ENT Flashcards
Define tonsillitis
Inflammation of the tonsils - most commonly viral infection
Presentation of tonsillitis
Fever
Sore throat
Painful swallowing
Poor intake
Headache
Vomiting
Red inflamed tonsils
Exudate
Centor crtieria
Fever >38
Tonsillar exudate
Absence of cough
Tender anterior cervical lymph nodes
3 or more = 40-60% chance of bacterial
Management of tonsillitis
Conservative!
Safety netting
Antibiotics if centor >3 or FeverPain >4
Penicillin
Define quindy
Peritonsillar abscess - arises when there is a bacterial infection with trapped pus forming an abscess
Presentation of quinsy
Sore throat
Painful swallowing
Fever
Neck pain
Referred ear pain
Swollen tender lymph nodes
Trismus - cant open mouth
Change in voice - hot potato
Management of quinsy
Incision and drainage
Abx
?steroids
Indications for tonsillectomy
7 or more in 1 year
5 per year for 2 years
3 per year for 3 years
Recurrent peritonsillar abscesses
Enlarged tonsils - affecting breathing
Complications to tonsilectomy
Pain
Sore throat
Damage to teeth
Infection
Post-tonsillectomy bleeding
Define otitis media
Infection in the middle ear - often preceded by viral URTI
Common organism in otitis media
Streptococcus pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
Staphylococcus aureus
Presentation of otitis media
Ear pain
Reduced hearing
Preceding or ongoing UrTI
Balance
Vertigo
Discharge from ear
Otoscopy in otitis media
Bulging red inflamed tympanic membrane
Management of otitis media
Most resolve within 3 days out abx
Simple analgesia
Define glue ear
Otitis media with effusion - middle ear fills with fluid as a result of infection
Otoscopy in glue ear
Dull tympanic membrane with air bubbles or visible fluid level
Management of glue ear
Often resolves within 3 months
Grommets
Congenital causes of hearing loss
Maternal rubella,
CMV
Genetic deafness
Down’s syndrome
Perinatal causes of hearing loss
Prematurity
Hypoxia during or after birth
Causes of hearing loss
Jaundice
Meningitis
Encephalitis
Otitis media
Glue ear
Chemo
Presentation of hearing loss
Newborn hearing screening programme
Parental concerns
Behavioural changes
Ignoring calls or sounds
Frustration or bad behaviour
Poor speech and language development
Poor school performance
Define epistaxis
Nosebleeds - often originate in Kiesselbach’s plexus, little’s area caused by picking nose
Management of epistaxis
Sit up and tilt head forwards
Squeeze soft part of the nostrils together
Spit any blood don’t swallow
If does not stop in 10-15 minutes
Nasal pack
Nasal cauteru -
Naseptin - reduces inflammation and crusting
Define cleft lip
A congenital condition where there is a split or open section of the upper lip
Define cleft palate
A defect exists in the hard or soft palate at the roof of the mouth
Complications of cleft lip or palate
Feeding difficulties
Swallowing dificulties
Speech problems
Psycho-social difficulties
Management of cleft lip or palate
Plastics - surgical correction
Define tongue tie
Also know as ankyloglossia - baby is born with a short tight lingual frenulum, resulting in poor extension of the tongue
Management of tongue tie
Conservative support
Frenotomy
