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Year 2 > ENT > Flashcards

ENT Flashcards

1
Q

What is the criteria used to decide whether or not to give antibiotics for a sore throat?

A 
CENTOR:
tonsillar exudate
lymphadenopathy
history of fever
absence of cough
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2
Q

What is the treatment of strep throat?

A

penicillin

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3
Q

What is the most important investigation for BPPV?

A

Dix-Hallpike manoeuvre

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4
Q

What is the treatment for BPPV?

A

Epley manoeuvre

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5
Q

What is hearing loss associated with Menieres?

A

sensorineural

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6
Q

What is the most useful investigation for an acoustic neuroma?

A

MRI

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7
Q

How long does BPPV tend to last?

A

10-20 seconds

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8
Q

What kind of hearing loss do you get with otitis externa?

A

conductive hearing loss

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9
Q

What is the treatment of otitis externa?

A

mild cases: topical acetic acid 2% spray

severe inflammation: 7 days of topical antibiotic with or without a topical steroid

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10
Q

What are the features of cholesteatoma?

A

foul smelling discharge and hearing loss

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11
Q

What is the treatment of a cholesteatoma?

A

patients are referred to ENT for consideration of surgical removal

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12
Q

What type of malignancy may present as painless lymphadenopathy?

A

Nasopharyngeal carcinoma (due to its tendency for early spread)

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13
Q

What is the management of haemorrhage following a tonsillectomy?

A

primary haemorrhage is within 6-8 hours and required immediate return to theatre.
Secondary haemorrhage is between 5-10 days after surgery and is associated with wound infection. Treatment is with admission and antibiotics

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14
Q

What is the treatment of a perforated tympanic membrane?

A

nothing- let it rest and arrange to see in 4 weeks

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15
Q

How long does it take for a perforated eardrum to heal itself?

A

6-8 weeks

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16
Q

What causative organisms are involved in otitis externa?

A

Staph aureus and pseudomonas aeruginosa

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17
Q

What is the treatment for otitis externa if the infection spreads?

A

Flucloxacillin

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18
Q

What is Rinnes test?

A

tuning fork is placed over the mastoid process until the sound is no longer heard followed by repositioning over the external acoustic meatus

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19
Q

What are the results for Rinnes test in a normal ear?

A

Air conduction > bone conduction

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20
Q

What is Webers test?

A

tuning fork is placed in the middle of the forehead equidistant from the patients ears then they are asked where they heard it loudest

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21
Q

What are the results of Webers test?

A

sound localised to the unaffected side: sensorineural

Sound localised to the affected side: conductive

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22
Q

What is a Thyroglossal cyst?

A

more common in patients <20 years old. They are usually midline, between the isthmus of the thyroid and hyoid bone. Moves upward with protrusion of the tongue

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23
Q

What is a pharyngeal pouch?

A

it is more common in older men and represents a posteromedial herniation between thyropharyngeus and cricopharyngeus muscles.

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24
Q

What is a cystic hygroma?

A

a congenital lymphatic lesion typically found in the neck classically on the left side which is most evident at birth

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25
Q

What is a Branchial cyst?

A

an oval, mobile cystic mass that develops between the sternocleidomastoid muscle and the pharynx. develops due to failure of obliteration of the second branchial cleft in embryonic development.

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26
Q

What are the symptoms of Menieres?

A

tinnitus, hearing loss, vertigo and a feeling of fullness

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27
Q

What kind of hearing loss does otosclerosis cause?

A

bilateral conductive hearing loss

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28
Q

What is Presbycusis?

A

age-related sensorineural hearing loss

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29
Q

What drugs can cause ototoxicity?

A

gentamicin, furosemide, aspirin, quinine

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30
Q

At what sound frequences can hearing loss occur?

A

3000-6000Hz

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31
Q

In what condition can you get bilateral acoustic neuromas?

A

Neurofibromatosis type 2

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32
Q

What are the features of vestibular neuronitis?

A

recent viral infection, recurrent vertigo attacks lasting for hours or days with NO hearing loss

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33
Q

What is the treatment for acute otitis media with perforation?

A

oral antibiotics (amoxicillin)

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34
Q

What kind of hearing loss is associated with a perforated ear drum?

A

conductive hearing loss

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35
Q

What are the symptoms of a base of the skull fracture?

A

Battle sign, bleeding from the ear, CSF rhinorrhoea, raccoon eyes

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36
Q

What is trigeminal neuralgia?

