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Medicine Year 5 > ENT > Flashcards

ENT Flashcards

1
Q

Bilateral age related sensorineural hearing loss

A

Presbycusis

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2
Q

presenting complaint of presbycusis

A

cannot follow conversations

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3
Q

bilateral conductive hearing loss at 20-30 years with associated tinnitus and vertigo

A

otosclerosis

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4
Q

inheritance of otosclerosis

A

autosomal dominant

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5
Q

otoscopy finding in otosclerosis

A

flamingo tinge

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6
Q

pathophysiology of otosclerosis

A

normal bone is replaced by vascular spongey bone

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7
Q

conductive hearing loss at 2 years

A

otitis media with effusion (glue ear)

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8
Q

3 complications of glue ear

A

speech and language delay
behavioural problems
balance issues

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9
Q

2 conditions requiring immediate ENT referral for glue ear

A

downs or cleft palate

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10
Q

name 4 ototoxic drugs

A

aminoglycosides (gentamicin)
furosemide
aspirin
cytotoxic drugs

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11
Q

bilateral high frequency hearing loss in a factory worker

A

noise damage

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12
Q

explain the meaning of rinne negative and positive

A

negative is abnormal (bone > air)
positive is normal (air > bone)

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13
Q

explain webers results in unilateral sensorineural and conductive hearing loss

A

conductive: weber localises to the affected side
sensorineural: weber localises to the unaffected side

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14
Q

most common organism in otitis media

A

h. influenzae

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15
Q

when do you give abx in otitis media

A

if perforation, systemically unwell or under 2 years

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16
Q

what abx are given in otitis media

A

5 day amoxicillin

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17
Q

management of otitis externa

A

topical steroid and abx drops

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18
Q

difference in management of otitis externa in diabetes

A

ciprofloxacin to cover pseudomonas

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19
Q

perforated tympanic membrane for 6w

A

refer to ENT for myringoplasty

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20
Q

management of acute sensorineural hearing loss

A

immediate ENT referral
high dose oral prednisolone
MRI, audiology

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21
Q

most common cause of sensorineural hearing loss

A

idiopathic

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22
Q

criteria for cochlear implant in adults

A

failed trial of hearing aid

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23
Q

sudden onset vertigo post viral infection with loss of hearing

A

viral labyrinthitis

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24
Q

recurrent vertigo attacks post viral infection with no hearing loss

A

vestibular neuronitis

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25
Q

examination findings for vestibular neuronitis

A

horizontal nystagmus

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26
Q

treatment of vestibular neuronitis

A

prochlorperazine in acute phase
then vestibular rehabilitation exercises

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27
Q

gradual onset of vertigo triggered by changes in head position which last 1-20 seconds

A

BPPV

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28
Q

diagnosis and treatment of BPPV

A

Diagnosis: Dix Hallpike
Treatment: Epley

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29
Q

what would the dix hallpike test show in BPPV

A

rotatory nystagmus

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30
Q

elderly patient with dizziness on neck extension

A

vertebrobasilar ischaemia

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31
Q

recurrent episodes of vertigo, tinnitus and sensioneural hearing loss lasting 30-60 mins with a sensation of fullness/roaring in the ear

A

Meniere’s disease

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32
Q

examination findings in meniere’s disease

A

Romberg positive
Nystagmus

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33
Q

medication to prevent meniere’s

A

Betahistine

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34
Q

unilateral vertigo, tinnitus and sensorineural hearing loss with an absent corneal reflex and possible facial palsy

A

Acoustic neuroma
(vestibular schwannoma)

35
Q

association with acoustic neuromas

A

Neurofibromatosis type 2

36
Q

cranial nerves involved in acoustic neuroma

A

V: absent corneal reflex
VII: facial nerve palsy
VIII: hearing loss, vertigo and tinnitus

