ENT Flashcards
hearing loss:
- causes of conductive? 5
- excessive wax build up
- otosclerosis
- otitis media
- glue ear
- paget’s bone disease
hearing loss:
- causes of chronic sensorineural? 3
- causes of acute sensorineural? 7
chronic:
- accumulated environmental noise toxicity
- presbycusis (ie aging, loose high pitched sounds first)
- FH/genetics
acute:
- noise exposure
- gentamicin/other toxin
- mumps
- acoustic neuroma
- MS
- stroke
- vasculitis
tinnitus:
- what is it?
- causes of unilateral tinnitus w sensorineural hearing loss? 2
- causes of bilateral tinnitus w sensorineural hearing loss? 2
- causes of tinnitus w conductive hearing loss? 3
when you can hear sounds inside your head that are created by your inner ear, not your environment (often ringing)
unilateral + sensorineural
- acoustic neuroma
- meniere’s disease
bilateral + sensorineural
- over-exposure to loud noises
- age-related hearing loss
tinnitus + conductive
- wax build up
- otitis media
- otosclerosis
nb other rare causes
discharging ear:
- technical name?
- common causes? 3
- other causes? 4
otorrhoea
- otitis media (w perforated ear drum)
- otitis externa
- perforated ear drum dt trauma
- CSF leak dt head trauma
- epidural abscess
- ear foreign body
- neoplasm
vertigo:
- what is it?
- what makes it worse? 1
- associated symptoms? 5
illusion of movement, often rotatory
worsened by movement (better if stay still)
- difficulty walking (or even standing)
- nausea/vomitting
- pallor
- sweating
- (hearing loss or tinnitus)
vertigo:
- labyrinth & 8th nerve causes?
- brainstem or cerebellum causes?
- other cause?
labyrinth & 8th nerve
- benign positional vertigo
- Meniere’s disease
- acute labyrinthitis (aka vestibular neuronitis)
- motion sickness
- trauma
- ototoxic drugs
- herpes zoster virus
brainstem or cerebellum causes
- MS
- acoustic neuroma
- stroke/TIA
- migraine
other = ALCOHOL INTOXICATION
facial palsy:
- how to differentiate between upper + lower motor neurone lesion?
- symptoms/signs?
- LMN causes?
- UMN causes?
- treatment?
UMN: frontal sparing (they CAN wrinkle their forehead)
on affected side:
- inability to fully close eye
- paralysis of muscles of facial expression
- hyperacusis
- change in taste
- idiopathic (bells) (nb more common in pregnancy + diabetes) -MOST COMMON
- CV disease (e.g. brainstem stroke)
- iatrogenic (e.g. for dental treatment)
- infective (often viral, if bilateral likely to be Lyme disease)
- trauma (fractures of skull base, forceps delivery, etc)
- neurological (Gillian barre, mononeuropathy dt DM, sarcoidosis etc)
- neoplastic
- HTN in pregnancy + eclampsia
- CV disease
- intracranial tumours
- MS
- syphillis
- HIV
- vasculitis
treat underlying cause!
- if bells, steroids and eye protection
facial pain:
- sinus causes? 3
- nose causes? 3
- ear causes? 2
- mastoid causes? 1
- teeth causes? 1
- soft tissue infection causes? 2
- neuro causes?
- parotid gland causes? 6
- eye causes? 2
- headache causes? 3
- vasculitis cause? 1
- tumour causes? 4
- bone causes? 2
- psychological cause? 1
sinus:
- sinusitis
- trauma
- carcinoma
nose:
- URTI
- nasal injury
- foreign bodies
ear:
- otitis media
- otitis externa
mastoid:
- mastoiditis
teeth:
- dental abscess
local soft tissue infection
- cellulitis
- erysipelas
neuro
- trigeminal neuralgia
- herpes zoster
- post-herpetic neuralgia
parotid gland:
- mumps
- other causes of parotiditis
- abscess
- duct obstruction
- calculi
- tumour
eye
- orbital cellulitis
- glaucoma
headaches
- cluster
- migraine
- medication-overuse
vasculitis
- temporal arteritis
tumours: - nasopharyngeal - oral - posterior fossa - brain stem gliomas (nb also upper lobe lung cancer)
bone
- maxillary or mandibular osteitis
- cyst
idiopathic/atypicalpain , may be worse with fatigue or stress, often linked with depression or mood disturbances
facial pain:
- how to diagnose?
