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Final Year Defintions > ENT > Flashcards

ENT Flashcards

1
Q

What are the bones of the middle ear?

A

Maleus, incus, stapies

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2
Q

Define otalgia

A

Ear pain

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3
Q

What is the difference between primary and secondary otalgia

A

Primary is ear pain with an abnormal looking ear (often infection)

Secondary is ear pain with a normal looking ear (irritation to other nerves - trigeminal, facial, glossopharyngeal, vagus, spinal nerves)

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4
Q

Meniere’s disease

A

Cochlear issue. Increase in pressure of the
paralymph of the inner ear. Presents with vertigo, nausea, vomiting, hearing loss and tinnitus. If not all the symptoms are present, it is known as atypical menier’s disease

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5
Q

What is a VNG?

A

videonystagnography, eye test assessing for assessing vestibular system. It is a good test for vertigo. Hallpike test is a part of the screen.

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6
Q

What is Hallpike test?

A

test for vertigo caused by BPPV, patient is moved suddenly LG from upright seated position to lying position. If positive, nystagmus is seen

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7
Q

Ramsay Hunt Syndrome

A

Herpes Zoster infection of the 7th cranial nerve (facial)

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8
Q

How can you tell the difference between an UMN and LMN cause of a facial nerve palsy?

A

UMN is forehead sparing

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9
Q

Causes of stridor

A

Airway obstruction
Epiglottitis
Croup
Laryngeal carcinoma

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10
Q

List the causes of vertigo (HINT: think IMBALANCE)

A

Infection - eg: labyrinthitis, Ramsay Hunt (post-shingles)
Menier’s
Benign Paroxysmal Positional Vertigo (BPPV)
Aminoglycosides
Lymph - fistula berween inner and middle ears causing vertigo and sensorineural hearing loss
Arterial - eg: migraine, TIA, CVA
Nerve lesions - eg: acoustic neuroma, vestibular schwannoma
Central lesions - eg: demylination, tumour
Epilepsy

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11
Q

Define: otitis externa

A

Inflammation and infection of the external auditory canal, usually caused by staph / strep / pseudomonas - treated using topical antibiotics +/- topical steroids

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12
Q

What is malignant otitis externa?

A

Severe otitis external, usually caused by pseudomonas - associated with diabetes

Can be fatal - high risk of skull osteomyelitis leading to abscesses, meningitis, encephalitis and death

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13
Q

Define: otitis media

A

Inflammation and infection of the middle ear, usually secondary to an URTI

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14
Q

Name the four classifications of otitis media

A

(a) Acute otitis media
(b) Otitis media with effusion (glue ear)
(c) Chronic otitis media
(d) Chronic suppurative otitis media

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15
Q

What is “glue ear”

A

Otitis media with effusion

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16
Q

What causes the following type of discharge?

- Watery

A

eczema of ear canal, CSF, early otitis externa

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17
Q

What causes the following type of discharge?

- Purulent

A

acute otitis externa, furnunculosis, otitis media (following ear drum perforation)

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18
Q

What causes the following type of discharge?

- Mucoid

A

chronic suppurative otitis media with perforation

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19
Q

What causes the following type of discharge?

- Bloody

A

rauma, acute otitis media, carcinoma

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20
Q

What causes the following type of discharge?

- Foul smelling

A

cholesteatoma, chronic suppurative otitis media

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21
Q

What is the most common cause of conductive hearing loss in children?

A

OME - otitis media with effusion

22
Q

What causes a flat trace tympanogram (usually in children)?

A

OME - otitis media with effusion

23
Q

List some ototoxic drugs - do they result in permament or temporary hearing loss

A

Aminoglycosides (eg: vancomycin, gentamycin) - permanent
Chemotherapy (eg: cisplatin) - permanent
Salicylates (eg: aspirin) - temporary
Quinine - temporary
Loop diuretics (eg: furosemide) - temporary

24
Q

List some causes of vertigo (HINT: think IMBALANCE)

A 
Infection / Injury 
Meniere's disease
Benign Positional Paroxysmal Vertigo
Aminoglycosides
Lymph / Labyrinthitis 
Arterial (eg: migraine, TIA, CVA)
Nerve (eg: acoustic neuroma)
Central lesion (eg: demyelination --> MS)
Epilepsy
25
Q

List some causes of conductive hearing loss (HINT: think WIDENING)

A 
Wax
Infection
Drum - perforation 
Extra ossicles - otosclerosis 
Neoplasia 
INjury 
Granulomatous
26
Q

List some causes of sensorineural hearing loss (HINT: think DIVINITY)

A 
Developmental / Degenerative
Infection
Vascular 
Inflammation
Neoplasia
Injury 
Toxins
lYmph
27
Q

What is prebyacussis?

