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Finals Flash Cards 🩺 > ENT > Flashcards

ENT Flashcards

1
Q

What are some features of BPPV?

A
  • Vertigo triggered by change in head position
  • May be associated with nausea
  • Each episode typically lasts 10-20 seconds
  • Positive Dix-Hallpike
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2
Q

Vertigo, tinnitus and hearing loss is most likely to indicate?

A

Meniere’s disease

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3
Q

What is the management for acute attacks of Meniere’s disease?

A

Buccal or IM prochlorperazine

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4
Q

What is the management for prevention of Meniere’s disease?

A

Betahistine and vestibular rehabilitation exercises may be of benefit

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5
Q

Features of Viral Labyrinthitis?

A
  • Recent viral infection
  • Sudden onset
  • Nausea and vomiting
  • Hearing may be affected
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6
Q

Features of Vestibular neuronitis?

A
  • Recent viral infection
  • Recurrent vertigo attacks lasting hours or days
  • No hearing loss
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7
Q

What are some differentials for tonsillitis?

A

Pharyngitis: Symptoms include sore throat, fever and headache, unlike tonsillitis patients do not usually have lymphadenopathy
Mononucleosis: Characterized by fatigue, sore throat, fever and swollen lymph nodes. Key difference is the presence of extreme fatigue and splenomegaly

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8
Q

What is Lemierre’s Syndrome?

A

It is a complication of tonsillitis where inflammation leads to pharyngotonsillitis, inflammation within the internal jugular vein and septic emboli.
Treatment may require high-dose benzylpenicillin and surgical debridement.

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8
Q

What is a retropharyngeal abscess?

A

It is a rare complication of tonsillitis characterised by soft tissue swelling, more common in young children. Symptoms include a stiff and extended neck and refusal to eat or drink.

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8
Q

What is the most common complication of tonsillitis?

A

Recurrent tonsillitis.

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9
Q

What are some risk factors for head and neck neoplasms?

A
  • Smoking
  • Alcohol misuse
  • Viral Infections, HPV (Specifically type 16) and EBV
  • Exposure to radiation, including both UV and ionizing radiation
  • Immunosuppression
  • Occupational exposure to harmful substances like acid mists, asbestos, wood dust
  • Family history
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10
Q

What are some indications for Adenoidectomy?

A
  • Recurrent or persistent otitis media (due to obstruction of the eustachian tube by enlarged adenoids)
  • Adenoid hypertrophy resulting in upper airway obstruction
  • In association with a tonsillectomy for recurrent tonsillitis
  • Recurrent or chronic sinusitis or adenoiditis
  • Dysphagia with failure to thrive
  • Speech impairment
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11
Q

What type of reaction is Allergic Rhinitis?

A

Type 1 hypersensitivity reaction

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12
Q

What is the first-line treatment of otitis externa?

A
  • Topical antibiotic or a combined topical antibiotic with a steroid
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13
Q

What is the treatment of Ramsey Hunt syndrome?

A

Oral Aciclovir (800mg orally 5 times a day for 7 days) and corticosteroids (Prednisolone 60mg orally daily for 5 days)

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14
Q

What bacteria are commonly implicated in Otitis Media?

A

Streptococcus Pneumoniae
Haemophilus Influenzae
Moraxella Catarrhalis

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15
Q

What is the management of recurrent or chronic sinusitis?

A
  • Avoid Allergen
  • Intranasal corticosteroids
  • Nasal irrigation with saline solution
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16
Q

What are some red flag symptoms in Chronic Sinusitis?

A
  • Unilateral symptoms
  • Persistent symptoms despite compliance with 3 months of treatment
  • Epistaxis
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17
Q

What are some complications of Rhinosinusitis?

A
  • Persistent infection
  • Orbital Cellulitis
  • Intracranial involvement: Meningitis and encephalitis
  • Mucoceles
  • Osteomyelitis
  • Pott’s puffy tumour (Subperiosteal abscess)
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18
Q

What is a cholesteateoma?

