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Eye basics > ENT > Flashcards

ENT Flashcards

1
Q

DDx of vertigo?

A

CPA tumour
Cerebrovascular disease
Migraine
MS
Cervical vertigo
Drug-induced
Psychological

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2
Q

Examples of Cerebellopontine angle tumours?

A

Vestibular schwannoma
Brainstem glioma
Medulloblastoma
Neurofibromatosis

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3
Q

Characteristics of peripheral nystagmus?

A

Equal in direction, speed & amplitude in both eyes
No change in direction with gaze
Never purely vertical
Suppressed by fixation

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4
Q

Causes of BPPV?

A

Idiopathy >50%
Secondary = trauma, viral labyrinthitis, MD, Migraines

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4
Q

Surgery for BPPV?

A

Indication = refractory to conservative mx
Posterior semicircular canal occlusion
Vestibular neurectomy/singular neurectomy

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5
Q

invx for sudden unilateral SNHL?

A

MRI tro vestibular schwannoma
Blood tests
Syphilis, thyroid, CSR, ERP, RP etc

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6
Q

Mx of idiopathic acute unilat SNHL?

A

Oral Pred 1mg/kg up to 60mg for 10-14D BEST
2nd line intratympanic dexa
Hyperbaric O2 therapy

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7
Q

Mx of vestibular schwannoma?

A

<1.5cm = monitoring
1.5 - 2.5cm = Radiation vs Excision
>2.5cm = excision

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8
Q

Pathophysiology of Meniere’s?

A

Dysregulation of endolymphatic fluid homeostasis -> endolymphatic hydrops

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9
Q

Symptoms of MD?

A

Episodic vertigo, lasts minutes to hours
Tinnitus
Ear fullness
Hearing loss - fluctuating

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10
Q

Medical therapy for MD?

A

Diuretics + low-sodium diet
IT Dexa
Vestibular suppressants
Betahistine hydrochloride
Avoid caffeine + alcohol +derivatives

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11
Q

Mx of Labyrinthitis?

A

Acute phase:
- vestibular sedatives e.g. Stemetil, Sturgeron
- Bed rest
- Betaserc w/wo steroid
- Treat any viral infection
Convalescent phase:
- Betaserc
- Vestibular rehab

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12
Q

Cranial nerves usu injured in BOS frac?

A

CN 6 7 8

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13
Q

RF for NPC?

A

EBV infection
Salt-preserved food
1st degree relative
Epigenetic modulation

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14
Q

Histological classification of NPC?

A

Type 1 = SCC
Type 2 = undifferentiated SCC
2a = keratinizing undiff SCC
2b = non-keratinizing undiff SCC

Type 2b closely a/w EBV

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15
Q

Causes of conductive hearing loss - mid ear

A

AOM
OME
CSOM
Cholesteatoma
Otosclerosis
Temporal bone trauma

Think of ossicular chain disruption as well

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16
Q

Causes of Conductive hearing loss - external ear

A

Foreign body
Otitis externa
TM perforation or retraction

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17
Q

Causes of Sensorineural hearing loss - acquired

A

Noise-induced
Age-related
Infective/inflammatory
Ototoxic drugs
Tumour - Acoustic neuroma, CPA tumour
Meniere’s disease
Perilymph fistula

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18
Q

Causes of Sensorineural hearing loss - congenital

A

Intrauterine TORCH infections
Hereditary - syndromic/not
Birth trauma etc etc

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19
Q

Components of GRBAS scale?
For voice evaluation

A

Grade of hoarseness
Roughness
Breathlessness
Asthenia
Strain

Asthenia = physical weakness or no energy

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19
Q

What is the only legit mx for tinnitus?

A

Tinnitus retraining therapy. Kinda like psychotherapy - to modify emotional rxn to tinnitus.

Everyth else are placebo like gingko, meds wtv.

20
Q

Ddx for unilateral leukoplakia?

A

Parakeratosis
Hyperkeratosis
Mild/moderate dysplasia
Malignant = SCC
Infective = TB, candida

21
Q

invx of unilateral leukoplakia?

A

CT neck
Panendoscopy
Biopsy with laser

22
Q

Causes of unilat vocal cord palsy?

A

Neurological - PICA, MS, AICA, lateral medullary syndrome
Neoplasia - larynx, mediastinum, thyroid, lung
Iatrogenic - Surgery, intubation

23
Q

Mx of unilateral vocal cord palsy?

