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Year 4 - NSS > ENT > Flashcards

ENT Flashcards

1
Q

Balance
- Inputs

A

Balance Inputs

  1. Vestibular
  2. Proprioceptive
  3. Ocular
  4. Cerebral
  5. Cerebellar
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2
Q

Vestibular system
- Detection parameter

A

Vestibular system
- Uses acceleration

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3
Q

Vestibular system
- Sacule role

A

Vestibular system Sacule

  • Stops us falling over
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4
Q

Balance
- Vision tools

A

Balance - Vision

  1. Smooth pursuit (following with eyes)
  2. Optokinetic eye movements
  3. Seccard function (rapidly viewing two objects)
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5
Q

Balance differential
- On standing

A

Balance differential
- On standing

  • Postural hypotension
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6
Q

Balance differentials
- Stamping gait
- Antalgic gait

A

Balance differentials
- Stamping gait
- Antalgic gait

  1. Diabetic peripheral neuropathy
  2. Osteoarthritis
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7
Q

Vestibular ocular reflex
- Function
- Neurological structures

A

Vestibular ocular reflex

  1. Ability to keep eyes on object when head turns
  • Neurology
    1. Vestibular nerve
    2. Vestibular nuclei
    3. Ocular muscle nuclei
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8
Q

Balance
- Fixed head position differential

A

Fixed head direction
- Differentials

  1. Vestibular neuritis
    - VO reflex overactive
    - Nystagmus due to correction
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9
Q

Balance
- Centralised compensation

A

Balance
- Centralised compensation

  1. Vestibular apparatus impaired
  2. Other mechanisms engaged
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10
Q

Vestibular migraine
- Pres
- Mx

A

Vestibular migraine

  • Pres
    1. Migraine
    2. Middle aged females
    3. Imbalance
  • Worse before periods/ovulation
    4. Photophobia/phonophobia
  • Mx
    1. Diet (B2, D3, Mg)
    2. Sleep
    3. Stress/hormones
    4. Medication
  • Topiramate
  • Venlafaxine
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11
Q

Menieres
- Pres

A

Menieres

  1. Tinnitus
  2. Dizziness
  3. Fullness
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12
Q

Nasal septum defect

  • Chronic Vs acute
  • Surgical repair
A

Nasal septum defect

  • Chronic Vs acute
    1. Asymmetrical nasal turbulants
  • Surgical repair
    1. Costochondral cartilage
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13
Q

Stridor Vs stertor

A

Stridor Vs stertor

  1. Stridor is below the larynx
  2. Stertor is oropharyngeal
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14
Q

Bernoulli principle

A

Bernoulli principle

  • Velocity of fluid passing down tube increases
  • Pressure on tube wall decreases
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15
Q

Rhinosinusitis
1. Symptoms
2. Length

A

Rhinosinusitis

  1. Symptoms
    - Nasal blockage/discharge/congestion
    - Facial pain/pressure
  2. Classification
    - Chronic if 12 weeks
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16
Q

HDM Vs pollen allergy

A

HDM Vs pollen allergy

  1. Season
    - Winter house heating
  2. Mattress
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17
Q

Chronic rhino sinusitis
- Mx

A

Chronic rhino sinusitis
- Mx

  • without polyps
    1. Saline
    2. Corticosteroids
    3. ABx
    Eg.co-amox
    4. Decongestant
    Eg. Oxymetazoline
  • with polyps
    1. Medical
    -Steroid/saline, doxy
    2. Polypectomy
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18
Q

Epistaxis

  • Blood supply
  • Management
A

Epistaxis

  • Blood supply (warms air)
  • Management
    1. Head forward
    2. Thumb and index
  • on soft portion of nose
    3. Ice cube on roof of mouth
  1. Adrenaline and lignocaine cotton wool
  2. Cautery
  3. Sphenopalatine artery
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19
Q

