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ent Flashcards

1
Q

Are unilateral nasal polyps a red flag

A

Yes

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2
Q

What is a serum mono spot test

A

To test for mononucleosis / glandular fever

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3
Q

Investigation for BPPV

A

Dix-hallpike

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4
Q

Treatment for BPPV

A

Epley

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5
Q

T/F bilateral polyps are a red flag

A

F - a unilateral polyp is red flag

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6
Q

What is Samter’s triad

A

Asthma
Aspirin sensitivity
Nasal polyposis

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7
Q

Treatment for polyps

A

Topical corticosteroids usually work

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8
Q

*carhart notch @ 2000hz

A

Otosclerosis

  • stapes
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9
Q

Which organisms are commonly found in acute otitis media

A

Strept. Pneumoniae
Haemophilus influenza
Moraxella catarrhalis

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10
Q

Via what route does the normal middle ear relieve the air within it

A

Via the Eustachian tube

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11
Q

What additional treatment to grommet insertion can improve resolution of otitis media with effusion

A

Adenoidectomy

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12
Q

What is thought to be the underlying pathophysiology behind otitis media with effusion

A

Poor Eustachian tube function

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13
Q

How do grommets prevent accumulation of middle ear effusion

A

By allowing equalisation of pressure between the air in the middle ear and atmosphere

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14
Q

name missing

A
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15
Q

Name missing

A
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16
Q

Name missing

A
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17
Q

Name missing

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18
Q

Name missing

A
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19
Q

What are chemoreceptors

A

Taste adn smell receptors

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20
Q

How often are chemoreceptors replaced

A

Every 10 days

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21
Q

How often are olfactory receptors replaced

A

Every 2 months

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22
Q

What cells replaces taste and smell receptors ?

A

Basal cells

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23
Q

What do the olfactory bulb neurons pass through to reach the temporal lobe adn olfactory areas

A

The olfactory tract

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24
Q

How do the vagus nerve exit the cranial cavity

A

Via jugular foramen

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25
Q

What is the first nerve to branch off of vagus

A

Superior laryngeal nerve

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26
Q

How does the vagus nerve descend through the neck ?

A

Through the carotid sheath

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27
Q

What nerve branches off the vagus at the mediastinum and then ascends ?

A

Recurrent laryngeal

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28
Q

*vertigo lasting seconds to minutes

A

BPPV

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29
Q

*vertigo lasting days - weeks

A

Labyrinthitis AND vestibular neuronitis

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30
Q

What triggers BPPV

A

Positional changes

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31
Q

*vertigo lasting 20 minutes to several hours

A

Menieres

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32
Q

Vertigo associated conditions associated with hearing loss and/or tinnitus

A

Menieres + labyrinthitis

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33
Q

What can be seen on blood film of glandular fever ?

A

Atypical lymphocytes

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34
Q

Second line treatment of child with persistent otitis media with effusion (persisten glue ear)

A

Adenoidectomy

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35
Q

Other than antibiotics what other medication can you give in severe tonsillitis

A

Steroids

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36
Q

First line treatment for child with persistent otitis media with effusion

A

Grommet insertion

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37
Q

Does otitis media with effusion present with signs and symptoms of acute inflammation

A

No

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38
Q

What is a cystic hygroma

A

A benign congenital lymphatic lesion, most commonly located in left posterior triangle of neck

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39
Q

*neck lump that can sometimes present pain when drinking alcohol

A

Hodgkin’s lymphoma

40
Q

*neck lump that usually presents within 2 years of life

A

Cystic hygroma

41
Q

*neck lump commonly seen in older men

A

Pharyngeal pouch

42
Q

*neck lump usually located between isthmus of thyroid and hyoid bone

A

Thyroglossal cyst

43
Q

*neck lump = most common cause if neck

A

Reactive lymphadenopathy

44
Q

*neck lump that moves upwards on swallowing

A

Goitre

45
Q

*neck lump associated with dysphagia , aspiration and chronic cough and commonly seen in older men

A

Pharyngeal pouch

46
Q

*pulsatile lateral neck lump

A

Carotid sheath

47
Q

What criteria is used to determine whether or not a sore throat is likely to be viral or bacterial ?

A

CENTOR

One point for each:
Tonsillar exudate
Tender anterior cervical nodes
History of fever
Absence of cough

48
Q

What is the most common bacteria fro sore throat ?

A

Streptococcus pyogenes (group a)

49
Q

What group of pathogens cause the majority of tonsillitis cases ?

