ENT Flashcards
Sneezing
Nasal itching
Nasal discharge / congestion
‘Allergic crease’ may be present
Allergic rhinitis
Rhinorrhoea
Sneezing
Itchy nose
Nasal congestion
Non-allergic rhinitis
Nasal blockage / discharge
Facial pain / pressure
Headache
Reduction in sense of smell
Acute sinusitis
Blocked nose or runny nose
Reduced sense of taste & smell
Otherwise well
Nasal polyps
Progressive breathing difficulty often exacerbated by exertion
Associated with vasculitis
Often idiopathic
Subglottic stenosis
Redness / swelling of ear canal
Itching in early stages
Can become sore and painful
Discharge / increased earwax
Hearing may be impacted
Otitis externa
Ear pain
Fever
Inflamed ear
Middle ear effusion may occur
Opaque tympanic membrane
Acute otitis media
Pain, tenderness and swelling behind the ear
Acute mastoiditis
Disproportional pain and headache, very severe
Granulation tissue at bone-cartilage junction of ear canal
Exposed bone in ear canal
Facial nerve palsy
Malignant otitis externa
Unilateral discharge from ears
Foul smelling discharge
Conductive hearing loss may occur
Rarely vertigo, facial nerve palsy, meningitis or intracranial abscess
Cholesteatoma
Sudden severe ear pain followed by bleeding and hearing loss / tinnitus
Perforated tympanic membrane
Gradual onset hearing loss
Typically 2nd and 3rd decades
Otosclerosis
Middle ear effusion - fluid visible
Altered TM colour
TM retraction
May present with hearing loss
Otitis media with effusion
Aka. Glue ear
Gradual onset hearing loss
Typically in older generations
Presbycusis
Progressive sensorineural unilateral hearing loss and tinnitus
Imbalance may occur
Facial numbness can occur
Vestibular schwannoma
Firm, red nodules on ear
Sores on skin of ear
Hearing problems
Tinnitus
Vertigo
Squamous cell carcinoma of the ear
Severe inflammatory reaction
Vesicle formation and painful ulcers surrounding the mouth
Gingivostomatitis
Primary infection of Herpes Simplex Virus 1 (HSV-1)
Often misdiagnosed as bacterial
On fingers and nails
Occupational hazard (dentistry and anaesthetics)
Use of gloves for prevention
Herpetic whitlow
Rapid onset of fever, headache, seizures, focal neurological signs and impaired consciousness
Herpes simplex encephalitis
High fever
Hyperemia
Yellow / greyish-white papulovesicular lesions in the mouth
Herpangina
Oral enanthem
Macular / maculopapular / vesicular rash of the hands & feet
Hand, foot and mouth disease
Recurrent painful ulcers in mouth
Ulcers are round or ovoid
Ulcers have inflammatory halos
Confined to the mouth
No systemic disease
Aphthous ulcer
White patches on red, raw mucous membranes in the throat / mouth
White patches come off easily
Oral candidiasis
Painful lesions
Commonly in the mucosa of hard and soft palate
Can occur anywhere there is stratified squamous epithelium
Squamous cell papilloma
Malaise
Sore throat, mild analgesia needed
Temperature
Lasts 3-4 days
Possible lymphadenopathy
Viral tonsilitis
Systemic upset
Fever
Odynophagia
Halitosis
Unable to go to work / school
Lymphadenopathy
Lasts ~1 week
Bacterial tonsilitis
Unilateral throat pain
Odynophagia
Trismus
Medial displacement of tonsil and uvula
Concavity of palate lost
Peritonsilar abscess
(quinsy)
Chronic sore throat
‘Malodorous breath’
Tonsilliths
Peritonsilar erythema
Tender cervical lymphadenopathy
Chronic tonsillitis
Severe sore throat
Greyish-white membrane across pharynx (pseudomembrane)
Diptheria
Classic triad of fever, pharyngitis and lymphadenopathy
Malaise, lethargy
Sore throat
Gross tonsillar enlargement
Palatal petechial changes
Infectious mononucleosis
Mild pain while speaking / swallowing
Varying degrees of hoarseness
Contact ulcer
Severe sore throat
Drooling saliva
Pyrexia
Normal oral cavity
Stridor may be present
Epiglottitis
Hoarse voice
Dysphonia
Throat discomfort
Reinke’s oedema
Obligate mouth breathing
Hyponasal / muffled voice
Snoring / sleep disturbance
Seen in children
Adenotonsillar hypertrophy
Dysphonia
Dysphagia
Odynophagia
(unilateral) Otalgia
Neck lump
Stridor may be present
Head and neck cancer
A tumour with features of catecholamine excess - headaches, palpitations, diaphoresis and hypertension
Sympathetic paraganglioma
A tumour with mass effects - cranial nerve palsies, a neck mass or tinnitus
Parasympathetic paragangliomas
Persistent clear rhinorrhoea
Headache
CSF leak
‘Cauliflower ear’
Common in rugby players / boxers
Pinna haematoma
Bruising behind ear - ‘battle sign’
Temporal bone fracture
Sore throat
Generally unwell
Limited neck movement
Febrile
Trismus
Red / tender neck
Deep neck space infection
SOB upon rest / exertion
Choking
Coughing
Inability to complete sentences
Sternal recession
Tracheal tug
Pyrexia
Cyanosis
Stridor
Airway obstruction
Nausea and vomiting
Vertigo upon:
Looking up
Turning over in bed
First lying down at night
Bending forward
Rising from bending
Benign positional paroxysmal vertigo
Severe first attack - lasts hours
Nausea and vomiting
Prolonged vertigo (days)
Viral symptoms - headache, malaise
Vestibular neuritis
Severe first attack - lasts hours
Nausea and vomiting
Prolonged vertigo (days)
Viral symptoms - headache, malaise
Tinnitus / hearing loss
Labyrinthitis
Light-sensitive during dizzy spells
Phonophobia
Fluctuating hearing loss
Motion sensitivity / motion sickness
Vestibular migraine
Attacks characterised by triad of:
Severe paroxysmal vertigo
Sensorineural hearing loss
Tinnitus of affected side
Sensation of ear being full
Change in hearing or tinnitus around time of dizzy spells
Meniere’s disease
