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ENT/Ophthalmology > ENT > Flashcards

ENT Flashcards

1
Q

Give 4 criteria for an urgent suspicion of head and neck cancer referral

A
  • Hoarseness >6 weeks
  • Ulceration/swelling of oral mucosa >3 weeks
  • Dysphagia
  • Neck lumps >3 weeks
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2
Q

Why can laryngeal cancer present with hoarseness?

A

Tumour prevents vocal cords moving normally

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3
Q

What is the most common type of head and neck cancer?

A

Squamous cell carcinoma

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4
Q

Give 3 differentials for a midline neck mass

A
  1. Thyroglossal duct cyst
  2. Thyroid nodules
  3. Diffuse goitre
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5
Q

Give 3 differentials for a lateral neck mass

A
  1. Malignant lymphadenopathy
  2. Parotid lump
  3. Branchial cysts
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6
Q

Which 2 malignancies are most commonly associated with dysphagia?

A

Laryngeal and Lung (tumour infiltrating recurrent laryngeal nerve)

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7
Q

Which 2 groups of people should you have a high index of suspicion for when presenting with otitis media with effusion?

A

Young South-East Asian men = nasopharyngeal carcinoma

Middle aged adults = Neck nodules

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8
Q

Give 3 red flags for sinonasal cancers

A
  • Unilateral symptoms
  • Blood stained discharge
  • Dental/orbital signs e.g. loose teeth
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9
Q

Which vessels are branches of the external carotid artery?

A
  • Sphenopalatine
  • Greater palatine
  • Superior labial
  • Lateral nasal
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10
Q

Which vessels are branches of the internal carotid artery?

A

Anterior and posterior ethmoidal

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11
Q

Which 4 vessels comprise the Kiesselbach’s plexus? (GASS)

A

Greater Palatine
Anterior ethmoidal
Sphenopalatine
Superior labial

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12
Q

Give 5 causes of epistaxis

A
  • Trauma
  • Nasal septal deviation
  • Inflammation
  • Malignancy
  • Foreign body
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13
Q

What are the 1st aid measures for epistaxis?

A

Trotter’s method: upright position and leaning forward
o Head forward over bowl
o Pinch soft part of nose
o Ice over bridge/back of neck/ in mouth for vasoconstriction

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14
Q

Give 3 medical management options for epistaxis

A
  • Silver nitrate cautery
  • Diathermy cautery
  • Nasal packing
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15
Q

Give 2 secondary care interventions for epistaxis

A
  • Suction clot

- Spray local anaesthetic

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16
Q

What is a septal haematoma and why does it need immediate management?

A

Blood collection under lining of nose which can become infection = septal perforation and nasal collapse (Saddle deformity)

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17
Q

Give 4 points in the management of a septal haematoma

A
  1. Anaesthetic
  2. Incise
  3. Drain
  4. Pack
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18
Q

Give 3 complications of sinusitis

A
  • Periorbital cellulitis
  • Potts Puffy tumour
  • Intracranial sepsis
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19
Q

Define allergic rhinitis and its cause

A

Nasal obstruction causing sneezing and watery eyes due to IgE mediated reaction to inhaled allergens

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20
Q

Give 3 management options for allergic rhinitis

A
  1. Non-sedative antihistamine
  2. Nasal decongestant
  3. Allergen avoidance
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21
Q

What is chronic rhinosinusitis?

A

Inflammation of nose + sinuses with nasal obstruction or nasal discharge +/- facial pain

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22
Q

Give 4 red flag symptoms in chronic rhinosinusitis

A
  • Periorbital oedema
  • Double vision
  • Severe headache
  • Bleeding
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23
Q

What is a septal deformity and what surgery can be used to correct it?

A

Unilateral nasal obstruction treated by septoplasty

24
Q

Give 3 causes of septal perforation

A
  1. Trauma
  2. Malignancy
  3. Cocaine use
25
Q

Give 2 medical management options for septal perforation

A

Saline rinses

Emollients

26
Q

Give 4 differentials for facial pain

A
  • Migraine
  • TMJ problem
  • Trigeminal neuralgia
  • Sinusitis (10%)
27
Q

Which symptoms does a patient need to have to have sinusitis?

A

Nasal blockage +/- discharge

28
Q

Which antibiotic should be given in tonsillitis?

A

Penicillin B or erythromycin

29
Q

Define Ludwig’s angina

A

Infection of the deep neck space of a dental origin

30
Q

Give 3 risks of oral cancer

A

Smoking
Alcohol excess
Betel

31
Q

Which virus is implicated in oropharyngeal cancer?

A

HPV 16

32
Q

Which test is used to test newborn hearing in Scotland?

A

Automated Brainstem Responses

33
Q

How many words should a 2 year old know?

A

150-300 words

34
Q

How many words should a 3 year old know?

A

900-1000 words

35
Q

What should be done for all children with delayed speech?

A

Hearing test

36
Q

Define otitis media with effusion (glue ear)

A

Middle ear fluid for at least 3 months in absence of overt signs of infection

37
Q

Why is otitis media with effusion more common in children?

A

Shorter Eustachian tube means less distance for fluid to travel

38
Q

Give 4 risks of otitis media with effusion

A
  • Parental smoking
  • Bottle feeding
  • Nursery attendance
  • Low SE status
39
Q

What is the management of glue ear?

A

Watch and wait with 3 month follow up

Persistent: grommets and hearing aids

40
Q

Define acute otitis media

A

Inflammation of middle ear = infected effusion and presenting most often with local symptoms e.g. URTI, otalgia

41
Q

What is the management strategy for acute otitis media?

A

48-72hrs: watch and wait

If not resolved: 5 days amoxicillin

42
Q

Define recurrent acute otitis media

A

3 or more episodes in 6 month

OR

4 in a year

43
Q

What is the name of the congenital abnormality when the external ear fails to develop?

A

Microtia

44
Q

What is usually the cause of chronic otitis media?

A

Perforation of tympanic membrane

45
Q

What is a cholesteatoma?

A

Skin cells collecting in the middle ear and becomes infected, releasing enzymes to destroy ossicles

46
Q

What is the treatment of a cholesteatoma?

A

Surgery to excise

47
Q

Give 4 risks of tympanomastoid surgery

A
  • Hearing loss
  • Dizziness
  • Taste alteration
  • Facial nerve palsy
48
Q

Give 3 subjective hearing tests for children and the ages at which they are performed

A
  • Distraction testing 6-9 months
  • Visual response audiometry 9-24 months
  • Play audiometry >24 months
49
Q

Give 3 objective hearing tests for children

A
  • Otoacoustic emissions
  • Auditory brainstem response
  • Tympanometry
50
Q

Give 5 signs of increased WOB in children

A
  • Nasal flaring
  • Tracheal tug
  • Head bobbing
  • Grunting
  • Subcostal recessions
51
Q

Define Choanal atresia

A

Congenial condition which is neonatal emergency, holes at the back of the nose closed off by bony deformity

52
Q

What is the most common cause of stridor in infants?

A

Laryngomalacia

53
Q

Define Laryngomalacia

A

Floppiness of the airway with a curled epiglottis = obstructed airway

54
Q

What is the difference between stertor and stridor?

A

Stertor: above larynx
Stridor: larynx and below

55
Q

Give 2 causes of midline neck lumps in children

A

Thyroglossal duct cysts

Thyroid mass

56
Q

Give 2 causes of lateral neck lumps in children

A

Reactive lymph nodes

Lymphoma

ENT/Ophthalmology (2 decks)

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