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FINALS: Passmed > ent > Flashcards

ent Flashcards

1
Q

NICE recommend that clinicians consider a suspected cancer pathway referral (for an appointment within 2 weeks) for laryngeal cancer in people aged 45 and over with:
____________________

A

persistent unexplained hoarseness or
an unexplained lump in the neck

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2
Q

rules for interpreting audiogram

A

< 20 = normal. > 20 = abnormal (need loudness to hear)

Air > bone = normal (alphabetically you I remember as A comes before B)

Bone > air = abnormal (it is abnormal to start counting alphabets from B)
this is conduction loss

Air + Bone loss = mixed sensory and conduction loss

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3
Q

sudden onset horizontal nystagmus, hearing disturbances, nausea, vomiting and vertigo –> ?

A

Acute viral labrynthitis

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4
Q

Non-resolving otitis externa with worsening pain. Mx?

A

should be referred urgently to ENT

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5
Q

Horizontal nystagmus is a feature of____________

A

vestibular neuronitis

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6
Q

Recurrent otitis externa following numerous antibiotic treatment should raise suspicion of ________

A

Candida infection

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7
Q

Meniere’s tends to come in ________

A

episodes; no Hx makes Dx unlikely

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8
Q

otitis externa tx?

A

topical ciprofloxacin + dexamethasone

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9
Q

Gingival hyperplasia: _______________________________

A

phenytoin, ciclosporin, calcium channel blockers and AML

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10
Q

‘Double-sickening’ suggests –>

A

bacterial sinusitis

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11
Q

__________ may be useful in the acute phase of vestibular neuronitis, but should be stopped after a few days as it delays recovery by interfering with central compensatory mechanisms

A

Prochlorperazine

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12
Q

All post-tonsillectomy haemorrhages should be assessed by ENT

A
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13
Q

Unilateral glue ear in an adult:

A

needs evaluation for a posterior nasal space tumour

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14
Q

how would you describe the pain in sinusitis

A

frontal pressure pain which is worse on bending forward

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15
Q

tx for sinusitis lasting 10 or more days?

A

intranasal corticosteroids

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16
Q

what is double sickening

A

‘double-sickening’ may sometimes be seen, where an initial viral sinusitis worsens due to secondary bacterial infection

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17
Q

auricular haematomas - who is it common in? what do you want to avoid? how will you manage?

A

rugby players/wrestlers

cauliflower ear

samdeday assessment by ENT, incision and drainage

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18
Q

BPPV - Dx? TX?

A

Dx: Dix-hallpike manoeuvre
Tx: Epley manoeuvre

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19
Q

branchial cyst

A

smooth, soft, fluctuant, non-tender, does not move on swallowing, does not transilluminate

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20
Q

Pt born with cleft palate has foul-smelling, non-resolving discharge and hearing loss

A

Cholesteatoma - non-cancerous growth of squamous epithelium

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21
Q

what do you see on otoscopy for cholesteatoma?

A

‘attic crust’ - seen in the uppermost part of the ear drum

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22
Q

acoustic neuromas: damage to
- cranial nerve VIII:
- cranial nerve V:
- cranial nerve VII:

A
  • cranial nerve VIII: hearing loss, vertigo, tinnitus
  • cranial nerve V: absent corneal reflex
  • cranial nerve VII: facial palsy
23
Q

epistaxis: anterior vs posterior bleeds

A

anterior: visible source of bleeding, usually due to damage to Kiesselbache plexus

Posterior: more profuse bleeding, originates in deeper structures, higher risk of aspiration and airway compromise

24
Q

Epistaxis Mx

A
  1. is pt stable? if yes
    - Sit forward with mouth open
    - Pinch nose firmly

If unsuccessful,
3. use topical antiseptic like Nasepetin

If bleeding persists for 10-15 min, consider
4. cautery - used if source of bleed is visible
5. packing if bleeding point cannot be visualised/cautery not tolerated

If pt unstable –> surgery (sphenopalatine ligation)

25
Q

features of head/neck cancers

A
  • neck lump
  • hoarseness
  • persistent sore throat
  • persistent mouth ulcer
26
Q

2 week wait for head and neck cancers: laryngeal, oral, thyroid

A
  1. laryngeal: age >45 with persistent unexplained hoarseness/neck lump
  2. ulceration in oral cavity lasting for more than 3 weeks
  3. thyroid: unexplained thyroid lump
27
Q

When investigating patients with hoarseness a _______ should be considered

A

chest x-ray
to exclude apical lung lesions.

28
Q

ear condition mostly found in diabetics + caused by pseudomonas aeruginosa

A

malignant otitis externa –> progresses to temporal bone osteomyelitis

29
Q

Tx for Meniere’s: acute/prevention

A

acute: buccal/IM prochlorperazine
prevention: betahistine/vestibular rehab exercises

30
Q

Samter’s triad

A
  • asthma
  • nasal polyps
  • aspirin sensitivity
31
Q

nose features that always require investigation

A

unilateral Sx

32
Q

what shrinks nasal polyps well

A

topical corticosteroids

33
Q

Cancer that is
- associated with EBV
- cervical lymphadenopathy
- otalgia, unilateral serous OM
- nasal obstruction
- cranial nerve palsies

A

nasopharyngeal
CT/MRI (combined)
treat with radiotherapy

34
Q

you can tell its a thyroid swelling because

A

moves upwards with swallowing

35
Q

otoscopy: red, swollen, or eczematous canal = _______. mx?

A

otitis externa
topical antibiotic or a combined topical antibiotic with a steroid

36
Q

severe throat pain localising to one side + deviation of uvula to unaffected side + trismus + reduced neck mobility =

A

Peritonsillar abscess (quinsy)

37
Q

which post-tonsillectomy haemorrhages must be seen by ENT?

A

all

Primary, or reactionary haemorrhage most commonly occurs in the first 6-8 hours following surgery. It is managed by immediate return to theatre.

Secondary haemorrhage occurs between 5 and 10 days after surgery and is often associated with a wound infection. Treatment is usually with admission and antibiotics.

38
Q

CENTOR score

A

Cough absent
Exudative tonsils
Node - lymphadenopathy
Temperature

39
Q

Tx for sudden-onset SHL?

A
  • urgent ENT referral
  • high-dose corticosteroids
40
Q

cyst that moves upwards with protrusion of tongue?

A

thyroglossal cyst

41
Q

Elderly patient
Dizziness on extension of neck

A

Vertebrobasilar ischaemia

42
Q

impt sign of acoustic neuroma?

A

absent corneal reflex

43
Q

____________ is a treatment option for chronic rhinosinusitis

A

Nasal irrigation with saline solution

44
Q

Unilateral glue ear in an adult:

A
45
Q

Antibodies titres for streptolysin O

A

Diseases include rheumatic fever, post streptococcal glomerulonephritis and scarlet fever

46
Q

Tx for otitis externa

A

NICE recommend that for mild cases (mild discomfort and/or pruritus; no deafness or discharge), consider prescribing topical acetic acid 2% spray.

When features of more severe inflammation are present they advise 7 days of a topical antibiotic with or without a topical steroid.

oral antibiotics (flucloxacillin) if the infection is spreading

If a patient fails to respond to topical antibiotics then the patient should be referred to ENT.

47
Q
A
48
Q

Otitis externa in diabetics:
in non-diabetics:

A

treat with ciprofloxacin to cover Pseudomonas

gentamicin

49
Q

After fundoscopy, next Ix for suspected agre-related wet macular degenration

A

fluorescein angiography –> particularly useful for identifying macular neovascularisation, which is a hallmark of wet age-related macular degeneration (AMD)

50
Q

Otitis externa in diabetics: treat with

A

ciprofloxacin to cover Pseudomonas

51
Q

A 45-year-old male presents with a painful and swollen right cheek. He reports having a bad taste in his mouth and difficulty opening his mouth due to pain. Examination reveals a tender and erythematous swelling of the right parotid gland. The patient is febrile and has an elevated white blood cell count. What is the most likely diagnosis?

A

Sialadenitis

inflammation of the salivary glands. The parotid gland is the most commonly affected, and the presentation can be acute or chronic. Sialadenitis is typically caused by bacterial infection, and the symptoms include painful swelling of the affected gland, difficulty opening the mouth, fever, and a bad taste in the mouth. Treatment includes antibiotics and adequate hydration. Complications of sialadenitis include abscess formation, duct obstruction, and recurrent infections.

52
Q

_______________ characteristically contain cholesterol crystals + commonly in anterior triangle of neck. ___________is more common in posterior triangle and transilluminates

A

Branchial cysts
Cystic hyGLOWma = transilluminates

53
Q

____________________ is the persistent sensation of having a ‘lump in the throat’, when there is none

A

Globus pharyngis (also known as globus hystericus)

FINALS: Passmed (40 decks)

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