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MSRA > ENT > Flashcards

ENT Flashcards

1
Q

How are nasal septal haematomas managed?

A

Incision, drainage and Abx

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2
Q

Why are nasal septal haematomas managed aggressively?

A

Because of the risk of septal necrosis within 3-4 days - this can then result in ‘saddle-nose’ deformity

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3
Q

What is the audiogram conduction pattern in sensorineural hearing loss?

A

Both air and bone conduction are impaired

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4
Q

What is the audiogram conduction pattern in conductive hearing loss?

A

Only air conduction is impaired

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5
Q

What is the audiogram conduction pattern in mixed hearing loss?

A

Both air and bone conduction are impaired, air tending to be worse than bone

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6
Q

What is the difference between viral labyrinthitis and vestibular neuritis?

A

Viral labyrinthitis = hearing loss

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7
Q

Describe the nystagmus in viral labyrinthitis:

A

Spontaneous, unidirectional, horizontal and towards the unaffected side

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8
Q

How can epistaxis be managed if packing fails?

A

Surgically, by means of a sphenopalatine ligation

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9
Q

What is the name of the plexus of blood vessels in the nose that can be responsible for anterior epistaxis?

A

Kiesselbach’s plexus

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10
Q

What pathologies can present with epistaxis?

A

Splenomegaly
Leukaemia
Waldenstrom’s macroglobulinaemia
ITP
Juvenile angiofibroma - adolescent males
Hereditary haemorrhagic telangiectasia - elderly
Granulomatosis with polyangiitis
Pyogenic granuloma

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11
Q

In which patient groups should you use Naseptin with caution?

A

Peanut, soy or neomycin allergies

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12
Q

What is an alternative to Naseptin?

A

Mupirocin

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13
Q

What activities should be avoided to reduce the risk of re-bleeding after a period of epistaxis?

A

Blowing or picking the nose
Heavy lifting
Exercise
Lying flat
Drinking alcohol or hot drinks

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14
Q

What are the Centor criteria?

A

Presence of tonsillar exudate
Tender anterior cervical lymphadenopathy or lymphadenitis
Fever
Absence of cough

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15
Q

What is the chance of isolating strep with a Centor score of 0-2?

A

3-17%

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16
Q

What is the chance of isolating strep with a Centor score of 3-4?

A

32-56%

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17
Q

What are the FeverPAIN criteria?

A

Fever over 38°C
Purulence (pharyngeal/tonsillar exudate)
Attend rapidly (3 days or less)
Severely Inflamed tonsils
No cough or coryza

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18
Q

What is the alternative to phenoxymethylpenicillin for those that are penicillin allergic?

A

Clarithromycin

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19
Q

How would normal hearing present on Rinne’s and Weber’s testing?

A

Rinne’s - A>B bilaterally
Weber’s - midline

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20
Q

How would sensorineural hearing loss present on Rinne’s and Weber’s testing?

A

Rinne’s - A>B bilaterally
Weber’s - lateralises to unaffected ear

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21
Q

How would conductive hearing loss present on Rinne’s and Weber’s testing?

A

Rinne’s - B>A in affected ear, A>B in unaffected ear
Weber’s - lateralises to affected ear

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22
Q

What is Samter’s Triad?

A

Asthma
Aspirin sensitivity
Nasal polyposis

23
Q

How is otosclerosis inherited?

A

Autosomal dominantly

24
Q

What type of hearing loss does otosclerosis cause?

A

Conductive

25
Q

What type of hearing loss does Stickler syndrome cause?

A

Sensorineural

26
Q

What is the triad of Meniere’s disease?

A

Vertigo
Hearing loss
Tinnitus

27
Q

What is a branchial cyst?

A

An oval, mobile cystic mass that develops between the sternocleidomastoid muscle and the pharynx
Develop due to failure of obliteration of the second branchial cleft in embryonic development

28
Q

How would a thyroid lump move on swallowing?

