ENT Flashcards
Vestibular neuroticism and features
Inflammation of the vestibular nerve
- Single episode
- Severe dizziness
- N+V
Non-functioning lump Ix
(After TFTs)
USS of neck
Epistaxis mx
If minor bleeding from accessible site: cautery + d/c w/ topical naseptin (if persists -> anterior packing + d/c w/ ENT r/v next day [if persists ->admit +post packing)
Profuse bleeding from sites difficult to localise: admit + post pack ±abx
Which sinus is most associated with chronic sinusitis?
Maxillary sinus
Acoustic neuroma and features
Benign brain tumour (aka vestibular schwannoma)
Slow onset
- 1-sided Sensorineural hearing loss
- Vertigo
- Tinnitus
- TM fine
±neurofibromatosis
Meniere’s disease
Condition of inner ear that causes sudden attacks
- Feeling of fullness in one ear
- Episodes vertigo
- Episodes end with hearing loss and tinitus
Osteosclerosis and features
Abnormal bone growth in the middle ear
- Conductive hearing loss
- Worse during preg
Tympanosclerosis
Scarring of ear drum leading to calcification / chalky deposits
Which infx is most commonly associated with tonsillar SCC?
HPV
Sinusitis mx
doxycycline
Where do most epistaxes occur?
Anteriorly in Little’s area
Features of posterior bleed
- profuse bleeding
- bleeding bilat
- no bleeding points can be found
Evolving sunburn-like erythema and confusion >48h nasal packing
Toxic shock syndrome
How often should nasal packing be changed to reduce risk TSS?
48h
vertigo + tinnitus + aural fullnes w/ persistent, foul smell
cholesteatoma (abnormal collection of skin cells deep inside your ear)
Acoustic neuroma ix
MRI
Meniere’s ix
audiometry
Peripheral (ENT) v central (neuro) vertigo
Peripheral
- can walk but may be reluctant
- Hearing loss/tinnitus common
- No other neuro signs
- Horizontal + fatiguable nystagmus
Central
- Inability to stand/walk
- Hearing loss/tinnitus uncommon
- Commonly DANISH (cerebellar) signs
- Multi-directional & non-fatiguable nystagmus
Bilateral cervical lymphadenopathy + fever + myalgia + testicular swelling
Mumps
Acid/bitter taste in mouth whilst eating + pain in parotic/submandibular region
salivary duct stones
Severe tonsillitis mx
- senior support: anaesthetics+ senior ENT
- High flow O2
- Adrenaline nebs
- IV dex + abx
FeverPAIN score criteria and what scoring means
- Fever in last 24hr >38C
- Purulent tonsils
- Attend rapidly <3 days
- Inflammation of tonsils ++
- No cough
0-1: No abx, self care
2-3: back up abx
4-5: abx
Tonsillitis mx
Phenoxymethylpenicillin (5days)
or alt clarithromycin
features of mod acute tonsillitis
- unable to freely swallow fluids
- muffled voice
- clinically unwell
mod acute tonsillitis mx
- IV abx
- IV dexameth
- fluids
- analgesia
±drain Quinsy (abscess) if needed
Ludwig’s angina and features
Severe cellulitis involving floor of mouth where swelling develops rapidly
- tongue displaced superiorly and post -> blocking airway
Ludwig’s angina mx
- Airway mx
- IV steroids
- IV abx
SIGN criteria for tonsillectomy
- > = 7 episodes treated in 1 year, or >5 in 2 year period
- tonsils cause signif OSA in children
Otitis media mx
Amoxicillin
