ENT Flashcards
what is the common area for epistaxis called
littles area
which blood vessels supply the nose
sphenopalatine artery
internal maxillary
external carotid
management of epistaxis
inv: clotting, inr, fbc, lft, obs iv access G+S if massive sit up lean forwards and pinch nose apply ice pack to bridge of the nose cautery silver nitrate if visable anterior/posterior packing balloon catheters ( probably needed if posterior bleed) ligation / embolisation of bleeding artery (surgery)
2 differentials for tonsillitis
infectious mononucleosis
scarlett fever
why do you give penicillin v instead of amoxicillin in tonsilitis
because if its not tonsillitis and its infectious mononucleosis then amoxicillin will cause a maculopapular rash
what type of cancer does barretts lead to
oesophageal adenocarcinoma
squamous to columnar epithelium metaplasia
describe the pathophys behind vertigo
displacement of otolith in semicircular canals causing endolymph to move abnormally
management of bells palsy
prednisolone
if fever etc can give aciclovir
what type of nystagmus does bppv cause
rotational
3 causative organisms of otitis media
h influenxae
strep pneumonia
moraxella cattarhalis
otoscopy of otitis media
bulging red and dull tympanic membrane
managment of otitis media
amoxicillin and antipyretics
differential for vestibular schwannoma, investigation and management
meningoma (headache, hearing loss)
vertigo: menieres
inv: MRI head (cerebellopontine angle)
management: surgery
presentation and management of menieres
tinnitus vertigo and sensorineural hearing loss
mg: inform dvla, buccal prochlorperazine (antiemetic),beta histine
management of viral labrynthitis / vestibular neuronitis
short course of cyclizine or promethazine
PLUS
prochlorperazine
all antiemetics
what type of nystagmus is seen in labrynthitis and vestibular neuronitis
horizontal
what medication can be used to treat bppv
beta histine
presentation of cholesteatoma
ear discharge
hearing loss
vertigo
crusty ear drum
management of cholesteatoma
urgent ent referral
tympanoplasty
symptoms of vestibular schwannoma
vertigo tinnitus sensorineural hearing loss headaches facial nerve palsy absent corneal reflex
4 causes of facial nerve palsy
bells palsy
vestibular schwannoma
meningoma
parotid adenoma
2 week wait referral for ENT (red flags)
multiple unilateral nose bleeds
unilateral nasal polyps
signs of posterior nose bleed
usually bilateral and cant see the source
symptoms of nasal polyps
snoring
post nasal drip
nasal congestion
mg = polypectomy
management of chronic / recurrent sinusitis
intranasal steroid spray
nasal decongestants
nasal irrigation with saline
symptoms of nasopharyngeal carcinoma
recurrent unilateral epistaxis unilateral otitis media otalgia lymphadenopathy nasal obstruction and discharge cranial nerve palsies diagnosis: MRI head management : radiotherapy
causes of conductive hearing loss
otosclerosis (young age onset, inherited, progressive) glue ear wax build up tympanic membrane perforation cholesteatoma otitis media (rarely)
causes of sensorineural hearing loss
presbycusis (age related) idiopathic noise damage vestibular schwannoma menieres meningitis cholesteatoma ototoxic drugs congenital rubella or CMV infection
differentials for dysphagia
oesophageal cancer - will have red flags and RF
strictures - usually secondary to GORD, not progressive, solids and liquids
oesophagitis - acute, heart burn, pain on swallowing
achalasia - liquids and solids from the start, heartburn, food regurg and aspiration, cough
pharyngeal pouch - halitosis, food regurg, gets stuck
myasthenia gravis - worse throughout day, voice goes quiet etc
mediastinal mass compression - red flags
systemic sclerosis - CREST, calcinosis, raynaeuds, oesophageal dysmotility, sclerodactly, telangiectasia, pulmonary fibrosis so resp symptoms
otitis externa presentation and management
itchy painful ear with discharge otoscopy: inflamed ear canal mgx: topical fluclox with steroid if not resolved or worsening oral fluclox if still not resolved refer to ENT