A

Viruses

50
Q

Are throat swabs routinely taken in primary care

A

Mo

51
Q

Gram + cocci chains

A

Streptococcus pyogenes

52
Q

Pathogen that causes glandular fever

A

EBV

53
Q

Pathogen that produces a potent exotoxin

A

Corynebacterium diphtheria

54
Q

Most common causative organism of otitis externa (Swimmers ear)

A

Staph. Aureus

55
Q

Most common causative organism of otitis media

A

Haemophilus influenza

56
Q

What vertebral level is the thyroid cartilage located

A

C4/5/6

57
Q

What vertebral level is the cricoid cartilage located

A

C6

58
Q

At what vertebral level is the hyoid cartilage located

A

C3

59
Q

What is this likely to be

A

Otitis external - fungal cause

60
Q

What is this likely to be

A

Cholesteatoma

61
Q

What is this likely to be

A

Cholesteatoma

62
Q

What is this likely to be

A

Glandular fever -

Can be distinguished from bacterial tonsillitis due to gross enlargement of the tonsils with membranous exudate

63
Q

Investigation for glandular fever

A

Monospot +

Or

Paul Bunnel test

64
Q

What is this

A

Candidiasis

65
Q

What are the 4 features if labyrinthitis other than vertigo

A

Vertigo lasting days to weeks
Associated with viral infection
Associated with hearing loss or/and tinnitus
May experience tinnitus on affected side

66
Q

What is Ramsay hunt syndrome

A

Caused by reactivation of varicella zoster in the geniculate ganglion

Characterised by unilateral facial nerve palsy (CN VII)

Presents as: unable to raise eyebrows, or bear teeth, loss of nasalabial folds

Lesions are also visible with crusting in to behind the ear

67
Q

*pink tinge on tympanic membrane

A

Otosclerosis

This is known as Schwarze sign

68
Q

How to manage acute otitis media

A

Delayed oral antibiotic prescription (if symptoms don’t clear within 3 days come for antibiotics)

NICE recommends amoxicillin for acute OM w/o complications

69
Q

Management of Menieres

A

Prophylactic use of betahistine to reduce frequency of attacks

Acute use management = prochlorperazine

70
Q

What cancers is HPV associated with

A

Increased risk of oral, pharyngeal and laryngeal cancer

71
Q

What is the most common type of cancer in head and neck

A

Squamous cell carcinoma

72
Q

Difference between thyroid lump and thyroglossal lump

A

Thyroid lump = ascends on swallowing but no on protrusion of the tongue due to mass effect > infiltration of the recurrent laryngeal nerve

Thyroglossal lump = ascends on both swallow and tongue protrusion , voice hoarseness is intermittent > due to laryngeal oedema from hypothyroidism

73
Q

What should you see on anterior rhinoscopy for a septal haematoma

A

Bilateral cherry-red swelling

74
Q

What is a brachial cyst

A

Formed due to obliteration of the second, third adn fourth brachial cleft

Typically undetectable until the cyst swells in size - commonly due to infection

Do no move on tongue protrusion nor auscultate or trans illuminate

75
Q

what is the imaging modality of choice for neck lumps

A

Ultrasound

76
Q

Sensineural hearing loss unilaterally probably due to an inflammatory cause - what is the treatment

A

High dose prednisolone oral

77
Q

What is sudden sensorineural hearing loss

A

An ent emergency which is often idiopathic and requires urgent assessment by a specialist

High does steroids should be started as they are 85% effective if started within 24-48 hours of onset

78
Q

What is vestibular Schwanomma

A

A benign subarachnoid tumour that causes local pressure effects of CN VIII

79
Q

How does vestibular schwanomma present ?

A

Asymmetric or unilateral hearing loss
And progressive ipsilateral tinnitus

Larger tumours may cause mass effect leafing to signs of raised intracranial pressure and lead to focal neurology including compression of the 5th cranial nerve, 7th and 8th

80
Q

What is the management of vestibular schwannoma

A

Surgery

If over 40mm

If under = requires 6-monthly annual surveillance scans via MRI

81
Q

Most common mouth cancer

A

Squamous cell carcinoma

82
Q

Most common causative organism for AOM

A

Haemophilus

83
Q

*attic crust

A

Cholesteatoma

84
Q

Which diuretic can cause hearing loss

A

Furosemide

85
Q

*affected cranial nerve associated hearing loss

A

Vestibular schwannoma / acoustic neuroma

Ie hearing loss with an absent corneal reflex / facial palsy

86
Q

Management of sudden onset sensorineural hearing loss ?

A

URGENT - prescribe high dose oral prednisolone

87
Q

What is the main complication patients should be warned of when undergoing a mastoidectomy ?

A

Permanent unilateral facial weakness

  • facial nerve runs in close proximity to the mastoid process
    —> affecting ability to smile, or show teeth on affected side
88
Q

*hypothyroid + progressively deep voice ?

A

Reinke’s oedema (vocal cord oedema)

89
Q

Treatment of hypothyroid

A

Levothyroxine

90
Q

What is the rare sign seen in otosclerosis ?

A

Schwarze sign - or - flamingo flush

Describes a pink tinge to the tympanic membrane

91
Q

Treatment of mild - moderate otitis externa

A

Topical drops of combined abx and steroid

Keep the ear dry for the next 7-10 days

92
Q

Treatment of severe otitis externa

A

Ie when the meatus is is completely occluded and there is significant swelling of the external meatus

Can be treated with strip of ribbon gauze ‘Pope’ wicks - which can then be used for the application of topical antibiotics (usually gentamicin)

93
Q

Common complication of chronic sinusitis

A

Nasal polyps - presenting as continuous purulent nasal discharge and snoring / apnea

94
Q

Treatment of nasal polyps

A

Nasal steroids

95
Q

Management of vestibular neuronitis

A

Prochlroperazine

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