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Year 4 > ENT > Flashcards

ENT Flashcards

1
Q

Describe the fever pain score

A

Fever in past 24 hours
Puss on tonsils
Attends within 72 hours
Severely inflamed tonsils
No cough or coryza

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2
Q

Describe the centor criteria for diagnosing acute tonsilitis

A

Can’t cough
Exudates
Nodes
Temperature
OR: Young (other)

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3
Q

Management of acute tonsilitis

A

First line: aracetamol

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4
Q

When are antibiotics indicated in Acute Tonsilitis

A

If three or more centor criterions are present

If fever pain score is 2 or more

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5
Q

Specific sign of peritonsilar abscesses

A

Trismus
Ulnar deviation
Dysphagia
Torticolis

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6
Q

What often preceeds acute otitis media

A

A viral URTI

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7
Q

Features of acute otitis media

A

Pain
Hearing Loss
Aural fullness before going away as the tympanic membrane perforates

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8
Q

What is Chronic Otitis Media

A

Dry tympanic membrane without a fever etc (no signs of infection

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9
Q

Signs of Glue Ear (otitis media with effusion) on examination

A

Dull tympanic membrane

Pain persists for a few weeks since onset (whereas the other perforates)

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10
Q

Management of otitis media in children under 3 months

A

If 38 degrees or more = refer to hospital

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11
Q

When are antibiotics indicated for acute otitis media

A

After 4 days

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12
Q

When should the four day rule be scrapped in children with otitis media

A

If they’re systemically unwell (but not enough for admission)

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13
Q

Complications of otitis media

A

Mastoiditis
Labrynthitis
Facial nerve palsy (CN 7)

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14
Q

Indications for an adenoidectomy

A

Persistent otitis media
Obstructive sleep apnoea or snoring
Tonsillelctomy alongside
CHornic sinusitis or adenoiditis
Dysphagia with failure to thrive

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15
Q

If someone who has had an adenoidectomy presents with persistent bleeding, what should be done

A

Post-nasal pack insertion and taken back to theatres again

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16
Q

Describe the onset of acute rhinosinusitis

A

Sudden onset for less than 12 weeks

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17
Q

What is the criteria to diagnose acute rhinosinusitis

A

1 nasal blockage or discharge + 1 of facial pain/reduction in sense of smell

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18
Q

Management of acute rhinosinusitis if symptoms are <5 days

A

Paracetamol, decongestants and irrigation with saline

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19
Q

Management of symptoms in rhinosinusitis lasting >10 days or worsening

A

Topical steroids or antibiotics

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20
Q

When should someone with rhinosinusitis be referred to ENT

A

If tehre are red flag signs (displaced globe, double vision or periorbital oedema

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21
Q

What causes BPPV

A

Calcium deposits in the semicircular canals

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22
Q

What brings on BPPV symptoms

A

Turning head to one side, turning in bed or looking upwards

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23
Q

How long do BPPV attacks last for

A

1 minute

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24
Q

Are there auditory symptoms in BPPV

A

No

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25
Q

Do BPPV symptoms recur

A

Yes

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26
Q

Diagnosis of BPPV

A

Dix-Hallpike manoeuvre

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27
Q

Treatment of BPPV

A

Epley Manouevre

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28
Q

What is a branchial cyst and where does it manifest

A

Manifests as a painful cyst ANTERIOR to sternocleidomastoid muscle just below the ear

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29
Q

What is a cholesteatoma

A

accumulation of skin debris iwthin th emiddle ear

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30
Q

What is cholesteatoma a complication of

A

Chronic otitis media

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31
Q

Features of Cholesteatoma

A

Foul smelling discharge, headache and otalgia

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32
Q

Examination findings in cholesteatoma

A

Areas of white in the attack behind the tympanic membrane

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33
Q

COmplication of cholesteatoma

A

Facial nerve palsy

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34
Q

What preceeds chornic sinusitis

A

Acute URTI

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35
Q

Signs of acute sinusitis

A

Unilateral, intense apin
Unilateral nasal discharge
Pain worse on sitting forwards

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36
Q

SIgns of chronic sinusitis

A

Painless but discharge full

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37
Q

Differentials for Sinusitis

A

TMJ
Migraines
Temporal arteritis
Herpes Zoster virus

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38
Q

COmplications of thyroid surgery

A

Hypoparathyroidismn
Hypothyroidism
Recurrent or superior laryngeal nerve destruction
Neck Haematoma
Thyrotoxic Storm

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39
Q

What is conductive hearing loss

A

Obstruction of sound waves between the outer ear and the stapes in the middle ear (path of osund movement

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40
Q

auses of conductive hearing loss

A

Wax
Otitis media with effusion
Eustachian tube dysfunction
Ear Infections
Perforations
Chornic Otitis Media

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41
Q

Examination findings in conductive hearing loss

A

Bone conduction greater than air conduction

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42
Q

First line management of epixstasis

A

Direct compression of nasal alae and sit forwards - spit out blood.

