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Finals Revision > ENT > Flashcards

ENT Flashcards

1
Q

List some causes of sensorineural hearing loss

A 
Perinatal abnormalities 
Infective/Inflammatory (meningitis) 
Trauma 
Drugs - aminoglycosides 
Neoplasia - vestibular schwannoma 
Idiopathic - Meniere's 
Ageing
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2
Q

List some causes of conductive hearing loss

A 
Wax
Otitis externa
Foreign Bodies 
MIddle ear effusion (glue ear) 
Chronic suppurative otitis media 
Otosclerosis 
Ossucular disruption
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3
Q

What foreign body must you be aware of

A

Hearing aid betteries - acid can corrode the skin.

Patient must go to hospital

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4
Q

Organisms causing otitis externa

A

S. aureus

Pseudomonas aeruginosa

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5
Q

Presentation of otitis externa

A

Red, swollen, eczematous canal

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6
Q

Treatment of otitis externa

A

Topical Abx (aminoglycosides not used if perforated tympanic membrane)
Topical Steroid
Severe - microsuction in ENT clinic

If extensively swollen use an ear wick
Oral abx if infecton is spreading
IV abx if malignant

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7
Q

Otitis media presentation

A

Otalgia - ear pain
Fever
Deafness
Otorrhoea - ear discharge

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8
Q

Complication of otitis media

A

mastoididtis

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9
Q

Otitis media Mx

A

Oral amox (erythromycin 2nd line) if:

  • lasting longer than 4 days
  • Immunocompromised
  • Younger than 2 yrs
  • Perforation
  • Systemically unwell
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10
Q

Timescale of otitis media with effusion (glue ear)

A

Fluid in middle ear for less than 3 months

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11
Q

Symptoms of glue ear

A

Conductive hearing loss
Prolonged cases = speech development
Mild dizziness or clumsiness

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12
Q

Mx of glue ear

A

Conservative
If deafness persists = hearing aid and grommet (drains the fluid)
Adenoidectomy - last resort

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13
Q

Pathophysiology of cholesteatoma

A

Squamous epithelium of external ear migrates to middle ear and forms a mass - erodes bone and soft tissue

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14
Q

What does cholesteotoma present with?

A

Smelly discharge
Severe hearing loss
Dizziness

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15
Q

Cholesteatoma Mx

A

Surgery. Drops do not help

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16
Q

What conditions present with tinnitis

A 
Meniere's 
Osteosclerosis 
Acoustic neuroma 
Hearing loss 
Drugs
17
Q

What kind of drugs can cause tinnitus?

A

Aspirin, Aminoglycosides, Loop diuretics, Quinine

18
Q

What is an acoustic neuroma

A

Hearing loss, vertigo, tinnitus, headaches - deep earache
Absent corneal reflex
Assoc. with NF2

19
Q

Signs of osteosclerosis

A

Onset 20-40
Conductive deafness
Tinnitus
Normal tympanic membrane

20
Q

Mx of tinnitus

A

Hearing aids,

White noise generator

21
Q

BPPV investigation and management

A

Ix and diagnosis- Dix Hallpike

Mx - Epley manoevre and vestibular exercises

22
Q

Acute attack of meniere’s Mx?

A

Prochlorperazine

23
Q

Prevention of Meniere’s

A

Betahistidine and Vestibular exercises

24
Q

Signs of acute labrynthitis

A

Dizziness
Deafness
Nausea

Recent viral infection
Nystagmus
Lasts for days

25
Q

Epitaxis Mx

A

Compress nose & Lean forward
Cautery
Nasal packing

26
Q

Septal haematoma Mx

A

Drained and give Abx

27
Q

What are nasal polyps normally associated with?

A

Eosinophilia
Aspirin allergy
Asthma

28
Q

Nasal polyps Mx

A

Topical corticosteroids

Surgical treatment if failed

29
Q

Nasal fracture - how to deal with it?

A

If non-displaced and uncomplicated - leave it

If massive swelling and displaced, wait for it to die downand manipulate under general aneasthetic

If complicated - may need general and srugery

Don’t leave it for more than 2 weeks

30
Q

Pharyngeal infection organisms

A

H. influenzae
Pneumococcus
Haemolytic strep

31
Q

Pharyngeal MX

A

Penicillin V

Do a monospot test if you suspect EBV

32
Q

Complications of pharyngeal infection

A

Rheumatic fever
Glomerulonephritis
Septicaemia
Quinsy

33
Q

Tonsilectomy guidelines

A

SIGN: >7 per year
>5 in 2 consecutive years
>3 in 3 consecutive years

NICE - more than 5 episodes per year

If disabling normal function, it should be considered

34
Q

When assessing a neck lump, what are you looking at/asking?

A

Size
Location - anteroir triangle/posterior triangle/mid-line
Shape - well defined?
Consistency - smooth, nodular, hard
Fluctuance - suggests fluid filled
Trans-illumination - suggest fluid filled - cystic hygroma
Pulsatility - suggests vascular - carotid body tumour/aneurysms
Temp - suggests infective cause
Overlying skin changes - erythema / ulceration?
Relation to overlying tissue - mobility/ask to turn head
Asculatation - assess bruits - carotid aneurysm

35
Q

Brachial cyst

A

Anterior triangle
Embryonic development - failure of obliteration of secind brachial cleft
Presents in early adulthood

36
Q

Congenital neck lump, typically on the L side and presents before 2yrs

A

Cystic hygroma

37
Q

What lump moves upward with protrusion of tongue

A

Thyroglossal cyst

38
Q

Does a carotid aneurysm move with protrusion of tongue?

A

No

Finals Revision (7 decks)

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