ENT Flashcards
manoeuvre to diagnose BPPV
dix hallpike
manoeuvre to treat BPPV
epleys
Recent viral infection
Sudden onset vertigo
Nausea and vomiting
Hearing may be affected
Viral labyrinthitis
Recent viral infection
Recurrent vertigo attacks lasting hours or days
No hearing loss
Vestibular neuronitis
Gradual onset
Vertigo triggered by change in head position
Each episode lasts 10-20 seconds
BPPV
Vertigo associated with hearing loss, tinnitus and sensation of fullness or pressure in one or both ears
Menieres
Elderly patient
Dizziness on extension of neck
Vertebrobasilar ischaemia
Unilateral hearing loss, vertigo, tinnitus
Absent corneal reflex is important sign
Associated with neurofibromatosis type 2
Can have ataxia, facial numbness/weakness, double vision
Acoustic neuroma
Unexplained, unilateral ear ache for more than 4 weeks with unremarkable otoscopy management?
should be referred under the 2 week wait
2ww for laryngeal cancer criteraa
aged 45 and over with:
persistent unexplained hoarseness or
an unexplained lump in the neck
2ww referral for oral cancer?
Unexplained oral ulceration or mass persisting for greater than 3 weeks
Unexplained red, or red and white patches that are painful, swollen or bleeding
Unexplained one-sided pain in the head and neck area for greater than 4 weeks, which is associated with ear ache, but does not result in any abnormal findings on otoscopy
Unexplained recent neck lump, or a previously undiagnosed lump that has changed over a period of 3 to 6 weeks
Unexplained persistent sore or painful throat
Signs and symptoms in the oral cavity persisting for more than 6 weeks, that cannot be definitively diagnosed as a benign lesion
conductive hearing loss, tinnitus and positive family history
Otosclerosis (the replacement of normal bone by vascular spongy bone)
otosclerosis rx
stapedectomy
hearing aids
Menieres treatment
acute attacks: buccal or intramuscular prochlorperazine. Admission is sometimes required
prevention: betahistine and vestibular rehabilitation exercises may be of benefit
Who gets abx in otitis media
MEDIA:
More than 4 days of symptoms
Extremely unwell (systemically)
Discharge or perforation
Immunocompromised or significant co-morbidity
Age <2 & bilateral
OM antibiotic
amoxicillin
Fever PAIN score for tonsillitis
Fever over 38°C.
Purulence (pharyngeal/tonsillar exudate).
Attend rapidly (3 days or less)
Severely Inflamed tonsils
No cough or coryza
Dry TM perf mx
reassure, f/u 4 weeks
Sarcoid can cause what facial swelling
bilat parotid swelling
Most common type of salivary neoplasm
pleomorphic adenoma (benign)
child <2yo with a left sided transluminating lymphatic lump in posterior triangle
cystic hygroma
Neck lump that is pulsatile, lateral and immobile on swallowing
carotid aneurysm
Unilateral cystic lump between sternocleidomastoid and pharynx in a 20yo
Branchial cyst
Midline neck lump that moves with the tongue in teenager
thyroglossal cyst
Acute viral parotitis (mumps) pathogen
paramyxovirus
do u routinely give abx in sinusitis
no not unless severe
when do you consider intranasal steroids in sinusitis
intranasal corticosteroids may be considered if the symptoms have been present for more than 10 days
drugs causing gingival hyperplasia
(Can Cause Puffy gums!) Cyclosporin, Ca Channel blocker and Pheyntoin.
Haemorrhage 5-10 days after tonsillectomy is often due to?
infection- admit to ENT and abx
