ENT Flashcards

1
Q

Pharyngeal pouch management

A

AVOID ENDOSCOPY due to perf risk
Smaller pouches: no intervention necessary
Larger pouches: surgery

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2
Q

African lady with chronic nose swelling. Dx + responsible organism + Rx?

A

Rhinoscleroma - chronic granulomatous bacterial disease of URT
Klebsiella

Tropical disease ~South America/Africa

Rx: Tetracycline or Cipro

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3
Q

Indication for ABx in tonsillitis

A

at least 3 out of 4 centor criteria:

  • tonsillar exudate
  • tender anterior lymphadenopathy
  • lack of cough
  • fever
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4
Q

OSA diagnostic test

A

Polysomnography (sleep studies) - monitors number of desaturations

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5
Q

Hoarse voice, chest pain, chronic cough - worse after eating spicy food

A

GORD ie. can cause hoarse voice

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6
Q

Management of facial injury causing swollen nose and deviated nasal bones + asymmetrical and boggy septum

A

Septal haematoma evacuation (as can lead to septal necrosis)

Then review in 7 days to determine if not manipulation required

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7
Q

Most USEFUL investigation for neck lump

A

FNA

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8
Q

Elderly lady with progressive dysphagia to solids, pain on swallowing, weight loss

A

Hypopharyngeal ca

Dysphagia occurs when larynx invaded

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9
Q

Most common head and neck cancer

A

Squamous cell laryngeal cancer

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10
Q

Presentation of squamous cell laryngeal cancer

A

Persistent hoarse voice in male alcoholic/smoker ie. refer all hoarse voice >6/52 urgently to ENT

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11
Q

What is Frey’s syndrome?

A

Injury to auriculotemporal nerve, which reforms inappropriately- complication of parotid surgery

Parasympathetic impulses inappropriately trigger sympathetic nerves:

  • gustatory sweating
  • facial swelling
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12
Q

A few days old newborn shows poor otoacoustic testing performance; mother had fever and rash during pregnancy

A

Congenital rubella syndrome, features:

  • eye, ears, brain, cardiac
  • related to contact in 1st trimester
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13
Q

ENT complication and treatment for severe hyperbilirubinaemia in newborn

A

Cx: Hearing loss or damage

Rx: Exchange transfusion (plot graph of bilirubin levels + blue UV light conservatively first)

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14
Q

Repeated and prolonged exposure to what level of noise can cause hearing loss?

A

> 85db

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15
Q

Young boy with ear pain and fever

o/e: tender ear, tender boggy swelling posterior to pinna

?Dx + Rx

A

Mastoiditis - swelling of mastoid process (usually due to untreated OE)

Rx: admission for IV ABx

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16
Q

Part of the ear most commonly affected in otosclerosis

A

Stapes

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17
Q

Which narrow structure connects nasopharynx to middle ear? Clinical relevance?

A

Eustachian tube

Small in kids ie. easily blocked -> glue ear

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18
Q

Most appropriate hearing test in newborn

A

Otoacoustic emissions
OR
Auditory brainstem responses

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19
Q

Most appropriate hearing test in >5yo

A

Pure tone audiometry

20
Q

60yo male with hoarse voice >2months.

PMH GORD

A

Chronic laryngitis (where Sx last >3/52)

21
Q

Singer with 3 week history of hoarse voice. No other Sx

A

Vocal cord nodule

22
Q

Singer with 3 week history of hoarse voice. Also has pain

A

vocal cord granuloma

23
Q

Drugs that cause hearing loss

A

Aspirin
Gent
Frusemide
Quinine

24
Q

Features of TMJ dysfunction

A

Covers anything from muscles of mastication to temporamandibular joint

Px: ear/jaw pain -> restricted mandibular movement, multiple manifestations eg.

  • teeth grinding at night
  • ear ache
  • tender tragus
25
Q

Complications of ingestion of bleach

A

laryngeal structural/vocal cord damage ie. hoarse voice
oesophagitis
pneumonitis

26
Q

Poorly controlled asthmatic boy with voice hoarseness

A

Drug induced dysphonia ~inh steroids

  • causes myopathy of vocal cords
  • reverses when steroids withdrawn
27
Q

Nigerian woman with purulent discharge of swollen parotid gland, fever, anterior uveitis, facial palsy

A

Heerfordt’s syndrome (form of sarcoidosis)

Other features of sarcoid can also be present

28
Q

Treatment of branchial cyst

A

Excision (may recur)

29
Q

Cause of OSA in children with normal BMI

A

Chronic tonsillitis

30
Q

Child with sore throat, dysphagia, halitosis, fever, trismus, headache, neck pain, ear ache, displacement of tonsil inferomedially

Dx+Rx

A

Quinsy (peritonsillar abscess)

Rx: analgesia, DRAINAGE, ABx

31
Q

Facial/peripheral swelling + weight gain following sore throat

A

Post-streptococcal glomerulonephritis

32
Q

Genetic conditions with SN hearing loss

A

Pendred syndrome
Usher’s syndrome
Alport’s syndrome
Waardenburg syndrome

33
Q

Red flags for investigation if have nasal congestion

A
numbness
bleeding
tooth loss
unilateral obstructing mass
suspicion of tumour
34
Q

Commonest cause of orbital cellulitis in children

Ix + Rx

A

Ethmoidal sinus infection (medial wall of orbit is thin)

Ix: Contrast CT
Rx: IV Abx

35
Q

Viral labyrinthitis features

A

SUDDEN

N+V, horizontal nystagmus, hearing disturbance, vertigo

36
Q

Glue ear Rx

A

Conservative UNLESS
affecting education or have Downs/Cleft palate
(then refer for hearing test)

37
Q

What is polychondritis?
Common causative organisms?
Rx?

A

Infection of ear, often follows bites/trauma/surgery

Pseudomonas or S aureus

Rx: IV ABx + Steroids
(NB. if recurrent, consider Wegener’s)

38
Q

When to consider malignant OE?

Rx?

A

Persistent OE in DM/immunosuppressed/elderly, as may have extended to bony ear canal

Rx: admit for IV ABx

39
Q

Samter’s triad

A

Asthma + aspirin sensitivity + nasal polyps

40
Q

Nasal polyps Rx?

A

Topical steroids

ENT referral for ALL

41
Q

Initial treatment of epistaxis

A

Pinch soft part of nose and lean FORWARD

42
Q

Vestibular neuronitis features

A

Recurrent vertigo and nausea for hours, post viral

NB. NO tinnitus/hearing loss

43
Q

Otosclerosis vs presbycusis

A
Otosclerosis = conductive
Presbycusis = SN
44
Q

Age of presentation of glue ear/OME

Associations of OME

A

~2 years old

speech/language/balance/behavioural delay

45
Q

“Aural fullness” + SN h/l

A

Meniere’s

46
Q

Acoustic neuromas can be manifestation of which genetic condition?

A

NF2

47
Q

Treatment for candidial OM

A

Topical antifungal for 14/7

+/- ENT referral for aural toilet