ENT Flashcards
Mirror image nuclei in biopsy of neck type of cell and condition and other features
Cell type - Reed sternberg cells
Large non tender rubbery lymph nodes 25% have systemic symptoms
Alcohol induced lymph node pain
Lymphadenopathy in 75% but non painful
Hearing loss in conductive hearing loss
Just air conduction impaired
Hearing loss in sensorineural loss
Both air and bone conduction loss
Normal audiogram
Above the 20 decibel line
Bilateral acoustic neuroma
Cause?
Acoustic neuroma Also called?
Neurofibromatosis type 2
Vestibular schwannoma
Which salivary glands most commonly have tumours?
80% of salivary gland tumours are in the parotid and 80% of them benign
Entropion complication
Corneal ulcer
Treatment herpes zoster ophthalmicus
Oral acyclovir 7-10 days started within 72hours if possible
Oral corticosteroids may reduce duration of pain
Occupational involvement = ophthalmologist review
Predisposing factors x3 for perichondritis of the pinna
Piercings/trauma, infection (otitis extern) masjid surgery, pseudomonas
Perichondritis?
Inflammation of the connective tissue surrounding cartilage common in the pinna
First presentation otitis externa treatment
Adequate analgesia
Clean external ear canal
Topical abx and steroid
Order of ossicles lateral to medial
Malleus incus stapees
Percentage of preschool children with otitis media with effusion
20%
Ome presentation give x 3 symptoms
Hearing loss
Mild pain
Autophony - can hear own voice loudly
Age group typically affected by otitis media e
2-5 years old
Otoscopy finding of ome
Retracted, dull timpani membrane with reduced movement
Ome hearing loss and what level of decibels lost
Conductive 20-40 decibels
Ome treatment
Watchful waiting
Grommet insertion
Adenoidectomy
cholesteatoma presentation. which part of tympanic membrane is affected?
mild otalgia, ottorhoea (smelly and prurelent), hearing loss,unilateral tinnitus
pars flaccida, top of eardrum
Surgery for cholesteatoma
mastoidectomy and tympanoplasty to repair the drums
risks of mastoidectomy
vertigo, facial nerve damage, hearing loss
cholesteatoma problems if untreated x4
ossicle damage tympanic membrane damage facial nerve palsy cerebral abcess mastoid bone and cochlear damage
perforated tympanic membrane presentation and hearing loss type?
otalgia
discharge
conductive
operation for repair of tympanic membrane
Myringoplasty
perforated tympanic membrane, management?
keep dry only prescribe drops if becomes infected
vertigo define:
A sensation of rotation or movement of one’s self (subjective vertigo) or of one’s surroundings (objective vertigo) in any plane.
acoustic neuroma most common presentation
unilateral sensorineural hearing loss, tinnitus and imbalance.
gold standard to image acoustic neuroma
Gandolinium-enhanced MRI
Radiotherapy and surgery to treat
meniere’s disease triad?
hearing loss, vertigo, tinnitus
exact complaints of BPPV, how long does it last and well in between or not? triggers? relieving factors?
Short lived vertigo (20-30 seconds), relieved when keeping head still, triggered with change in head position.
May have associated nausea
Between episodes of vertigo feel well
Between what frequencies is a pure tone audiogram commonly measured?
250hz - 8000hz
three hearing tests
audiogram
Speech audiometry
Immittance audiometry
how many adults expected to have hearing loss
1 in 5
most common type of hearing loss in adults?
presbycusis, sensorineural
most common causes of tinnitus
most common - presbycusis others: wax touching eardrum menier's TMJ disorders
most common throat cancer
squamous cell carcinoma
three results on tympanogram
type A - a big peak: normal pressure in the middle ear
type B - flat peak, little or no change, non compressible fluid in middle ear
type C - peak is below 0 -eustachian tube problem
measure hearing loss in 18 month old child
reinforcement audiometry
what kind of epithelium in the sinuses?
respiratory - pseudostratified columnar epithelium with goblet cells
name of simple test for air flow
nasal sniff test
part of the nose where nasal bleeds occur
little’s areas or Keiselbach’s plexus
treat nosebleed
packing, arterial ligation, quaterisation
unilateral nasal polyp in child and then in adult
child any polyp suggests CF adult unilat - cancer
most common cause of obstructive sleep apnoea in children
adenotonsillar hypertrophy
sleep study proper name
polysomnography
epiglottitis management
Management is usually conservative with intravenous or oral antibiotics but intubation may be needed .
most common bacterial cause of tonsillitis
strep A
as well as weight loss, what treatment can we give adults with Obstructive sleep apnoea?
CPAP
treatment quinsy
drainage plus metranidazole 500mg bd
Glandular fever
3 weeks general malaise petechiae on palate fever septic enlarged tonsills with exudate in sheets very sore throat
where are adenoids?
roof and posterior wall of nasopharynx
three types of stridor and likely areas affected
inspiratory - laryngeal
expiratory - tracheobronchial
biphasic - glottitis
stretor? inspiratory or expiratory?
stretor is only inspiratory and is a gasping/snoring noise caused by partial block of airway above the larynx
acute mastoiditis symptoms
Bulging of pinna – swelling and tenderness behind ear
Fever
Ear discharge, hearing loss
possibility of cerebral abcess
tonsillitis episodes per year for tonsillectomy
severe episodes:
7in 1 year
5 per year for 2
3 a year for 3
severe or profound hearing loss children what proportion born?
1 in 1000
three worrying signs head and neck malignancy
breathing trouble, swallowing trouble, pain
2 most common trache tube types?
double lumen or single lumen
where does the parotid open to in mouth?
2nd molar
submandibular duct opens onto
under tongue
most common parotid tumour
pleomorphic adenoma
complication of parotid surgery
Freys syndrome (gustatory sweating) and facial palsy
nerves at risk in submandibular gland surgery
Lingual, hypoglossal, marginal mandibular branch of facial
gold standard for lump in the neck
USS + FNAC
TNM what does T stand for?
Tumour, how aggressive is tumour
otomycossis
fungal infection external ear
acitinic keratosis treatment
s. flourouracil or nitrogen
2 conditions that cause cerebral abcess
cholesteatoma and mastoiditis
what is bony labyrinth filled with
what is membranous filled with
perilymph
endolymph
