ENT Flashcards
Define Benign Paroxysmal Positional Vertigo (BBPV)
Vertigo lasting seconds to minutes on changing head position (e.g. sitting to lying down or turning the head suddenly)
Aetiology/ Risk Factors for BBPV
Displacement of otoliths (from degeneration, trauma or post-viral) into the semi-circular canals
Presenting symptoms of BBPV
- Dizziness
- Vertigo
- Loss of balance or unsteadiness
- Nausea/vomiting
Signs of BBPV on physical examination
No signs
Investigations for BPPV
Hallpike Test
Define Meniere’s Disease
Recurrent episodes of tinnitus , paroxysmal vertigo and unilateral fluctuating hearing loss
Aetiology/ Risk Factors of Meniere’s Disease
• Disturbed homeostasis of endolymph (fluid in the inner ear)
Presenting Symptoms and Signs of Meniere’s Disease
- Vertigo
- Loss of hearing in affected ear
- Tinnitus
- Loss of balance
- Headaches
- Nausea/vomiting
Investigations for Meniere’s
• There is NO SPECIFIC TEST that will confirm the diagnosis
• Some other investigations (e.g. MRI, electrocochleography) may be used to exclude
other causes of such symptoms
Define Thyroglossal Cyst
An epithelium-lined cyst found along the course of descent of the thyroid gland
Aetiology/ Risk Factors of thyroglossal cysts
• The thyroglossal duct is an embryonic remnant of the path of descent of the thyroid
gland from the mouth down to its normal position during development
• The duct normally disappears in the 6th week, but if some tissue remains, it could
develop into a cyst
• Risk Factors
o RARE familial variants
Epidemiology of thyroglossal cysts
- Present in CHILDREN and ADOLESCENTS
- Mean age of presentation: 5 yrs
- 3 x more common than branchial cysts
Presenting symptoms of thyroglossal cysts
• A swelling/lump is noticed in the midline of the anterior neck
• Usually ASYMPTOMATIC
• May be tenderness or rapid enlargement due to
infection
Thyroglossal cysts on physical examination
• Midline, smooth, rounded swelling • Typically found between the thyroid notch and the hyoid bone • Moves upwards on protrusion of the tongue • Moves upwards with swallowing • Can be transilluminated • Differential Diagnosis o Lymph node o Dermoid cyst o Ectopic thyroid tissue
Investigations for thyroglossal cysts
• NONE may be necessary if the patient is euthyroid
• If the cyst is suprahyoid, TFTs should be performed to exclude a lingual thyroid -
because removal of the lingual thyroid will make the patient hypothyroid
• Ultrasound/MRI
o Helps differentiate from other structures
Define Tonsillitis
Inflammation due to infection of the tonsils
Aetiology/ Risk Factors of tonsillitis
• Usually VIRAL (e.g. common cold or influenza)
• Can be bacterial (caused by group A streptococci)
• Risk Factors
o Immune deficiency
o Family history of tonsillitis or atopy
Epidemiology of tonsillitis
- VERY COMMON
* Usually in children and young adults
Symptoms of tonsillitis
- Pain in the throat
- Painful swallowing
- Pain may be referred to ears
- Abdominal pain (in small children)
- Headache
- Loss of voice or changes in voice
Tonsillitis on physical examination
• Red throat
• Swollen tonsils, which may have white flecks of pus
• High temperature (sometimes)
• Swollen lymph nodes
• Classic streptococcal tonsilitis features:
o Acute onset
o Headache
o Abdominal pain o Dysphagia
• Examination:
o Intense erythema of tonsils and pharynx
o Yellow exudate
o Tender, enlarged anterior cervical glands
Investigation for tonsillitis
- Throat swabs and rapid antigen tests can be performed (but are NOT recommended)
- Swabs may not be able to distinguish between infection and colonisation
