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ICM Matrix > ENT > Flashcards

ENT Flashcards

1
Q

What typically preceeds acute otitis media

A

Viral URTI

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2
Q

causes of acute otitis media

A

viral or bacterial

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3
Q

S/s acute otitis media

A
  • otalgia
  • ear tugging
  • fever
  • URTI sx
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4
Q

Otoscopy findings in acute otitis media

A
  • loss of light reflex due to bulging tympanic membrane
  • middle ear effusion
  • inflammation (erythema)
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5
Q

How is acute otitis media diagnosed

A

Clinical

Otoscopy

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6
Q

When are abx indicated in acute otitis media

A
  • sx persist >4 days
  • systemically unwell (not requiring admission)
  • immunocompromised
  • <2yo and bilateral otitis media
  • perforation and/or discharge
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7
Q

sx of cerumen impaction

A
  • Hearing loss
  • Blocked ears
  • Ear discomfort
  • Feeling of fullness in ear
  • Earache
  • Tinnitus
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8
Q

When should ear drops NOT BE USED

A

perforated tympanic membrane, active dermatitis, or active infection of the ear canal.

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9
Q

Causes of labyrinthitis

A

viral, bacterial or associated with systemic diseases

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10
Q

labyrinthitis

A

inner ear infection

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11
Q

labyrinthitis vs vestibular neuritis

A

vestibular neuritis : only the vestibular nerve is involved, hence there is no hearing impairment

labyrinthitis : both the vestibular nerve and the labyrinth are involved, usually resulting in both vertigo and hearing impairment

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12
Q

sx of labyrinthitis

A
  • vertigo
  • n&v
  • hearing loss
  • tinnitus
  • preceding or conceding URTI sx
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13
Q

signs of labyrinthitis

A
  • sensorineural loss
  • gait disturbance
  • nystagmus
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14
Q

how is labyrinthitis diagnosed

A

clinical

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15
Q

otitis externa

A

inflammation (redness and swelling) of the external ear canal

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16
Q

sx of otitis externa

A
  • ear pain
  • itch
  • discharge
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17
Q

common trigger of otitis externa

A

swimming

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18
Q

What should be done if otitis externa is not responding to initial treatment

A

ENT referral

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19
Q

Vertigo

A

false sensation that the body or environment is moving.

20
Q

Which neurological finding may be found with vertigo

A

nystagmus

21
Q

Main causes of vertigo

A

central : brain pathology - uncommon

peripheral : inner ear pathology

22
Q

chronic suppurative otitis media (CSOM)

A

Ear discharge persisting for more than 2 weeks, without ear pain or fever

23
Q

chronic suppurative otitis media sx

A

persistent ear discharge
hearing loss
tinnitus

24
Q

chronic suppurative otitis media management

A

ENT referral

25
Q

What is mastoiditis

A

when an infection spreads from the middle to the mastoid air spaces of the temporal bone

26
Q

s/s of mastoidits

A
  • otalgia: severe, classically behind the ear
  • fever
  • swelling, erythema and tenderness over the mastoid process
  • external ear may protrude forwards
27
Q

how is mastoiditis diagnosed

A

clinical

CT if complications supected

28
Q

complication of mastoiditis

A
  • meningitis
  • facial nerve palsy
  • hearing loss
29
Q

s/s menieres disease

A
  • recurrent episodes of vertigo, tinnitus and hearing loss
  • fullness / pressure in ear
  • positive Romberg
30
Q

management of menieres disease

A
  • ENT specialist referral
  • acute attacks: buccal or intramuscular prochlorperazine
  • stop driving until sx controlled
31
Q

how long do attacks last in menieres disease

A

present for at least 20 minutes, but typically last a few hours

32
Q

What does barotrauma lead to

A

perforated tympanic membrane

33
Q

sx of barotrauma

A
  • hearing loss
  • ear pain
  • fullness in ear
34
Q

What does positive and negative Rinnes test indicate

A

Positive : air conduction > bone conduction (normal)

Negative : bone conduction > air conduction (conductive hearing loss)

35
Q

What is the webers test result in conductive and sensorineural hearing loss

A

conductive : lateralises to affected ear

sensorineural : lateralises to unaffected ear

36
Q

How to manage hearing loss in primary care if all other causes have been treated/excluded

A
  • ENT referral for audiological assessment

- hearing aids

37
Q

When to urgently refer a patient with hearing loss

A
  • Sudden onset (over 3 days or less) unilateral or bilateral hearing loss which has occurred within the past 30 days and all other causes excluded
  • Unilateral hearing loss associated with focal neurology
  • Hearing loss associated with head or neck injury
  • Hearing loss associated with severe infection or Ramsay Hunt syndrome
  • Rapidly progressive hearing loss
38
Q

Causes of tympanic membrane perforation

A
  • infection (most common)
  • barotrauma
  • direct trauma
39
Q

most common infectious agents of acute sinusitis

A

Haemophilus influenzae
rhinovirus
Streptococcus pneumoniae

40
Q

sx of acute sinusitis

A
  • facial pain (worse on leaning forward)

- thick nasal discharge

41
Q

How can allergic rhinitis be classified

A
  • seasonal
  • occupational
  • perennial: symptoms occur throughout the year
42
Q

sx of allergic rhinitis

A
  • sneezing
  • bilateral nasal obstruction
  • clear nasal discharge
  • post-nasal drip
  • nasal pruritus
43
Q

sx of nasal polyps

A
  • nasal obstruction
  • rhinorrhoea
  • sneezing
  • poor sense of taste and smell
44
Q

which feature of nasal polyps is unusual and requires further investigation

A

unilateral nasal polyps or bleeding

45
Q

management of nasal polyps

A
  • ENT referral

- topical corticosteroids

46
Q

how long do sx have to persist to be chronic sinusitis

A

12 weeks

ICM Matrix (15 decks)

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