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Finals > ENT > Flashcards

ENT Flashcards

1
Q

list the causes of sensorineural hearing loss

A 
noise / trauma
infection - HIV, CMV, rubella
presbycusis
drugs - gentamicin, furosemide
meniere's
acoustic neuroma
vascular problem
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2
Q

what do you see in rhinnes and weber’s test in sensorineural hearing loss?

A

rhinnes +ve (i.e. normal - air conduction better than bone)

weber’s localises to normal ear

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3
Q

what do you see in rhinnes and weber’s test in conductive HL?

A

rhinnes -ve ( ie. abnormal - bone conduction better than air)
weber’s localises to affected ear

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4
Q

causes of conductive hearing loss

A

impaction
cholesteatoma
otosclerosis
otitis

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5
Q

how does cholesteatoma present?

A

conductive HL
headache
vertigo
facial nerve palsy

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6
Q

causes of otitis externa and management

A

staph aureus / p. aeruginosa (swimmers)

topical neomycin

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7
Q

causes of otitis media and management

A

h. influenza / s. pneumoniae

5/7 amoxicillin in systemically unwell

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8
Q

complication of spreading otitis media and management

A 
mastoiditis (bone infection)
blood cultures and CT
tympanocentesis
IV ceftriaxone 
(meningitis and encephalitis)
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9
Q

causes and general presentation of central vertigo

A

severe instability, cant walk
CVA
migraine
acoustic neuroma

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10
Q

causes and general presentation of peripheral vertigo

A

horizontal nystagmus
BPPV
meniere’s
vestibular neuritis

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11
Q

presentation and investigation of acoustic neuroma

A

unilateral sensorineural hearing loss!!!
tinnitus, altered facial sensation, vertigo, ataxia
MRI

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12
Q

how can you tell a stroke from other causes of vertigo?

A

HINTS test

  • Head Impulse +ve
  • Nystagmus (unidirectional/ horizontal)
  • Skew -ve
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13
Q

presentation of BPPV (and Ix finding)

A

20-30 second attacks on head movement

dix halle pike maneuver = rotatory nystagmus and vertigo

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14
Q

management of BPPV

A

inform DVLA
epley’s manoeuvre +/- antiemetic
follow up 4/52

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15
Q

triad in meneires disease

A
  1. vertigo - mins-hours
  2. tinnitus - low roaring
  3. fluctuation SN hearing loss
    + feeling of aural fullness and +ve romberg’s test
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16
Q

what causes vestibular neuritis / labyrinthitis

A

neuritis - HSV reactivation

labyrinth - viral , URTI, drugs

17
Q

causes of objective tinnitus

A

movement of blood, TM spasm

18
Q

causes of subjective tinnitus

A

otosclerosis, impaction, infection, menieres, acoustic neuroma
MS/ head injury
drugs

19
Q

unilateral nose bleed in a child with visible bleeding point likely to be where?

A

anterior

little’s area in kiesselbach’s plexus

20
Q

management of epistaxis if can see bleeding point?

A

cautery with silver nitrate

21
Q

bilateral, profuse epistaxis in elderly likely to be where? and management?

A

posterior

ribbon packing and foley catheter

22
Q

what are some pathological causes of epistaxis

A 
clotting disorder 
leukaemia
juvenile nasopharyngeal angiofibroma
hereditary telangiectasia
wegeners / GPA (eroded nasal septum)
23
Q

causes of enlarged parotid gland

A 
mumps
HIV
sjogren's
sarcoid
vomiting - bulimia
benign pleomorphic adenoma 
warthin's tumour in elderly
24
Q

causes of lymphadenopathy

A 
CHICAGO
Cancer (lymphoma, CLL, mets)
Hypersensitivity
Infection (EBV, TB, HSV, HIV)
Collagen disease (sjogren's, SLE, RA, dermatomyositis)
Atypical
Granulomas - sarcoid
Other
25
Q

csf leak from nose suggest fracture where?

A

cribriform plate

26
Q

what are the centor criteria

A 
fever
exudate
tender cervical lymphadenopathy
absence of cough
(4-5 points = penicillin)
27
Q

what does virchow’s node suggest

A

stomach, lung, breast, bowel cancer

28
Q

most common type of thyroid cancer

A

papillary (radioactive iodine treatment)

29
Q

red flags in neck lump

A 
stridor
previous radiation
family history of thyroid ca
voice change
cervical lymphadenopathy
30
Q

presentation of a thyroglossal cyst

A

moves on swallowing and tongue protrusion
non tender
mobile
presents in first 10 years

31
Q

how does a branchial cyst present

A

painless , fluctuant, lump in anterior triangle - usually behind the sternocleidomastoid muscle

32
Q

how does a cystic hygroma present

A

fluid filled sac on left side of neck

33
Q

investigations in obstructive sleep apnoea

A

epworth sleepiness scale >10

polysomnography (>5 apnoeas in 1 hour)

Finals (18 decks)

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