Brainscape's Knowledge GenomeTM

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


See full index

Finals > ENT > Flashcards

ENT Flashcards

1
Q

What is allergic rhinitis?

A

Inflammatory condition of the nasal mucosa

Characterised by nasal pruritus, sneezing, rhinorrhoea, nasal congestion

It is associated w/ allergic conjunctivitis with eye redness, puffiness and watery discharge
It is IgE MEDIATED RESPONSE TO ALLERGENS WITHIN THE ENVIRONMENT AND may demonstrate a seasonal variation

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

What are the causes of sensironeural hearing loss?

A 
Presbycusis 
Noise induced hearing loss 
congenital infections- rubella, CMV 
Neonatal complications 
drug induced deafness (aminoglycosides- gentamicin/neomycin) 7
Vascular pathology- stroke, TIA,
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the risk factors for H+N neoplasia?

A

Smoking
Alcohol misuse
Viral infections- HPV (TYPE 16) and EBV
Radiation exposure
Immunosuppresion (Organ transplantation)
Occupational exposure (acid mists, asbestos, wood dust)
FHx

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

What do H+ N cancers present with?

A

Hoarseness, throat pain, tongue ulcers or a painless neck lump and symptoms for longer than 3 weeks duration should prompt utgent referral
they may present with weight loss and lymphadenopathy

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

What are the features of acute otitis media?

A

Deep seated pain, impaired hearing with systemic illness and fever
The onset is usually rapid with a feeling of aural fullness, followed by discharge when the tympanic membrane perforates with relief of pain
Tympanic membrane shows injection of blood vessels and then diffuse erythema
Bacterial infection is common particularly in young children

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

What are the complications of otitis media?

A

Extra cranial complications’ facial nerve palsy, mastoiditis, petrositis, labyrinthitis

Intra cranial- Meningitis, sigmoid sinus thrombosis (sepsis, swinging pyrexia, meningitis), brain abscess

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

What is the treatment of AOM?

A

most the time don’t need to treat but can give Amoxicillin for 5-7 days if systemically unwell, bilateral otitis media and under 2, >4days etc…

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

What is a cholesteatoma and what does it present like?

A

Overgrowth of stratified squamous epithelium in the middle ear
persistent foul smelling discharge, headache, otalgia

On examination there will be an area of white in the attic behind the tympanic membrane

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

What is a vestibular schwannoma, what are the clinical features, Ix, Management?

A

Benign subarachnoid tumour that causes local pressure effects on the VIII cranial nerve

clinical features- asymmetric or unilateral hearing loss and progressive ipsilateral tinnitus

MRI should always be performed in a pt with unilateral tinnitus and sensorineural deafness

Management is with surgery

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

What are the causes of conductive hearing loss?

A 
Wax impaction 
Otitis media w/ effusion 
Eustachian tube dysfunction 
Ear infections 
Perforations of the tympanic membrane 
Chronic suppurative otitis media
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the clinical features of Menieres?

A

typically affects one ear, in 30 to 60 year old
Characterised by sudden paroxysmal vertigo (lasting 12-24 hours)
associated with deafness and tinnitus
attacks normally occur in clusters with periods of remission
nausea and vomiting, bed bound, fluctuating hearing

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

How do you manage menieres?

A

Betahistine

Prochlorperazine for acute attack

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

epistaxis

A

sjdkljwapo

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

What are the risk factors for head and neck cancers?

A 
Leukoplakia (1/3 become cancerous) 
Erytroplakia (1/2 become cancerous)
Tobacco/alcohol 
HPV 16 and 18 
Occupation- woodwork, textiles, nickel
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the symptoms of head and neck cancer?

A 
Odynophagia/dysphagia >3 weeks
Hoarseness >3 weeks
Trismus- oropharyngeal malignancy 
Referred otalgia 
Dyspnoea/stridor

If they have had odynophagia/dysphagia/hoarseness for >3 weeks then they need a 2ww referral

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

What are the signs of H and N cancer?

A 
Erythroplakia
Leukoplakia 
Bleeding in mouth/throat or haemoptysis 
Persistent mouth ulceration (>3 weeks) 
Persistent unexplained neck lump (>3 weeks)
Weight loss, night sweats, fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How do you diagnose H and N cancer?

