Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine Finals > ENT > Flashcards

ENT Flashcards

1
Q

What is acute otitis media and what are the most common causative organisms?

A

Acute middle ear infection

Most common cause = strep pneumonia or haemophilus influenzae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How does acute otitis media present?

A

Ear pain

Reduced hearing

Fever

Cough/coryza/sore throat

If tympanic membrane has ruptured - discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is seen on otoscopy in acute otitis media?

A

Bulging red tympanic membrane

Dull/absent light reflex (due to middle ear effusion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are indications for antibiotics for acute otitis media?

A

Symptoms lasting more than 4 days

Systemically unwell

Immunocompromised

<2 years + bilateral otitis media

Perforation/discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What antibiotic is used for acute otitis media?

A

Amoxicillin

Clarithromycin if pen allergic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are complications of acute otitis media?

A

Perforation of the tympanic membrane

Labyrinthitis

Mastoiditis –> urgent ENT referral needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is otitis externa and what are the most common causative organisms?

A

Inflammation of the outer ear

Organisms = Pseudomonas / staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does otitis externa present?

A

Ear pain

Itching

Discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is seen on otoscopy in otitis externa?

A

Normal tympanic membrane

However often not able to be visualised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How is otitis externa managed?

A

Topical Neomycin + Dexamethasone

If tympanic membrane is perforated has to be Clarithromycin + Dexamethasone

If no response -> oral flucloxacillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is malignant otitis externa?

A

Life-threatening form of otitis externa - spreads to the temporal bone and becomes temporal bone osteomyelitis

found in immuno-compromised people esp. diabetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does malignant otitis externa present?

A

Deep-seated severe ear pain

Temporal headaches

Purulent discharge

May be cranial nerve palsies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How is malignant otitis externa managed?

A

ENT referral for IV Abx/debridement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is acute sinusitis and how does it present?

A

Inflammation of the facial sinuses

Facial pressure which is worse on bending forewards

Thick, purulent nasal discharge

Nasal obstruction

Tenderness of the affected areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is acute sinusitis managed?

A

Supportive

If symptoms have not improved after 10 days - intranasal corticosteroids can be tried

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is allergic rhinitis and how does it present?

A

Inflammatory disorder of the nose (sensitised to dust mites/grass/pollen)

Sneezing

Bilateral nasal obstruction

Clear nasal discharge

Nasal pruritus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is allergic rhinitis managed?

A

Anti-histamines e.g. Cetirizine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is chronic rhinosinusitis? How does it present?

A

Inflammatory disorder of the paranasal sinuses

Facial pain worse on bending forwards

Nasal obstruction

Symptomsneed to have been present for at least 12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When do nasal polyps/chronic rhinosinusitis require referral for 2WW?

A

If unilateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the most common bacterial cause of acute tonsillitis?

A

Group A strep (Strep pyogenes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How does acute tonsillitis present?

A

Red, inflamed, enlarged tonsils

+/- exudae

+/- fever

+/- cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the Centor criteria?

A

Estimates probability of acute tonsillitis being bacterial

Fever

Exudate

Lymphadenopathy

Absence of cough

If 3 or more = abx indicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the antibiotic of choice for acute tonsillitis?

A

Penicillin V

If pen allergic = Clarithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the indications for tonsillectomy?

A

7 episodes in a year
5 episodes every year for 2 years
3 episodes every year for 3 years

Enlarged tonsils causing difficulty

Recurrent abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

When is post-tonsillectomy bleeding a cause for concern?

A

If bleeding occurs less than 24 hours post surgery -> immediate return to surgery

If occurs more than 24 hours post surgery -> antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is Quinsy and how does it present?

A

Peritonsillar abscess (complication of untreated bacterial tonsillitis)

Symptoms of tonsillitis

Trismus - patient unable to open mouth

UNILATERAL Swelling + erythema

Patient will be extremely unwell - fever, tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How is Quinsy managed?

A

Admit for incision and drainage + abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How should post-tonsillectomy bleeding be managed as an F1?

A

Call ENT reg

Get IV access - take bloods (FBC, clotting, group and save, cross match)

Nil by mouth in case surgery is needed

If severe bleeding- anaesthetics should be called

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the causative organism for glandular fever?

A

Epstein-barr virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How does glandular fever present?

A

Triad of sore throat, fever and lymphadenopathy

Malaise

Palatal petechiae

Splenomegaly - at risk of splenic rupture

Deranged LFTs

Lymphocytosis

Haemolytic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What blood test results may be seen in glandular fever?

A

Deranged LFTs

Lymphocytosis

Haemolytic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which antibiotics should you not give to someone with glandular fever and why?

A

Ampicillin/Amoxicillin

Causes a maculopapular pruritic rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How is glandular fever diagnosed? When should the test be conducted?

A

Monospot test

Conduct in 2nd week of illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How is glandular fever managed?

A

Supportive

Advise patients to avoid contact sports for 4 weeks due to risk of splenic rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is otosclerosis and how does it present?