37
Q

what does the HINTS exam distinguish between

A

vestibular neuronitis and posterior circulation stroke

38
Q

age of onset for cholesteatoma

A

10-20 years

39
Q

medication which can cause tinnitus

A

Aspirin/NSAIDS

40
Q

unilateral middle ear effusion in an adult

A

can indicate nasopharyngeal cancer

41
Q

what is samters triad

A
  1. asthma
  2. aspirin sensitivity
  3. nasal polyps
42
Q

treatment for nasal polyps

A

topical steroid

43
Q

unilateral polyps

A

red flag

44
Q

most common site of bleeding in epistaxis

A

little’s area
anterior nasal septum

45
Q

management of epistaxis for a non visible bleeding site

A

anterior packing

46
Q

management of epistaxis for a visible bleeding site

A

silver nitrate cautery

47
Q

medication to avoid in peanut allergy

A

Naseptin

48
Q

management of epistaxis when the nose will not stop bleeding

A

sphenopalatine ligation in theatre

49
Q

management of ramsay hunt syndrome

A

7 day oral aciclovir
5 day steroids

50
Q

when would you consider abx and intranasal decongestants in sinusitis

A

no recovery in 10 days
or double sickening

51
Q

management of chronic rhinosinusitis

A

nasal irrigation with saline

52
Q

what is rhinitis medicamentosa

A

rebound nasal congestion due to extended decongestant use

53
Q

neck lump after viral infection

A

reactive lymph nodes

54
Q

rubbery and painless neck lump which worsens with alcohol and is associated with night sweats and splenomegaly

A

lymphoma

55
Q

neck lump which moves up on swallowing and is associated with thyroid symptoms

A

thyroid swelling

56
Q

midline neck lump in a 20 year old patient between the thyroid isthmus and hyoid bone which moves up with protrusion of the tongue and can present as painful if infected

A

Thyroglossal cyst

57
Q

older man presenting with dysphagia, regurgitation, aspiration and chronic cough with a midline lump that gurgles

A

pharyngeal pouch

58
Q

congenital lymphatic lesion in the neck at birth (commonly the left) which transilluminates

A

cystic hygroma

59
Q

mobile cyst between the sternocleidomastoid muscle and pharynx presenting in early adulthood with cholesterol crystals and fluid

A

branchial cyst

60
Q

pathophysiology of branchial cyst

A

failure of closure of the second branchial cyst

61
Q

multiloculated and heterogeneous lump above hyoid

A

dermoid cyst

62
Q

what is a cervical rib associated with

A

thoracic outlet syndrome

63
Q

epidemiology of cervical rib

A

adult female

64
Q

pulsatile neck mass which does not move on swallow

A

carotid aneurysm

65
Q

young adult presenting with pancreatitis, orchitis, hearing loss and encephalopathy with a neck lump

A

mumps
viral parotitis

66
Q

facial nerve palsy and parotid swelling

A

sarcoidosis

67
Q

slow growing painless mobile lump in parotid gland of older female

A

pleomorphic adenoma

68
Q

management of simple bacterial tonsillitis

A

10 days of oral pen v

69
Q

tonsillitis with ulnar deviation

A

quinsy (peritonsillar abscess)

70
Q

management of quinsy

A

IV Abx and surgical drainage
consider tonsillectomy in 6w

71
Q

management of a primary and secondary post-tonsillectomy haemorrhage

A

for both CALL ENT
primary (in hrs): return to theatre
secondary (5-10 days): abx (commonly infection)

72
Q

what infection is tonsillar SCC associated with

A

HPV

73
Q

globus, hoarseness, no red flags

A

laryngopharyngeal reflux

74
Q

management of laryngopharyngeal reflux

A

trial of PPI

75
Q

management of 3w hx of mouth ulcer

A

2ww to oral surgery

76
Q

name 4 causes of gingival hyperplasia

A

phenytoin, ciclosporin, calcium channel blockers and AML

77
Q

what is ludwigs angina

A

rare infection of mouth floor and neck and soft tissues

78
Q

treatment of acute necrotising ulcerative gingivitis

A

paracetamol
metronidazole
chlorhexidine mouthwash

79
Q

what is mastoiditis

A

post auricular inflammation

80
Q

management of mastoiditis

A

IV Abx immediately (can cause meningitis)

81
Q

what is siaidentitis

A

inflammation of the salivary glands secondary to obstruction (stones in submandibular gland occlude wharton’s duct)

82
Q

episodic facial pain, dry mouth and halitosis

A

siaidenitis

83
Q

which duct drains the parotid gland

A

stenses duct

Medicine Year 5 (27 decks)

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