A

unilateral facial pain characterised by brief electric shock like pains, abrupt onset and termination. may be triggered by light touch

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37
Q

What is otosclerosis?

A

sclerosis of bone and fixation of the stapes to the oval window

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38
Q

What kind of hearing loss does otosclerosis cause?

A

Conductive

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39
Q

What type of hearing loss is associated with Menieres?

A

Sensorineural

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40
Q

What is first line treatment in tonsilitis?

A

Penicillin V as amoxicillin has the potential to cause a rash in glandular fever

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41
Q

What is the treatment for otitis media?

A

oral amoxicillin. if penicillin allergic then erythromycin

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42
Q

What is the treatment of gingivitis?

A

Oral metronidazole

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43
Q

How do sensorineural and conductive hearing loss appear on an audiogram?

A

sensorineural- both bone and air conduction are below 20dB

conductive: only air conduction is below 20dB

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44
Q

What are the most common causative organisms involved in acute sinusitis?

A

Strep pneumoniae, haemophilus influenzae and rhinoviruses

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45
Q

What would give you unilateral vertigo and doesn’t affect hearing?

A

Vestibular neuronitis

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46
Q

What is a nasal septal haematoma?

A

it occurs post nasal trauma and is a haematoma between the septal cartilage and the overlying perichondrium

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47
Q

What is Ludwig’s angina?

A

Cellulitis at the floor of the mouth

48
Q

If a monospot test was positive, what is this a marker of?

A

Infectious mononucelosis

49
Q

What virus causes mononucleosis?

A

EBV

50
Q

What is a pleomorphic adenoma?

A

benign, mixed parotid tumour. it occurs in the middle aged and is a slow growing painful lump

51
Q

What is a Warthin’s tumour?

A

it is a benign cystic tumour of the salivary glands that contains abundant lymphocytes and germinal centers

52
Q

What symptoms are indicative of a stone in the glands?

A

recurrent unilateral swelling and pain on eating

53
Q

Which gland is most commonly affected by stones?

A

Submandibular

54
Q

What are the features of Ramsay hunt syndrome

A

Vesicles on the tympanic membrane, otalgia, facial paralysis, taste loss, dry eyes, tinnitus, vertigo and hearing loss.

55
Q

Reactivation of what virus causes ramsay hunt syndrome?

A

Varicella Zoster in CN VII

56
Q

What is Bell’s palsy?

A

Facial weakness on one side.

57
Q

What is the treatment of Ramsay hunt syndrome?

A

oral aciclovir and corticosteroids

58
Q

What are the features of viral labyrinthitis?

A

sudden onset horizontal nystagmus, hearing disturbances, nausea, vomiting and vertigo. the patient has usually had a viral infection

59
Q

What is the difference between labyrinthitis and vestibular neuritis?

A

Labyrinthitis: the vestibular nerve and the labyrinth (vertigo and hearing impairment)
Vestibular neuritis: the vestibular nerve only. (vertigo)

60
Q

What is the treatment for a perforated ear drum if it does not heal itself?

A

myringoplasty

61
Q

When would you perform a tonsillectomy?

A

when the person has had 5 or more episodes of tonsilitis per year

62
Q

What is the causative organism in otitis externa in diabetics?

A

Pseudomonas

63
Q

What are the commonest tumours of the parotid gland?

A

Pleomorphic adenoma

64
Q

What is a mucoepidermoid carcinoma?

A

it is a malignant tumour of the parotid gland. accounts for 30% of cases

65
Q

What is an adenoid cystic carcinoma?

A

malignant tumour

66
Q

What is the management of otitis media with effusion?

A

Grommets

67
Q

What is the cause of presbycusis?

A

loss of outer hair cells, loss of ganglion cells, strial atrophy

68
Q

What is an acoustic neuroma?

A

Slow growing benign schwannoma of vestibular nerve

69
Q

What would you suspect if someone presented with asymmetric sensorineural hearing loss

A

Vestibular schwannoma

70
Q

What is Vertigo that lasts seconds to minutes?

A

BPPV

71
Q

Vertigo that lasts from minutes to hours?

A

menieres disease

72
Q

Vertigo that lasts hours to days?

A

Labyrinthitis, vestibular neuronitis, migrainous vertigo

73
Q

What causes BPPV?

A

loose otoliths from urtile displaced into semicircular canals- most commonly in the posterior semicircular canal

74
Q

What condition associated with vertigo also have tinnitus?

A

Menieres disease and labyrinthitis

75
Q

Where is an area in the nose that is a frequent site of nasal haemorrhage

A

Little’s area

76
Q

what are causative organisms associated with sinusitis?

