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ENT Flashcards

1
Q

Tx of otitis media externa

A

Topical ABx +/- steroids then oral flucloxaccilin

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2
Q

Necrotising otitis media externa sx and mx

A

Extension to mastoid and temporal bones
Urgent ENT referral, CT head, IV cipro

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3
Q

Management of otitis media

A

Admit if severe systemic, complications, <3m with 38

W/o perf- >4d abx
With perf- oral amor 5d
With effusion- observe

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4
Q

Complications of otitis media

A

Perforation- damage chordates tympani- reduce taste in anterior 2/3

Mastoiditis- discharge and swelling behind ear

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5
Q

Mx of cholesteatoma

A

Referral for surgery

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6
Q

Sx of meniere disease

A

Clustered attacks- <12hrs
Fullness
Progressive SNHL- unilateral
Vertigo
Tinnitus

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7
Q

Ix and Mx of Menderes disease

A

Audiometry
Cyclizine- anti emetic , betahistine- anti vertigo

Surgical

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8
Q

Viral neuronitis vs labyrinthitis sx

A

After URTI
Vertigo and nystagmus

VL- hearing may be affected
VN- no hearing

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9
Q

BPPV sx

A

Sudden rational vertigo <30s
Provoked by head turning
Nystagmus

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10
Q

BPPV ix and mx

A

Ix- Dix hallpike- up beat nystagmus

Mx- Epley + beta histine

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11
Q

Causes of hearing loss

A

Conductive- external canal obstruction
Tympanic membrane perf
Ostsclerosis

SN
Drugs- aminoglycosides, vancomycin
Infective
Menieres, MS

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12
Q

Sx of vestibular schwannoma

A

Unilateral
SNHL
Vertigo
Headahce
CN palsies- absent corneal. reflex

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13
Q

Otosclerosis sx

A

Bilateral conductive deafness and tinitus

Can have redness of promontory of cochlea

Family history
Improve with noise and worse with pregnancy, menstruation

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14
Q

Mx of otosclerosis

A

Hearing aid
Stapes implant

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15
Q

Mx of vestibular schwannoma

A

Gamma knife surgery
Radio

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16
Q

Mx of sinusitis

A

> 10d- high dose nasal CS for 14d

Phenoxymethylpenicillin- 7d if think infective

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17
Q

Samters triad

A

Asthma, nasal polyps, aspirin hypersensitivity

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18
Q

Mx of fractured nose

A

If septal haematoma- evacuation, packing and suturing

Reduce before swelling
Or if swelling- re examine after 1 week

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19
Q

Mx of epistaxis

A

Compress nasal cartilage 15 mins
If bleeding visualised- cautery
Non- packing
If continue- referral

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20
Q

What is quinsy

A

Peri tonsillar abscess causing uvula deviation

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21
Q

What prompts tonsillectomy

A

7 in 1 year
5 for 2 years
3 for 3

2 of quinsy or 1 quinsy with significant tonsillitis

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22
Q

Sx of Scarlett fever

A

2-4 days after GAS
Sandpaper rash

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23
Q

Organsim causing tonsillitis

A

Strep pyogenes

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24
Q

Bells palsy mx

A

Eye care
Pred 50mg 10 days

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25
Q

Ramsay hunt syndrome sx

A

Vesicular rash around ear
Facial nerve palsy
Vertigo

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26
Q

Mx of Ramsay hunt

A

Valciclovir 7d and steroids 5d

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27
Q

Sx of septal haematoma

A

Bilateral purple swelling

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28
Q

Mx of septal haematoma

A

Surgical drainage
Examination underanaesthatic
If not swelling reduce, if swelling- examine in 1 week

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29
Q

Sx of brachial cyst

A

Cyst in lateral neck, superficial to SCM muscle
With acellular fluid with cholesterol crystals in aspirate

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30
Q

Sx of thyroglossal cyst

A

Midline
Moves with tongue

31
Q

When to refer oral ulcer to secondary care

A

> 3 weeks of unexplained persistent ulcer

32
Q

Mx of sudden vertigo and dysduadochokinesis

A

Referral
CT head
?stroke

33
Q

Problem with using nasal decongestants for long periods

A

Rhinitis medicamentosa
Withdrawal of extended use
Should cease use

Tachyphylaxis

34
Q

Sx of nasopharyngeal cancer

A

Unilateral ear effusion
Not associated with URTI
Otalgia

2ww referral

35
Q

Sx of perforation

36
Q

Bleeding after tonsillectomy mx

A

If 6-8hrs- primary- return to theatre

If 5-10d- secondary haemorrhage
urgent seen by ENT and ABx

37
Q

Interpretation of audiograms

A

Above 20db line normal
In SN- both bone and air impaired
Conductive- only air
Mixed- both

