ENT Flashcards
Otalgia, fever, hearing loss, bulging tympanic membrane witth loss of light reflex
Otitis media
typically preceded by URTI - Strep Pneu, H. inf,
Tx - self limiting - give abx if >4/7, systemically unwel or perforation/discharge
Comp - mastoiditis, meningitis, brain abscess, facial nerve paralysis
Otalgia, foul smelling, non-resolving discharge, hearing loss
Cholesteatoma
may cause vertigo/facial nerve palsy by local invasion
Red flags in chronic rhinosinusitis
unilateral symptoms
persistent symptoms despite compliance with 3 months of treatment
epistaxis
NB - post nasal drip can cause chronic cough
Progressive, bilat high-frequency hearing loss
Presbyacuisis - age-related sensory
middle aged, progressive deafness + tinnitus, FHx
Otosclerosis - ADom
replacement of normal bone by vascular spongy bone
Onset 20-40yr
Bilat acoustic neuroma
NF2
erythematous areas on tongue with a white-grey border
Geographic tongue - benign
Reassurance
Causes of gingival hyperplasia
Phenytoin, ciclosporin, CCB (esp nifedipine)
AML
Severe, unrelenting deep-seated otalgia, headaches, purulent discharge
Diabetic/immunocomp
Malignant otitis externa
(pseudonomas aureg)
Tv IVAbx and seen by ENT
Red flags for mouth lesions
Unexplained oral ulcer >3w
Unexplained patches that are painful/swollen/bleeding
Unexplained one sided pain in head/neck >4w
Higher suspicion in >40, smokers and drinkers
Rubbery, painless lymphandenopathy
Lymphoma
May be associated night sweats/splenomegaly
Pain while drinking alcohol
oval, mobile cystic mass between the sternocleidomastoid muscle and the pharynx
Brachial cyst - present in early adulthood
Pain on eating/talking, fever, foul taste in mouth
Parotid gland swelling
Bilat - Mumps, sacroid, Sjogrens, Lymphoma, alco liv des
Unilat - tumour, parotid stones, inf
Ear pain, facial rash, vertigo/tinnitus, facial palsy
Ramsey hunt
Reactivation of VZV in CN VII
Tx - aciclovir + steroids
Rhinne and weber summary
Conductive
Rhinne - BC>AC in affected, Weber lateralises to affected
Sensory - AC>BC bilat, Weber lat to unaffected
Recent URTI, sudden onsent N/V, hearing affected
Viral labyrinthitis
Recent viral inf, recurrent vertigo attacks, hearing fine, horizontal nystagmus
Vestibular neuronitis
Tx - short term relief = prochlorperazine
Conductive hearing loss, normal tympanic membrane/pink tinge
Otosclerosis
+ve FHx, often exacerbated by pregnancy
pink tinge = Shwartz sign