Epistaxis
- Nasal packing brand

A

Epistaxis
- Nasal packing

  1. Merocel
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20
Q

Ear wax
- Make up
- Pathology

A

Ear wax

  • Make up
    1. Cerumen (water soluble)
  • Pathology
    1. Rare
    2. Completely impacted >2mm
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21
Q

Ossicles and window

A

Ossicles and window

  1. Malleus
  2. Incus
  3. Stapes

Oval window
(Round window allows for give)

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22
Q

Otoscopy
- Structures

A

Ear exam
- Structures

  1. Attic
  2. Handle of malleus
    - Pars placida
  3. Pars tensa
  4. Light reflex
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23
Q

Cochlea
- Components

A

Cochlea
- Components

  1. Organ of corti
    - Tonotropic distribution
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24
Q

Outer ear
- Symptoms

A

Outer ear
- Symptoms

  1. Pain
  2. Discharge
  3. Later, hearing loss
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25
Q

Middle ear
- symptoms

A

Middle ear
- symptoms

  1. Hearing loss - conductive
  2. Discharge
    - moderate mucoid
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26
Q

Inner ear
- Symptoms

A

Inner ear
- Symptoms

  1. Hearing loss
  2. Tinnitus
  3. Vertigo
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27
Q

Otology
- Exam Steps

A

Otology
- Exam Steps

  1. Healthy ear first
  2. Inspect
    - pinna
    - mastoid
  3. Otoscopy
    - Canal
    - Tympanic membrane
  4. Hearing test
    - Whisper
    - Tuning fork
  5. Facial nerve exam
  6. Coordination and Romberg
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28
Q

Otology
- Four investigations

A

Otology
- Four investigations

  1. Pure tone audiometry
  2. Tympanogram
  3. CT
  4. MRI
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29
Q

Pinna Haematoma
- Tx

A

Pinna Haematoma
- Tx

  1. Aspiration X 2
  2. Compression bandage
  3. 24hr review
  4. Surgical drain
    - quilted stitch
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30
Q

External ear
- conditions

A

External ear
- conditions

  1. BCC
  2. Otitis externa
    - Swollen
    - Debris
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31
Q

Otitis externa

  1. Organism
  2. Symptoms
  3. Treatment
A

Otitis externa

  1. Organism
    - Pseudomonas
  2. Symptoms
    - Painful
    - Serious discharge
    - Swollen canal
    - Debris
  3. Management
    Topical toilet (cleaning)
    Topical antibiotics
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32
Q

Otitis externa
- Complication

A

Otitis externa
- Complication

  1. Necrotising otitis externa
    - in diabetics
33
Q

Ear canal
- cold water swimmers condition

A

Ear canal
- cold water swimmers condition

  1. Exostoses
  2. Benign bony protrusions
34
Q

Eat drum
- chalky deposits

A

Eat drum
- chalky deposits

  1. Tympanosclerosis
  2. Benign
35
Q

Retracted tympanic membrane
- Mx

A

Retracted tympanic membrane
- Mx

  1. Differentiate from perforation
  2. Often no treatment
  3. Occasionally process to cholesteatoma
36
Q

Tympanic perforation
- Management

A

Tympanic perforation
- Management

  1. Dry
    - conservative
  2. Recurrent infections
    - surgery
    (Tympanoplasty)
37
Q

Acute otitis media
- Sx
- Mx

A

Acute otitis media
- Sx
1. Pain
2. Hearing loss
3. Ottorhoea

  • Mx
    1. Analgesia
    2. Antibiotic
  • especially <2yo
  1. Rarely mastoiditis
    - surgery
38
Q

Glue ear
- Pathology
- Tx

A

Glue ear

  • Pathology
    1. Common in children
    2. Middle ear fluid
  • Tx
    1. Observation
    2. Surgery
  • Grommets
  • Myringotomy
39
Q

Cholesteatoma
- Pathology
- Tx

A

Cholesteatoma

  • Pathology
    1. In growing epithelium
    2. Prone to infection
  • Tx
    1. Surgical excision
  • mastoid surgery (mastoid cavity created)
40
Q

