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Dannys Medicine Finals > ENT > Flashcards

ENT Flashcards

1
Q

Where is the problem is conductive hearing loss?

A

due to external / middle ear

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2
Q

Where is the problem is sensorineural hearing loss?

A

due to inner ear / CNVIII

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3
Q

Signs of CHL compared to normal on rinnes test?

A

Normal = air conduction > bone conduction

CHL = bone conduction > air conduction

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4
Q

Signs of CHL and SNHL compared to normal on weber test?

A

Normal =equal

CHL = lateralises to affected ear

SNHL = sound louder in normal ear

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5
Q

Common organisms of Acute Otitis Media and how does it happen?

A

URTI migrates to middle ear via eustachian tube

common organisms : strep pneumoniae and h.influenzae

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6
Q

When should Abx be given in Acute Otitis Media and what is given?

A

Symptoms for more than 4 days, under 2 years old, systemically unwell or perforation

Amoxicillin for 5-7 days

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7
Q

Acute Otitis Media

Common complications?

A

hearing loss

mastoiditis

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8
Q

CHOLESTEATOMA

symptoms?

A

foul smelling brown discharge

hearing loss

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9
Q

CHOLESTEATOMA

signs on otoscopy?

A

Otoscopy

‘attic crust’ - seen in the uppermost part of the ear drum

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10
Q

CHOLESTEATOMA

What congenital abnormality increases the risk?

A

Cleft palate increases the risk by 100 fold

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11
Q

CHOLESTEATOMA

What is it?

A

Growth of keratinising squamous epithelial cells trapped in skull base causing localised destruction

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12
Q

Otitis Externa

What is it commonly known as?

Symptoms?

A

Swimmers ear

SWIM DIP
Discharge
Itch
Pain

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13
Q

Otitis Externa

Common causing bacteria?

A

pseudomonas aeruginosa

staph aureus

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14
Q

Otitis Externa

Treatment?

A

topical antibiotic or a combined topical antibiotic with a steroid

if a pt fails to respond to tx refer to ENT

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15
Q

BPPV

Features?

A

vertigo triggered by change in head position associated with nausea lasting 10-20 seconds

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16
Q

BPPV

Cause?

A

canaliths (crystals) in semi-circular canals

17
Q

BPPV

What test is a positive sign?

A

Hallpike manoeuvre

causes rotatory nystagmus

18
Q

Symptomatic relief of BPPV?

A

Epley manoeuvre (successful in around 80% of cases)

19
Q

Meniere’s Disease

features including Triad?

how long do episodes last and how long may someone have symptoms for?

A

Vertigo
Tinnitus
Sensorineural hearing loss

+ sensation of fullness in the ear

episodes lasting minutes to hours
resolve after 5-10 years

20
Q

What causes Meniere’s Disease

A

Excessive pressure and progressive dilation of the endolymphatic system

21
Q

What is Vestibular Neuronitis

A

cause of vertigo that often develops following a viral infection.

22
Q

Features of Vestibular Neuronitis?

A

vertigo lasting hours - days
nausea and vomiting may be present
horizontal nystagmus is usually present
no hearing loss or tinnitus

23
Q

Management of Vestibular neuronitis?

A

1st - vestibular rehabilitation exercises

2nd - a short oral course of prochlorperazine

24
Q

Most common type of head and neck cancer?

A

Squamous cell carcinomas

25
Q

how can vestibular neuritis be distinguished from Labyrinthitis

A

vestibular neuritis = the vestibular nerve is involved, hence there is no hearing impairment;

Labyrinthitis is used when both the vestibular nerve and the labyrinth are involved, usually resulting in both vertigo and hearing impairment.

26
Q

Features of Labyrinthitis?

A

Patients typically present with an acute onset of:
vertigo: not triggered by movement but exacerbated by movement
nausea and vomiting
hearing loss
tinnitus
preceding or concurrent symptoms of upper respiratory tract infection

27
Q

What causes a Septal Haematoma and what happens if it is left untreated?

A

Trauma

untreated causes irreversible septal necrosis and ‘saddle nose’ deformity

28
Q

Sign of Septal Haematoma

A

Feeling of nasal obstruction and classically, bilateral swelling arising from septum

29
Q

Management of recurrent or chronic sinusitis?

A

avoid allergen
intranasal corticosteroids
nasal irrigation with saline solution

30
Q

What to do if acute sinusitis lasts more than 10 days?

A

intranasal corticosteroids may be considered

31
Q

Epistaxis

common location of bleeds?

A

Anterior (90%) - Klasselbach’s Plexus

Posterior - Woodnuffs Plexus

32
Q

Epistaxis management?

A

1) Lean forward with mouth open and pinch cartilage for 20 mins

2) Cauterise bleeding if it can be visualised
3) Pack the nose if it can’t be visualised

4) Give topical antiseptic (Naseptin) if first aid measures successful

Dannys Medicine Finals (9 decks)

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