ENT Flashcards
What are the causes of tonsillitis?
Bacterial: Group A Strep
Viral: EBV, Rhinovirus, Coronavirus, Adenovirus
What are the 2 types of hearing loss?
Conductive: Common
Sensorineural: Majority of permanent impairment
What is a common cause of conductive hearing loss?
Glue ear
50% conductive deafness resolves in 3m
95% resolves in 1year
What are the causes of deafness?
Genetic: Turners, Kleinfelters
Infection: TORCH, HIV
Asphyxia
Alcohol & drugs
What are the RFs for deafness?
Fhx Infection Ototoxic medications Craniofacial abnormalities Low birth weight Prematurity Head injury Neurodegenerative disease
How does deafness present?
Speech delay
Behavioural problems
Other physical signs
How is hearing loss investigated?
Hearing tests
MRI/CT
Chromosomal studies
How is deafness managed?
Cochlear implant Conductive: Grommets Hearing aids BSL Communication help
What are the causes of a middle ear infection?
Viruses
Pneumococcus
Group A strep
H.influenzae
What is seen on examination in otitis media?
Red bulging tympanic membrane
Loss of normal light reflection
Occassional perforation
Effusion: Air bubble, fluid level, retracted/concave/indrawn drum
What are the signs & symptoms otitis media is associated with (systemically)?
Pain Fever Irritability Pulling/tugging on ear Poor feeding
How is acute otitis media treated?
Admit: <3m w/temp >38
Paracetamol/NSAID
If no systemic features or no better after 72hrs:
Broad-spec Abx: Amoxicillin 20-30mg/kg TDS 5days (Clarithromycin if penicillin allergic)
What are the complications of otitis media?
Mastoiditis
Meningitis
Recurrent ear infections: Secretory otitis media
What is glue ear?
Otitis media with effusion
Who is affected by glue ear?
90% with cleft palates
What is the treatment for glue ear?
Active observation: 6-12w spont resolution common (followed by 2 hearing tests)
>6-12w: Refer to ENT
After referral: 3m active observation, hearing aids, autoinflation (Valsalva manoeuvre)
Surgery: Myringotomy & grommets
What investigations are done to diagnose Otitis media with effusion?
Examination
Assess any hearing loss
Tympanometry: Assess ability of eardrum to react to sound
Audiometry: Determine the level of hearing loss
What are the signs & symptoms of tonsillitis?
Fever > 38.5
Pain on swallowing
Painful cervical lymphadenopathy
Tonsillar Exudate
How is tonsillitis treated?
Viral: Conservative
Bacterial: After confirmation with throat swab
Abx: Penicillin V/ Erythromycin for 10days
What antibiotics should you avoid giving in tonsillitis?
Amoxicillin
If caused by EBV will cause maculopapular rash
What is the Centor criteria?
Diagnosis of Group A Strep as cause of sore throat: Tonsillar Exudate Tender anterior cervical lymph nodes Absence of cough History of fever
When should a tonsillectomy be considered?
Tonsillitis: >7 episodes in 1 year OR 5 in 2 consecutive years OR 3 in 3 consecutive years
What are the signs & symptoms of a peritonsillar abscess?
Unwell Severe dysphagia Earache Trismus (lockjaw) Unilateral bulge of the soft palate Deviated uvula to the opposite side Tonsilitis w/associated halitosis Rupture: Aspiration pneumonia
How is a peritonsillar abscess treated?
Penicillin
6w post: Tonsillectomy
What are the complications of not treating tonsillitis caused by Group A Strep?
Rheumatic fever (mitral stenosis)
