ENT Flashcards
Rinne’s and Weber’s results
Rinne’s used to confirm conductive deafness
Weber’s used to localise conductive deafness
If Rinne’s is positive (AC>BC) in both ears problem cannot be conductive deafness, so Weber’s will lateralise to unaffected side = SN deafness
If Rinne’s is positive in one ear, Weber’s will lateralise to affected side to confirm conductive deafness
mx for bacterial tonsillitis
phenoxymethylpenicillin for 7-10 days
clarithromycin if penicillin allergy
cystic hygroma vs branchial cyst
cystic hygroma = congenital lymphatic lesion found on left side of neck, most are evident at birth, ~90% present <2 years
branchial cyst = oval mobile cystic mass that develops between SCM muscle and pharynx, present in early adulthood
what is quinsy
peritonsillar abscess
when should ABX be given in acute otitis media?
otitis media with perforation and/or discharge
symptoms lasting >4 days or not improving
systemically unwell but not requiring admission
immunocompromised
<2 years with bilateral otitis media
which ABX is used for acute otitis media if indicated
Amoxicillin
Erythromycin/Clarithromycin if penicillin allergy
features of otitis externa
pain on palpation of tragus
itching
discharge
hearing loss
mx for acute necrotising ulcerative gingivitis
- oral metronidazole
- chlorhexidine or hydrogen peroxide mouth wash
- simple analgesia
viral labyrinthitis vs vestibular neuronitis
viral labyrinthitis: recent viral infection, sudden onset vertigo, N&V, hearing may be affected
vestibular neuronitis: recent viral illness, vertigo can last hours/days, NO hearing loss
mx of Ramsay Hunt syndrome
oral aciclovir AND corticosteroids
Samter’s triad
asthma, aspirin sensitivity and nasal polyposis
when should intranasal corticosteroids be considered for acute sinusitis
symptoms for >10 days
causes of bacterial otitis media
H. influenzae
S. pneumoniae
mx of malignant otitis externa
Ciprofloxacin
mx of haemorrhage post-tonsillectomy
all should be assessed by ENT primary haemorrhage (if haemorrhage occurs in first 6-8 hours) - immediate return to theatre secondary haemorrhage (5-10 days post-op) - admit for IV ABX as usually due to wound infection
most common anatomical origin for epistaxis
anterior nasal septum as Little’s area is located here where there are 4 arteries
mx of Meniere’s disease
acute attacks: prochlorperazine (either buccal or IM)
prevention: betahistine
mx of bilateral nasal polyps
topical corticosteroids
what is meant by double-sickening in sinusitis
initial viral sinusitis worsens due to a secondary bacterial infection
epistaxis mx
- First aid measures, e.g. sit forwards and pinch cartilage. Topical antiseptic, e.g. Naseptin, can be used once bleeding stops following first aid measures
- Cautery if bleeding point visible, if not then packing
- If above fails, sphenopalatine ligation
drugs that cause ototoxicity (FAV Q+A)
Furosemide Aminoglycoside Vancomycin Quinine Aspirin
hearing loss pattern in presbycusis
bilateral high-frequency hearing loss
operation that is performed to repair an unhealing tympanic membrane
myringoplasty
causes of gingival hyperplasia
PANIC
Phenytoin AML Nifedipine and amlodipine Inherited and idiopathic Ciclosporin
mx of vestibular neuronitis
vestibular rehabilitation exercises
short oral course of prochlorperazine (or an antihistamine)