38
Q

Bleed after thyroid surgery mx

A

Removal of stitches and call for senior help

39
Q

Organism for otitis media

A

H influenza

40
Q

Sx of bacterial sinusitis

A

Double sickening
Initial period and recovery
Then sudden worsening
Frontal pressure- worse leaning forwards
Thick discharge

41
Q

Surgical management of untreatable epistaxis

A

Ligation of sphenopalatine artery

42
Q

Mx of vestibular neuritis

A

Prochlorperazine for acute phase

43
Q

Sx of cholesteoma

A

Chronic ear infections
Offensive discharge
SNL
Vertigo

44
Q

Antiseptic for epistaxis and its CI

A

Naseptin
Contains peanuts

45
Q

Mx of perf tymp from barotrauma

A

Self limiting
Follow up in a few weeks

46
Q

Organism of otitis external

A

Pseudomonas aeruginosa

47
Q

Sx of otitis externa vs media

A

Externa- recent swimming- ear pain, itch, discharge - red swollen canal on otoscopy
Pain on trigs pull

Media- bulging tympanic membrane on otoscopy
after URTI
Discharge- perforation
Glue- retracted tympanic membrane

48
Q

Sx of cholesteatoma

A

foul-smelling, non-resolving discharge
hearing loss

49
Q

Mx of menieres

A

Prochlorperazine
Prevent attacks with beta histine

50
Q

Drugs causing hearing loss

A

Quinine
Furosemide
Gentamicin
Aspirin
Chemo

51
Q

2WW referral for laryngeal cancer

A

aged 45 and over with:
persistent unexplained hoarseness or
an unexplained lump in the neck

52
Q

2WW referral for oral cancer

A

unexplained ulceration in the oral cavity lasting for more than 3 weeks or
a persistent and unexplained lump in the neck.

53
Q

Sialolithiasis vs Sialadenitis

A

Sialothiasis- stone- colicky pain and post prandial swelling of the gland

Sialadenitis
Staphylococcus aureus infection
Pus may be seen leaking from the duct, erythema may also be note

54
Q

Mx of glue ear

A

No cormibidities- observe 6-12 weeks
Downs/cleft plate- ENT

55
Q

Positive Rinne test

56
Q

Perf eardrum feature and rinne and webers

A

Trauma, muffled sound
Rinne negative, Weber localise to affected side

57
Q

Bleeding after tonsillectomy

A

Referral to ENT

58
Q

Auricular haematoma mx

A

referral to ENT

59
Q

Conductive vs SN loss

A

Conductive- outer ear to round window(inner ear) - wax, perforation, ossicle defect

SN- inner ear- cochlea, nerve or brain- drugs, infection, meunière, MS

60
Q

Mx of vestibular neuritis

A

prochlorperazine- rapid relief - short course
vestibular rehabilitation exercises are the preferred treatment for patients who experience chronic symptoms

61
Q

Mx of mastoiditis

62
Q

Otosclerosis sx

A

Conductive deafness
Tinnitus
Flamingo tinge- tympanic membrane
Bilateral

63
Q

Presbycusis sx

A

Age related SN loss
Audiometry shows bilateral high-frequency hearing loss

64
Q

Mx of nasal polyp

A

Large unilateral- urgent referral to ENT
Most drink with CS

65
Q

Sudden SN hearing loss mx

A

Urgent referral and CS

66
Q

Nasopharyngeal carcinoma sx

A

Otalgia
Unilateral serous otitis media
Nasal obstruction- epistaxis
CN palsies

67
Q

Light reflex

A

Reflexting off surface of eardrum
Loss in otitis media

68
Q

Nasal haematoma mx

A

Urgent referral for drainage

69
Q

Peripheral vs central nystagmus tests

A

Nystagmus- unidirectional peripheral, bidirectional central

Abnormal head impusle- peripheral

Skew- Vertical central

70
Q

Nystagmus direction for labyrinth causes vs central

A

Central- towards and worse towards lesion

Labyrinth- away

Fast phase- saccade side named nystagmus

So left labyrinth cause- right beating nystagmus
Right cerebellar- right beating nystagmus

71
Q

Most common cause of laryngeal cancer

72
Q

Cause and tx of sudden onset SN hearing loss

A

Idiopathic
Treat with steroids

73
Q

Important part of ear to visualise in chronic discharge

A

Attic- for cholestoma

74
Q

Malodourous chronic discharge mx

A

Refer to ENT since could be cholestolema

Year 6 (28 decks)

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