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1 General Practice > ENT > Flashcards

ENT Flashcards

1
Q

How to tell whether someone has otitis media or externa?

A

externa- itchy, irritated upon palpation of tragus

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2
Q

How to tell if ear infection is viral or bacterial?

A

viral- one ear
bacterial- two ears + fever + loss of appetite…

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3
Q

Differentials for nose lesion?

A

tumour
polyp
trauma
infection

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4
Q

Name one scoring system for a sore throat and indication for treatment with antibiotics

A

CENTOR
FeverPAIN criteria
Indicate likelihood of strep infection

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5
Q

How to distinguish between vestibular neuronitis and labrynthitis?

A

hearing is unaffected in vestibular neuronitis

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6
Q

What is the first line treatment for otitis media?

A

amoxicillin 5-7 days

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7
Q

What is the treatment for otitis media with penicillin allergy?

A

clari or erythromcyin

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8
Q

List two complications of acute otitis media

A

meningitis
mastoiditis
intracranial abscess
sinus thrombosis
facial nerve paralysis
hearing loss
recurrence of infection
tympanic membrane perforation

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9
Q

List two bacteria associated with acute otitis media

A

H.influenzae
Strep pneumoniae
Strep pyogenes
Moraxella catarrhalis

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10
Q

List two viruses associated with otitis media

A

RSV
rhinovirus
adenovirus
influenza virus
parainfluenza virus

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11
Q

List two risk factors for otitis media

A

young age
male
smoking
immunodeficiency
no pneumococcal vaccine

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12
Q

What are grommets??

A

treatment for glue ear-middle part of ear canal fills up with fluid
small tube inserted into ear to drain fluid and keep eardrum open. They fall out naturally within 6 to 12 months

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13
Q

What is the treatment for glue ear?

A

watchful waiting for 3 months and review. If functional impairment then consider surgery or hearing aids. Steroids and decongestants don’t work

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14
Q

List two risk factors for tinnitus

A

age
noise exposure
drugs

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15
Q

List one drug associated with tinnitus

A

NSAIDs
aminoglycosides
diuretics

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16
Q

List two red flags associated with tinnitus

A
  1. significant suicide risk
  2. sudden onset with significant neurological symptoms/signs/suspected stroke
  3. Tinnitus with uncontrolled vestibular symptoms e.g. vertigo
17
Q

Two differentials for tinnitus with vertigo?

A

Merniere’s, acoustic neuroma, migraine

18
Q

How does infectious mono differ in presentation with bacterial tonsillitis?

A

mono- ant and post palpable lymph nodes
tonsillits- ant chain only

19
Q

List the typical triad of infectious mono

A

fever
pharyngitis
cervical lymphadenopathy

20
Q

What are the investigations for mono?

A

FBC and monospot

21
Q

List two differentials for sudden unexplained sensorineural hearing loss

A

trauma
stroke
viral
vestibular schwannoma
ototoxicity
autoimmune

22
Q

What is Merniere’s disease?

A

inner ear disease- vertigo, tinnitus, hearing loss

23
Q

What is the pathophysiology of merniere’s disease

A

unclear.
buildup of fluid in labyrinth of inner ear

24
Q

List two types of dizziness

A

vertigo
lightheadedness
presyncope
dysequilibrium

25
Q

Three differentials for dizziness?

A

vertigo
benign paroxysmal positional vertigo
complete heart block
bicuspid aortic valve

26
Q

Name a score to identify groups which would benefit from antibiotic treatment for tonsilitis

A

FeverPAIN

27
Q

What is quinsy?

A

In quinsy, the abscess (a collection of pus) forms between one of your tonsils and the wall of your throat. This can happen when a bacterial infection spreads from an infected tonsil to the surrounding area. Quinsy can occur at any age, but most commonly affects teenagers and young adults.

28
Q

What is the first line choice antibiotic for tonisillitis?

A

phenoxymethylpenicillin

29
Q

If patient has penicillin allergy, which antibiotic for tonsillitis?

A

clari or erythro

30
Q

Which antibiotic for tonsillitis is safe to used in pregnancy?

A

erythromycin

31
Q

List two criteria in FeverPAIN score

A

Fever in the previous 24h.
Purulence of tonsils.
Attended rapidly (patient seen in the first 3d of symptoms starting).
Inflamed tonsils.
No cough/coryza.

32
Q

Patient scores 4 on FeverPAIN. What is your plan?

A

antibiotics!

Score of 0 or 1: treat with simple measures.
Score of 2 or 3: offer a back-up prescription to be used if no improvement within 3–5d.
Score of 4 or more: offer antibiotics immediately if severe symptoms or a back-up prescription if less severe (diagnostic studies suggest about 60% of these patients will have a strep sore throat).

33
Q

The Centor score stratifies the risk of which infectious agent for tonsilitis?

A

group A beta-haemolytic strep

34
Q

What is Lemierre’s syndrome?

A

very rare…infection caused by fusobacterium necrophorum- more likely in recurrent infections

35
Q

25 year old with sore throat and fever. More unwell than expected. What could be the causative agent?

A

Fusobacterium necrophorum- Lemierre’s syndrome

1 General Practice (15 decks)

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