ENT Flashcards
presbycusis
aging of the cochlea hair cells + auditory system
bilateral hearing loss
bilateral vestibular schwannoma seen alongside what condition?
neurofibromatosis 2
unilateral hearing loss and painless discharge
cholesteatoma
unilateral parotid gland swelling, facial nerve palsy, facial pain
adenoid cystic carcinoma
tinnitus, aural fullness, deafness, vertigo in episodes
menieres
hearing loss improved when there is background noise
otosclerosis
Px of otosclerosis
conductive hearing loss, tinnitus. their voice sounds louder than it is. better hearing when there is lots of background noise
when do you give ABs in otitis media
when it hasn’t resolved after 3 days. 5-7 days of amoxicillin
mild otitis externa treatment
acetic acid 2% drops
moderate otitis externa Mx
gentamicin + hydrocortisone drops (NOT IF THEY HAVE GROMMETS/PERFORATED EARDRUM)
in Pts with BPPV what do you see in the dix-hallpike test
rotational nystagmus
at home treatment for BPPV
Brandt-Daroff exercises
labyrinthitis vs vestibular neuronitis
labrynthitis = loss of hearing, tinnitus
thyroglossal cyst
midline swelling, moves on tongue protrusion
branchial cyst
lateral swelling, doesn’t move on tongue protrusion
bilateral cherry red swelling after trauma to the nose
what? Mx?
septal haematoma
emergency incision and drainage (can lead to irreversible septal perforation and necrosis if its untreated)
thin watery secretions from nose, trauma
CSF rhinorrhoea
hearing loss in viral labyrinthitis or in vestibular neuronitis?
viral labrynthitis
peritonsillar abscess Px
sore throat, painful swallowing
deviated uvula
BPPV Px
vertigo, vomiting, nausea when the pt turns his head
Mx of Menieres
betahistine to prevent
prochlorperazine when the episodes happen
Px of vestibular schwannoma
tumour of CN8
unilateral hearing loss, tinnitus
vertigo
facial palsy
absent corneal reflex
Mx of epistaxis
- hold head down for 20 mins
- posterior packing OR anterior silver nitrate cautery
- embolisation of the sphenopalatine artery (Little’s area)
Dx of acoustic neuroma
MRI
cystic hygroma
neck lump that appears in infancy
does not trans-illuminate
in the posterior triangle of the neck
Px of sialolithiasis
stone in the salivary gland
pain around salivary gland
pain reproduced upon production of saliva (e.g. squeezing lemon juice in mouth)
feeling of lump in throat with no underlying pathology
Mx?
globus
drinking lots of water, sniffing out, stress reduction
vocal cord nodules
Px and Mx
hoarse voice
found in singers (voice abuse)
Mx: vocal rest, speech therapy
most common cause of hypercalcemia
parathyroid adenoma
damage to what nerve causes hoarse voice
recurrent laryngeal nerve
oral hairy leukoplakia
cause, Px and Mx
Epstein Barr virus
found in severely immunosuppressed patients (untreated HIV)
shaggy, irregular border, white, can’t be scraped off
nothing really to Mx
Px of aphthous ulcer
Mx
well demarcated lesion, painful, acute onset
Mx: topical steroids and analgesia
unexplained sudden sensorineural hearing loss Mx
MR HEAD
Ent emergency
damage to what nerve causes inability to alter pitch of voice
external branch of the superior laryngeal nerve (cricothyroid muscle)
oral thrush Mx
nystatin (anti fungal)
management of small vs large vestibular schwannoma
small: fractionated stereotactic radiotherapy
large: translabrynthine approach surgery
laryngeal papillomatosis
cause, Px, Mx
rare disease in children characterised by benign tumour (papilla) formation in the aero digestive tract. it is recurrent.
hoarse, gruff voice
Mx: microlaryngoscopy and biopsy (have to do many times)
Caused by HPV
most common cause of malignant otitis externa
pseudomonas
immunocompromised peopl
indications for tonsillectomy
if episodes of tonsillitis prevent normal function
7/year for a year
5/year for two years
3/year for 3 years
webers test
lateralises to one ear, what does it mean with regards to a conductive hearing loss or sensorineural hearing loss
lateralises to one ear
that ear could have a conductive hearing loss
or
the other ear could have a sensorineural hearing loss
a positive Rinne’s means….
air > bone
normal people
which test should be done first: weber or rinne
weber
when can you get a false negative rinne
severe sensorineural hearing loss
vibrations are transmitted to the other ear and heard better through bone
Mx of cholesteatoma
ENT out patient clinic
micro suction
CENTOR criteria
- absent cough
- tender anterior cervical lymphadenopathy
- exudate on tonsils
- fever >38
when should ABx be given according to Centor score
centor score >3 = phenoxymethylpenicillin
Mx of quinsy: 3 steps
- IV antibiotics
- surgical drainage
- tonsillectomy in 6 weeks
