ENT Flashcards
What is Benign paroxysmal positional vertigo (BPPV)
Vertigo lasting seconds to minutes on changing head position (E.g. sitting to lying down or turning the head suddenly)
What causes BPPV
Displacement of otoliths (from degeneration, trauma or post-viral) into the semi-circular canals
What are the signs and symptoms of BPPV
Dizziness
Vertigo
Loss of balance or unsteadiness on head movement
N+V
How is BPPV diagnosed
Dix-Hallpike manoeuvre - Diagnosis of posterior canal BPPV - Nystagmus with vertigo
Supine lateral head turns - Diagnose lateral (Horizontal) canal BPPV - Nystagmus with vertigo
What is Meniere’s disease
Recurrent episodes of tinnitus, paroxysmal vertigo and unilateral fluctuating hearing loss
What causes Meniere’s disease
Disturbed homeostasis of endolymph (fluid in the inner ear)
What are the signs and symptoms of Meniere’s disease
Vertigo Loss of hearing in affected ear Tinnitus Aural fullness Loss of balance Headaches N+V
Romberg’s test positive
Fukuda’s stepping test - When asked to march on the stop with eyes closed they will turn towards the affected side
How is Meniere’s disease diagnosed
No specific test that will confirm diagnosis
Pure-tone air and bone conduction with masking - Unilateral sensorineural hearing loss - Low frequencies first
Some other investigations (e.g. MRI, electrocochleography) may be used to exclude other causes of such symptom
What is a Thyroglossal cysts
An epithelium-lined cyst found along the course of descent of the thyroid gland
What are causes of Thyroglossal cysts
Embryonic remnant of the path of descent of the thyroid gland
What are signs and symptoms of Thyroglossal cysts
- Midline, smooth, rounded swelling
- Typically found between the thyroid notch and hyoid bone
- Moves upwards on protrusion of the tongue and with swallowing
- Can be transilluminated
DDs
- Lymph node
- Dermoid cyst
- Ectopic thyroid tissue
How are Thyroglossal cysts investigated
None may be necessary if the patient is euthyroid
If the cyst is supra hyoid, TFTs should be performed to exclude lingual thyroid - Because removal of the lingual thyroid will make the patient hypothyroid
US/MRI - Helps differentiate from other structures
What are causes of Tonsillitis
Usually viral - Common cold/Flu
Can be bacterial - Group A streptococci
RFs:
- Immune deficiency
- FHx of tonsillitis or atopy
What are the signs and 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
Red throat
Swollen tonsils, which may have white fleck of pus
Fever
Swollen lymph nodes
Classical strep:
- Acute onset
- Headache
- Abdominal pain
- Dysphagia
How is Tonsillitis diagnosed
Throat swabs and rapid antigen test can be performed but not usually recommended
Usually a clinical diagnosis
