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ENT Flashcards

1
Q

How does a nasal polyp present?

A

two month history of nasal blockage on the right side, which is now beginning to disrupt his sleep

Polyp on the right side and an inflamed mucosa bilaterally

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2
Q

What are the associations of polyps?

A

asthma, hypersensitivity (

Churg stauss

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3
Q

How to manage nasal polyps?

A

ALL patients referred t oENT

topical corticosteroids

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4
Q

When to prescribe abx fo otitis media

A

when perforation, systemic illness, immunocompromise

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5
Q

Which abx for otitis media?

A

5 day amoxicillin

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6
Q

cholestatoma - go

A

squamous epithelium ‘trapped’ discharge, smells, hearing loss,

every ear problem - hearing change / balance
otoscopy - attic crust
refer ENT surgery

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7
Q

thyroglosal cycst - go

A

in midline, asymptomatic,l move upward with protrusion of the tongue

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8
Q

thyroid lumps

A

nodule / carcinoma - move with swallowing but not with protrusion of tongue

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9
Q

branchial cyst

A

anterior triangle of neck, smooth pluctuant palinless mass on anterior border of sternocleidomastoid

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10
Q

long term use of nasal decongestants

A

tolerance (tachyphylaxis)

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11
Q

allergic rhinitis - what? and management?

A

sneezing, bilateal nasal obstruction, clear nasal discharge, post nasal drip
management - allergen avoidance, oral / intranasal antihistamin, intranasal corticosteroids short ocurse topical nasal decongestant

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12
Q

viral labyrinthitis

A

HEARING LOSS

vertigo

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13
Q

vestibular neuronitis

A

cause of vertigo develops following viral infection,

N+V, horizontal nystagmus, no hearing loss/ tinnitus

Mx - vestibular rehab

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14
Q

indications for tonsillectomy

A

5+ / year, episodes are disabling and prevent normal functioning, febrile convulsions (children), obstructive sleep apnoea, stridor, quinsy unresponsive to standard treatment

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15
Q

BPPV

A 
most common causes of vertigo
sudden onset vertigo triggered by changes in head position
average age onset = 55 years
ass. with nausea
positive dix hallpike manouvre

mx - epley manoeuvre

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16
Q

mastoiditis

A

swelling around ear, displacement of ear

red bulging tympanic membrane

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17
Q

conductive hearing loss

A

bone conduction better in affected side

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18
Q

sensorineural hearing loss

A

hearing better in other ear

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19
Q

acute otitis externa

A 
red, oedematous ear canal, narrowed and obscured by debris
conductive hearing loss
discharge
regional lymphadenopathy
cellulitis spreading beyond the ear
fever

mild cases <7 days - acetic acid spray

more severe inflammation / >7 days - topical abx and steroid

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20
Q

ramsay hunt syndrome

A

reactivation of existing varicella zoster virus in the geniculate ganglion. hence vesicles on tympanic membrane
p/c - auricular pain, faial nerve palsy, vesicular rash around the ear, vertigo and tinnitus
aciclovir and steroids

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21
Q

guillain barre syndrome

A

presents with progressive weakness starting distally and moving proximally

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22
Q

gingivitis

A

simple - painless, red swelling in the gum margin, bleeds on contact, acute necrotising ulcerative gingivitis - painful bledding gums with halitosis and punched out ulcers
necrotizing - oral metronidazole, chlorhexidine mouthwash, simple analgesia

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23
Q

Causative agent bacterial sore throat

A

group A beta haemolytic streptococcus

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24
Q

Post op stridor in patients who have undergone neck surgery management

A

Urgent removal of sutures (patients sent back to ward with a suture blade)

