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Surgery finals > ENT > Flashcards

ENT Flashcards

1
Q

What is a cholesteatoma? Describe the presentation

A

Locally destructive proliferation of squamous epithelium in the middle ear.

  • Foul smelling white discharge
  • Pain
  • Hearing loss
  • Vertigo
  • Facial paralysis (CN destruction)
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2
Q

Define tinnitus. What are some causes and red flags?

A

Sensation of sound without external stimulus

  • Idiopathic
  • Meniere’s disease
  • Acoustic neuroma
  • Drugs: aminoglycosides, aspirin, loop diuretics

Red flags: unilateral, vertigo, deafness

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3
Q

Define vertigo. What are some causes and red flags?

A

Illusion of movement

Peripheral:

  • Meniere’s
  • BPPV
  • Labyrinthitis
  • Vestibular neuronitis

Central:

  • Acoustic neuroma
  • BS, cerebellar lesion

Drugs: gentamicin, loops

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4
Q

What is the difference between labyrinthitis and vestibular neuronitis?

A

Vestibular neuronitis: no hearing loss or tinnitus

Labyrinthitis: hearing loss and tinnitus

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5
Q

Describe the pathophysiology and presentation of BPPV

A

Crystals in the semicircular canals that move when patient changes position -> rotational vertigo that lasts for seconds-minutes
*No hearing changes, no tinnitus

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6
Q

Describe the pathophysiology and presentation of Meniere’s disease

A

Dilatation of endolymph spaces in the semicircular canals

Spontaneous episodes of vertigo + tinnitus, hearing loss, aural fullness lasting 20 mins- 12 hours

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7
Q

Describe the pathophysiology and presentation of vestibular neuronitis

A

Inflammation of the vestibular nerve following viral infection
Vertigo, vomiting lasting several days

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8
Q

Describe the investigations and management of BPPV

A

Ix:
-Hallpike manoeuvre (vertigo + nystagmus elicited)

Mx:

  • Epley manoeuvre
  • Betahistine
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9
Q

Describe the management of Meniere’s disease

A

Anti-emetics: cyclizine, betahistine

Surgical

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10
Q

Describe the management of vestibular neuronitis

A

Conservative. Anti-emetics if needed (cyclizine)

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11
Q

Name some causes of hearing loss

A

Conductive:

  • Earwax
  • Foreign body
  • TM perforation
  • Cholesteatoma
  • Otosclerosis

Sensorineural:

  • Meniere’s disease
  • Viral labyrinthitis
  • Acoustic neuroma
  • Presbyacussis (age-related)
  • Drugs: aminoglycosides
  • Infections: meningitis, mumps
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12
Q

Describe the presentation of acoustic neuromas

A

Unilateral progressive hearing loss, tinnitus, vertigo

  • Headache
  • CN palsy: 7, 8
  • Cerebellar signs
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13
Q

Describe the investigations and management of acoustic neuromas

A

Ix:

  • Audiometry
  • MRI cerebellopontine angle

Mx:
-Surgical

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14
Q

Describe the causes of epistaxis

A 
Unknown
Trauma: nose picking, fractures
Coagulopathy
Pyogenic granuloma
Osler-Webber-Rendu/HHT
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15
Q

Describe the management of epistaxis

A

Not shocked:

  • Sit upright, tilt head down
  • Pinch over Little’s area for 15 minutes

Anterior:

  • > examination and cautery (silver nitrate stick) or gauze with vasoconstrictor
  • > packing
  • > referral to ENT

Posterior:
-Posterior packing: insert catheter w balloon + fill, admit for 48 hours

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16
Q

What is a myringotomy and what is it used for?

A

Procedure to make an incision in TM and allow release of fluid/pus/blood to relieve raised pressure in the middle ear

17
Q

What is grommet insertion and what is it used for?

A

Insertion of a grommet (small device) into the TM to allow drainage of fluids eg. chronic OME

18
Q

Describe the risk factors for nasopharyngeal carcinoma

A

Smoking
Salt-cured fish + meats
Being from HK or Southeast China

19
Q

Describe the presentation of nasopharyngeal carcinoma

A
  • Neck lump (common)
  • Hearing loss, ear pain, tinnitus
  • Nasal obstruction
  • Sore throat
  • Weight loss
20
Q

Describe the cause and presentation of thyroglossal cysts

A

Cyst forms in persistent thyroglossal duct
Midline neck lump
-Moves with swallowing and tongue protrusion

21
Q

Describe the causes of neck lumps

A

Midline:

  • Thyroglossal cysts
  • Thyroid lumps: TMNG, adenoma, carcinoma

Anterior triangle:

  • Branchial cyst
  • LNs

Posterior triangle:

  • LNs
  • Pharyngeal pouch
  • Cystic hygroma
  • Cervical rib
22
Q

Describe the presentation of epidermoid cyst

A

Smooth, well-circumscribed, rubbery lump with central punctum
Fixed to skin but mobile over deeper layers

23
Q

Describe the presentation of a lipoma

A

A soft and smooth dome-shaped lump easily movable under skin

Surgery finals (16 decks)

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