Facial palsy
- Causes

A

Facial palsy
- Causes

  1. Idiopathic
    - Bell’s
  2. Otological
  3. Parotid
41
Q

Facial palsy
- Mx

A

Facial palsy
- Mx

  1. Eye care
    - Tape at night
    - Hypomellose QDS
  2. Steroids
  3. Ramsey Hunt - viral
42
Q

Paediatric Airway noises

A

Paediatric Airway noises

  • Stertors
    1. Sleep apnoea
    2. Bilateral Choanal atresia
  • Stridors
    1. Epiglottitis
    2. Laryngotracheobronchitis
    3. Laryngeomalacia
43
Q

Pediatric airways
- Congenital abnormalities

A

Pediatric airways
- Congenital abnormalities

  1. Haemangiomas
  2. Craniofacial abnormalities
44
Q

Pediatric airways
- Three exams

A

Pediatric airways
- Three exams

  1. Tongue depressor
  2. Rigid laryngoscopy
  3. Microlaryngobronchoscopy
45
Q

Paediatric airway
- Obstructive sleep apnoea

Mx

A

Paediatric airway
- Obstructive sleep apnoea mx

  1. Sleep study
  2. Adenotonsilectomy
46
Q

Acute tracheobronchitis
- Mx

A

Acute tracheobronchitis
- Mx

  1. Oxygen
  2. Steroids
  3. Adrenaline
47
Q

Laryngeomalacia
1. Anatomy
2. Mx

A

Laryngeomalacia

  1. Anatomy
    - Omega shaped epiglottitis
  2. Mx
    - Watchful waiting
    - Surgery (micro laryngoscopy)
48
Q

Recurrent respiratory papillomatosis
- Mx

A

Recurrent respiratory papillomatosis
- Mx

  1. Debride
49
Q

Haemangioma
- Mx

A

Haemangioma
- Mx
1. Propranolol

50
Q

Parotid gland tumors
- Types

A

Parotid gland tumors
- Types

  1. Pleomorphic adenoma
    -70%
  2. Wharthins Tumors (30%)
  3. Malignant 1%
51
Q

Hearing aids
- Audiometry

  1. Graph
  2. Normal level
A

Hearing aids
- Audiometry

  1. Frequency Vs amplitude (DB)
  2. 20db normal
52
Q

Otitis media
- organisms

A

Otitis media

  1. Fungal
    - Aspergillus Niger
  2. Bacterial
    - Pseudomonas
53
Q

Otitis externa
- Mx

  1. Standard
  2. Stenosis
  3. Cellulitis
A

Otitis externa
- Mx

  1. Standard
    - ABx eg. Cipro
  2. Stenosis
    - Steroid combination
    - Oto-wick
  3. Cellulitis
    - Mark borders
    - HbA1c
    - Systemic ABx eg IV Fluclox and Cipro
54
Q

Malignant otitis externa
- Pres

A

Malignant otitis externa
- Pres

  1. Immuno compromise
  2. Old Man
  3. Night pain
    - wakes them up
  4. Facial palsy
  5. Refractory
55
Q

Malignant otitis externa
- DDx

A

Malignant otitis externa
- DDx

  1. Malignancy
    - Histology
56
Q

Necrotising otitis externa
- Pathophysiology

A

Necrotising otitis externa
- Pathophysiology

  1. Pseudomonas
  2. Osteomyelitis
  3. Nerve palsies
57
Q

Necrotising otitis externa
- Mx

A

Necrotising otitis externa
- Mx

  1. CT/MRI
  2. IV antibiotics
    - 6/52
  3. Strict water precautions
  4. Micro suctioning
58
Q

Tongue tie
- S&S
- Grading
- Mx

A

Tongue tie

  • S&S
    1. Heart shaped tongue
    2. Drooling & slow feeding
    3. Swallowing air
    4. Clicking movements
    5. Feeding restriction
  • Grading
    1. Minimal
    4. Heart shaped
  • Mx
    1. Clipping
    2. No anaesthesia (/sensation)
    3. Maintain gap
  • Bottle
  • Fingers
59
Q