A 
History and H and N exam 
Flexible nasal endoscopy 
Fine needle aspiration cytology 
CT/MRI of neck 
CXR/CT chest 
Bloods- FBC, UEs, LFT, TFT, glucose, albumin

Biopsy is diagnostic however avoid because it needs GA

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

In terms of H and N, what symptoms/signs would warrant 2ww referral?

A 
Odynophagia/dysphagia >3 weeks 
Hoarseness >3 weeks
Persistent unexplained neck lump >3 weeks
Persistent mouth ulceration>3 weeks
Leukoplakia 
Erytroplakia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the causes of dysphagia?

A

Structural changes- post op/radiotherapy
Obstructive- malignancy, pharyngeal oouch
Neurological- CVA/stroke
Muscular- age related weakness, cerebral palsy
Resp- COPD
Gastro oesophageal- LP reflux/GORD

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

What are the causes of neck lumps?

A

Infection
Neoplasm (lymphoma)
Thyroid- cyst, neoplasm, multinodular goitre
Thyroglossal cyst, cystic hygroma, branchial cyst
Salivary gland- neoplasm, infection, syone
Carotid aneurysm
Sebaceous cyst, lipoma

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

What are the 3 types of salivary glands?

A

Parotid
Submandibular
Sublingual

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

What are the causes of dry mouth?

A

Depression/anxiety
Drugs- antimuscarinics
Radiotherapy to head/neck
Sjorgens syndrome

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

What is scialadenitis?

A

Inflammation of gland
Caused by infection, stones, malignancy
Symptoms= swollen, tender gland
+/- Pus, +- fever and systemic symptoms

Treat w/ analgesia and abx

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

What is scialothiasis?

A

Calculi in glands

After eating swelling and pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q 
What is tonsilitis?
What does it present with 
What scoring system is used for tonsilitis?
Management?
Complications?
A

Acute bacterial infection (strep pyogenes, staph, m. Catarrhalis)

Symptoms= sore throat and odynophagia, pyrexia, malaise, lymphadenopathy +/- Pus on tonsils

Centor score= absence of cough, fever >38, tender cervical nodes, tonsillar exudates

Management
Analgesia, fluids, soft food, PO penicillin V if increased chance of being bacterial

Tonsillectomy if recurrent/complications

Complications= peritonsillar abscess (quincy), deep neck space infection

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

What is peritonsillar abscess?

What are the symptoms?

A

Pus between tonsil capsule and lateral pharyngeal wall (strep pyogenes)

Sore throat, odynophagia, dysphagia, TRISMUS (restriction of the range of motion of the jaws), hot potato voice, referred otalgia

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

What are the signs of peritonsillar abscess?

A

Unilateral swelling lateral to tonsil

Deviated tonsil and uvula to the opposite side

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

What is the management of tonsilitis?

A

ENT referral
Needle aspiration/incision and drainage
IV ABX +/- steroids for swelling
Analgesia, fluids, soft food

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

What are the symptoms, investigations and management of glandular fever (infectious mononucleosis)?

A 
Symptoms= prodromal illness= fever/malaise
Sore throat/dysphagia 
Cervical lymphadenopathy 
Abdo pain 
Hepatosplenomegaly

Investigations: FBC, LFTS, blood film, monospot test

Management: supportive (analgesia, fluids), monitor LFTS, advice - avoid intimate contact, no contact sport as it can cause splenic rupture, no alcohol because this can lead to liver damage

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

What are the symptoms of pharyngitis ?
What are the causes?
What advice would you give?

A

Acute= sudden onset sore throat
Causes are usually viral- rhinovirus, influenza, coronavirus, HSV, VZV
May be bacterial= group A strep

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

What is epiglottitis caused by?
What are the symptoms of epiglottitis
What is the management

A

Haemophilus influenza B
Symptoms= very dore throat and high fever, dysphagia, drooling, stridor
Management= immediate admission, airway protection (intubation/tracheostomy), IV abx and steroids

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

What is the safety netting for tonsilitis?

A

Seek urgent medical help if develop abdo pain (splenic rupture in EBV) , reduced urine output, breathing problems

Come back if abx dont work

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

What should you ask about in a patient who has came in with epistaxis?

