emergencies in ENT

Question 1

what are the factors that can worsen epistaxis ?

Answer 1

anticoagulants
hypertension
haematological disorders

Question 2

what are the areas of anastomosis in the nose causing nosebleeds ?

Answer 2

anterior nosebleed - little’s area (kiesselbach’s area)
posterior nosebleed - woodruff’s area

Question 3

what is the immediate management for epistaxis ?

Answer 3

1.if the bleeding point can be seen
perform cauterisation
2. source of bleeding cannot be seen clean out the nose with Nacl and insert adrenalin patties , if there is improvement then cauterize
3. if there is no improvement after adrenalin patties then insert an anterior nasal pack
4. no resolution after anterior nasal pack then insert a posterior nasal pack
5. if there is still no resolution then surgery or interventional radiology is indicated

Question 4

what is the supportive care associated with epistaxis management ?

Answer 4

resuscitate with IV fluids and O- blood
correct coagulopathy and manage hypertension

Question 5

what is the definitive treatment ladder for epistaxis ?

Answer 5

endoscopic sphenopalatine artery ligation
anterior ethmoid artery ligation
maxillary artery ligation
external carotid artery ligation
interventional radiology
laser of hereditary hemorrhagic telangiectasia

Question 6

wheere do the digestive and respiiratory tract overlap ?

Answer 6

oropharynx and hypopharynx

Question 7

what iis the function of the velopharyngeal reflex ?

Answer 7

prevents passage of undigested food into the nose

Question 8

what is thee relation between velopharyngeal reflex and adenoidectomies ?

Answer 8

sometimes a partial adenoidectomy is indicated when the palate is not completely formed , in order to keep thee velopharyngeal reflex a supeerior adenoidectomy is performed

Question 9

how is aspiration prevented ?

Answer 9

by the epiglottis
glottis
and laryngeal elevation

Question 10

when is a laryngectomy performed ?

Answer 10

in advanced laryngeal cancers
larynx is removed and air is taken in straight from the outside into the trachea

Question 11

what problems do patients face who have a laryngectomy ?

Answer 11

loss of humidification
problems swallowing

Question 12

what are thee anatomical positions of the larynx?

Answer 12

supra glottis
glottis
subglottis

Question 13

what is a trachesotomy ?

Answer 13

temporary or permanent prosthesis which is surgically placed in the trachea to improve breathing

Question 14

what are thee indications associated with a tracheostomy ?

Answer 14

upper airway obstruction
long term ventilation
low consciousness level
patient unable to clear upper airway secretions

Question 15

what does the term neck breather refer to ?

Answer 15

patient with a laryngectomy or a tracheostomy

Question 16

what is thee most common cause of OSA in addults ?

Answer 16

obesity

Question 17

what is the most common cause of OSA in children ?

Answer 17

adenoids

Question 18

what is the most sensitive investigation that can be used for OSA patients ?

Answer 18

nocturnal polysomnography

Question 19

what might you suspect inn a patient suffering from recurrent food bolus ?

Answer 19

oesophageal stricture

Question 20

what are the tonsils in waldezyers ring ?

Answer 20

pharyngeal tonsils = adenoids
tubal tonsils = Eustachian tube tonsils
Palatine tonsils
Lingual tonsils

Question 21

what tare the regional lymph nodes associated with waldeyers ring ?

Answer 21

retropharyngeal LN
Jugulo-digastric LN
Jugular chain LN
Submental and Submandibular LN

Question 22

what are the indications for a tonsillectomy ?

Answer 22

7 or more episodes in on year
5 or more episodes in thee past 2 years each
3 or more episodes in the past 3 years each
gagging is not an absolute indication for a tonsillectomy

Question 23

when should you suspect pharyngitis ?

Answer 23

posterior wall of the oropharynx may be red and inflamed without any change or infections in the tonsils
often associated with cough, coryza, fatigue and pallor

Question 24

what criteria is used to asses strep pharyngitis ?

Answer 24

FeverPAIN

Question 25

what is the presentation of tonsillitis ?

Answer 25

infection of the tonsils marked by fever, rapid onset and absence of other viral symptoms such as coryza and cough
severe inflammation of thee tonsils along with pus exudate on the surface

Question 26

if a patient with pharyngitis seems to not be doing very well physically what should you exclude ?

Answer 26

epiglottitis

Question 27

what is quinsy ?

Answer 27

pritonsillar abscess

Question 28

what are thee complications of acute tonsillitis ?

Answer 28

quinsy ( peritonsillar abscess )
retro and parapharyngeal abscess
acute glomerulonephritis
rheumatic fever

Question 29

what is the presentation of quinsy ?

Answer 29

unilateral throbbing pain
hot potato voice
trismus
congestion and oedema of the soft palate
tonsils displaced downwards and medially
uvula pushed to the opposite side
+/- torticollis

Question 30

what is thee management for quinsy ?

Answer 30

drainage under cover of antibiotics

Question 31

what is the necessary treatment for supraglottitis or epiglottitis ?

Answer 31

airway management
IV antibiotics
aerosolised adrenaline