypical monocytes 
monospot 
paul bunnel test 
low CRP 
deranged LFTs
51
Q

management of infectious mononucleosis

A

symptomatic
steroids if bad
abx, not amox

52
Q

features of tonsillar obstructive hyperplasia

A

snoring
muffled voice
dysphagia

53
Q

features of adenooid obstructive hyperplasia

A

mouth breathing
snoring
AOM/OME
hyponasal voice

54
Q

features of chronic tonsilitis

A 
chronic sore throat 
malodourus breath 
tonsilith 
peritonsillar oedema 
tender cervical lymphadenopathy
55
Q

in who is OME more common

A 
children 
males 
day care
older siblings 
recurrent URTI
56
Q

cause of OME

A 
recurrent AOM or URTI
premature 
craniofacial abnormality 
immune deficiency 
smoking 
day care 
allergy 
nutrition 
bottle feed 
seasonal
57
Q

symptoms of OME

A 
deafness 
behaviour issues 
poor school performance 
balance issues 
speech delay
58
Q

diagnosis of OME

A

hx, otoscopy, tuning fork

audiometry and tympanometry

59
Q

signs of OME on examiantion

A

TM retraction and reduced mobility and colour

visible middle ear fluid

60
Q

management of OME

A

waiting, review at 3m with PTA, otoscope and tympanometry
if persistent refer
if <3, or >3 and first line - grommets
if >3 and 2nd line - grommets and adenoidectomy

61
Q

complication of grommet insertion

A 
infection 
early extrusion 
retention 
perforation 
swimming issues

MB2 Ear, Nose and Throat (11 decks)

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