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ENT > Emergencies in ENT > Flashcards

Emergencies in ENT Flashcards

1
Q

Nasal Bone Fracture

  • Make sure no ________
  • Avoid contact sports ________
  • If not seen by ENT by Day ______, consider septorhinoplasty after _______
A

Nasal Bone Fracture

  • Make sure no septal haematoma
  • Avoid contact sports 2/12
  • If not seen by ENT by Day 14, consider septorhinoplasty after 9/12
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2
Q

Septal Haematoma

  • History of trauma, nasal obstruction
  • Post-op nasal surgery
  • _____________ swelling on the anterior nasal septum
  • Risk of ________
  • Leads to ________ of nose
A

Septal Haematoma

  • History of trauma, nasal obstruction
  • Post-op nasal surgery
  • Spongy/fluctuant swelling on the anterior nasal septum
  • Risk of necrosis
  • Leads to saddling of nose
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3
Q

Epistaxis: Bleeding from the nose

  • Anterior: from _______________
  • Posterior: from ___________________
  • Investigations/Treatment?
A

Epistaxis: Bleeding from the nose

  • Anterior: often from nasal septum
  • Posterior: medial/lateral nasal mucosa

Investigations/Treatment

  • Check Coag, FBC
  • ANTERIOR: Cauterize with silver nitrate cautery if bleed spot identified
  • POSTERIOR: CoPhenylcaine- decongestion and local anesthetic
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4
Q

Complications of Nasal Pack for Epistaxis?

A

1-Toxic Shock Syndrome (Streptococcus pyogenes and staph aureus)

2 Septal perforation

3 Adhesions

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5
Q

Complications of Acute Sinusitis?

A
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6
Q

What type of Cellulitis?

Characteristics?

A

Preseptal Cellulitis (Chandler I)

  • Eyelid Oedema
  • Erythema, pain, Fever
  • No vision impairment
  • Normal extraocular muscle movement
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7
Q

What type of Cellulitis?

Characteristics?

A

Orbital Cellulitis (Chandler II)

  • Oedema and inflammation of soft tissue but NO frank abscess formation
  • No vision impairment
  • Decreased extraocular muscle movement
  • Proptosis and chemosis
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8
Q

What type of Cellulitis?

Characteristics?

A

Subperiosteal Abscess (Chandler III)

  • Pus collection between the periorbita and bone
  • Orbital contents are displaced (inferolateral)
  • Chemosis, Proptosis
  • Limitation of ocular movement/ophthalmoplegia
  • Impaired visual acuity/colour
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9
Q

What type of Cellulitis?

Characteristics

A

Orbital Abscess (Chandler IV)

  • Pus collection within the orbital tissue
  • Often caused by rupture of Subperiosteal abscess
  • complete ophthalmoplegia (extraocular paralysis) + vision loss
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10
Q

What type of Cellulitis?

Characteristics/Causes?

A

Cavernous Sinus Thrombosis (Chandler V)

  • Intracranial complication (Not an end result of orbital complication)
  • Proptosis//Chemosis
  • Bilateral ocular symptoms- VI Nerve palsy (III,IV,V1,V2,VI)

Can be caused by:

  • PERIORBITAL CELLULITIS
  • Nasal FURUNCULOSIS
  • ACUTE RHINOSINUSITIS
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11
Q

Auricular haematoma can cause __________________.

It is treated with _______________________________

A

Auricular haematoma can cause Avascular Necrosis

It is treated with Immediate Evacuation

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12
Q

________________ is an infection of the tissue lining your ear cartilage. Symptoms include pain, redness and swelling. It is common amongst __________________

A

Perichondritis is an infection of the tissue lining your ear cartilage. Symptoms include pain, redness and swelling. It is common amongst Immunocompromised/DM

Seen in: Wegner’s

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13
Q

Mastoiditis => _________________________ => Intracranial complications => Neck (______) or Occipital Bone (_____)

  • Presentation
  • Diagnosis
  • Treatment
A

Mastoiditis => Subperiosteal abscess form => Intracranial complications => Neck (Bezold’s) or Occipital Bone (Citelli’s)

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14
Q

What would result from Trauma to Zone 1?

A
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15
Q

What would result from Trauma to Zone 2?

A
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16
Q

What would result from Trauma to Zone 3?

A
17
Q

Symptoms of Foreign Body Asphixiation?

A

Dysphagia

Chest pain

Regurgitate of oral intake including saliva

18
Q

________________________________;

  • “hot potato voice”
  • trismus (lockjaw)
  • asymmetric tonsils with uvula deviation

Treatment?

Complications?

A

Quinsy (Peritonsillar Abscess):

  • “hot potato voice”
  • trismus (lockjaw)
  • asymmetric tonsils with uvula deviation

Treatment:

  • Use needle and scalpel with plastic guard trimmed to keep penetration ≤1cm. Use headlight with a tongue depressor, Prepare suction.
  • Anaesthetize with Lidocaine spray, Wait a few minutes, then make approx. 1cm incision into anterior/medial tonsil over fluctuant spot.
  • Use blunt dissection with hemostat inferiorly and laterally to locate abscess. Suction while gently expressing pus.

Complications:

  • Airway compromise
  • Involvement of carotid sheath
19
Q

____________________are among the most serious of deep neck infections. They can extend to the mediosteinum.

  • Common in ________________
  • Adults due to _________________ or ___________________
A

Retropharyngeal Abscess: among the most serious of deep neck infections. They can extend to the mediastinum.

  • Common in Infants/Children
  • Adults due to foreign body or Pott’s Disease
20
Q

Epiglotitis:

  • Rarer in children due to _________________ vaccine
  • Odynophagia, sore throat, airway obstruction => ______________
  • Usually very ill – high ____, _______, ________
A

Epiglotitis:

  • Rarer in children due to H influenza B vaccine
  • Odynophagia, sore throat, airway obstruction => inspiratory stridor, cyanosis
  • Usually very ill – high WCC, CRP, temp
21
Q

__________________:Posterior nares blocked due to failure of canalization

A

Chonal Atresia:Posterior nares blocked due to failure of canalization

  • Can be Unilateral ( most common) => Bilateral real emergency
  • Infants are obligatory mouth breathers – cyanosis when feeding
  • Confirm – MRI/CT
22
Q

What is CHARGE syndrome?

A

Coloboma (Missing Structures of the Eye)

Heart defects

Atresia of Nasal Choanae (narrowing of the back of the nasal cavity => difficulty breathing)

Retardation

Gonadal Malformation

Ear abnormalities

ENT (7 decks)

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