A

Whether its bleedings from one side or both sides
One side= more likely to be anterior bleed
Both side= more likely to be posterior
How long
Any SOB, lethargy?
Previous episodes/surgery/trauma
Blood thinning medication

34
Q

What is the stepwise management of epistaxis?

A

Silver nitrate cauterisation

Nasal packing

Surgical intervention- ligation of the sphenopalantine artery

35
Q

What do foreign bodies in kids present like?

A

Offensive grey discharge from one nostril

36
Q

What are the clinical features of otitis externa?

A

Otalgia
Deafness
Discharge

37
Q

What pathogens cause otitis externa?

A

Pseudomonas auerignosa
Staph aureus
Candida
Aspergillus

38
Q

What is the managemeng of otitis externa?

A

Aural toilet (hoover out debris)
Antibiotics and steroid drops
Keep ear dry

If this doesnt work then referral to ENT for microsuction

39
Q

What do you need to think about in patients with otitis externa who have diabetes?

A

Necrotizing otitis externa

40
Q

What is necrotizing otitis externa?

A

Skull based osteomyelitis

Potentially fatal

41
Q

What are the suspicious features of necrotising otitis externa and what are the complications?

A

Suspicious features- night pain, granulations in ear canal, non resolving otitis externa

Complications- sinus thrombosis, cerebral abscess, meningitis, aspiration due to palsies

42
Q

What is the management of necrotising otitis externa?

A

Admit
Get a CT
Mdt management
IV abx until resolution of pain and inflammatory markers

43
Q

When should you give abx in acute otitis media?

A 
Under 2 years old 
Bilateral 
Symptoms of local complications- facial weakness, diziness, visual change, neck swelling
Severe or recurrent 
If no resolution after 3 days
44
Q

What should you do if pt has mastoiditis?

A

Admit
IV abx
+/- CT scan and surgery

45
Q

How do you read a audiogram

A

If there is a gap between the two lines= conductive hearing loss

If both low= sensironeural hearing loss

X= left

46
Q

When is hearing los an emergency?

A

If sensorineural treat as an emergency
Give high dose prednisolone for 1 week
They should have an audiogram the next working day

47
Q

What would be the rinnes and webers test show in conductive hearing loss?

A

Bone > air

Webers localises to affected ear

48
Q

What would the rinnes and webers show in sensironeueal hearing loss?

A

Air > bone in Rinnes

Normal ear localisation in Webers

49
Q

When would you admit someone with tonsilitis?

A

If they are unable to eat and drink

50
Q

What should your immediate management for quinsy be?

A

Aspiration
Admit IV Abx- benpen and metronidazole
Dexamethasone

51
Q

Why is stridor more common in children?

A

Small diameter of the airways

52
Q

What are the causes of stridor in children?

A 
Croup 
Acute epiglottitis 
Foreign body
Laryngeal papilloma
Congenital abnormalities
Laryngomalacia
53
Q

What are the causes of stridor in Adults?

A 
Laryngeal neoplasms 
Bilateral vocal cord palsy
Croup 
Epiglottitis
Trauma 
FB
Stenosis
54
Q

Why would you do a tracheostomy?

A

Real upper airway obstruction- supraglottic, glottic, subglottic

Impending upper airway obstruction

If they are in ITU for a long period of time

55
Q

What are the causes of otitis externa?

A

Can be bacterial or fungal
Bacterial= staph aureus or pseudomonas
Fungi- candida, aspergillus

56
Q

What advice should you give someone with otitis externa?

A

Dont go swimming
Dont use ear buds
Professional removal of ear wax

57
Q

What are the causes of middle ear infections?

A

Influenza, H influenza, staph pneumonia

58
Q

What are the symptoms of otitis media?

A 
Otalgia 
Fever
Conductive hearing loss 
Bulging tympanic membrane 
May have tympanic membrane perforation and pus/blood
59
Q

What is the treatment of acute otitis media?

A

Most cases resolve within 24 hours
May give topical abx/steroids
Oral amoxicillin in some cases

60
Q

What is chronic suppurative otitis media?
What are the symptoms?
What is the management?

A

This is repeated ASOM (for more than 6 weeks)
Non healing TM perforation

Symptoms= repeated ottorhoea, conductive hearing loss

Regular aural toilet, ENT referral, abx and steroid drops

61
Q

What are the symptoms of mastoiditis?