Tympanometry

  1. A
  2. Ad
  3. As
A

Tympanometry

  1. A
    - Compliance of 1.0 at 0 dePa
  2. Ad
    - Ossicular disarticulation
  3. As
60
Q

Tympanometry

  • Type B
  • Type C
A

Tympanometry

  • Type B
    1. Little or no peak
    2. Effusion/wax occlusion
  1. Perforation/grommet
  2. No seal/blocked probe
  • Type C
    1. Negative pressure
    2. Eustachian tube dysfunction
    3. Otitis media
    4. Possible retraction
61
Q

Otosclerosis
- Pathology

A

Otosclerosis
- Pathology

  1. Fusion of stapes
    - oval window
  2. Commonly familial
62
Q

Otosclerosis

  • Pres
A

Otosclerosis

  • Pres
  1. Young adult hearing loss
    - Female
    - Pregnant
  2. Gradual loss
    - Deep sounds
    - Whispers
  3. Quiet speech
  4. Easier to hear with background noise
  5. Tinnitus
63
Q

Laryngeomalacia
- Course
- Indication for surgery

A

Laryngeomalacia

  • Course
    1. Symptoms in first two weeks
    2. Self limiting in 2 years
    3. Improved by lying on front
  • Indication for surgery
    1. Poor feeding
    2. Low growth
    3. Cyanosis
64
Q

Otosclerosis
- Mx

A

Otosclerosis
- Mx

  1. Observe
  2. Hearing aid
  3. Surgery
    - Stapedectomy
    - Stapedotomy
65
Q

Tonsil
- Size grading

A

Tonsil
- Size grading

0 - within pillar
1 - <25% oropharynx
2 -26-50%
3 -50-75%
4. 75%+

66
Q

Quinsey
- Symptoms

A

Quinsey
- Symptoms

  1. Unilateral pain
  2. Jaw stiffness
    - Trismus
  3. Hot potato voice
67
Q

Ludwig’s angina
- ABx

A

Ludwig’s angina
- ABx

  1. CoAmox
  2. Met
68
Q

Middle Meatus
- Connection

A

Middle Meatus
- Connection

  1. Ethymoidal sinus
69
Q

Little’s area
- Supply

A

Little’s area
- Supply

  1. Ethmoidal (A and P)
  2. Sphenopalatine
  3. Superior labial (septal branch)
  4. Greater palatine
70
Q

Epistaxis
- Age groups

A

Epistaxis
- Age groups

  1. Young
    - Trauma
    - Haematology
  • Illicit drugs
  1. Old
    - Mucosal atrophy
    - Cancers
71
Q

Nasal packing
- More than 48hrs

A

Nasal packing
- More than 48hrs

  1. Antiseptic
    - bismuth eg. BIPP
  2. Antibiotic prophylaxis
72
Q

Epistaxis
- Surgical management

A

Epistaxis
- Surgical management

  1. Sphenopalatine artery
  2. External carotid artery
73
Q

Facial SSC
- Ix

A

Facial SSC
- Ix

  1. Punch Biopsy
  2. Nasal endoscopy
  3. CT chest
74
Q

Polyp
- Reactive history

A

Polyp
- Reactive history

  1. Allergies
  2. Smoking
  3. Aspirin
75
Q

Samter’s Triad

A

Samter’s Triad

  1. Asthma
  2. Nasal polyposis
  3. NSAID hypersensitivity
76
Q

Polyp
- Differentation from turbinates

  1. Paler colour
  2. Floppy/not rigid
  3. Non-sensate
A
77
Q

Polyps
- Malignant differentials

A

Polyps
- Malignant differentials

  1. SCC
  2. Adenocarcinoma
  3. Olefactory neuroblastoma
  4. Rhino-encapholocele
    - In children
78
Q

Antrum choanal polyp
- Presentation

A

Antrum choanal polyp

  1. Grey growth
  2. Growth down into mouth

Year 4 - NSS (5 decks)

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