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Pass Med finals pack > ENT > Flashcards

ENT Flashcards

1
Q

which disorder is associated with the following description:

  • Hearing loss, vertigo, tinnitus
  • Absent corneal reflex is important sign
  • Associated with neurofibromatosis type 2
A

acoustic neuroma

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2
Q

which disorder is associated with the following characteristics:

  • Elderly patient
  • Dizziness on extension of neck
A

vertebrobasilar ischaemia

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3
Q

which disorder is associated with the following:

  • associated with hearing loss, tinnitus and sensation of fullness or pressure in one or both ears
A

meniere’s disease

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4
Q

which disorder is characterised by the following:

  • gradual onset
  • triggered by change in head position
  • each episode lasts 10-20 seconds
A

benign paroxysmal positional vertigo

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5
Q

which disorder is characterised by the following:

  • recent viral infection
  • recurrent vertigo attacks lasting hours or days
  • no hearing loss
A

vestibular neuronitis

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6
Q

brainstorm some causes of vertigo:

A
  • posterior circulation stroke
  • trauma
  • multiple sclerosis
  • ototoxicity e.g. gentamicin
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7
Q

describe webers test

A
  • vibrating tuning fork
  • in centre of head
  • sound travels to both ears
  • if sound louder is one ear (say left)
  • will indicate conductive hearing loss in the opposite (right) ear
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8
Q

describe Rinne’s test

A
  • tuning fork next to each ear in turn
  • placed on mastoid process
  • if its louder on bone - indicates conductive hearing loss
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9
Q

what are acoustic neuromas ?

A

tumours of the vestibulocochlear nerve

form of sensorineural hearing loss

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10
Q

describe positive Rinne’s test

A

‘positive test’: air conduction (AC) is normally better than bone conduction (BC)

‘negative test’: if BC > AC then conductive deafness

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11
Q

exostosis caused by:

A
  • repeated exposure to cold water and wind
  • causes benign bony growth
  • in external auditory canal
  • form of conductive hearing loss
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12
Q

30 y/o female
pc: recurrent LHS nose bleeds, lasting 9 mins, starts again on cough

what part of the history prompts urgent investigation:

A
  • unilateral epistaxis is a red flag symptom
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13
Q

which disorder is characterised by the following:

  • recent viral infection
  • sudden onset
  • nausea and vomiting
  • hearing may be affected
A

viral labyrinthitis

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14
Q

what distinguishes vestibular neuronitis from labyrinthitis

A

unaffected hearing in vestibular neuronitis

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15
Q

finger spasms when blood pressure was taken

A

trousseau’s sign

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16
Q

firstline management for patient with otitis media with no improvement of symptoms after 2-3 days

A

start amoxicillin

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17
Q

what is the common anatomical origin of a nose bleed?

A
  • anterior nasal septum

- ‘little’s area’ confluence of 4 arteries

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18
Q

nasal decongestants should not be used for prolonged periods of time as…

A
  • increasing doses will be required to achieve the same effect
  • known as tachyphylaxis
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19
Q

following perforation of tympanic membrane - healing should occur within

A

6 to 8 weeks

if not… then mringoplasty can be performed to repair the perforation

20
Q

The cyst is filled with acellular fluid with cholesterol crystals and encapsulated by stratified squamous epithelium

This cyst is a benign, developmental defect of the branchial arches.

typical examination features

  • unilateral
  • anterior to sternocleidomastoid
  • non-tender
A

branchial cyst

21
Q

non-cancerous growth of squamous epithelium that is ‘trapped’ within the skull base causing local destruction.

  • foul smelling discharge
  • hearing loss
A

cholesteatoma

22
Q

quinsy should be treated with:

A
  • IV antibiotics

- surgical drainage

23
Q

past medical history of chronic ear infections and offensive discharge are suggestive of

A

cholesteatoma

24
Q

2 y/o lil baby

  • lump in neck
  • swelling in subcut tissue of posterior triangle
  • transilluminates

classic description of:

A

cystic hygroma

  • collection of dilated lymphatic sacs
  • which are fluctuant and brilliantly trans illuminable
25
Q

40 y/o female

  • painless neck lymo
  • mass beneath sternocleidomastoid
  • history of regurg of undigested food
  • coughing at night
  • halitosis
  • throat infections

classic history of:

A

pharyngeal pouch

26
Q

32 y/p female

  • recurrent infections and abscesses in neck
  • midline defect with overlying scab
  • moves upwards on tongue protrusion

what is it:

A

thyroglossal cyst

- connection with foramen caecum means it will move on tongue protrusion

27
Q

shingles affecting the facial nerve.

