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Pass Med > ENT > Flashcards

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
Q

What is an epidermoid cyst?

A

common cutaneous cysts resulting from proliferation of epidermal cells within a circumscribed space within dermis - firm, round nodules, central punctum may be present

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26
Q

cystic hygromas

A

congenital lymphatic lesions, found in neck and axilla, predilection for left side, present in infancy

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27
Q

branchial cleft cyst

A

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
Q

deep cervical abscesses

A

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
Q

lipoma

A

asymptomatic, soft and mobile, within dermal layer of skin, no centra punctum

30
Q

menreire’s disease

A

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
Q

meniere’s

A

sensorineural hearing loss, recurrent episodes of vertigo, tinnitus, episode last minutes -> hours

32
Q

Causes tinnitus

A

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
Q

which drugs cause gingival hyperplasia? (painful gums)

A

phenytoin, ciclosporin, CCB (especially nifedipine)

34
Q

Thyroid surgery complications

A

anatomical - recurrent laryngeal nerve damage, bleeding - haemotoma’s may rapidly expand, damage to parathyroids –? hypocalcaemia

35
Q

otosclerosis

A

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
Q

benign parotid tumours

A

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
Q

keither wagener classification hypertensive retinopathy 1-4

A

1 Artery narrowing, Silver wiring, Tortuosity
2 AV nipping
3 Cotton wool exudates flame and blots
4 Papilloedema

38
Q

Nasopharyngeal carcinoma risk factors

A

Smoking alcohol

39
Q

Nasopharyngeal carcinoma presentation

A

otits media, odynophagia

40
Q

seborrhoeic Dermatitis presentation and management

A

eczematous lesion scalp, periorboital, auricular, nasolabial folsds

head and shoulder, t gel, ketoconazole

41
Q

classic history pityruasis rosea

A

herald patch, follwing viral infection

multiple, erythematous, raised oval lesions, fir tree appearance

42
Q

management pityriasis rosea

A

nothing, unless itchy – topical steroids, oral antihistamines

43
Q

classic history guttate psoriasis

A

preceeded by strep sore throat,

44
Q

management strep sore throat

A

pen V 7-10 days

45
Q

Rhinophyma

A

acne roscea

46
Q

Bowen’s disease (intaepidermal SCC) features, management

A

elderly women, red, scaly patches, 5FU, imiquimo, cryotherapy, excision

47
Q

management bacterial conjuctivitis

A

chloramphenicol 2-3 hourly,
fusidic acid pregnant women
contact lenses should not be worn during epidose
do not share towels

48
Q

scarlet fever rash

A

strawberry tongue, facial sparing

49
Q

chicken pox rash

A

itchy, starts on head, macular –> vesicular –> papular

50
Q

Hirsutism causes

A

PCOS, cushing’s, CAH, androgen, obesity, adrenal tumour

51
Q

BBC features and management

A

slow growing, local invasion, mets v rare,

pearly, flesh coloured, papule and telangiectasia, may ulcerate,

surgical removal, curettage, imiquimod, fluorouracil

52
Q

alopecia areata

A

AI condiiton, localised, well demarcated pathces hair loss, in 50% hair will regorw by 1 year

53
Q

infectious agents sinuses

A

strep pneumonia, HIB, rhinovirus

54
Q

Management acute sinusitis

A

analgesia, intranasal decongestants, severe presentation? amoxicillin

55
Q

latanoprost - where in treatment of open angle glaucoma, and what mechanism?

A

increases outflow, first line

56
Q

nasolacrimal duct obstruction history and management

A

infant with a watery eye, otherwise well

teach massage of lacrimal duct

57
Q

skin patch testing - when used?

A

contact dermatitis

58
Q

when to used RAST

A

measures IgE to a mainstream allergen

59
Q

when to use skin prick

A

food allergies, pollen

60
Q

Entropian - presentation, mnagemetn

A

eye folding INWARDS, can cause ulcers, definitibe management is surgery, in meantime, use lubricants

61
Q

pathophys of dry ARMD

A

drusen in bruch’s membrane

62
Q

pathophys of wet ARMD

A

choroidal neovascularisation, leakage of serous fluid and blood –> rapid visual loss

63
Q

features ARMD

A

reduced acuity, central scotomas, on fundoscopy –> drusen, pigmentary changes

64
Q

management of psorias

A

chronic plaques - corticosteroid, plus vit D analogue,

2nd line - vit D analogue twice daily
3rd line - BD steroid, coal tar BD

65
Q

sebaceous cyst features

A

smooth, fluctuant, centrally located small epithelial defect

66
Q

spider naevi causes

A

liver disease, pregnancy COCP

Pass Med (6 decks)

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