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General Medicine > ENT > Flashcards

ENT Flashcards

1
Q

Management of septal haematoma of nose

A

Urgent drainage to prevent AVN of septal cartilage

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2
Q

Management of fractured nose

A

Analgesia
Exclude septal haematoma
Review in ENT clinic in 5-7d

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3
Q

What cell type is hypo-pharyngeal ca?

A

Squamous cell carcinoma

Arises from pharyngeal walls, epiglottis, pyro form fossa or upper oesophagus

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4
Q

What is Patterson-Brown-Kelly syndrome (Plummer-Vinson synd)

A

Triad of

  • dysphasia
  • glossitis
  • iron deficiency anaemia
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5
Q

Causes of lymphadenopathy

A 
Bacterial - pyogenic infection, TB, brucellosis
Viral- EBV, CMV, HIV
Protozoa - toxoplasmosis 
Lymphoma
Metastases
Collagen disease
Sarcoidosis
Amyloidosis
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6
Q

Causes of dysphagia

A 
Neurological - MG, MND, MS
foreign body
Pharyngeal pouch 
Post-cricoid web
Globus pharyngis
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7
Q

Cell type of laryngeal carcinoma

A

Squamous cell carcinoma

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8
Q

Features of laryngeal carcinoma

A

Hoarse voice
Airway obstruction
Hemoptysis

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9
Q

What is a thyroglossal cyst

A

Develops from thyroglossal ducts which usually disappear on development
Mid-line swelling
Above upper border of thyroid cartilage
Moves on swallowing and tongue protrusion

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10
Q

Causes of nasal obstruction

A 
Rhinitis 
Septal deviation
Nasal polyps
Foreign body
Sinonasal malignancy
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11
Q

What are nasal polyps

A

Oedematous paranasal sinus mucosa protruding through sinus ostia.
Single or multiple
Temporary improvement with steroids
Surgical removal

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12
Q

Causes of anosmia

A 
URTI
Nasal polyps
Sinonasal disease 
Old age
Drug tx
Head injury / trauma
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13
Q

What is sinusitis + causative organisms

A

Infection of a sinus causing facial pain

Strep pneumonia
H. Influenzae
Infection from dental abscess

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14
Q

Types of sinus tumour

A

Squamous cell
Adenocarcinoma in furniture of workers
Maxillary and ethmoid most commonly

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15
Q

Most common site of epistaxis

A

Littles area

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16
Q

Management of anterior nose bleed

A

Pressure on anterior septum

+/- adrenaline application

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17
Q

What is a common cause of nosebleeds in older patients

A

Arteriosclerotic vessel further back

Use balloon compression or packing

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18
Q

What is otorrhoea

A

Ear discharge

Usually from infection of outer or middle ear

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19
Q

What is otitis externa + how do you tx it

A

Inflammation of skin of ear canal
Bacterial, viral or fungal

Tx = remove debris, regular cleansing + antibiotic ear drops

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20
Q

Define cholesteatoma

A

Keratinising squamous epithelium of middle ear
Tympanic membrane defect containing white material - can erode local structures.
Surgery to remove the sac.

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21
Q

Causes of perforated tympanic membrane

A

Trauma

Chronic middle ear disease

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22
Q

Symptoms of perforated tympanic membrane

A

Decreased hearing

Whistling sound

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23
Q

What is otitis media + common organisms

A

Bacterial infection of middle ear
H. Influenzae
Strep pneumoniae

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24
Q

Symptoms of otitis media

A

Otalgia
Fever
Malaise

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25
Q

What is OME (glue ear)

A

Fluid in middle ear
Common in children
Syx = hearing loss, interference of language acquisition

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26
Q

What is Otosclerosis

A

Stapes becomes fixed by new bone formation
F>M
Surgical tx

27
Q

Features of vocal cord nodule

A

Bilateral
Free edge of vocal cord
Prevents full closure
Breathy harsh voice

28
Q

What is Reinke’s oedema

A

Oedema of the vocal cord
Caused by irritation
Causes = Smoking, voice abuse, acid reflux, hypothyroidism

29
Q

Risk factors for larangeal carcinoma

A 
SMOKING
Excess alcohol 
Male
Low socio-economic status 
>55 yo
30
Q

Symptoms of laryngeal carcinoma

A 
Hoarseness / voice change
Neck lump
Sore throat
Persistent cough
Stridor
Halitosis 
Otalgia
31
Q

Common organisms of tonsillitis

A

Bacterial - beta-haemolytic streptococcus

Viral - adeno, rhino, flu, resp syncytial virus

32
Q

Symptoms of tonsillitis

A 
Fever
Sore throat 
Dysphagia
Lymphadenopathy 
Malaise
33
Q

Symptoms of glandular fever

A 
Sore throat
Fever
Fatigue 
Weight loss
Malaise 
Vomiting
Petechiae
Decreased appetite
34
Q

