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Special Senses > ENT > Flashcards

ENT Flashcards

1
Q

Acute otitis media presentation

A

otalgia, fever, hearing loss, recent viral URTI and may present with ear discharge in children

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2
Q

Acute otitis media otoscope

A

bulging tympanic membrane with loss of light reflex, perforation with purulent otorrhoea

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3
Q

Acute otitis media Management

A

Generally self-limiting and does not required but if persists more than 4 days.

Abx if perforation or comorbidities

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4
Q

Acute sinusitis common causes

A

Haemophylis influenza and streptococcus pneumonia

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5
Q

Acute sinusitis presentation

A

Facial pain, nasal obstruction and nasal discharge

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6
Q

Acute sinusitis management

A

Analgesia, saline washout and intranasal decongestants
Intranasal corticosteroids if symptoms persist for more than 10 days
Oral Pen V if symptoms are severe

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7
Q

Most common organism causing tonsilitis

A

Strep pyogenes

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8
Q

Criteria for tonsilitis

A

CENTORS criteria:
No cough
Exudative tonsils
Cervical lymphadenopathy
Fever >38

FEVERPAIN score:
Fever for the previous 24 hours
Purulent tonsils
Attends within 3 days
Inflammed tonsils
No cough

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9
Q

Management of tonsillitis

A

If centor score>3 and feverpain score>4, prescribe antibiotics.

PenV (first-line)
Clari (if pen allergic)

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10
Q

Allergic rhinitis presentation

A

Sneezing, nasal obstruction and post-nasal drip

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11
Q

Management of allergic rhinitis

A

Allergen avoidance
Mild-to-moderate -> oral or intranasal antihistamines
Moderate-to-severe -> intranasal corticosteroids

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12
Q

Management of auricular haematomas

A

Same day assessment by ENT for incision and drainage

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13
Q

Benign paroxysmal positional vertigo presentation

A

Vertigo triggered by changes in head position. Lasts for 10-20 seconds each. Associated with nausea

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14
Q

Diagnosis of benign paroxysmal positional vertigo

A

Dix-hallpike manouevre - will show rotatory nystagmus

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15
Q

Managment of BPPV

A

Epley manoeuvre
Betahistine

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16
Q

What is a cholesteatoma?

A

Non-cancerous growth of squamous epithelium

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17
Q

Presenting features of cholesteatomas

A

Foul smelling
Non-resolving discharge
Hearing loss

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18
Q

What would you find on otoscopy with cholesteatoma?

A

Attic crust in the upper most part of the ear drum

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19
Q

Management of cholesteatoma

A

Refer to ENT

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20
Q

Cochlear impact suitability

A

Must have trialled hearign aids for a minimum of 3 months

21
Q

Otosclerosis presentation

A

conductive hearing loss with positive family history
Autosomal dominant

22
Q

Difference between glue ear and acute otitis media

A

Glue ear is otitis media with effusions

23
Q

Meniere’s disease triad

A

Vertigo, tinnitus and hearing loss
sensation of fullness within the ear

24
Q

Acoustic neuroma presentation

A

Tinnitus, vertigo and hearing loss
facial palsy

25
Q

Ear wax management

A

Irrigation or ear drops (olive oil)

26
Q

Causes of epistaxis

A

Trauma
Foreign body
Nose-picking
Cocaine use
Granulomatosis with polyangitis
Bleeding disorders

27
Q

Management of epistasis

A

First aid: lean forward and pinch nasal folds
If bleeding does not stop:
and bleeding point visible - silver nitrate cautery
if bleeding point not visible - packing
if bleeding continues - theatre for sphenopalatine ligation

28
Q

Management of glue ear

A

Grommet
Adenoidectomy

29
Q

What would you be worried about if patient comes in with unilateral serous otitis media?

A

Nasopharyngeal cancer

30
Q

How would you manage a perforated tympanic membrane that’s not healing?

A

Myringoplasty

31
Q

Malignant otitis externa - who gets it?

A

Immunocompromised individuals

32
Q

Malignant otitis externa - common causative organism

A

pseudomonas aureginosa

33
Q

Malignant otitis externa - progresses to what?

A

temporal osteomyolitis

34
Q

Diagnosis of Malignant otitis externa

A

CT scan

35
Q

Malignant otitis externa - management

A

refer to ENT for IV antibiotics

36
Q

Management of mastoiditis

A

IV antibiotics

37
Q

What is samster’s triad?

A

Asthma, aspirin sensitivity and nasal polyps

38
Q

Features of nasal polyps

A

Nasal obstruction, rhinorrhoea and poor sense of taste and smell

39
Q

Management of nasal polyps

A

Topical corticosteroids to shrink the polyp

40
Q

What features of polyps would make you worry?

A

Unilateral + bleeding

41
Q

Management of otitis externa

A

Topical antibiotics and a steroid for 1-2 weeks

If patients fail to respond to topical antibiotics, refer to ENT

42
Q

Features of quinsys

A

Severe throat pain which lateralises to one side
Deviation of the uvula to the unaffected side
Reduced neck mobility

43
Q

Definition of primary vs secondary haemorrhage following a tonsillectomy

A

Primary within the first 6-8 hours
Secondary within 5-10 days post surgery

44
Q

Management of primary haemorrhage following a tonsillectomy

A

Immediate return to theatre

45
Q

Management of secondary haemorrhage following tonsillectomy

A

IV antibiotics and admission

46
Q

Organism causing ramsay hunt syndrome

A

Varicella zoster virus

47
Q

Features of ramsay hunt syndrome

A

Auricular pain
Facial nerve palsy
Vesicular rash around the ear and eye

48
Q

Management of ramsay hunt syndrome

A

Oral aciclovir and corticosteroid

49
Q

Complications of thyroid surgery

A

Recurrent laryngeal nerve damage
Bleeding
Hypocalcaemia - damage to parotid glands

Special Senses (3 decks)

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