ENT Flashcards
What are the 2 bacteria that cause otitis externa?
Staph aureus
Pseudomonas
What skin conditions that can prone an individual to otitis externa?
Seborrheic dermatitis
Contact dermatitis (allergic or irritant)
What activity can prone someone to otitis externa?
Swimming
What is the difference between acute otitis media and otitis media with effusion (glue ear)?
Acute otitis media - primary complaint is ear pain, often self limiting.
Glue ear - primary complaint is hearing loss (speech developmental delay), needs intervention.
What is the treatment for otitis externa?
Topical antibiotic +/- topical steroid.
Abx - usually ciprofloxacin, but may use gentamicin.
What is malignant otitis externa?
How is it managed?
When bacteria (usually pseudomonas) invades temporal bone.
- deep otalgia
- otorrhea
- temporal headache
Typically affects diabetics and immunosuppressed.
CT head normally indicated
Treat with IV antibiotics that cover pseudomonas.
What is the second line treatment for otitis externa when it is spreading?
Flucloxacillin
What are the 5 circumstances where you should utilise antibiotics for acute otitis media?
Symptoms > 4 days Systemic upset Immunocompromised < 2 y/o and bilateral symptoms Perforated TM
How is mastoiditis treated?
IV antibiotics
What are the 2 treatment options for glue ear?
Grommet insertion
Adenoidectomy
What is the management of ongoing epistaxis after first aid measures fail?
- Silver nitrate cautery
- Nasal packing
- Ligation of the sphenopalatine artery (in theatre)
A patient has vertigo and an absent corneal reflex.
What is the likely diagnosis?
Vestibular neuroma (Schwannoma)
An elderly patient has vertigo that is worsened by neck extension.
What is the likely diagnosis?
Vertebrobasillar ischaemia
A patient has vertigo that lasts for hours at a time following a recent viral illness.
The doctor suspects viral labyrinthitis or vestibular neuronitis.
What is the key differentiating factor between these diagnoses?
Viral labyrinthitis - may have hearing loss
Vestibular neuronitis - never has hearing loss
What is the management for acute sinusitis?
Analgesia Intranasal corticosteroids if >10 days. Antibiotics if severe infection: - Phenoxymethylpenicillin 1st line - Co-amoxiclav if signs of more severe infection e.g. systemic upset.
What are 2 complications of acute sinusitis?
Venous sinus thrombosis
Brain abscess
What are the signs of a brain abscess?
Headache
Fever
Focal neurology
Signs of raised ICP
What imagining should be done for suspected vestibular neuroma?
MRI of the cerebropontine angle
What is the treatment for brain abscess? (3)
Antibiotics - 3rd gen cephalosporin and metronidazole
Surgery - craniotomy with washout of abscess
Dexamethasone for raised ICP
What is the investigation for venous sinus thrombosis?
MR venography
What is the treatment for venous sinus thrombosis?
LMWH short-term
Warfarin long-term
What is the likely cause of a midline neck lump in a 18 year old, that moves up with tongue protrusion?
Thyroglossal cyst
A 60 year old man presents with dysphagia and halitosis.
What is the suspected diagnosis?
What imaging technique would you use to confirm the diagnosis?
Pharyngeal pouch
Barium swallow with dynamic video fluoroscopy
What is the treatment for pharyngeal pouch?
Surgery