A

Upwards

29
Q

How would a thyroglossal cyst move on protrusion of tongue?

A

Upwards

30
Q

Which manoeuvre diagnoses BPPV?

A

Dix-Hallpike

31
Q

Which manoeuvre treats BPPV?

A

Epley

32
Q

How should simple otitis externa be managed?

A

Mild (no signs of hearing loss/discharge) - topical acetic acid
Severe - combined topical Abx/steroid

33
Q

How do you manage Ramsay-Hunt Syndrome?

A

Oral aciclovir and steroids

34
Q

What is the likely cause of recurrent otitis externa?

A

Candida albicans

35
Q

At what frequency do patient’s with noise-induced hearing loss ‘trough’ - before recovery - on audiogram?

A

4000Hz

36
Q

How do you treat patient’s at the severer end of otitis externa?

A

1/52 of topical Abx +/- steroid

37
Q

From what vessels does posterior epistaxis originate?

A

Sphenopalatine artery

38
Q

What is Schwartz’s sign indicative of?

A

Otosclerosis

39
Q

How is tonsillitis treated?

A

Phenoxymethylpenicillin 10 days

40
Q

What is sialolithiais?

A

An obstructing salivary stone - most commonly occurs in the submandibular gland, characteristically produces pain and swelling after eating

41
Q

What are the different types of thyroid cancer?

A

Papillary - 60-70% - young patients, betwen 20-40, lymphatic spread, excellent prognosis
Follicular - 20-25% - middle-aged patients, blood spread, good prognosis
Anaplastic - 10-15% - elderly patients, aggressive local extension, poor prognosis
Medullary (C-cell) - 5-10%, usually elderly, but sometimes familial

42
Q

How does chrondrodermatitis nodularis present?

A

Solitary firm nodule with a central crust and surrounding erythema, usually unilateral and tender, may be difficult to sleep on affected side

43
Q

How does relapsing polychondritis present?

A

Recurrent episodes of cartilage inflammation, with or without destruction. Inflammation tends to spare lobes of ear (because of lack of cartilage) and looks like cellulitis. Can lead to cauliflower ears/saddle deformity of the nose

44
Q

What is the most common type of oropharyngeal cancer?

A

SCC

45
Q

What are the most common causative organisms in a peritonsillar abscess?

A
  1. Streptococcus pyogenes
  2. Viridans strep/S. aureus/Haemophilus
46
Q

When should children be referred to ENT for consideration for grommets?

A

If they have BILATERAL otitis media with effusion (also known as glue ear) or severe hearing loss –>refer to ENT + give Abx (also give Abx if there is evidence of perforation in unilateral disease)

47
Q

When should patient’s with sudden-onset sensorineural hearing loss (SSNHL) be referred to ENT?

A

For same-day assessment

Majority of cases re idiopathic, but MRI will be performed to exclude vestibular schwannoma. High-dose steroids are used in all patients with SSNHL

48
Q

Which drugs may be responsible for tinnitus?

A
  1. Aspirin/NSAIDs
  2. Loop diuretics
  3. Aminoglycosides
  4. Quinine
49
Q

What are the causes of gingival hyperplasia?

A
  1. Phenytoin
  2. Ciclosporin
  3. Calcium channel blockers
  4. AML
50
Q

What do you use to treat otitis externa in diabetics, and why?

A

Ciprofloxacin, to cover against pseudomonas

51
Q

Should a suspected diagnosis of Meniere’s be confirmed by ENT?

A

Yes –> routine referral

52
Q

When should antibiotics be given in otitis media?

A
  1. Sx > 4 days or not improving
  2. Systemically unwell but not requiring admission
  3. Immunocompromise/high risk of complications
  4. <2y/o with b/l otitis media
  5. Otitis media with perforation and/or discharge in the canal
53
Q

How is the diagnosis of mastoiditis made, and how is it treated?

A

Clinically
With IV abx

MSRA (18 decks)

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