A

Cholesteateoma is a complication of chronic otitis media caused by the abnormal accumulation of skin, squamous epithelium within the middle ear cleft and mastoid air cells

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19
Q

What is the diagnostic criteria for acute rhinosinusitis?

A

Sudden onset of symptoms for less than 12 weeks duration including one of:

Nasal blockage/congestion OR nasal discharge
Facial pain/pressure OR loss/reduction of sense of smell

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20
Q

What bacteria are commonly implicated in Otitis Externa?

A
  • Pseudomonas Spp
  • Staphylococcus Aureus
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21
Q

What are the clinical features of mastoiditis?

A

Similar symptoms and signs of acute otitis media in addition to inflammation over the mastoid process (retro-auricular), pinna protrusion, and loss of post-auricular sulcus.

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22
Q

What are the clinical features of a cholesteateoma?

A

A cholesteateoma presents with persistent foul smelling discharge, headache and otalgia

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23
Q

What is the management of a Cholesteatoma?

A

Surgical intervention to remove the abnormal skin and squamous epithelium accumulation. This approach helps prevent severe complications such as facial nerve palsy and CNS complications

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24
Q

What imaging is recommended for a suspected middle ear cholesteatoma?

A

High-resolution CT scan of the petrous temporal bone

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25
Q

What is a Schwartze sign and when is it seen?

A

It is reddish discoloration of the promontory seen during otoscopic examination .

The discoloration is the result of the increased blood flow to the promontory due to the characteristic otosclerotic lesion.

Occurs in up to 10% of patients with otosclerosis

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26
Q

What structures are in the inner ear?

A
  • Semicircular canals
  • Vestibule (Middle section)
  • Cochlear
27
Q

What is the most common cause of a perforated tympanic membrane?

A

Infection

Other causes include barotrauma or direct trauma

28
Q

What is the management of a perforated tympanic membrane?

A
  • No treatment is needed in the majority of cases as the tympanic membrane will usually heal after 6-8 weeks.
  • Refer to ENT if not resolving within this time
29
Q

What would you find on otoscopy in otitis media?

A
  • Bulging tympanic membrane –> Loss of light reflex
  • Opacification or erythema of the tympanic membrane
  • Perforation with purulent otorrhoea
  • Decreased mobility if using a pneumatic otoscope
30
Q

When should you prescribe antibiotics in otitis media?

A
  • Symptoms lasting more than 4 days and not improving
  • Systemically unwell
  • Immunocompromise
  • Younger than 2 years with bilateral otitis media
  • Otitis media with perforation and/or discharge in the canacl
31
Q

What is Presbycusis?

A

Type of sensorineural hearing loss that affects elderly individuals.

Occurs as sensory hair cells and neurons in the cochlea atrophy over time.

32
Q

What is the treatment of Ramsey Hunt syndrome?

A
  • High dose aciclovir
  • High dose steroids
  • Eye protection
33
Q

What drugs give you Gingival hyperplasia?

A

Phenytoin
Ciclosporin
CCBs
AML

34
Q

What are the main features of Cholesteatoma?

A
  • Foul-smelling, non resolving discharge
  • Hearing loss
35
Q

What is the management of cholesteatoma?

A

Patients are referred to ENT for consideration of surgical removal

36
Q

Where is the most likely source of bleeding in Epistaxis?

A

Kiesselbach’s plexus

37
Q

If bleeding in Epistaxis does not stop after 10-15minutes of continuous pressure what should you do?

A
  • If you can see the bleed –> Cautery
  • If no obvious source of bleeding –> Packing
38
Q

What should be done for patients with epistaxis that have failed all emergency management?

A

May require sphenopalatine ligation in theatre

39
Q

When should someone with acute sensorineural hearing loss be seen?

A

It is an emergency and requires urgent referral to ENT for audiology assessment and brain MRI

40
Q

What symptoms can impacted ear wax cause?

A
  • Pain
  • Conductive hearing loss
  • Tinnitus
  • Vertigo
41
Q

What are some risk factors for Glue ear?

