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Year 2 MBChB > ENT > Flashcards

ENT Flashcards

1
Q

What is sinusitis?

A

Inflamm of lining of paranasal sinuses

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2
Q

What is the presentation of sinusitis?

A

Pain over cheek that increases with straining/bending down
Discharge
Blocked nose
Hyposmia

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3
Q

What is the management of sinusitis?

A

Phenylnedhrine

Drainage

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4
Q

What are the causes of airway obstruction?

A 
Inflamm/allergy 
Foreign bodies 
Compression 
Trauma 
Neuro 
Burn 
Cancer 
Congenital
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5
Q

What are the signs and symptoms of airway obstruction?

A 
SOBOE 
Choking 
Stridor 
Coughing 
Tracheal tug 
Cyanosis 
Pyrexia
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6
Q

How is airway obstruction assessed?

A

Appearance
Skin circulation
Work of breathing
Flexible endoscopy

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7
Q

How is airway obstruction managed?

A 
ABC 
O2 
Heliox 
Steroid 
Adrenaline 
Tracheostomy (avoid if poss) 
Removal of thing causing
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8
Q

What are complications of nasal trauma?

A

Epistaxis
CSF leak
Anosmia

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9
Q

Which arteries are likely to be responsible in epistaxis?

A

Spenopalatine artery anastomosis
Ethmoid artery anastomosis
Greater palatine artery

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10
Q

What is the management of epistaxis?

A 
Rhesus if necessary 
Pressure, ice 
Suction to remove clots 
Nasal pack 
Cautery 
Surgery
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11
Q

What are the causes of rhinitis?

A

Viral URTI
Allergic
Non-allergic or infective

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12
Q

What causes intermittent allergic rhinitis?

A

Grass
Trees
Fungal spores

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13
Q

What causes persistent allergic rhinitis?

A

Dust mite
Cats
Dogs

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14
Q

How is persistent allergic rhinitis classified?

A

Symptoms for more than 4 days of the week or lasting longer than four weeks

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15
Q

How is intermittent allergic rhinitis classified?

A

Symptoms for less than 4 days of the week or lasting less than four weeks

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16
Q

What is the management of allergic rhinitis?

A

Antihistamines > topical steroids > both

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17
Q

What are nasal polyps?

A

Benign tear shaped growths in nose or sinuses

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18
Q

What are nasal polyps associated with?

A

Non-allergic rhinitis

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19
Q

What is the presentation of nasal polyps?

A 
Nasal obstruction 
Drip 
Sneezing 
Facial pain 
Changes in smell
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20
Q

How are nasal polyps diagnosed?

A

Nasal endoscopy

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21
Q

What is the management of nasal polyps?

A

Oral steroids > topical steroids > surgery

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22
Q

How does acute infective rhino sinusitis present?

A

Facial pain
Discharge
Nasal blockage

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23
Q

How is acute infective rhinosinusitis managed?

A

Analgesics

Decongestants

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24
Q

What is Meniere’s disease?

A

Disorder of inner ear

Increased hydraulic pressure in endolymphatic system

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25
Q

How does Meniere’s disease present?

A 
Vertigo: >2 20 min episodes 
Tinnitus
Sensorineural HL 
Sensation of aural fullness 
Nystagmus
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26
Q

How is Meniere’s disease investigated?

A

Audiometry
ECOG
ENG
Otoscopy

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27
Q

How is Meniere’s disease managed?

A

Lifestyle and diet
Meclizine
Prochlorperazine

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28
Q

What are the key features of presbycusis?

A

Age related sensorineural HL

Bilateral high frequency HL

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29
Q

What is otosclerosis?

A

Autosomal dominant replacement of normal bone by vascular spongy bones

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30
Q

What are the key features of otosclerosis?

A

Onset: 20-40 y/o
Tinnitus
Conductive HL
+ve FH

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31
Q

What is the peak age of OME?

A

2 y/o

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32
Q

How does OME present?

A

HL
Speech and language delay
Behaviour/balance probs

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33
Q

What drugs causes ototoxicity?

A

Gent
Aspirin
Furosemide

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34
Q

What are the features of vestibular schwanomma?

A

HL, vertigo, tinnitus
Absent corneal reflex (CN V)
Facial palsy (CN VII)

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35
Q

What are the features of viral labrynthitis?

A

Vertigo
N&V
May be HL

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36
Q

What are the features of vestibular neuritis?

A

Recurrent vertigo attacks lasting hours - days

No HL

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37
Q

What are the features of BPPV?

A

Gradual onset
Triggered by position
Lasts seconds

38
Q

What are the features of an acoustic neuroma?

A

HL
Tinnitus
Vertigo
Absent corneal reflex

39
Q

What is otitis media?

A

Inflamm of the middle ear

40
Q

What causes otitis media?

A

Usually viral

41
Q

What is a complication of otitis media?

A

Mastoiditis

42
Q

What are the common organisms in otitis media?

A

H influenza
Strep pneumonia
Catarrhalis
Strep pyogenes

43
Q

How does otitis media present?

A 
Otalgia 
Malaise 
Fever 
Rhinorrhoea 
Vomiting
44
Q

What is seen on examination in otitis media?