A

Conservative = speech therapy
Surgical = injection / open surg

Surgical for pts with aspiration or need good voice use

24
Q

use single lumen or double lumen tube for tracheostomy?

A

just double lumen used nowadays.
Must do CXR after putting in

25
Q

Cutoff for “large volume” in epistaxis?

A

Above half cup volume each time

26
Q

What is Wallenberg syndrome?

A

Neurological condition due to lateral medullary infarction due to occlusion of PICA / Vertebral artery

Dysphagia
Hoarseness
Ataxia / dysmetria / dysdiadochokinesia
Horner’s
Vertigo
Nystagmus, diplopia
Ipsilateral loss of pain and temp in face
Contralat loss of pain and temp in body below face

27
Q

Risk factors for oral cavity cancer?

A

Smoking
Spirits
Spices
Sharp teeth
Sun exposure
Syphilis

28
Q

Commonest subsite of oral cancer?
Common subtype of oral cancer?

A

Oral tongue, lateral border
SCC commonest.

29
Q

Symptoms of oral canceR?

A

Non-healing ulcer
Oral cavity mass
Change in denture fit
Bleeding
Neck lump
Otalgia
Dysarthria
Trismus

30
Q

Examples of benign cavity lesions?

A

Torus
Lingual thyroid
Dermoid
Ranula
Apthous ulcer
Pyogenic granuloma
Fibroma
Lichen planus
Pemphigus / pemphigoid
Cancer!

31
Q

What is lichen planus?

A

T-cell mediated AI disorder where inflammatory cells attack skin annd mucosal keratinocytes.

32
Q

What is otosclerosis?

A

New bone formation causing fusion of fixation of stapes footplate to the oval window

33
Q

post-op mx of cholesteatoma?

A

Scan annually cuz recurrence is high.
Clearance of mucosa from ear is impaired after cholesteatoma surgery, so earwax accumulation is common

Use eardrops!

34
Q
A
35
Q

How to classify tinnitus?

in hx taking

A

Pulsatile vs Non-pulsatile.
TRO vascular origin cause.

Vascular causes -
1. Jugular bulb right below floor of inner ear. If got dehiscence of floor then can have transmitted noise/vibration.

  1. Sinus too near the mastoid
  2. Glomus jugulare = paraganglioma in mid ear. Will have red hue behind TM with rising sun shape, involving floor of cavity or the TM.
    Blanching colour points to vascular tumour
36
Q

Otoscopy of OME?

A

Yellow hue present. If recent OME then it has typical air fluid level that moves with valsalva maneuver.

37
Q

Causes of referred pain in ear?

A

Tumours of hypopharynx
Tonsilitis
Sinusitis
TMJ disorder
Impacted tooth (wisdom tooth)
Anything in throat!! e.g. retropharyngeal abscess, epiglottitis, tumour etc

38
Q

Surgery for pseudocyst of pinna?

만두귀. inside got serous fluid

A

there is separation btw leaflets of cartilage in pinna.
Aim is to remove the dead space btw the cartialge to prevent recurrence. They take out the anterior cartilage, then use buttoning/dental roll/tension dressing to keep them tgt.

39
Q

What is a retention cyst in mouth?

A

Glands in mouth near tonsils get blocked -> forming cyst

40
Q

Which level of LNs does thyroid lymph drain into?

A

2 3 4 6

41
Q

4Cs for thyroid surgery indications?

A

Cancer
Compressive
Cosmesis
Control

Usu anyth >2cm we consider excision

Also consider if mass is growing retrosternally. Cuz if that happens then any surgery aft that is super hard cuz need to do thoracotomy

42
Q

Why is RLN injury impt for thyroid surgery?

A

actl RLN is injured rarely, but its hard to find external branch of RLN which controls cricothyroid muscle.
The cricothyroid muscle pulls the thyroid palate forward to produce high pitched sound

43
Q

only 3 invx needed to confirm thyroiditis?

A

TFT
FNAC
US

TSH low + Free T4 high

44
Q

Air bone gap > 60 implies what?

A

Ossicular discontinuity

45
Q

Are abx very useful for OME?

A

Not really

46
Q

HEaring loss in Meniere’s?

A

Low frequency hearing loss.
With every MD attack the hearing drops a bit, so after 10-15 yrs of MD the SNHL is very profound, although the hearing loss kinda plateaus.

47
Q
A
48
Q
A

Eye basics (5 decks)

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