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Finals > ENT > Flashcards

ENT Flashcards

1
Q

Describe the origin of epistaxis

A

Originates from Kiesselbach’s plexus which is also known as little’s area

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2
Q

What is the management of epistaxis?

A

Sit up
Tilt head forward

If doesn’t stop after 15 mins:
Nasal packing
Nasal cautery

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3
Q

What is benign paroxysmal positional vertigo?

A

Most common cause of vertigo characterised by sudden onset dizziness and vertigo triggered by changes in head position.

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4
Q

What are the features of BPPH?

A

Vertigo triggered by change in head position
Nausea
Episode typically lasts 10-20s
Positive Dix-Hallpike manoeuvre (Vertigo and nystagmus)

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5
Q

What is the management of BPPV?

A

Usually resolves spontaneously after few weeks-months

Epley manoeuvre

Betahistine

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6
Q

What is the causative organism in epiglottitis?

A

Haemophilus influenza type B

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7
Q

What is the presentation of Epiglottitis?

A 
Sore throat and stridor
Drooling
Tripod position
High fever
Difficulty or painful swallowing
Septic and unwell appearance
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8
Q

What are the investigation and diagnosis for epiglottitis?

A

Lateral xray of neck: thumb sign or thumbprint sign

Diagnosis: direct visualisation only by senior/airway trained staff

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9
Q

What is the management of epiglottitis?

A

Intubate
IV antibiotics (cefrtriaxone)
Steroids (dexamethasone)

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10
Q

What is infectious mononucleosis?

A

Caused by EBV.

Spread by saliva

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11
Q

What are the features of infectious mononucleosis?

A 
Fever
Sore throat
Fatigue
Lymphadenopathy
Tonsillar enlargement
Splenomegaly

Rash following antibiotics (amoxicillin or cefalosporins)

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12
Q

What are the investigations for infectious mononucleosis?

A

Monospot test
Paul-Bunnell test

Specific antibody test

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13
Q

What is the management of infectious mononucleosis?

A

Usually self limiting - lasting 2-3 wks

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14
Q

What is the complications of infectious mononucleosis?

A

Burkitt’s lymphoma is associated with EBV

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15
Q

What is labyrinthitis?

A

Inflammatory disorder of the membranous labyrinth affecting both vestibular and cochlear end organs

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16
Q

What is the presentation of labyrinthitis?

A 
Vertigo
N+V
Hearing loss
Tinnitus
Preceding or concurrent sy of URTI
17
Q

What are the signs of labyrinthitis?

A

Spontaneous horizontal nystagmus
Sensorinueral hearing loss
Abnormal head impulse test
Gait disturbance

18
Q

What is the diagnosis and management of labyrinthitis?

A

Largely based on history and examination

Management:
Usually self-limiting
Prochlorperazine or antihistamines

19
Q

What is meniere’s disease?

A

Disorder of the inner ear characterised by excessive pressure and progressive dilation of the endolymphatic system.

20
Q

What are the features of meniere’s disease?

A

Recurrent vertigo, tinnitus and hearing loss
Sensation of aural fullness or pressure
Nystagmus and positive romberg test
Episodes last min-hours
Typically unilateral but can become bilateral

21
Q

What is the diagnosis and management of meniere’s disease?

A

ENT assessment required to confirm diagnosis

Patient informs DVLA and stop driving until control of symptoms

Acute: buccal or IM prochlorperazine

Prevention: Betahistine and vestibular rehab exercises.

22
Q

What is otosclerosis and give the inheritance?

A

Replacement of normal bone by vascular spongy bone.

Autosomal dominant and affects young adults

23
Q

What is the features of otosclerosis?

A

Conductive deafness
Tinnitus
normal TM
Positive family history

24
Q

What is the management of otosclerosis?

A

Hearing air

Stapedectomy

25
Q

What is the causative organism of otitis media/

A

Strep Pneumonia is most common cause

Other causes:
Haemophilus influenzae
Moraxella catarrhalis
Staph aureus

26
Q

What is the presentation of otitis media?

A 
Ear pain
Reduced hearing
URTI syndroms
Balance issues
Vertigo
Discharge
27
Q

What is the examination of otitis media

A

Otoscopy shows bulging red inflamed looking membrane.

If perforated: discharge and hole in TM

28
Q

What is the management of otitis media?

A

Resolve without antibiotics unless:
Immunocomprimised, <2yr or otorrhoea = amoxicillin

Simple analgesics

Antibiotics and review if perforated TM

29
Q

What are the features of otitis externa?

A

Ear pain
Itch
Discharge
Otoscopy: red, swollen or eczematous canal

30
Q

What is the management of otitis externa?

A
  1. Topical antibiotic or combined topical antibiotic with a steroid
  2. Consider contact dermatitis secondary to neomycin

Oral antibiotics

Taking a swab

Empirical use of antifungal agent

31
Q

What is sinusitis

A

Can be bacterial or viral. Usually lasts 2-3 weeks and resolves without treatment

32
Q

What is the management of sinusitis?

A

Symptoms <10days = no abs

No improvement after 10 days = 2 weeks high dose steroid nasal spray

No improvement after 10 days and likely bacterial cause = consider delayed or immediate prescription abs

1. Penicillin V for 5 days course
Alternatives:
Clarithromycin
Erythromycin
Doxycycline
33
Q

What is tonsillitis and give the causative agents

A

Inflammation of the tonsils

Most common cause = viral infection

Most common bacteria = Group A strep (strep pyogenes)

Second more common bacteria = Strep pneumonia

34
Q

What are the features of tonsillitis?

A

Sore throat
Painful swallowing
Red, inflamed and enlarged tonsils ± Exudates

35
Q

What is the centor criteria?

A

Used to estimate probability that tonsillitis is due to bacteria

3 or more = abs

Fever >38
Tonsillar exudates
Absence of cough
Tender cervical lymphadenopathy

36
Q

What is the management of tonsillitis?

A

Only if centor score >3 or feverpain score >4 give abs

Pen V for 10 days

Clarithromycin if allergic to penicillin

37
Q

Investigation for achalasia?

A

Oesophageal manometry study

38
Q

Treatment for achalasia?

A

Pneumatic dilation

39
Q

What is the surgical treatment for achalasia?

A

Heller cardiomyotomy

Finals (20 decks)

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