ENT π Flashcards
signs of hereditary hemorrhagic telangiectasia
nose bleeds
and red freckles on lips, face, fingertips, tongue and inside surfaces of the mouth.
what is a Quinsy (peritonsillar abscess)
a complication that develops from untreated acute tonsillitis
on clinical examination of a patient with a peritonsillar abscess what would you see
uni-tonsillar bulge and uvula deviation.
sore throat
headache
pyrexia
lymphadenopathy
tonsilitis
do you order blood tests when investigating tonsillitis
only if they are immunodeficient
what is the Centor criteria for acute tonsillitis
history of fever
no cough
tonsillitis exudates
tender anterior cervical lymphadenopathy
how many centor criteria needs to be fulfilled and other criteria to be able to prescribe antibiotics for tonsillitis
3 or more centor criteria
other features include:
marked systemic upset
immunodeficiency
history of rheumatic fever
what is the most complication of tonsillitis
recurrent tonsiliitis
how does peritonsillar abscess present
presents with difficulty swallowing, sore throat, muffled voice and trismus
what is the first line antibiotic for bacterial tonsillitis
phenoxymethylpenicillin
describe acute otitis media
inflammation of the middle ear with effusion
occurs primarily in children
often associated with URTI
sx of acute otitis media
Neonates
Irritability
Difficulty feeding
Fever
Young children
Holding or tugging ear
Irritability
Fever
Older children and adults
Otalgia (ear pain)
Hearing loss
Fever
features of chronic otitis media - glue ear
persistent pain lasting weeks
drum looks abnormal and reduced mobility of membrane
features of chronic suppurative otitis media
perforation of the tympanic membrane with otorrhoea for > 6 weeks
when do you admit patients for otitis media
any children under 3 months with temp over 38
children with suspected acute complications
children who are very systemically unwell
mx of otitis media when admission or antibiotics are not needed
paracetamol or ibuprofen
when do you offer antibiotics for otitis media and what course do you offer
children who are systemically unwell but donβt require admission or those at high risk of complications
5-7 day course of amoxicillin
extra-cranial complications of otitis media
facial nerve paralysis
mastoiditis - most common
intra-cranial complications of otitis media
meningitis
sigmoid sinus thrombosis
intracranial brain abscess
how would mastoiditis present
as a boggy mass over the mastoid process tender to palpation
systemically unwell
intense ear pain
sx of labyrinthitis
vertigo
nausea
vomiting
imbalance
how does meningitis present
sepsis
headache
vomiting
photophobia
phonophobia
how does sigmoid sinus thrombosis present
sepsis
swinging pyrexia
meningitis
how would a brain abscess present
sepsis and neurological signs
characteristic features with allergic rhinitis
nasal pruritus, sneezing, rhinorrhoea and nasal congestion
what is allergic rhinitis often associated with
allergic conjunctivitis