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EOY4 > ENT > Flashcards

ENT Flashcards

1
Q

Hearing loss, vertigo and tinnitus which also presents with an absent corneal reflex is due to what pathology?

A

Acoustic neuroma

Absent corneal reflex due to affecting nearby cranial nerve 5

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2
Q

What are some drugs that can cause tinnitus?

A

Aspiring
Aminolglycosides
Loop diuretics
Quinine

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3
Q

What organism is most likely to be responsible for malignant otitis externa?

A

Pseudonomas aeruginosa

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4
Q

Which organism causes glandular fever?

A

Epstein Barr virus

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5
Q

Which blood test can diagnose Epstein Barr virus?

A

Paul Bunnel test

(EBV causes infectious mononucleosis of B lymphocytes so they produce an antibody which can be detected by the Paul Bunnel antigen)

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6
Q

In patients with glandular fever, which antibiotic should be avoided due to likelihood of causing an itchy maculopapular rash?

A

Amoxicillin / co-amoxiclav

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7
Q

How would uncomplicated otitis media be managed?

A

Analgesia
Antipyretics
(Only Abx if symptoms do not improve after 4 days)

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8
Q

Which nerve passes through the parotid gland?

A

Facial nerve

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9
Q

In which salivary gland is malignancy most likely?

A

Submandibular gland

Although most tumours occur in the parotid gland, but these are most likely to be benign

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10
Q

What is sialthiasis?

A

Salivary stones

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11
Q

In which glands are salivary stones most likely to occur?

A

Submandibular

Secretions here are thicker and richer in calcium

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12
Q

Facial nerve dysfunction affecting the forehead and the lower facial nerves is due to an upper or lower motor neurone lesion?

A

LMN

UMN is forehead sparing

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13
Q

In a sore throat when antibiotics are indicated, which antibiotic and for how long should it be prescribed?

A

Benzylpenicllim 10 days

Erythromycin if pen allergic

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14
Q

If antibiotics are indicated in otitis media, which is first line?

A

Amoxicillin

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15
Q

When are antibiotics indicated in otitis media?

A

If symptoms don’t improve after 4 days
If they are systemically unwell
If the tympanic membrane has perforated
If they are immunocompromised

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16
Q

A man present with bilateral tinnitus and hearing loss. There is family history of similar problems. Audiometry shows bilateral conductive hearing loss. What is the likely diagnosis?

A

Otosclerosis

Autosomal dominant

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17
Q

How can Bell’s palsy and Ramsay Hunt syndrome be differentiated between?

A

Both can cause facial weakness

Ramsay Hunt will present with otalgia and vesicles in the ear

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18
Q

What is the cause of Ramsay Hunt syndrome?

A

Reaction of varicella zoster virus in the geniculate ganglion of the facial nerve (CN VII)

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19
Q

What are some presenting features of Ramsay Hunt syndrome?

A

Ear pain
Vesicular rash
Facial nerve palsy
Vertigo and tinnitus

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20
Q

What is the most common cause of respiratory distress post thyroidectomy?

A

Haematoma

Presents within 24 hours (respiratory distress after 24 hours is likely due to hypoCa)

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21
Q

A patient reports paraesthesia and difficulty breathing 2 days post thyroidectomy. What is the most likely complication?

A

Hypocalcaemia secondary to parathyroid gland damage

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22
Q

What is the gold standard investigation for acoustic neuroma?

A

MRI head

23
Q

Which condition classically presents with dry mouth, dry eyes and swollen parotid glands?

A

Sjögren’s syndrome

24
Q

What is the inheritance pattern of otosclerosis?

A

Autosomal dominant

25
Q

Does otosclerosis present with sensorineural or conductive hearing loss?

A

Progressive conductive hearing loss

26
Q

Are the ossicles found in the outer, middle or inner ear?

A

Middle ear

They connect the tympanic membrane to the cochlea

27
Q

What is the name of the branch of the facial nerve that travels through the middle ear cavity?

A

Chorda tympani

This supplies the tastebuds in the anterior 2/3rds of the tongue

28
Q

If there is normal hearing in the right ear, but in the left ear bone conduction is greater than air conduction. Weber test also localises to the left ear. What does this indicate?