A

Bulging TM
Air fluid level
Red/yellow/cloudy TM

45
Q

How is otitis media managed?

A

Analgesia

Abx if systemically unwell

46
Q

What is the management of vestibular neuritis?

A

Self-limiting
Prochlorperazine
Anti-emetic

47
Q

How does OME present?

A 
Mild conductive HL 
Intermittent otalgia 
'popping' sensation 
Balance problems 
AOM history
48
Q

What is seen on examination in OME?

A

Retracted TM
Immobile TM
Loss of light reflex

49
Q

What is the management of OME?

A

Observe (3m)
Grommets
Adenoidectomy

50
Q

What is the management of vestibular schwannoma?

A

Surgery

51
Q

How does otitis externa present?

A

Itch
Pain
Otorrhoea
Temporary dulled hearing

52
Q

What are the causes of otitis externa?

A

Swimming
Skin problems
Otitis media

53
Q

What is the management of otitis externa?

A

Acetic acid spray

Abx + steroid drops

54
Q

What HL is it when there is an air bone gap and the bone is normal?

A

Conductive

55
Q

What HL is it when there is no difference between air and bone conduction?

A

Sensorineural

56
Q

What HL is it when there is an air bone gap but both are abnormal?

A

Mixed

57
Q

What is a cholesteatoma?

A

Abnormal squamous cells in the middle ear

58
Q

What are RFs for a cholesteatoma?

A

Cleft palate

Grommets

59
Q

How does a cholesteatoma present?

A

Progressive conductive HL
Vertigo
Headache
Facial nerve palsy

60
Q

How is a cholesteatoma managed?

A

Tympanomastoidectomy

Tympanoplasty

61
Q

What is the first line management of epistaxis?

A

First aid measures + stop anticoagulants

62
Q

What is the second line management of epistaxis?

A

Chemical cautery of visibly bleeding vessels

63
Q

What is the third line management of epistaxis?

A

Nasal packing

64
Q

What is the fourth line management of epistaxis?

A

Endoscopic cautery

65
Q

What is the fifth line management of epistaxis?

A

Ligation of arteries; local arteries then external carotid

66
Q

What is the last management of epistaxis?

A

Arterial embolisation

67
Q

What is the common site of epistaxis?

A

Kiesselbach’s plexus

68
Q

What are features of lymphoma?

A

Rubbery, painless lymphadenopathy, may be associated night sweats or splenomegaly

69
Q

What are the features of a thyroid swelling?

A

Moves upwards on swallowing

70
Q

What are the features of thyroglossal cyst?

A

Usually midline, moves upwards on protrusion of tongue

71
Q

What is a pharyngeal pouch?

A

Posteromedial herniation between thyropharyngeus and cricopharynxgeus muscles

72
Q

What are the features of a pharyngeal pouch?

A

Midline lump that gurgles on palpation, dysphagia, regurgitation, aspiration, chronic cough

73
Q

What are the features of a cystic hygroma?

A

Congenital, classically on the left side

74
Q

What is a branchial cyst?

A

Remnant of the second branchial cleft in embryonic development

75
Q

What are the features of a branchial cyst?

A

Present in early adulthood, oval, mobile cystic mass

76
Q

How is sleepiness assessed?

A

Epworth scale

77
Q

How is sleep apnoea diagnosed?

A

Sleep studies

78
Q

How is sleep apnoea managed?

A

Weight loss, CPAP

79
Q

What are predisposing factors for sleep apnoea?

A

Obesity, macroglossia, large tonsils, Marfan’s

80
Q

What are the consequences of sleep apnoea?

A

Daytime somnolence, hypertension

81
Q

What are the features of FeverPAIN score?

A 
Fever in last 24 hours 
Purulence 
Acute: last 3 days 
Inflamed tonsils 
No cough
82
Q

When should someone be referred for a tonsillectomy?

A

7 well documented episodes of tonsillitis in the last year, 5 in the last 2 years, 3 in the last three years

83
Q

What is the most common organism in tonsillitis?

A

Strep pyogenes

84
Q

What is the management of tonsillitis (able to swallow)?

A

Penicillin V oral 500mg qds for 10 days

85
Q

What is the management of tonsillitis (unable to swallow)?

A

Benzylpenicillin IV 1.2g qds

86
Q

What is the investigation of choice for glandular fever?

A

Monospot test

87
Q

What is the management of glandular fever?

A

Rest, fluids, analgesia, AVOID CONTACT SPORTS in first 8 weeks to prevent splenic rupture

88
Q

What is the normal dB for hearing?

A

0-20

89
Q

What is black hairy tongue due to?

A

Defective desquamation of the filiform papillae

90
Q

What drugs cause gingival hyperplasia?

A

Phenytoin, ciclosporin, CCBs

91
Q

What organism is common in malignant OE?

A

Pseudomonas

92
Q

What are the key features in the history for malignant OE?

A

Diabetes/immunosuppression

Severe, unrelenting, deep-seated otalgia, temporal headaches, purulent otorrhoea

Year 2 MBChB (8 decks)

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