A

Otosclerosis = remodelling of the bones in the middle ear

Causes conductive hearing loss

Presents as hearing loss and tinnitus (usually mainly difficulty which lower pitched sounds)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Which hearing problem causes issues with lower pitched sounds?

A

Otosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is seen on otoscopy in otosclerosis?

A

Normal tympanic membrane

May be flamingo pink tinge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

How is otosclerosis managed?

A

Hearing aid/stapedectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How does Meniere’s disease present?

A

Triad - hearing loss, tinnitus and vertigo

Symptoms come on episodes

Most prominent symptom = vertigo

Symptoms are usually unilateral

Feeling of fullness/pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What medication is used for acute management of Meniere’s, and what is used as prevention?

A

Acute attacks = Prochlorperazine

Prophylaxis = Betahistine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is classed as sudden sensorineural hearing loss? How is investigated? How is it managed?

A

Hearing loss over less than 72 hours

Referral to ENT for investigation with audiometry

Oral or intra-tympanic high-dose corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

How does Eustachian tube dysfunction present?

A

Often a recent URTI

reduced/altered hearing

Popping noises

Sensation of fullness

Pain/discomfort

Tinnitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is benign paroxysmal positional vertigo? How is it diagnosed and how is it treated?

A

Sudden onset of vertigo triggered by movement of head position (e.g. rolling over in bed)

Symptoms settle after 20-60 seconds

Diagnosis = Dix-Hallpike manoeuvre will show rotary nystagmus

Management = Epley manoeuvre

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is vestibular neuronitis?

A

Inflammation of the vestibular nerve which develops following a viral infection

45
Q

How does vestibular neuronitis present?

A

Recurrent vertigo

Nausea/vomiting

Horizontal nystagmus

NO HEARING LOSS OR TINNITUS

46
Q

How is vestibular neuronitis and labyrinthitis differentiated?

A

Labyrinthitis = vertigo, hearing loss, tinnitus

Vestibular neuronitis = just vertigo

47
Q

How is vestibular neuronitis managed?

A

Short course of Prochlorperazine (up to 3 days)

if no improvement -> vestibular rehabilitation

48
Q

What is labyrinthitis?

A

Inflammatory disorder of the labyrinth usually secondary to a viral infection e.g. otitis media/meningitis

49
Q

How does labyrinthitis present?

A

Recent URTI

Acute onset vertigo

Sensorineural hearing loss

Tinnitus

Horizontal nystagmus

50
Q

How is labyrinthitis managed?

A

Self-limiting

Prochlorperazine can provide symptomatic relief

51
Q

What is an acoustic neuroma/vestibular schwannoma?

A

Benign tumour of the Schwann cells of the vestibulocochlear nerve

52
Q

What condition is associated with bilateral acoustic neuromas?

A

Neurofibromatosis type II

53
Q

How does an acoustic neuroma present?

A

Gradual onset

Unilateral sensorineural hearing gloss

Tinnitus

Dizziness

Imbalance

Sensation of fullness

54
Q

What is a characteristic finding of acoustic neuroma?

A

Absent corneal reflex

55
Q

What is a cholesteatoma?

A

A benign growth of squamous epithelial cells deep inside ear

56
Q

How does a cholesteatoma present?

A

Foul-smelling, non-resolving discharge

Conductive hearing loss

57
Q

What is seen on otoscopy in cholesteatoma?

A

Attic crust (brown dried skin in the upper eardrum?

58
Q

How is a cholesteatoma managed?

A

Any discharge which does not respond to abx should be referred to ENT

59
Q

What is Ramsay Hunt syndrome?

A

Syndrome caused by herpes zoster virus - when a shingles outbreak occurs in the facial nerve distribution

Ear pain

Lower motor neurone facial nerve palsy (forehead not spared)

Vesicular rash around the ear

60
Q

How is Ramsay Hunt syndrome managed?

A

Oral aciclovir + oral prednisolone

61
Q

What is the most common site for a nose bleed to originate from?

A

Little’s area (in the Kiesselbech’s plexus)

62
Q

What are common triggers for epistaxis?

A

Nose picking

Colds

Sinusitis

Trauma

Changes in weather

Coagulation disorders

Cocaine use

63
Q

How is a nose bleed managed?

A

Tilt head forwards

Pinch nose for up to 20 mins

If bleeding does not stop…

If source of bleed is visible -> Cautery

If source of bleed is not visible -> packing

64
Q

What does a bilateral nose bleed suggest?

A

More likely to be a posterior source of bleeding

65
Q

What are features of nasal polyps?

A

Nasal obstruction

Snoring

Anosmia

Usually bilateral - if unilateral it is suggestive of tumours

66
Q

How are unilateral nasal polyps managed?

A

Urgent referral to ENT

67
Q

What conditions are associated with nasal polyps?

A

Samter’s triad

Asthma

Cystic fibrosis

Eosinophilic GPA

68
Q

How are nasal polyps managed?

A

Topical corticosteroids

Polypectomy

69
Q

What is presbycusis and how does it present?

A

Sensorineural hearing loss which affects the elderly

Usually affects higher frequency first e.g. female voices

Difficulty using telephone

70
Q

How can you tell the difference between a thyroid swelling and a thyroglossal cyst?