- other symptoms to ask about?
- management of atypical facial pain?
SOCRATES
- otorrhoea
- hearing loss
- nasal obstruction +/- watery eyes
- proximal muscle weakness (polymyalgia rheumatic)
- any lumps on face
- tricyclic antidepressant
rhinosinusitis
- cause of acute?
- cause of chronic?
- symptoms? 7
- treatment? 3
- cold virus or URTI
- allergies (or sometimes fungus)
- runny nose (+/- post-nasal drip)
- nasal congestion
- decreased sense of smell
- halitosis
- pain/pressure/fullness in nose, eyes or ears
- toothache
- headache
nb children often have a cough as well whereas adults often don’t
depends on cause, often symptomatic:
- OTC analgesia
- nasal decongestanats
- antihistamines (if allergy)
epistaxis:
- causes of anterior bleeds? 3
- causes of posterior bleeds? 4
- which ages most at risk?
- picking your nose
- blowing nose too hard
- inside of nose being too dry (change in air)
- trauma
- HTN
- underlying haemophilia
- iatrogenic (e.g. anticoagulants)
- young kids
- elderly
- pregnant women
epistaxis:
- how to treat minor? 4
- how to treat major/recurrent? 3
- which groups to worry about recurrent in? 4
- sit forward
- pinch nose hard for 15mins (just above nostrils)
- breath through mouth
- can use naseptin cream applied to nostrils following attack (for both minor + major)
- nasal cautery
- nasal packing
- find underlying cause
- children < 2 years old
- people >50 (higher chance of cancer)
- Chinese origin (higher chance of cancer)
- people with other signs (nasal obstruction, facial pain, hearing loss, eye symptoms etc)
pharyngitis:
- symptoms? 6
- signs that it is caused by bacteria? 4 (incl name of criteria)
- red flags for more active treatment? 5
- painful throat (esp when swallowing)
- dry, scratchy throat
- red throat
- bad breath/funny taste
- mild cough
- neck lymphadenopathy
Centaur criteria (if 3 or 4 signs present, likelihood of bacteria is >60%)
- tonsillar exudate
- tender anterior cervical lymph nodes
- absence of cough
- history of fever
- stridor (or difficulty breathing)
- recurrent sore throats
- immunosuppressed (incl on chemo)
- quinsy
- signs of sepsis or severe dehydration
pharyngitis:
- advice for self-care? 6
- gargle with warm salty water (not kids)
- drink plenty of water (not hot drinks)
- eat cool or soft foods
- suck ice cubes, ice lollies or hard sweets (not kids)
- avoid smoking/smoky places
- rest
salivary gland conditions, what are they and how do they present:
- sialolithiasis?
- sialoadenitis?
- sjogren’s syndrome?
- commonest tumour?
- viral infections? 5
sialolithiasis
= calcium stones block exist of saliva
- painful lump under the tongue
- pain that increases when eating (as more saliva being produced)
sialoadenitis = infection, often secondary to stones - lump in cheek or under chin - pus in mouth - strong/foul-smelling pus - fever
sjogren's syndrome = autoimmune attack of saliva producing cells (most common in SLE) - dry mouth - dry eyes - tooth decay - sores in mouth - joint pain/swellng - dry cough - unexplained fatigue - swollen salivary glands - frequent salivary gland infection
pleomorphic adenoma
- influenza
- mumps
- coxsackie virus
- echovirus
- cytomegalovirus
