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GP ACRRM > ENT > Flashcards

ENT Flashcards

1
Q

Signs of an “unsafe” TM perforation on otoscopy

A
  • Superior and/or posterior edge of tympanic membrane perforation
  • Perforation involving fibrous edge or annulus of the tympanic membrane
  • Associated granulation tissue
  • White mass within middle ear seen through perforation
  • Bone erosion
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2
Q

What is the diagnosis and what is initial management?

A

Normal tympanic membrane

No management required

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3
Q

What is the diagnosis and what is initial management?

A

Acute OM

Antibiotics only if:

  • <6 mo
  • <2y with bilateral infection
  • Associated otorrhoea
  • at high risk of suppurative complications (e.g. ATSI child living remotely, immunosuppression)
  • systemically unwell
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4
Q

What is the diagnosis and what is initial management?

A

Attic Cholesteatoma

Refer to ENT

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5
Q

What is the diagnosis and what is initial management?

A

Cholesteatoma with bone destruction of external ear canal

Refer to ENT for surgical management

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6
Q

What is the diagnosis and what is initial management?

A

Cholesteatoma with retraction pocket

Refer to ENT for surgical removal

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7
Q

What is the diagnosis and what is initial management?

A

Congenital cholesteatoma

Refer to ENT for removal

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8
Q

What is the diagnosis and what is initial management?

A

Exostoses

No management required, if become so large that are obstrucing ear canal and affecting hearing, can refer to ENT for removal

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9
Q

What is the diagnosis?

A

Haemotympanum

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10
Q

What is the diagnosis?

A

Osteoma

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11
Q

What is the diagnosis and what is initial management?

A

Retracted TM

Observation

If associated hearing loss, suscpicion of cholesteaoma or erosion of ossicles, refer

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12
Q

What is the diagnosis and what is initial management?

A

“Safe” subtotal central TM perforation

Watch and wait, if not healing, refer for tympanoplasty

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13
Q

What is the diagnosis and what is initial management?

A

Otitis media with effusion

Referral for tympanostomy tube required if:
- persisting >6 months

  • associated speech delay or learning problems
  • structural damage to tympanic membrane (e.g. retraction, cholesteatoma)
  • bilateral hearing loss on audiometry
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14
Q

What is the diagnosis and what is initial management?

A

Central TM perforation

This would be considered “Safe” a is central, not inovlving the posterior or superior edges and no signs of underlying cholesteatoma.

Appropriate to watch and wait +/- treat underlying cause (e.g. with ABx if AOM)

If not healing, consider referral to ENT for tympanoplasty

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15
Q

What is the diagnosis and what is initial management?

A

Total perforation - this one would be considered “Safe” as it does not involve the annulus.

Conservative management to begin with would be appropriate (watch and wait), if not healing, could be referred for tympanoplasty

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16
Q

What is the diagnosis and what is initial management?

A

Tympanosclerosis

17
Q

What is the diagnosis and what is initial management?

A

Cholesteatoma - note the white keratin deposits in the attic

Refer to ENT for consideration of surgical removal

18
Q

What is the diagnosis?

A

Tympanosclerosis

19
Q

What is the diagnosis and what is initial management?

A

Otitis media with effusion

Referral for tympanostomy tube required if:
- persisting >6 months

  • associated speech delay or learning problems
  • structural damage to tympanic membrane (e.g. retraction, cholesteatoma)
  • bilateral hearing loss on audiometry
20
Q

What is the diagnosis and initial management?

A

Severe AOM - I’d probably start antibiotics for this

21
Q

What is the diagnosis and what is initial management?

A

Acute OM

Antibiotics only if:

  • <6 mo
  • <2y with bilateral infection
  • Associated otorrhoea
  • at high risk of suppurative complications (e.g. ATSI child living remotely, immunosuppression)
  • systemically unwell
22
Q

What is the diagnosis and initial management plan

A

Normal TM, no management

23
Q

What is the diagnosis and initial management

A

Bullous myringitis

Often caused by viral or mycoplasma infection

Treat with analgesia and antibiotics to cover mycoplasma

24
Q

What is the diagnosis and initial management?

A

Exostoses

No management required unless obstructing the ear canal an impairing hearing

25
Q

What is the diangosis and initial management plan?

A

Foreign body in External auditory meatus

Removal required - in young children this may require sedation.

As is a round bead, suction may be more approriate that trying to grasp with forceps

GP ACRRM (14 decks)

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