ENT Flashcards
`difference between chronic suppurative otitis media and chronic serous otitis media
Suppurative: tympanic membrane ruptured, +/- cholesteatoma, chronic otorrhoea for 6-12 weeks
Serous: tympanic membrane not ruptured, persists more than 4-12 weeks.
Common organism for chronic suppurative otitis media?
P, aeruginosa
Treatment of tonsillitis
phenoxymethylpenicillin 10days
Centor criteria for tonsillitis
fever = 1
exudate on tonsils = 1
no cough = 1
tender lymphadenopathy = 1
age(3-14) = 1
feverPAIN score
1 point for:
- fever >38
- purulent (pharyngeal or tonsillar exudate)
- no cough or coryza
- severely inflammed tonsils
- attend rapidly (3 days or less from onset of symptoms)
the triad of Meniere’s disease
fluctuant hearing loss
vertigo
tinnitus
treatment of meniere’s disease
vestibular rehabilitation
prochlorperazine - acute attacks
betahistine - preventative treatment
otosclerosis VS cholesteatoma VS acoustic neuroma
otosclerosis: autosomal dominant, young patients, positive family history, normal bone is replaced by vascular spongy bone, pink tinge on eardrum (schwartz sign) tx: hearing aids or stapedectomy
cholesteatoma: unilateral destruction and expanding growth of skin cells, changes on eardrum, presents with ear discharge and conductive hearing loss, tx: surgical removal of growth
acoustic neuroma: found in cerebellopontine angle
Major diagnostic symptoms of chronic sinusitis
12 weeks non-resolution of symptoms with:
- nasal obstruction
- nasal discharge
- facial pain
- loss of smell
what is pseudopseudohypoparathyroidism
have features of pseudohypoparathyroidism: short 4th and 5th metacarpals, round face, short stature, basal ganglia calcification, decreased IQ
Non-sedating antihistamine
Ceterizine
Loratadine
Indications for tonsillectomy
cancer or suspected cancer
tonsillar haemorrhage
quinsy
Immunocompromised patients or other diseases such as diabetes, cystic fibrosis, guttate psoriasis
ALL of the following criteri: >= 5 episodes in the last year or >5episodes/year over a 2 year period or >3episodes/year over a 3 year period, symptoms for at least a year, episodes of sore throat are disabling and preventing normal function
which drugs are ototoxic?
aminoglycoside: gentamicin, neomycin, streptocycin
loop diuretic: furosemide, ethacrynic acid
most common organism causing otitis externa
pseudomonas
staph aureus
treatment of cholesteatome
surgical removal
side effect of chloramphenicol (topical/oral/pregnancy)
oral during pregnancy (esp 3rd trimester) - neonatal grey baby syndrome
topical: unknown for systemic effect but can cause eye stinging, skin reaction, angioedema, bone marrow disorders, fever, paraesthesia
oral: bone marrow suppression
how to treat conjunctivitis?
viral: supportive
bacterial: only give abx after 3 days supportive tx: chloramphenicol eyedrops 0.5%, ointment 1% -> fusidic acid 1% as 2nd line
vestibular neuronitis VS labrynthitis
differences in PC?
both has: vertigo, nystagmus to the opposite side of lesion, n&v
vestibular neuronitis will not have tinnitus or deafness (but labrynthitis has both)
post URTI
Treatment of labrynthitis
anti-emetic: prochlorperazine, promethazine, cyclizine
vestibular sedative: cinnarizine (calcium blocker and histamine antagonist), betahistine (histamine analogue)
what diseases can you associate with livedo reticularis?
idiopathic (most common)
polyarteritis nodosa
systemic lupus erythematosus
cryoglobulinaemia
antiphospholipid syndrome
Ehlers-Danlos Syndrome
homocystinuria
?polymyositis
?RA
?lymphoma
?TB
?Raynaud’s
management of acute sinusitis
paracetamol/ibuprofen
topical nasal decongestant (not oral)
nasal irrigation with warm saline solution
adequate fluid and rest
antibiotics usually in severe/prolonged infection (>5 days) : phenoxybenzylpenicillin
common organism for sinusitis
strep pneumonia
haem influenza
moraxella catarrhalis
treatment of chronic suppurative otitis media
aminoglycoside or quinolone eardrop
(common organism is pseudomonas)