A 
Otalgia
Hearing loss 
Malaise 
Pyrexia 
Pinna down and forwards
Post auricular swelling
62
Q

What is acute otitis media w/ effusion?
What are the symptoms?
What are the causes?
What is the management?

A

Fluid in the middle ear
Glue ear

Symptoms

  • middle ear fluid with no signs of infection (it is painless)
  • conductive hearing loss 20-30
  • speech delay and school problems
Causes
eustachian tube dysfunction 
Nasal/ sinus infeftion 
Allergic response 
Ciliary dysfuncton

Management
Most resolve by themselves
If more than 3 months without resolution then give grommets and hearing aids

63
Q

What is cholesteatoma?

A

Accumulation of keratinising squamous epithelium in the middle ear
Caused by pseudomonas aeurignosa

64
Q

What is the presentation of cholesteatoma?

A

Conductive hearing loss
Foul smelling otorrhoea
Attic retractuin and squamous debris

65
Q

What do you get with tympanic membrane perforation?

A

Conductive HL

+/- pain, tinnitus, vertigo

66
Q

What are the causes of sensironeural hearing loss?

A 
Anything that affects the inner ear
Menieres 
Viral infection 
Ototoxic drugs 
Temporal bone fracture 
Tumour (exclude acoustic neuroma with an MRI or CT)
67
Q

What is an acoustic neuroma?

A

A vestibular schwannoma which compresses the craniak nerve 8

68
Q

What are the symptoms of acoustic neuroma?

A

Unilateral SNHL, tinnitus, vertigo +/- neuro symptoms

69
Q

How do you investigate acoustuc neuroma?

How do you manage?

A

Pure tone audiometry
CT/MRI

Management is with surgical excision (there is a risk to the facial nerve), highly focused radiotherapy

70
Q

What is presbyacusis?

What symptoms do you get?

A

A cause of sensironeural hearing loss, it is due to aging and loss of outer hair cells of cochlea
You get bilateral SNHL +/- tinnitus which is worse with background noise

Pure tone audiometry and otoscopy can be used to disgnose

71
Q

What are some causes of ototoxicity?

A

Diuretics
Aminoglycosides (gentamicin)
Salicylates
Chemo agents

72
Q

What are the causes of vertigo?

A 
Menieres 
Acoustic neuroma 
Ramsay hunt 
Otoxicity 
BPPV
Acute labyrinthitis
73
Q

What is BPPV
What is the diagnostic Ix
What is the treatment

A

The presence of debris in the semicircular canals of the ears causing vertigo upon head movement
The hallpike manouevre is diagnostic, where certain movements of the head causes fatiguable nystagmus
Epley manoueveres and vestibular sedatives (prochlorperazine)

74
Q

What is the management of labyrinthitis and vestibular neuronitis?

A

Vestibular sedatives (prochlorperazine)
Bed rest
Antiemetics

75
Q

What are the features of menieres disease and how do you treat?

A

Vertigo
Sensironeural hearing loss
Tinnitus
Aural fullness

Treatment involves antihistamines and bed rest

76
Q

Give some causes of facial palsy..,

A

Bells palsy
Ramsay hunt
Stroke

77
Q

What should you do Ix wise for facial palsy?

A 
Hx 
Ent exam 
Neuro exam 
PTA
Electroneurogeaphy 
MRI/CT
78
Q

What is bells palsy?

What is the management?

A

Viral infection of facial nerve (increased risk in diabetes and pregnancy)
Ipsilateral facial palsy +/- pain

Management= high dose PO steroids, eye care and analgesia

79
Q

What is ramsay hunt syndrome?
What are the symptoms
What is the management

A

Herpes zoster virus infection of the facial nerve
Symptoms= ipsilateral facial palsy, ear pain/vesicles, vesicular rash +/- SNHL, vertigo, tinnitus

Management= acyclovir +/- steroids
Eye care and analgesia

80
Q

What are the red flags for FNP?

A

Neuro symptoms- CVA
Progressive palsy/ parotid mass- neoplasm
Associated ear infection/ foul otorrhoea- cholesteatoma

Finals (24 decks)

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