Signs of glandular fever

A 
Fever
Lymphadenopathy
Splenomegally
Hepatitis
Haemolysis
35
Q

Define Trismus

A

Inability to normally open the mouth

36
Q

Define quinsy

A

Collection of pus outside of the capsule of the tonsil.
Pushes the uvula across
Needs urgent ENT referral

37
Q

Indications for tonsillectomy

A

Suspected malignancy
OSA due to tonsilar hypertrophy
Recurrent tonsillitis (5/yr for 2yrs)
Quinsy + recurrent tonsillitis

38
Q

What are adenoids

A

Lymphoid tissue in the nasopharynx of children.

Increase in size until 4 then disappear in adulthood.

39
Q

Cell types of tonsil tumours

A

Younger pts - lymphoma (smooth)

Older pts - squamous cell ca. (Ulcerated)

40
Q

What is a pharyngeal pouch

A

Mucosal herniation through the pharyngeal musculature because cricopharyngeus doesn’t relax.
Dysphagia for solids + regurgitation

41
Q

What causes Ménière’s disease

A

Distension of the membranous labyrinth by accumulation of endolymph

42
Q

What is benign paroxysmal positional vertigo

A

Secondary to degeneration of utricular neuroepithelium in semicircular canals.
Spontaneous or after head injury.
Free floating material affects endolymph flow

43
Q

Symptoms of benign paroxysmal positional vertigo

A

Attacks of vertigo - precipitated by head movement

44
Q

Management of benign paroxysmal positional vertigo

A

Steady resolution over weeks

Most cases can be treated by - Epley manouvre

45
Q

What drugs can cause ototoxicity

A

Gentamicin
Streptomycin
Quinine
High dose aspirin

46
Q

What is Ramsay hunt syndrome and what are its symptoms

A

Herpes zoster infection of the geniculate ganglion
Affects facial nerve and vestibulocochlear nerve

Facial muscle paralysis
Herpetic eruption on ear canal (shingles)
+/- tinnitus, hearing loss, vertigo

47
Q

What is labyrinthitis and what causes it

A

AKA vestibular neuronitis
Most common cause of vertigo

Sudden severe vertigo, vomiting and ataxia
No tinnitus, no hearing loss

May be viral in origin

48
Q

Management of labyrinthitis

A

Antiemetics - often prochlorperazine

Syx settle over few days

49
Q

Symptoms of vestibular neuronitis

A

unsteadiness,
nausea and vomiting.
Feels like room is rotating.
Moving the head aggravates symptoms.

50
Q

Examination findings in vestibular neuronitis

A

Spontaneous, unidirectional, horizontal nystagmus
fast direction towards the healthy ear.

On walking / in Romberg’s test, the patient tends to fall towards the affected side.

51
Q

Management of vestibular neuronitis

A

antiemetic
prochlorperazine (vestibular suppressant) may be useful short term.
Promethazine and domperidone may be useful.
3 days steroids
Early activity encouraged - promote vestibular compensation.

52
Q

What is an acoustic neuroma

A

tumour of the vestibulocochlear nerve
Schwannoma
benign and slow growing
symptoms due to mass effect

53
Q

Risk factors for acoustic neuroma

A

Neurofibromatosis.

High-dose ionising radiation to head and neck

54
Q

Presentation of acoustic neuroma

A

unilateral sensorineural hearing loss is an acoustic neuroma until proven otherwise.

Unilateral tinnitus.
Impaired facial sensation.
Balance problems without other explanation.

55
Q

What is a quinsy

A

Collection of pus outside the capsule of the tonsil
Deviates the uvula
Needs urgent ENT referal

56
Q

What is trismus

A

Inability to normally open mouth

57
Q

Symptoms of tonsillitis

A 
Fever 
Sore throat
Dysphagia
Lymphadenopathy 
Malaise
58
Q

Common organisms of tonsillitis

A

Viruses - adeno / rhino / influenza / resp syncytial

Bacterial - beta-haemolytic / streptococcus

59
Q

Symptoms of layngeal cancer

A 
Hoarseness
Voice change
Neck lump
Odynophagia 
Persistent cough
Stridor 
Halitosis 
Otalgia
60
Q

Risk factors for laryngeal carcinoma

A 
**Smoking**
Excess alcohol 
Male
Low socio-economic status
>55yo
61
Q

What is reinke’s oedema

A

Oedema of the vocal cord

62
Q

Treatment of epistaxis from littles area

A

Apply pressure to lower nose

Lean head forward

63
Q

What makes sinusitis pain worse

A

Bending

Coughing

64
Q

What is swimmers ear

A

Acute otitis externa

General Medicine (25 decks)

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