ENT Flashcards
Management of glue ear
Conservative (review in 3m)
If persistent - hearing aids or grommits
Inheritane of otosclerosis
Autosomal dominant
Organisms for otitis externa
Bacterial - pseudomonas aerguinosa, staph aureus
Fungal - aspergillus niger (divers)
Who gets malignant otitis externa and how is it managed?
Diabetics - IV antibiotics
Management of bacterial otitis externa
antibiotic + steroid (ciprofloxacin/dexamethasone)
Organisms that cause otitis media
Resp viruses
- strep pnemoniae
- H. influenzae
- Moraxella catarhalis
Management of otitis media
Delayed Abx (5 days) Give immediately if: - symptoms >4d + not improving - systemically unwell - immunocomprimised - <2y with bilteral OM - perforation and/or discharge
Presentation of vestibular schwannoma
Unilateral sensorineural HL
Intermittent dizziness
Facial numbness
Investigation of vestibular schwannoma
MRI
Duration of vertigo with cause (mins, hours, days, days/weeks)
Mins = BPPV
Hours = Menieres
Days = Vestibular neuronitis
Days - Weeks = Labrynthitis
What does the facial nerve provide parasympathetic supply to?
H + N glands
Submandibular + sublingual salivary glands
What type of hypersensitivity reaction is allergic rhinitis?
Type I hypersensitivity reaction
When are nasal polyps concerning? How should this be managed?
If UNILATERAL (considered neoplastic until proven otherwise) - CT + biopsy
How are nasal polyps managed?
Mild-Mod = intranasal corticosteroid +/- anti-leukotriene (montelukast) Severe = oral corticosteroids - surgery
How are acute and chronic sinusitis differentiated?
Acute = <4 weeks Chronic = >4 weeks
Management of persistent sinusitis
Penicillin V for 7 days
What prophylactic treatment redduces recurrence of chronic sinusitis?
Corticosteroids
Which arteries are ligated (progressing) when managing a nosebleed?
Sphenopalantine
Anterior ethmoidal
External carotid
What are the steps of epistaxis management?
First aid measures
topical anti-septic (noseptin or mupuracin)
if vessels visible - cautery with silver nitrate
if not visible - packing
(^^^give co-phenylcaine first^^^)
Most common salivary gland tumour
Pleomorphic adenoma
Most common salivary gland to get stone (sialothiasis)
Submandibular gland
What are the centor criteria?
Tonsillar exudate
No cough
Tender cervical lymphadenopathy
Fever
Management of bacterial tonsilitis
Phenoxymethylpenicillin (5days) - if unable to swallow admit for benzylpenicillin + IV fluids
Management of peritonsillar abscess (quinsy)
Needle aspiration Iv pen (10 days) + IV dex
How long to avoid contact sports in glandular fever?
8 weeks
Investigation of glandular fever
BC + film
- lymphocytosis + atypical lymphocytes
- heterophil ab test (monospot or Paul Bunnell)
What is most common type or nasal, oropharyngeal and larygneal ca?
SCC
Which younger patients may present wiht laryngeal ca?
HPV +ve