This results in ear pain, vesicles in the external ear canal associated with vertigo and deafness.

indicative of:

A

Ramsay-hunt syndrome

  • herpes zoster oticus
  • caused by reactivation of the varicella zoster virus in the geniculate ganglion of the seventh cranial nerve
28
Q

management of ramsay-hunt syndrome

A

oral aciclovir

and corticosteroids

usually given

29
Q

A 50-year-old female presents with bilateral parotid gland swelling and symptoms of a dry mouth. On examination she has bilateral facial nerve palsies. This improved following steroid treatment.

A

sarcoidosis

Sarcoid occurs bilaterally in 70% of cases and facial nerve involvement is recognised. Treatment is conservative in most cases although individuals with facial nerve palsy will usually receive steroids with good effect.

30
Q

An 18-year-old boy presents with pancreatitis. He has bilateral painful parotid enlargement.

likely to be:

A

viral parotitis

31
Q

A 50-year-old lady presents with symptoms of a dry mouth that has been present for the past few months. She also has a sensation of grittiness in her eyes.

On examination she has a diffuse swelling of her parotid gland. There is no evidence of facial nerve palsy.

likely diagnosis:

A

sjogren’s syndrome

32
Q

high-frequency loss associated with ageing

A

presbyacusi

33
Q

what describes the replacement of normal bone by vascular spongy bone.

It causes a progressive conductive deafness due to fixation of the stapes at the oval window.

A

otosclerosis

34
Q

management of otosclerosis

A

hearing aid

stapedectomy

35
Q

A 64-year-old woman with a one week history of pain above and lateral to her left eye. On examination she is tender over that area.

indicative of:

A

temporal arteritis

36
Q

A 62-year-old woman presents with a two week history of shooting pains across her left cheek. The pain is sometimes triggered by touching her face. She has no past medical history note

indicative of:

A

trigeminal neuralgia

37
Q

common cause of bacterial otitis media

A

Haemophilus influenzae is a common cause of bacterial otitis media

38
Q

The combination of asthma, aspirin sensitivity and nasal polyps is known as

A

Samter’s triad

In patients with asthma, aspirin and other NSAIDs should be avoided as these may precipitate an asthma exacerbation.

39
Q

Features
- ear pain, itch, discharge

-otoscopy: red, swollen, or eczematous canal

indicative of:

A

otitis externa

causes of otitis externa include
- infection: bacterial (staph. aureus, pseudo. aeruginosa) of fungal

  • seborrheic dermatitis
  • contact dermatitis
40
Q

An 8-year-old child presents with enlarged tonsils that meet in the midline and are covered with a white film that bleeds when you attempt to remove it. He is pyrexial but otherwise well.

indicative of:

A

acute bacterial tonsillitis

41
Q

A 10-year-old child presents with enlarged tonsils that meet in the midline. Oropharyngeal examination confirms this finding and you also notice peticheal haemorrhages affecting the oropharynx. On systemic examination he is noted to have splenomegaly.

indicative of:

A

infectious mononucleosis

42
Q

James, 40, has presented to his GP with weakness of the right side of his face, which examination confirms. James also reveals that he has experienced pain in his ear and otoscopy reveals the presence of vesicles on his tympanic membrane. Which of the following is the likely diagnosis?

A

ramsay hunt syndrome

43
Q

A 33-year-old with coryzal symptoms presents with a one day history of vertigo and nausea. There is no hearing loss on examination

A

vestiubular neuronitis

44
Q

A 62-year-old man with a 3 month history of dizziness when he rolls over in bed. Episodes last for about 20 seconds

A

benign paroxysmal positional vertigo

45
Q

A 51-year-old female with a 3 week history of recurrent attacks of vertigo, right ear tinnitus and the sensation of fullness in her right ear. On testing, there is noted to be right-sided hearing loss affecting low frequencies.

A

meniere’s disease

46
Q

pain on palpation of the tragus, itching, discharge and hearing loss

A

Otitis externa

47
Q

A 4-year-old is brought to the general practitioner by her mother. She has been distressed with ear pain for the past 14 hours. She is constantly touching and pulling at her ear. Whilst she is sat in the waiting room her mother notices a discharge of foul smelling fluid from the ear, following which the pain resolves.

A

Acute suppurative otitis media

Pass Med finals pack (40 decks)

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