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43
Q

If direct compression does not work to fix epixstasis, what should be done

A

Cautery

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44
Q

If nasal cautery doesn’t work to fix epixstasis, what should be done

A

Nasal packing

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45
Q

What aggressive therapies may be used for persistent nasal bleeds

A

Nasal Balloon Catheter

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46
Q

What condition is a big risk factor for malignant otitis externa

A

DM

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47
Q

WHat species usually causes malignant otitis externa

A

Pseudomonas Aeruginosa

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48
Q

If pain is worsening in otitis externa, what should be doen

A

Refer to ENT

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49
Q

Is hering affected in Vestibular Neuritis

A

No

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50
Q

SIgns of Meniere’s disease

A

Hering loss, tinnitus and sensation of fullness or pressure in one or both ears

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51
Q

Signs of an acoustic neuroma

A

Absent corneal reflexes

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52
Q

What condtiions is an acoustic neuroma associated with

A

Neurofibromatsosis Type 2

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53
Q

First line treatment of otitis externa

A

Topical antibiotic + topical steroid for 1-2 weeks

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54
Q

What finding is Dix-Hallpike manoeuvre supposed to sus out

A

Rotary Nystagmus

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55
Q

What is Sialadenitis

A

Inflammatorion of slaivary gland secondary to obstructed stones in the duct

56
Q

What medication is most useful to prevent taccks of meniere’s disease

A

Betahistine

57
Q

What surgery is commonly used to improve airflow thorugh the nasal passage

A

INferior Turbinectomy

58
Q

What is Empty Nose SYndrome

A

Complication of a turbinectomy - secondary atrophic rhinitis (nasal obstruction, sob and dryness)

59
Q

Management of button batteries being put up the nose

A

Emergency removal (surgical)

60
Q

WHy do button batteries need to be removed form the nasal passage immediately

A

The negative pole and cause tissue necrosis through electolysis

61
Q

Main type of cancer of the head and neck

A

SCC

62
Q

RIsk factors for head and neck neoplasms

A

Smoking
Alcohol
EBV
HPV 16
UV exposure
Immunosuppression
Asbestosis

63
Q

Signs of Head and Neck neoplasms

A

Hoarseness
Throat Pain
Tongue Ulcers

Painless neck lumps

64
Q

When should someone with a neck lump be referred to ENT

A

If the neck lump / symptoms persist for more than 3 months

65
Q

Management of hereditary haemorrhagic telangiectasia

A

BLood transfusion and iron supplements

66
Q

When should a patient presenting with hoarsness be referred to ENT 2 week rule

A

> 3 weeks symptom durations

67
Q

When is chronic laryngitis from GORD most commonly experienced

A

Morning

68
Q

What is Reinke’s Oedema

A

Enlargement of the vocal cords (hypothyoridism oassociated)

69
Q

Signs of Reinke’s Oedema

A

Persistent Hoarsness

70
Q

What is Meniere’s Disease

A

Dilation of endolymphatic spaces

71
Q

How long does vertigo last in Meniere’s disease

A

12-24 hours

72
Q

Onset of Meniere’s Disease

A

30-60

73
Q

Is Meniere’s disease unilateral or bilateral

A

Unilateral

74
Q

Describe the pattern of onset of meniere’s disease

A

Comes in clusters with periods of remission where function recovers

75
Q

Management of Meniere’s Disease

A

Betahistine

76
Q

Role of betahistine

A

Reduces frequency of attacks

77
Q

What branch of the facial nerve supplies taste to the anterior tnoguse

A

Chorda Tympani nerve

78
Q

Investigations for bleeding noses (specifically after trauma)

A

Anterior rhinoscopy

79
Q

If there has been nasal trauma, what is the first line management

A

Refer all patients suspected of septal haematoma to ENT for emergency incision and drainage

80
Q

What is the most commmon cause of otitis externa

A

Staph aureus
Pseudomonas

81
Q

Management of mild to moderate otitis externa

A

Topical antibiotic and steroid drops

Keep ear dry for 7-10 days

82
Q

Management of severe otitis media

A

Topical Gentamycin

83
Q

What indictaes severe otitis media

A

When the meatus is completely occluded or has significant swelling

84
Q

When should oral antibiotics be considered for otitis externa

A

WHen infection spreads beyond external ear canal or a wick cannot be inserted for topical antibiotics

People with diabetes or immunocompromised

85
Q

Signs of otosclerosis

A

Progressive deafness in young adults (not acute)

86
Q

What causes otosclerosis

A

Bone at the base of the stapes thickens and fuses with the choclea

Stops stapes from banging into the chochloea - conductive hearingl oss

87
Q

Initial management of otosclerosis

A

Hearing aids

88
Q

Last lie management of otosclerosis

A

Stapedectomy

89
Q

Management of a pinna haematoma

A

Decompression of the haematoma within 24 horus

90
Q

Most common cause of pinna haematomas

A

Rugby tackles

91
Q

Name two glands affected in sialdenitis

A

Sub-mandibular glands
Parotid glands

92
Q

What examination sign points to a thyroglossal cyst

A

It will move up when the tongue is pushed out

93
Q

What is Presbycusis

A

Age-related conductive hearing los (loss of higher frequency noise)