A

Conductive hearing loss of the left ear

29
Q

Air conduction is greater than bone conduction bilaterally. However, Weber test localised to the right ear. What does this indicate?

A

Left sensorineural hearing loss

Rinne-ve = no conductive loss. If sensorineural loss then Weber will be loudest in unaffected ear

30
Q

What is a myringotomy?

A

Surgical incision into the tympanic membrane to relieve pressure. E.g. in glue ear, then followed by grommet insertion

31
Q

What is Samter’s triad?

A

Asthma + nasal polyps + NSAID (especially aspirin) insensitivity

32
Q

Rhinosinusitis is classed as chronic when symptoms persist after how long?

A 
12 weeks
(Then subclassified as CRS with or without polyps)
33
Q

How does rhinosinusitis present?

A

At least one symptom e.g. nasal congestion, nasal drip, facial pain, reduced smell
Plus either endoscopic signs or CT changes

34
Q

The association of asthma, aspirin insensitivity and nasal polyps is known as what?

A

Samter’s triad

35
Q

How could you manage a patient with nasal polyps?

A

Intranasal steroids (reduce polyps in most px)
Polypectomy (high rate of recurrence)
Turbinate trimming is resultant turbinate hypertrophy

36
Q

What is Chvostek’s sign an indicator of?

A

Hypocalcaemia

Tapping over cheek will cause twitching of facial muscles

37
Q

What are some signs and symptoms of hypocalcaemia?

A 
Tetany, paraesthesia, muscle cramps
Depression
Chvostek’s sign
Trousseau’s sign
Prolonged QTc
38
Q

What complications can result from thyroid surgery?

A

Bleeding (haematoma in confined space can lead to respiratory obstruction)
Recurrent laryngeal nerve damage
Parathyroid gland damage (hypoCa)

39
Q

Epiphora refers to what?

A

Excess tear production

40
Q

Which bone forms the cribiform plate?

A

Ethmoid bone

41
Q

What nerve axons descend through the cribiform plate?

A

Olfactory nerve

42
Q

What type of epithelial cells line the nasal mucosa?

A

Pseudostratified columnar epithelium with goblet cells

43
Q

What is the role of the nasal conchae?

A

To warm and humidify the nasally inspired air

44
Q

How should vocal cord nodules be treated?

A

Conservative: voice rest, speech therapy, avoid irritants eg smoking and alcohol

Surgical excision (If conservative measures fail)

45
Q

What are some risk factors for laryngeal cancer?

A

Male
Increasing age
Alcohol
Smoking

46
Q

What is Reinke’s oedema?

A

Swelling of the vocal cords
Sac like appearance of fluid filled vocal cords
Almost exclusive to female smokers that present with a very deep and hoarse voice

47
Q

What are some differentials for a hoarse voice?

A 
Larnygeal cancer 
Laryngitis
Vocal cord palsy 
Reinke’s oedema 
Vocal cord nodules
Reflux laryngitis
48
Q

How should Reinke’s oedema be managed?

A

Conservatively e.g. stop smoking, voice rest, SALT

May require laser surgery

49
Q

What are some differential diagnoses for dysphagia?

A

Intrinsic: larnygeal Ca, strictures, pharyngeal pouch, achalasia
Neurological: MS, bulbar palsy, myasthenia
Other: globus hystericus, cord palsy

50
Q

What is the dose of intramuscular adrenaline for an 8 year old experiencing an anaphylactic reaction?

A

0.3ml of 1:1000 IM adrenaline

Can be repeated after 5 minutes

51
Q

Can adenoid hypertrophy cause otitis media?

A

Yes by blocking the Eustachian tube

52
Q

What age group is adenoid hypertrophy most common in?

A

Children

They are lymphatic tissue so enlarge during childhood then shrink before puberty

53
Q

Which bronchus is an inhaled foreign body more likely to fall into?

A

The right bronchus as this is more vertically positioned

54
Q

What is the likely diagnosis of a painless neck lump in children that transluminates brightly?

A

Cystic hygroma

EOY4 (15 decks)

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