ENT Flashcards
Pharyngeal pouch management
AVOID ENDOSCOPY due to perf risk
Smaller pouches: no intervention necessary
Larger pouches: surgery
African lady with chronic nose swelling. Dx + responsible organism + Rx?
Rhinoscleroma - chronic granulomatous bacterial disease of URT
Klebsiella
Tropical disease ~South America/Africa
Rx: Tetracycline or Cipro
Indication for ABx in tonsillitis
at least 3 out of 4 centor criteria:
- tonsillar exudate
- tender anterior lymphadenopathy
- lack of cough
- fever
OSA diagnostic test
Polysomnography (sleep studies) - monitors number of desaturations
Hoarse voice, chest pain, chronic cough - worse after eating spicy food
GORD ie. can cause hoarse voice
Management of facial injury causing swollen nose and deviated nasal bones + asymmetrical and boggy septum
Septal haematoma evacuation (as can lead to septal necrosis)
Then review in 7 days to determine if not manipulation required
Most USEFUL investigation for neck lump
FNA
Elderly lady with progressive dysphagia to solids, pain on swallowing, weight loss
Hypopharyngeal ca
Dysphagia occurs when larynx invaded
Most common head and neck cancer
Squamous cell laryngeal cancer
Presentation of squamous cell laryngeal cancer
Persistent hoarse voice in male alcoholic/smoker ie. refer all hoarse voice >6/52 urgently to ENT
What is Frey’s syndrome?
Injury to auriculotemporal nerve, which reforms inappropriately- complication of parotid surgery
Parasympathetic impulses inappropriately trigger sympathetic nerves:
- gustatory sweating
- facial swelling
A few days old newborn shows poor otoacoustic testing performance; mother had fever and rash during pregnancy
Congenital rubella syndrome, features:
- eye, ears, brain, cardiac
- related to contact in 1st trimester
ENT complication and treatment for severe hyperbilirubinaemia in newborn
Cx: Hearing loss or damage
Rx: Exchange transfusion (plot graph of bilirubin levels + blue UV light conservatively first)
Repeated and prolonged exposure to what level of noise can cause hearing loss?
> 85db
Young boy with ear pain and fever
o/e: tender ear, tender boggy swelling posterior to pinna
?Dx + Rx
Mastoiditis - swelling of mastoid process (usually due to untreated OE)
Rx: admission for IV ABx
Part of the ear most commonly affected in otosclerosis
Stapes
Which narrow structure connects nasopharynx to middle ear? Clinical relevance?
Eustachian tube
Small in kids ie. easily blocked -> glue ear
Most appropriate hearing test in newborn
Otoacoustic emissions
OR
Auditory brainstem responses