ENT Flashcards
What are features of presbycusis?
difficulty hearing high-pitched sounds
Difficulty differentiating ‘s’ and ‘th’
Finding women’s voices more difficult to hear than mens - high frequency hearing loss
Bilateral impairment
what organism causes epiglottitis?
Haem influenzae B
What is a cholesteatoma?
serious and rare complication of chronic otitis media and commonly occurs in younger patients (aged 5-15 years old)
it is caused by the abnormal accumulation of skin, squamous epithelium within the middle ear cleft and mastoid ear cells
How does cholesteatoma present?
foul smelling discharge, headache and otalgia
area of white in the attic behind the tympanic membrane seen on examination (?)
What are the features of acute otitis media?
deep seated pain, impaired hearing with systemic illness and fever
onset is usually rapid with a feeling of aural fullness followed by discharge when the tympanic membrane perforates with relief of pain
Tympanic membrane shows injection of blood vessels and then diffuse erythema
Bacterial infection is common particularly in young people
What are the risk factors of scleritis?
rheumatoid arthritis - most common associated condition
SLE
sarcoidosis
granulomatosis with polyangiitis
what are the features of scleritis?
red eye
classically painful but sometimes only mild pain/discomfort is present
watering and photophobia are common
gradual decrease in vision
how is scleritis managed?
same day assessment by ophthalmologist
oral NSAIDs are typically first-line
oral glucocorticoids
immunosuppressive drugs for resistant cases
How should acute sinusitis be treated?
analgesia
intranasal decongestants or nasal saline
intranasal corticosteroids may be considered if symptoms have been present for more than 10 days
oral antibiotics are not normally required but may be given for severe presentations
How should perforated tympanic membrane be managed?
- no treatment needed in majority of cases as membrane will usually heal after 6-8 weeks - avoid getting water in the ear during this time
- prescribe abx to perforations that occur after an episode of acute otitis media
myringoplasty may be performed if the tympanic membrane does not heal by itself
What features suggest an adenocarcinoma of the oesophagus?
progressive dysphagia, may have previous symptoms of GORD or Barretts oesophagus
what is a thyroglossal cyst?
more common in patients < 20y/o
usually midline, between the isthmus of the thyroid and the hyoid bone
moves upwards with protrusion of the tongue
may be painful if infected
what is a cystic hygroma?
a congenital lymphatic lesion typically found in the neck, classically on the left side
most are evident at birth, around 90% are present before 2 years of age
what is a branchial cyst?
an oval, mobile, cystic mass that develops between the sternocleidomastoid muscle and the pharynx
develops due to failure of obliteration of the 2nd branchial cleft in embryonic development
usually present in early adulthood
what are the features of otitis externa?
ear pain, itch, discharge
otoscopy: red, swollen or eczematous canal