94
Q

Labrynthitis vs vetsibular neuritis

A

Labrynthitis has hearing loss whereas vestibular neuritis does not

95
Q

How is Ramsay hunt syndrome treated

A

Aciclovir and high dose prednisolone

96
Q

Name two medications that can cause ototoxicity

A

Gentamycin
Vacomycin

97
Q

First line investigation and GOLD standard for presbycusis

A

Audiometry

98
Q

Medical managmenet of nasal polyps

A

Intransala topical steroid drops

99
Q

What can cause glossitis

A

Iron deficiency anaemia
B12 deiciency
Folate deficiency
Coeliac’s

100
Q

Treatment of oral candidiasis

A

Miconazoel gel

101
Q

How long does it take for a perforate ear drum to resolve

A

6 weeks

102
Q

What is the most common cause of sudden onsett sensineural hearing loss

A

Idiopathic

103
Q

First line management from chronic rhino sinusitis (>12 weeks)

A

Nasal irrigation with saline

104
Q

How is a haemorrhage 5-10 days after a tonsillectomy treated differently to one that happens hours after

A

More likely to be wound infection as a cause rather than a primary haemorrhage cause

105
Q

Where are cystic hygromas commonly found

A

In babies on the left side of the neck

106
Q

Where is a branchial cyst located

A

Sternocleidomastoid and the pharynx

107
Q

What is the role of the weber’s test

A

To check for sensorineural hearing loss

108
Q

What is the role of Rhinne’s test

A

To check for conductive hearing loss

109
Q

In sensorineural hearing loss, what is a positive weber’s test

A

If the sound localises to the unaffected side

110
Q

In conductive deafness, what is a positive Weber’s test

A

Sound localises to the affected side

111
Q

Medical treatment of vestibular neuronitis

A

Prochlorperazine (antiemetic)

112
Q

How long should prochlorperazine be given for vestibular neuronitis

A

3 days maximum

113
Q

What is the threshold at which an audiometry reading is normal

A

20db

114
Q

Management of post operative stridor

A

urgent removal of sutures and call for help - EMERGENCY

115
Q

What drugs cause gingival hyperplasia

A

Phenytoin
Ciclosporins
CCBs

116
Q

In what gland are Whartons ducts found

A

Submandibular gland

117
Q

What type of nystagmus is seen with Vetsibular Neuritis

A

Horiztonal

118
Q

Management of Vestibular Neritis

A

Oral Prochlorperazine

119
Q

Risk Factors of nasopharyngeal carcniomas

A

Southern Chinese people
EBV

120
Q

CLinical features of nasopharyngeal carcniomas

A

Otalgia
Cervical Lymphadenopathy
Unilateral otitis media
Epizstasis

121
Q

First line management of a nasopharyngeal carcniomas

A

Radiotherapy

122
Q

What findings are consistent with presbycusis on audiometry

A

Bilateral high-frequency hearing loss

Air conduction better than bon e

123
Q

AGe onset of cholesteatoma

A

30+

124
Q

Signs of otitis media in children

A

Touching and pulling at her ear

125
Q

Criteria for referring mouth ulcers to oral surgery

A

Ulcer persisting for over 3 weeks

Unexplained
Bleeding at site
Associated neck lump
Pain in neck >4 weeks
Signs of oral cavities >6 weeks

> 40

126
Q

Management of septal haematoma

A

Admission to hospital: Surgical incision and drianage + antibiotics

127
Q

Is aural fullness experienced in Meniere’s disease?

A

Yes

128
Q

Indications for 1-yearly outpatient surveillance

A

When the patient refuses active treatment for malignant ear tumours

129
Q

Management of sensirneural hearing loss

A

High dose prednisolone

130
Q

Where is the origin of Kiesselbach’s plexus

A

Anterior Nasal Septum

131
Q

HOw many arteries suppply Kiesselbach’s plexus

A

4 arteries

132
Q

Management of glue ear in adults

A

Refer to ENT under 2 weeks rule

Glue ear not common in adults -> possibly nasopharyngeal carcnioma

133
Q

What drug causes nasal polyps

A

Aspirin

134
Q

When, with someone who has nasal polyps, should they be referred to ENT as first line

A

If polyps are unilateral

135
Q

Where are pleomorphic adenomas commonly found

A

IN the tail of the parotid glands

136
Q

Warthins tumour vs pleomorphic adenomas

A

Warthin tumours affect males vs females

Warthin tumours is multiple tumour nodules vs one large mass

137
Q

What medications can cause tinnitus

A

NSAIDs and Aspirin

Year 4 (16 decks)

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