ENT Flashcards
Drugs that cause gingival hyperplasia?
phenytoin
ciclosporin
calcium channel blockers (especially nifedipine)
What is ramsay hunt syndrome?
caused by the reactivation of the varicella zoster virus in the geniculate ganglion of the seventh cranial nerve.
Viral labyrhnthitis symptoms?
Recent viral infection
Sudden onset
Nausea and vomiting
Hearing may be affected
Vestibular neuronitis symtoms?
Recent viral infection
Recurrent vertigo attacks lasting hours or days
No hearing loss
Symptoms of vertebrobasilar ischaemia?
Elderly patient
Dizziness on extension of neck
What kind of hearing loss is aged related hearing loss?
Sensorineural deafness
What is vestibular neuronitis?
recurrent vertigo attacks lasting hours or days
nausea and vomiting may be present
horizontal nystagmus is usually present
no hearing loss or tinnitus
What should be used if source of the bleeding can be seen in a nosebleed 10-15 minutes after just using pressure?
Silver nitrate Cautery
Management of vestibular neuronitis?
buccal or intramuscular prochlorperazine is often used to provide rapid relief for severe cases
a short oral course of prochlorperazine, or an antihistamine (cinnarizine, cyclizine, or promethazine) may be used to alleviate less severe cases
vestibular rehabilitation exercises are the preferred treatment for patients who experience chronic symptoms
Centor criteria?
presence of tonsillar exudate
tender anterior cervical lymphadenopathy or lymphadenitis
history of fever
absence of cough
FeverPAIN criteria?
Fever over 38°C.
Purulence (pharyngeal/tonsillar exudate).
Attend rapidly (3 days or less)
Severely Inflamed tonsils
No cough or coryza
What are nasal polyps associated with?
asthma (particularly late-onset asthma)
aspirin sensitivity
infective sinusitis
cystic fibrosis
Kartagener’s syndrome
Churg-Strauss syndrome
How long after a perforated eardrum should referral be indicated?
After 6-8 weeks
What is secondary haemorrhage after a tonsillectomy associated with>
Wound infection
Treatment is admission and abx
How many weeks does a mouth ulcer have to be present to be persistent?
3 weeks
What should you do if a patient fails to respond to topical antibiotics?
ENT referral
What is Meiner’s disease?
Associated with hearing loss, tinnitus and sensation of fullness or pressure in one or both ears
Management of vestibular neuronitis?
buccal or intramuscular prochlorperazine is often used to provide rapid relief for severe cases
a short oral course of prochlorperazine, or an antihistamine (cinnarizine, cyclizine, or promethazine) may be used to alleviate less severe cases
vestibular rehabilitation exercises are the preferred treatment for patients who experience chronic symptoms
Management of vestibular neuronitis?
buccal or intramuscular prochlorperazine is often used to provide rapid relief for severe cases
a short oral course of prochlorperazine, or an antihistamine (cinnarizine, cyclizine, or promethazine) may be used to alleviate less severe cases
vestibular rehabilitation exercises are the preferred treatment for patients who experience chronic symptoms
Most common cause of bacterial otitis media?
Haemophilus influenzae
Features of Meiner’s disease?
Recurrent episodes of vertigo, tinnitus and hearing loss (sensorineural). Vertigo is usually the prominent symptom
a sensation of aural fullness or pressure is now recognised as being common
other features include nystagmus and a positive Romberg test
episodes last minutes to hours
typically symptoms are unilateral but bilateral symptoms may develop after a number of years
What is meiner’s disease?
Disorder of the inner ear of unknown cause. It is characterised by excessive pressure and progressive dilation of the endolymphatic system
Most important part of ear to visualise in cholesteatoma?
Attic crust. Seen in upper most part of ear drum
What is otosclerosis?
Progressive conductive deafness due to fixation of the stapes at the oval window
Tympanic membrane in otosclerosis
- the majority of patients will have a normal tympanic membrane
- 10% of patients may have a ‘flamingo tinge’, caused by hyperaemia
Haemorrhage 5-10 days after tonsillectomy is commonly associated with what?
Wound infection
What is Wallenberg syndrome?
posterior inferior cerebellar artery stroke
vertigo (‘sensation of room spinning’), nystagmus, ipsilateral facial pain, and contralateral loss in temperature sensation)
Hearing loss in labrynthitis?
Sensorineural hearing loss
What is Ludwig’s angina?
progressive cellulitis that invades the floor of the mouth and soft tissues of the neck. Most cases result from odontogenic infections which spread into the submandibular space.
Sudden-onset sensorineural hearing loss is treated with what?
Oral corticosteroids
normal corrected QT interval
less than 430 ms in males and 450 ms in females
normal PR interval is
120 - 200 ms.
Normal QRS duration is
80 - 120 ms
First line for otitis externa in diabetics?
ciprofloxacin to cover Pseudomonas
What is a brachial cyst filled with?
Acellular fluid with cholesterol crystals and encapsulated by stratified squamous epithelium.
Typical features of a brachial cyst?
unilateral, typically on the left side
lateral, anterior to the sternocleidomastoid muscle
slowly enlarging
smooth, soft, fluctuant
non-tender
a fistula may be seen
no movement on swallowing
no transillumination
What is halitosis?
Bad breath
If a patient presents with acute necrotizing ulcerative gingivitis CKS recommend the following management:
refer the patient to a dentist, meanwhile the following is recommended:
oral metronidazole* for 3 days
chlorhexidine (0.12% or 0.2%) or hydrogen peroxide 6% mouth wash
simple analgesia
Presentation of acute necrotising ulcerative gingivitis?
painful bleeding gums with halitosis and punched-out ulcers on the gums
Ramsay hunt treatment?
Oral aciclovir
