ENT Flashcards
most common cause of otits media?
H influenza
Mx of septal haematoma
urgent ENT review
surgical drainage
IV ABx
what happens if septal haematoma is left untreated?
irreversible septal necrosis within 3-4 days
–> saddle shaped defect in nose
drugs which cause gingival hyperplasia (4)
phenytoin
ciclosporin
CCB
AML (not a drug hehe!)
mild OE treatment (ie no discharge/deafness)
Topical acetic acid 2% spray
mod/severe OE treatment
7 days TO ABx +/- TO steroid
bacterial causes of otitis externa
staph aureus
pseduomonas aeruginosa
define primary haemorrhage post tonsillectomy
6-8 hours post surgery
Mx primary haemorrhage post tonsillectomy
return to theatre
define secondary haemorrhage post tonsillectomy
5-10 days pot surgery
cause of secondary haemorrhage post tonsillectomy
wound infection
Mx secondary haemorrhage post tonsillectomy
ENT admission + Abx
why are posterior nose bleeds more significant than anterior ones?
deeper vessels origin
higher risk of aspiration + airway compromise
step by step mx of nose bleed
1) first aid
- sit with torso forward,mouth open
- pinch soft cartilage firmly for 20 mins, brathing through mouth
2) Topical antiseptic e.g. naseptin
3) cautery - 1st TO anaesthestic, wait 3-4 minute to take effect, then AgNO3 to cauterise bleeding point for 10s
4) nasal packing - again anaesthetise first
5) if all else fails - surgical Mx
surgical Mx of nose bleed
sphenopalatine ligation
first line Mx AOM
self limiting
consider alt if not self limiting after 3 days
ABx Mx AOM
5-7 course of amox
erythromycin if pen allergic
what % of AOM is viral?
50%
audiometry findings presbycusis
bilateral hihg freq hearing loss
inheritance pattern otosclerosis
autisoal dominant
what is otosclerosis
replacement of normal bone by vascular pongy bone
peak age glue ear
2 years old
most common PS glue ear
hearing loss
hearing loss frequency for noise induced hearing loss
3000-6000Hz
Sx if acoustic neuroma affects CN VIII
hearing loss,vertigo
tinnitus
Sx if acoustic neuroma affects CN V
absent corneal reflex
Sx if acoustic neuroma affects CN VII
facial palsy
which condition do you see bilateral acoustic neuromas in?
NFM 2
how long for tymapanic membrane perforation not to have healed before considering referral to ENT
6 weeks
what pathogen to suspect if recurrent OE not improving despite numerous ABx treatment?
candida albicans
average age of onset BPPV
55
what type of nystagmus is noted in BPPV
rotatory nystagmus towatd affected ear
reocurrence rate BPPV after Tx
50% within 3-5 years of diagnosis
which drug is most useful for preventing attqacks of menieres?
betahistine
> 4 w unexplained unilateral otalgia with unremarkable otoscopy mx?
2ww ENT
what causes ramsay hunt syndrome
reactivation of VZV in the geniculate ganglion of CN VII
symptoms of ramsay hunt syndrome
auricular pain 1st
then CN VII palsy
vesicular rash round ear
vertigo/tinnitus
Mx ramsay hunt syndrome
PO aciclovir
corticosteroids
Webers test in unilateral SNHL
lateralised to unaffected side
webers test in unilateral CHL
lateralises to affected side
Rinne’s test in CHL
Rinne’s ‘negative’
BC >AC
cause of black hairy tongue
accumulation of keratinin and dead cells
staining from food/drink tobacco products
Sx of black hairy tongue
tickling sensation or asymptomatic
Mx of black hairy tongue
good oral hygiene
appearance of hairy leukoplakia
white, corrugated lesions along border of tongue
what conditions is hairy leukoplakia associated with?
immunosuppressed pt particularly those with HIV/AIDS
which salivary glands have the most tumours?
parotid
which salivary glands have the most stones?
submandibular
what type of gland is a parotid gland
serous
what type of gland is a submandibular gland
serous and mucous
what type of gland is a sublingual gland
mucous
what type of tumour makes up the majority of parotid tumours?
pleomorphic adenoma (80%)
complications of thyroid surgery? (3)
damage to parathyroid glands –> hypocalcaemia –> QTC prolongation
rec laryngeal nn damage
bleeding –> haematoma –> laeryngeal oedema