A
  • Male sex
  • Siblings with glue ear
  • Higher incidence in winter/spring
  • Day care attendance
  • Parental smoking
  • Bottle feeding
42
Q

What is Little’s area?

A

Little’s area in the anterior nasal septum is the site of Kiesselbach’s plexus, supplied by 4 arteries. Epistaxis therefore most commonly originates from the anterior of the nose.

43
Q

What predisposing factors are there for Black Hairy tongue?

A
  • Poor oral hygiene
  • Antibiotics
  • Head and neck irradiation
  • HIV
  • IVDU
44
Q

How do you get black hairy tongue?

A

Results from defective desquamation of the filiform papillae

45
Q

What is Ludwig’s Angina?

A

Life-threatening cellulitis of the soft tissues involving the floor of the mouth and neck

46
Q

What are the features of nasal polyps?

A
  • Nasal obstruction
  • Rhinorrhoea, sneezing
  • Poor sense of taste and smell
47
Q

What is the management of nasal polyps?

A

All patients with suspected nasal polyps should be referred to ENT for a full examination.
- Topical corticosteroids shrink polyp size in around 80% of patients

48
Q

What is a red flag symptoms of nasal polyps?

A

Unilateral polyps

49
Q

What are the features of a thyroglossal cyst?

A

Usually midline, between the isthmus of the thyroid and the hyoid bone.
Moves upwards with protrustion of the tongue

50
Q

Why should you refer urgently for Unilateral glue ear?

A

They need evaluation for a posterior nasal space tumour

51
Q

What are the red flag signs of a neck lump that point towards malignancy?

A
  • A hard and fixed mass
  • The patient is over 35 years old
  • The presence of a mucosal lesion
  • A history of persistent hoarseness or dysphagia
  • The presence of Trismus
  • The presence of unilateral ear pain
52
Q

What is the initial management for epistaxis?

A

Lean forward and apply pressure to pinching the outside of their nose just above the nostrils for 15 minutes

53
Q

What is the management for septal haematoma?

A

Immediately refer to ENT for incision and drainage under general anaesthetic.
Must be done quickly to preserve blood supply to the nasal cartilage. Untreated can lead to saddle-nose deformity

54
Q

What is Samter’s triad?

A

Asthma, Aspirin sensitivity and nasal polyposis

55
Q

What is the penicillin allergy alternative for tonsillitis?

A

Clarithromycin

56
Q

What should you do in primary haemorrhage following tonsillectomy

A

Immediate return to theatre

Primary haemorrhage = 6 to 8 hours following tonsillectomy

57
Q

What is Ramsey Hunt caused by?

A

Herpes Zoster Oticus

58
Q

Why do Auricular Haematomas require urgent referral to ENT?

A

They are a build up on blood between the cartilage and perichondrium.

They can restrict blood supply and lead to necrosis of the connective tissue/

59
Q

What is the treatment of Quinsy?

A

Needle aspiration or I&D + IV Antibiotics, some may use steroids

60
Q

What are the symptoms of Nasopharyngeal carcinoma?

A

Otalgia
Unilateral serous otitis media
Nasal obstruction, discharge and/or epistaxis
Cranial nerve palsys

61
Q

What is the management of a nasal septal haematoma?

A
  • Surgical drainage
  • Intravenous antibiotics
62
Q

What type of nystagmus indicates BPPV on Dix-Hallpike manouvre?

A

Vertical Nystagmus

63
Q

In what condition would you see bilateral vestibular schwannomas?

A

Neurofibromatosis type 2

64
Q

What is the investigation of choice for vestibular schwannomas?

A

MRI Cerebellopontine angle

65
Q

Why do you get trismus in quinsy?

A

The pus causes the pterygoid muscles to go into spasm preventing them
from opening their mouth.

66
Q

What lymph node is most commonly involved with a quinsy?

A

Jugulodiagastric lymph node

67
Q
A

Finals Flash Cards 🩺 (32 decks)

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