A

streptococcus pneumoniae and haemophilus influenzae

77
Q

What does a RAST test measure?

A

levels of IgE

78
Q

What would happen to a patients voice if polyps are found on the free edge of vocal cords?

A

prevents full closure and gives breathy, harsh voice

79
Q

What is Reinkes oedema?

A

collection of tissue fluid in subepithelial layer of vocal cord. Due to the poor lymphatic drainage, vocal cords are predisposed to oedema

80
Q

What is the treatment of Reinke’s oedema?

A

surgery to incise the vocal cords

81
Q

What is in the vestibular labyrinth?

A

urticle and saccule- 2 small communicating sacs in the vestibule of the bony labyrinth and 3 semicircular ducts in the semicircular canals

82
Q

What is the normal range of hearing?

A

20dB and quieter

83
Q

How does conductive hearing loss look on audiogram?

A

There is a gap between air and bone conduction because there is something in the ear blocking sound transmission

84
Q

How does sensorineural hearing loss look on audiogram?

A

Both bone and air conduction are affected (they will both be below 20dB)

85
Q

What kind of hearing loss can ear wax cause?

A

Conductive

86
Q

What kind of hearing loss is accompanied by cholesteatoma?

A

Conductive

87
Q

What kind of hearing loss is caused by prolonged exposure to noise in the work place?

A

Sensorineural

88
Q

What is the most common cause of sensorineural hearing loss?

A

Presbyacusis

89
Q

How would mixed hearing loss look on audiogram?

A

gap between air and bone conduction however the bone conduction thresholds still show normal hearing range

90
Q

When can the foetus hear in utero?

A

18 weeks

91
Q

How do you test babies hearing?

A

Otoacoustic emission (hair cells produce sound in response to sound)

92
Q

What is primary gingivostomatitis?

A

it is inflammation of the gingiva and oral mucosa and is the most common infection of the mouth

93
Q

What is the virus responsible for gingivostomatitis?

A

HSV1

94
Q

What is the treatment of gingivostomatitis?

A

Aciclovir

95
Q

What does HSV 2 cause?

A

Genital lesions

96
Q

How do you detect herpes simplex virus?

A

Swab the lesion and run Viral PCR looking for viral DNA

97
Q

What is Herpangia?

A

It is vesicles/ulcers on the soft palate

98
Q

What causes Herpangia?

A

Coxsackie virus

99
Q

What causes Hand Foot and mouth disease?

A

Coxsackie virus

100
Q

What are the symptoms of coxsackie virus?

A

mouth ulcers and spots on the hands and feet. It generally begins with a fever and is then followed a day or 2 later with flat discoloured spots or bumps that may blister

101
Q

What is Chancre?

A

painless genital ulcer found in the primary stages of syphillis.

102
Q

What are Apthous ulcers?

A

recurrent painful ulcers of the mouth that are round and have inflammatory halos. they are confined to the mouth and begin in childhood

103
Q

What should you be worried about if someone has a sore throat and lethargy on week 2 and is between 15-25 y/o?

A

infectious mononucleosis (glandular fever)

104
Q

What causes Glandular fever?

A

Epstein barr virus

105
Q

What is quinsy?

A

Peri-tonsillar abscess

106
Q

What is mastoiditis?

A

The result of an infection that extends to the air cells of the skill behind the ear

107
Q

What is the most common causative organisms in bacterial sore throats?

A

Streptococcus pyogenes

108
Q

What are complications of bacterial sore throats?

A

Rheumatic fever (fever, arthritis and pancarditis) and glomerulonephritis

109
Q

What drug can cause neutropenia?

A

Carbimazole

110
Q

What is the treatment for strep throat?

A

Phenoxymethylpenicillin/ penicillin V

111
Q

What is the treatment for diptheria?

A

Penicillin or erythromycin if penicillin allergic

112
Q

What are the features of infectious mononucleosis?

A

fever, lymphadenopathy, sore throat, pharyngitis, tonsilitis, malaise, lethargy

113
Q

What is the treatment for glandular fever?

A

bed rest, paracetamol. avoid sport (splenomegaly), corticosteroids

114
Q

What tests are done to look for infectious mononucleosis?

A

EBV IgM and heterophile antibody

115
Q

What is the treatment for otitis media?

A

Most resolve in 4 days or amoxicillin

116
Q

What is the management of otitis externa?

A

topical aural toilet, swab, topical clotrimazole or gentamicin

Year 2 (10 decks)

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