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25
What is an epidermoid cyst?
common cutaneous cysts resulting from proliferation of epidermal cells within a circumscribed space within dermis - firm, round nodules, central punctum may be present
26
cystic hygromas
congenital lymphatic lesions, found in neck and axilla, predilection for left side, present in infancy
27
branchial cleft cyst
congenital epithelial cysts develop due to failure of obliteration of second branchial cleft in embryonic development, present by early adulthood, smooth, painless, do not transilluminate
28
deep cervical abscesses
occur following a course of infection - recent dental work, URTI, neck / oral cavity trauma. Presents with painful / tender swelling, hot to touch, symptoms of infection - fever, chills, aches, pains
29
lipoma
asymptomatic, soft and mobile, within dermal layer of skin, no centra punctum
30
menreire's disease
disorder of the inner ear of unknown cause, characterised by excessive pressure and progressive dilation of endolymphatic system recurrent episodes of vertigo, tinnitus, hearing loss (sensorineural), vertigo usually prominent symptom ENT assessment is required to confirm the diagnosis, patients should inform the DVLA acute attacks - prochlorperazine, admission sometimes required prevention - betahistine / vestibular rehab
31
meniere's
sensorineural hearing loss, recurrent episodes of vertigo, tinnitus, episode last minutes -> hours
32
Causes tinnitus
meniere's (hearing loss, vertigo, tinnitus, sensation of fulness or pressure), otosclerosis - onset usually at 20-40 years, conductive deafness, +ve fam history, normal tympanic membrane acoustic neuroma - hearing loss, vertigo, tinnitus, absent corneal reflex, associated with neurofibromatosis hearing loss - excessive loud noise, presbycusis drugs - aspirin, aminoglycosides, loop diuretics, quinine
33
which drugs cause gingival hyperplasia? (painful gums)
phenytoin, ciclosporin, CCB (especially nifedipine)
34
Thyroid surgery complications
anatomical - recurrent laryngeal nerve damage, bleeding - haemotoma's may rapidly expand, damage to parathyroids --? hypocalcaemia
35
otosclerosis
replacement of normal bone by vascular spongy bone, causes progressive conductive deafness , autosomal dominant, typically affects young adults onset 20-40 years conductive deafness, tinnuties, normal typmapinc membrance, +ve fam history x - hearing aid, stapedectomy
36
benign parotid tumours
benign pleoorphic adenocarcinoma - most common, proliferation of epithelial and myoepithelial cells, slow growing, lobular, not well encapsulated, recurrence rate of 1-5% warthin tumour - papillary cystadenoma
37
keither wagener classification hypertensive retinopathy 1-4
1 Artery narrowing, Silver wiring, Tortuosity 2 AV nipping 3 Cotton wool exudates flame and blots 4 Papilloedema
38
Nasopharyngeal carcinoma risk factors
Smoking alcohol
39
Nasopharyngeal carcinoma presentation
otits media, odynophagia
40
seborrhoeic Dermatitis presentation and management
eczematous lesion scalp, periorboital, auricular, nasolabial folsds head and shoulder, t gel, ketoconazole
41
classic history pityruasis rosea
herald patch, follwing viral infection multiple, erythematous, raised oval lesions, fir tree appearance
42
management pityriasis rosea
nothing, unless itchy -- topical steroids, oral antihistamines
43
classic history guttate psoriasis
preceeded by strep sore throat,
44
management strep sore throat
pen V 7-10 days
45
Rhinophyma
acne roscea
46
Bowen's disease (intaepidermal SCC) features, management
elderly women, red, scaly patches, 5FU, imiquimo, cryotherapy, excision
47
management bacterial conjuctivitis
chloramphenicol 2-3 hourly, fusidic acid pregnant women contact lenses should not be worn during epidose do not share towels
48
scarlet fever rash
strawberry tongue, facial sparing
49
chicken pox rash
itchy, starts on head, macular --> vesicular --> papular
50
Hirsutism causes
PCOS, cushing's, CAH, androgen, obesity, adrenal tumour
51
BBC features and management
slow growing, local invasion, mets v rare, pearly, flesh coloured, papule and telangiectasia, may ulcerate, surgical removal, curettage, imiquimod, fluorouracil
52
alopecia areata
AI condiiton, localised, well demarcated pathces hair loss, in 50% hair will regorw by 1 year
53
infectious agents sinuses
strep pneumonia, HIB, rhinovirus
54
Management acute sinusitis
analgesia, intranasal decongestants, severe presentation? amoxicillin
55
latanoprost - where in treatment of open angle glaucoma, and what mechanism?
increases outflow, first line
56
nasolacrimal duct obstruction history and management
infant with a watery eye, otherwise well | teach massage of lacrimal duct
57
skin patch testing - when used?
contact dermatitis
58
when to used RAST
measures IgE to a mainstream allergen
59
when to use skin prick
food allergies, pollen
60
Entropian - presentation, mnagemetn
eye folding INWARDS, can cause ulcers, definitibe management is surgery, in meantime, use lubricants
61
pathophys of dry ARMD
drusen in bruch's membrane
62
pathophys of wet ARMD
choroidal neovascularisation, leakage of serous fluid and blood --> rapid visual loss
63
features ARMD
reduced acuity, central scotomas, on fundoscopy --> drusen, pigmentary changes
64
management of psorias
chronic plaques - corticosteroid, plus vit D analogue, 2nd line - vit D analogue twice daily 3rd line - BD steroid, coal tar BD
65
sebaceous cyst features
smooth, fluctuant, centrally located small epithelial defect
66
spider naevi causes
liver disease, pregnancy COCP

Pass Med (6 decks)

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