A

Thyroid swelling - moves upward on swallowing

Thyroglossal cyst - moves upward on protrusion of tongue

71
Q

Neck lump: dysphagia, regurgitation, halitosis?

A

Pharyngeal pouch

72
Q

Neck lump: evident at birth, soft, transilluminates?

A

Cystic hygroma

73
Q

Neck lump: presents in childhood, infront of sternocleidomastoid, does not transilluminate?

A

Branchial cyst

74
Q

Neck lump: firm swelling with weakness/numbness?

A

Cervical rib

75
Q

Neck lump which moves upwards on swallowing?

A

Thyroid swelling

76
Q

Neck lump which moves upwards on protrusion of the tongue?

A

Thyroglossal cyst

77
Q

What are risk factors for head + neck cancers?

A

Smoking

Alcohol

HPV

EBV

78
Q

What are red flags for head and neck cancers?

A

Lump in the mouth or on lip

Unexplained mouth ulceration persisting for more than 3 weeks

Erythroplakia or Leukoplakia

Unexplained hoarse voce

Unexplained thyroid lump

79
Q

What type of cancer are head and neck cancers usually?

A

Squamous cell carcinoma

80
Q

What is a normal Rinne’s test result and what does an abnormal test mean?

A

Normal result = air conduction > bone conduction

Conductive hearing loss = bone conduction > air conduction

81
Q

How can you interpret Weber’s test?

A

Sensorineural deafness = louder in non-affected ear

Conductive deafness = louder in affected ear

82
Q

What is a cervical rib and how can it present?

A

An extra rib above first rib
Can be felt as a lump in the neck
Can lead to thoracic outlet syndrome

83
Q

Whens should otitis externa be referred to ENT?

A

Non-resolving + worsening pain

84
Q

What is the usual causative organism of malignant otitis externa?

A

Pseudomonas

85
Q

Management for otitis externa + perforation?

A

Topical clarithromycin+dexamethasone

86
Q

What is sialdenitis? How is it treated?

A

Inflammation of the salivary glands due to viral/bacterial infection

Treated w/ Abx + oral hygiene advice.

87
Q

How should noise-induced hearing loss be treated?

A

Hearing aid

88
Q

What is the hereditary pattern of otosclerosis?

A

Autosomal dominant

89
Q

Which salivary gland swelling can cause facial nerve palsy?

A

Malignant tumours – e.g. Adenoic cystic carcinoma

90
Q

What is the most common benign salivary tumour?

A

Pleomorphic adenoma

91
Q

What are symptoms of a thyroid lump?

A 
Voice hoarseness
Difficulty swallowing – dysphagia, painful swallow
Airway compromise
Weight loss
Low-grade fever
May be cervical lymphadenopathy
92
Q

Which type of head and neck cancer is most associated with HPV?

A

Oropharyngeal squamous cell carcinoma

93
Q

What does loss of corneal reflex suggest?

A

Vestibular schwannoma/acoustic neuroma

94
Q

When should a hoarse voice be investigated?

A

If it has lasted more than 3 weeks

95
Q

What is the most common cause of hearing impairment post head injury?

A

Perforated tympanic membrane

96
Q

What can you prescribe for epistaxis to reduce crusting?

A

Topical antiseptic e.g. Naseptin (chlorhexidine + neomycin)- caution in peanut allergies

97
Q

What is seen during Dix-Hallpike manoevure in BPPV?

A

Vertigo + Rotary nystagmus

98
Q

How is an auricular haematoma managed?

A

Require same day ENT assessment for incision ad drainage

99
Q

How can you manage epistaxis which has failed all emergency management?

A

Ligation of the sphenopalatine artery in theatre

100
Q

How does a nasal septal haematoma present and how should it be managed?

A

Head/facial trauma- may be relatively minor

Bilateral red boggy swelling from nasal septum

Surgical drainage + IV Abx

101
Q

What is Ludwig’s Angina and how is it managed?

A

Type of progressive cellulitis which affects the floor of the mouth and the soft tissues of the neck- presents with neck swelling, dysphagia and fever

needs emergency airway management = IV Abx
Preauricular sinus

102
Q

What is glue ear?

A

Otitis media with effusion

103
Q

What are risk factors for glue ear?

A 
Male
Family history
Bottle feeding
Parental smoking
Eustachian tube dysfunction
Down syndrome
104
Q

How does glue ear present?

A

Hearing loss
Most common cause of conductive hearing loss in children
May be secondary problems e.g. speech and language delay

105
Q

How is glue ear treated?

A

Grommet insertion or Adenoidectomy

106
Q

Which drugs can cause hearing loss?

A 
Gentamicin/Vancomycin
Furosemide
Sildenafil
Aspirin
Quinines
107
Q

How are acoustic neuromas diagnosed?

A

MRI of the cerebellopontine angle

108
Q

What is the 2WW criteria for laryngeal cancer?

A

> 45 + persistent unexplained hoarse voice

>45 + unexplained lump in neck

Medicine Finals (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions