ENT Flashcards
What score is used in tonsilitis
FeverPAIN
4-5 = Bacterial tonsilitis is likely
Fever during 24 hrs prev
Purulence
Attended within 3 days
Inflamed tonsils
No cough or coryza
How is viral tonsilitis managed
Supportive and safety netting
Simple analgesia and paracetamol
Start abx if pain persisits after 3 days or fever goes above 38.2
How is bacterial tonsilitis managed
ABX if feverpain <4
Pen V for 10 days
(clarithromycin if true penicillin allergy)
Usually causative organism is strep A
What are the features of quincy
Sore thaot
Trismus (can’t open mouth)
Change in voice (hot potato)
Swelling beside tonsils
Painful swallow
Fever
Ear pain
Lymph nodes up
Caused usually by strep A, staph aureus or Hib
Needs incision and drainage
Abx before and after surgert
What is the management of post tonsillectomy bleeding
Call ENT urgently
IV access and bloods
Sit them up- spit blood
NBM
IV fluids
Theatre
Hydrogen peroxide gargle or adrenaline soaked swab
What are the main causes of otitis media
Strep pneumoniae
Hib, moraxella, staph aureus
You will see a bulging red ear
What is the management of otitis media
Resolves without abx within 3 days- 1 week
Prescribe abx if
-systemically unwell/ immunocompromised
-Less than 2 with bilateral otitis media
-Otorrhoea (discharge)
Amoxicillin for 5 days (clarith if allergic)
What are the features of glue ear (otitis media with effusion)
Reduced hearing
Ear infections
Blocked eustachean tube
Dull tympanic membrane with air bubbles/ fluid level
Treated conservatively witin 3 months
If co-morbidities- grommets
What do different types of hearing loss look like on an audiogram
Normal hearing- readings between 0-20 DB
Sensorineural hearing loss- air and bone readings will be below the 20 DB line on chart (this means louder than 20 DB)
Conductive hearing loss- bone conduction will be normal (0-20 DB) but air conduction will be below the 20 DB line
Mixed hearing loss- both air and bone will be below 20 DB line but there will be a difference of over 15 DB between the two
What is the management for nosebleeds
Sit up and tilt head forwards
Squeeze soft part of nose 10-15 mins
Spit blood out
Bleeding doesn’t stop in 10-15 mins
-Nasal packing
-Nasal cautery
Naseptin 4x daily for 10 days - contraindicated in peanut/ soya allergy
What are the features of a cystic hygroma
Cyst filled with lymphatic fluid
Congenital abnormality in posterior triangle on L side neck/ armpit
Can be large
Soft
Non tender
Transilluminate
Aspiration or surgical removal
What are the features of a thyroglossal cyst
Can get infected
Midline of neck lump
Mobile
Non tender
Soft
Fluctuant
Move up and down with the tongue moving - stick tongue out
USS or CT to confirm
Surgical removal