A

Age-related hearing loss

28
Q

What is the difference between conductive and sensorineural hearing loss?

A

Conductive hearing loss = problem with structures of the ear (i.e. between auricle and round window - canal, drum, malleus, incus or stapes)

Sensorineural hearing loss = problem with the inner ear or nervous system (i.e. cochlear, cochlear nerve or brain)

29
Q

Which tuning fork do you use for Rinne’s and Webber’s testing?

A

512 Hz

30
Q

What is Rinne’s testing for?

A

Air v. bone conduction - i.e. conductive hearing loss

31
Q

What are normal findings in Rinne’s test?

A

Air conduction lasts longer / is louder than bone conduction

32
Q

What Rinne’s test findings are suggestive of conductive hearing loss?

A

Bone conduction is stronger than air conduction (i.e. noise heard louder with tuning fork placed on mastoid process than in front of external meatus)

33
Q

What Rinne’s test findings are suggestive of sensorineural hearing loss?

A

NONE - Rinne’s test is NORMAL with sensorineural hearing loss

34
Q

What is Webber’s testing for?

A

Localisation of hearing loss

35
Q

What are normal findings in Webber’s test?

A

Sound is heard equally across both ears

36
Q

What Webber’s test findings are suggestive of conductive hearing loss?

A

Sound is heard loudest in ABNORMAL ear

37
Q

What Webber’s test findings are suggestive of sensorineural hearing loss?

A

Sound is heard loudest in NORMAL ear

38
Q

If a patient has normal Rinne’s test and Webber’s test louder on the Right - what does that suggest?

A

Sensorineural hearing loss in LEFT ear

39
Q

if a patient has abnormal Rinne’s test (on the R) and Webber’s test louder on the Right - what does that suggest?

A

Conductive hearing loss in the RIGHT ear

40
Q

List some causes of tympanic membrane perforation?

A

Trauma
Barotrauma
Foreign body
Otitis media

41
Q

Outline the management of nasal fractures

A

1) Stop bleeding, manage pain, ice
2) Do not reduce on first presentation
3) Check for boggy nasal septum - septal haematoma
4) Discharge with outpatient appointment for 1 week
5) MUA within two weeks with nose brace

42
Q

What is the most serious complication of a nasal fracture? How is it managed?

A

Septal haematoma - risk of infection, septal necrosis, saddle nose deformity

Must be drained, give antibiotics and packing

43
Q

What is the Centor Criteria?

A

Criteria for determining whether or not antibiotics are required for tonsillitis

44
Q

What are the functions of the larynx?

A

Phonation (production of speech sounds)
Positive thoracic pressure (i.e. auto-PEEP)
Respiration
Prevention of aspiration

45
Q

Describe the presentation of Bell’s Palsy

A

Sudden onset:

  • Complete unilateral facial weakness (forehead involved)
  • Dry eye (due to inability to close eye)
  • Drooling
  • Speech difficulty
  • Ear pain
  • Hyperacusis
  • Ageusia (decreased taste)
46
Q

Which cranial nerve is affected in Bell’s Palsy?

A

Facial - CN VII

47
Q

Is the forehead involved in Bell’s Palsy?

A

YES

48
Q

What is the immediate management of Bell’s Palsy

A

Eye protection + Prednisolone

49
Q

Describe the presentation of Ramsay Hunt Syndrome

A

Onset of symptoms following ear pain

  • Complete unilateral facial weakness (forehead involved)
  • Vesicular rash in auditory canal
  • Decreased taste
  • Hyperacusis
  • Vertigo
  • Tinnitus
50
Q

Is the forehead involved in Ramsay Hunt Syndrome?

A

YES

51
Q

Why is the forehead involved in facial nerve palsies?

A

Because they are LMN lesions - the forehead is spared in UMN lesions

Final Year Defintions (13 decks)

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