ENT Flashcards
Managment overview of oral leukoplakia
Biopsy it, reduce the risk factors, and monitor. Consider surgery
What is sialadenosis.
Benign enlargement of the parotid. Painless enlargement, due to alcohol, malnutrtiion, bulimia
Thyroglossal duct cyst Mx
Check to see if thyroid gland ok (associated with ectopic thyroid). Then do Sx (remove cyst, tract and part of hyoid)
Patient had thyroidectomy for CA. TG starts to increase a few months after.. Dx?
CA returning
Which bacteria can cause this paediatric neck mass
Necrotic LNs, voilacious skin
Mycobacterium avium lymphadenitis
Dx this
Lateral neck mass, gets bigger on valsalva. Patient is a trumpet player
Laryngeocele
Rhinitis medicamentosa
When someone takes nasal decongestant for a long time, the vessels get damaged, releasing edema and causing more nasal decongestion. Turbinates will be beefy red
Whistling on insp is a sign of
Nasal perf. Look out for nasal surgery or cocaine use
Mx of TMJ disorders
Soft diet and warm compress, then can try night guard if bruxism. Do NSAID if bad or initial did work. Muscle relaxant if muscle spasms,
Why can laryngeal or oral squamous cell carcinoma cause otalgia
Referred otalgia, since the CNX and CNIX innervation of larynx and tongue areas converge to the same areas as the ear sensory innervation
Invx and mx overview of choanal atresia
If suspect try and pass catheter down nasal cavity. If doesn’t pass, then confirm Dx with CT or endoscopy. Tx by keeping an oral airway until Sx
Epiglottis Abx to give empirically
Best to give Ceftriaxone (cover HiB and Strep) and Vanco (cover staphylococcus). Airway should be maintained prior
Invx and mx for mastoiditis
Clinical Dx, but can do imaging if unclear or suspect neuro complication. Give Abx and drain
Difference in location of issue between expiratory, inspiratory and biphasic stridor.
Insp is supraglottic obs, biphasic is subglottic and exp is tracheo (malacia )
Mx for peritonisllar abcess
Needle drainage then Abx
Dx
Patient has very similar symptoms to epiglottis. Is a young adult and uvula is deviated to one side
This is peritonsilar abscess
Difference in symptoms between viral and bacterial rhinosinusitis. And how to manage each
Viral; no or short lived fever, mild symptoms, resolved in less than 10 days. Bacterial; fever for at least 3 days, symptoms for more than 10 days, and worse signs. Supportive for the former and Abx for thr latter
Difference in presentation between acute OM and OM with effusion
AOM has active inflam, so will have bulging TM, fever etc.
Managment of O.E.
remove debris, Abx (cover pseudomonas and staph) commonly quinolone, with or without GCs
Tx for hairy leukoplakia
Just restore the immunity of the patient
Mx of a torus mandibularis or palatirus
If mass becomes symptomatic or compromises the eating, breathing of the patients. Also if it prevents the fitting of dentures.
Acute Otitis media vs otitis media with effusion signs and symptoms
AOM will have fever, pain, bulging tympanic membrane that is red and hardly transparent. Whereas OM and effusion is not inflammatory, so no fever, mild pressure, and can see the effusion fluid, but normal a tympanic membrane.
OM and effusion Mx (consider if last more than 3 mo)
Observe. If more than 3 months, it is chronic, and should be indicated for a Tymoanostomy
First line for necrotising otitis external
IV ciprofloxacin
What is paracusis of willisii
In otosclerosis, the patient can often hear better with background noise. Contrasted to presbycusis
What is oxymetazoline
Main nasal decong
Mx of ruptured tympanic membrane
Reassure and observe, only tympanoplasty if fails to heale