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Y3 GP Tutorials > ENT > Flashcards

ENT Flashcards

1
Q

Meniere’s Disease presentation

A

episodic sudden onset vertigo
low frequency hearing loss
low frequency roaring tinnitus
sensation of fullness in ear

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2
Q

Meniere’s Disease pathophysiology

A

over production / impaired absorption of endolymph in inner ear
possibly: viral infection / autoimmunity / allergies

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3
Q

Meniere’s Disease investigation

A

Ref to ENT

- sensorineural HL

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4
Q

Meniere’s Disease management

A 
No cure
v Pressure: diet, thiazide diuretics
Sx: antihistamines, benzo, phenothiazine, anticholinergics
HL management: corticosteroids
Intratympanic therapy
Meniett device
Rehabilitation therapy 
Inform DVLA (X driving - sudden onset vertigo)
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5
Q

Presbycusis pathophysiology

A

age related SN HL

progressie and irreversible damage to hair cells of organ of Corti > impaired hearing

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6
Q

Presbycusis clinical features

A

progressive BL HL (higher frequencies)
> 60 y/o
difficulty hearing
linked to depression + social isolation

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7
Q

Presbycusis investigations

A

pure tone audiometry

speech audiometry

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8
Q

Presbycusis management

A

hearing aids
speech to text
cochlear implants
family support

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9
Q

Mastoiditis pathophysiology and causes

A

infection of mastoid air cells surrounding middle + inner ear

  • AOM / COM
  • choleasteoma
  • mastoid bone injury
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10
Q

Mastoiditis management

A

Abx
myringotomy
mastoidectomy

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11
Q

Mastoiditis complications

A 
facial paralysis 
labrynthitis (n/v, vertigo)
cerebral blood clots > headaches, visual changes
cerebral abscess
meningitis
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12
Q

Cholesteatoma features

A

abnormal growth of skin cells in middle ear / mastoid air cells > disruption of ossicles and tympanic membrane => hearing loss / tinnitus, purulent discharge, +/- TM perf

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13
Q

Cholesteatoma investigations

A 
TM retraction pocket / perf
crust / kertainisation 
mass behind TM
purulent discharge
Conductive HL + abnormal audiogram
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14
Q

Cholesteatoma management

A

routine ENT referral (semi-urgent) - surgery

Aural discharge: topical Abx

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15
Q

Acute sinusitis pathogen

A

aka rhinosinusitis

= viral URTI

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16
Q

Acute sinusitis features

A 
<12 weeks presentation (> is chronic)
nasal blockage
discharge
pain / headache
cough 
discharge + oedema
fever
17
Q

acute sinusitis complications

A

polyps
cerebral abscess
meningitis

18
Q

acute sinusitis management

A

consider Abx
symptomatic management
adv re natural course of infection
ENT ref if sev / atypical sx

19
Q

chronic sinusitis management

A

IN corticosteroids
nasal irrigation
ENT ref if sev / atypical sx
LT Abx

20
Q

thyrotoxicosis management

A

carbamazepine
beta blocks (sx)
surgery
radioactive iodine

21
Q

how to differentiate vestibular neuritis and labrynthitis

A

both inflammation of vestibulocochlear nerve
vestibular neuritis = x tinnitus / HL
labrynthitis = tinnitus + HL

22
Q

labrynthitis features

A 
= inflammation of vestibulocochlear nerve due to viral / bac infection 
sev vertigo
HL
tinnitis
nystagmus
n/v
anxiety
malaise
23
Q

Labrynthitis investigations

A

diagnosis of exclusion
= nystagmus, hearing + balance test, neurological examination
= complete history + viral URTI history

24
Q

Labrynthitis management

A

typically self limiting 4-6 weeks

nausea: antihistamines + antiemetics
ref: vestibulocochlear rehabilitation

25
Q

Allergic rhinitis pathophysiology

A

inflammatory condition of the URT

IgE associated response to environmental allergens

26
Q

Nasal polyps management

A

IN corticosteroids
nasal saline irrigation
nasal polypectomy

27
Q

Allergic rhinitis management

A

Allergen avoidance
antihistamines (oral / IN)
IN corticosteroids
LTRA

28
Q

BPPV =

A

benign paroxysmal positional vertigo

29
Q

BPPV pathophysiology and causes

A

= otoliths (abnormal crystals) > semicircular canals, movement disrupts laminar flow of endolymph and + follicular hair cells > interpreted as movement => vertigo

idiopathic, inner ear disorders, surgery

30
Q

BPPV clinical features

A 
dizziness + vertigo
n/v
nystagmus
balance problems
post sudden movement (temporary but sudden onset)
31
Q

BPPV investigations

A

electronyastamography ie. record nystagmus

MRI (to detect other inner ear disorders)

32
Q

BPPV management

A

spontaneous resolvement

  • sx: antihistamines + antiemetics
  • Canalith respositionning
  • Epley maneuver
  • change lifestyle (movements / sports / diet)
  • soft collar support
  • surgery = canal plugging
33
Q

Nasal fracture complications

A

septal haematoma

req urgent drainage

34
Q

Vestibulopathy pathophysiology

A

damage to inner ears

=> dizziness, imbalance, nausea, visual problems, hearing loss, high falls risk

Y3 GP Tutorials (9 decks)

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