ENT Flashcards

1
Q

Give 2 or more examples of courses of hoarsness.

A
  1. Laryngitis
  2. Vocal cord nodules
  3. Laryngopharyngeal reflux
  4. Muscular tension dysphonia
  5. Vocal cord palsy
  6. Laryngeal cancer
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2
Q

Bowing of the vocal cords so that they don’t close properly on phonation, leaving a “glottic chink” can be see on endoscopy in which condition?

A

Muscular Tension Dysphonia

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3
Q

What cell type are malignant laryngeal tumours usually?

A

Squamous cell carcinoma

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4
Q

Which nerve does the recurrent laryngeal nerve come from?

A

Vagus nerve

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5
Q

The commonest cause of stridor is __________.

A

Croup (laryngotracheobronchitis)

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6
Q

Stridor is a high pitched inspiratory noise due to obstruction where?

A

At or below the larynx

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7
Q

Give 1 congenital and 2 acquired causes of stridor.

A

Congenital: Laryngomalacia

Acquired: Tumour, trauma, foreign body, epiglottitis, laryngitis, croup, anaphylaxis

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8
Q

The pharyngeal mucosa herniates through Killian’s dehiscence in which condition?

A

Pharyngeal pouch

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9
Q

What condition has a sensation of a lump in the throat that is noticed on swallowing saliva (rather than food/ liquid)?

A

Globus pharyngeus

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10
Q

What are the 3 indications for tracheostomy?

A
  1. Upper airway obstruction
  2. Ventilation (weaning)
  3. Protection from aspiration
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11
Q

Which blood vessel does the left recurrent pharyngeal artery loop around?

A

Aortic arch

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12
Q

Which blood vessel does the right recurrent pharyngeal artery loop around?

A

Right subclavian artery

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13
Q

What is the most common type of thyroid cancer?

A

Papillary thyroid cancer

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14
Q

Which nasal sinuses open into the middle meatus?

A

Frontal
Anterior ethmoid
Middle ethmoid
Maxillary

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15
Q

If a patient with nasal fracture has a boggy swelling seen on both sides of the nasal septum, what complication of fracture do they likely have?

A

Septal haematoma

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16
Q

Is X-ray indicated in nasal fracture if no other fractures are suspected?

A

No

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17
Q

What should be done first when treating epistaxis, nasal packing or nasal cauterisation?

A

Cauterisation

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18
Q

If a clear fluid leaking from the nose is positive for glucose and Beta-2 transferrin, what is it likely to be?

A

CSF

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19
Q

Fungal sinusitis is usually caused by what?

A

Aspergillosis

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20
Q

What surgical treatment is used for all types of fungal sinusitis?

A

FESS- Functional Endoscopic Sinus Surgery

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21
Q

What is the most common type of malignant nasal tumour?

A

Squamous cell carcinoma

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22
Q

Juvenile nasal angiofibroma is a benign nasal tumour than may present as recurrent ________ in young men.

A

Epistaxis

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23
Q

Which antibiotic can be prescribed to be taken long term for chronic rhinosinusitis with polyps?

A

Doxycycline

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24
Q

Acute rhinosinusitis is usually caused by a ______.

A

Virus

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25
Q

Two of the arteries which supply the nose, the anterior and posterior ethmoidal arteries are branches of which artery?

A

Internal carotid artery

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26
Q

90% of patients with necrotising (malignant) otitis externa have which systemic condition?

A

Diabetes

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27
Q

What is the likely cause of a neck lump that is smooth, flutuant, non tender, located to the anterior edge of the sternocleidomastoid muscle and does not move with tongue protrusion?

A

Branchial cysts (=embryological remnant of the cervical sinus)

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28
Q

Give 3 potential differentials for a neck lump in the anterior triangle.

A
  1. Lymph node enlargement
  2. Branchial cyst
  3. Carotid body tumour
  4. Carotid artery aneurysm
  5. Laryngocele
  6. Submandibular salivary stone
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29
Q

Give 3 potential differentials for a neck lump in the midline.

A
  1. Thyroid nodule
  2. Thyroglossal cyst
  3. Dermoid cyst
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30
Q

Give 2 potential differentials for a neck lump in the posterior triangle.

A
  1. Lymph node
  2. Cystic hygroma
  3. Sebaceous cyst
  4. Pharyngeal pouch
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31
Q

_______________ cancer is more common in people of Asian origin and typically presents with epistaxis, headaches, lymph node metastasis or unilateral hearing loss.

A

Napsopharyngeal

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32
Q

If a patient with likely bacterial pharyngitis is penicillin allergic which other antibiotics can be prescribed?

A

Clarithromycin

Erythromycin

33
Q

Myringoplasty is an operation to repair what?

A

A hole in the tympanic membrane

34
Q

Name 4 possible causes of vertigo.

A
  1. BPPV
  2. Labyrinthitis
  3. Meniere’s disease
  4. Vestibular migraine
  5. Acoustic neuroma
  6. MS
  7. Head injury
35
Q

Name 1 or more drugs that are associated with causing tinnitus.

A
  1. Aspirin
  2. Quinine
  3. Aminoglycosides eg. Gentamicin
  4. Loop diuretics
  5. Cisplatin
36
Q

In Ramsay Hunt syndrome vesicular lesions may be seen on the anterior two-thirds of the tongue and where else?

A

External auditory meatus, pinna

37
Q

Little’s area is the most common origin of epistaxis and is located on the ______ nasal septum.

A

Anterior

38
Q

In otosclerosis which middle ear bone becomes fixed in place?

A

Stapes

39
Q

Which condition is an autosomal dominant condition characterised by conductive deafness, tinnitus and potential vertigo, a normal tympanic membrane, and tends to appear age 20-40yrs

A

Otosclerosis

40
Q

Branchial cysts are usually filled with _________ crystals.

A

Cholesterol

41
Q

Cystic hygromas are located in the _______ triangle of the neck.

A

Posterior

42
Q

A perforated ear drum will usually heal by itself in _____ to _____ weeks.

A

6-8 weeks

43
Q

The most common causes of bacterial otitis _______ are Hib, Strep pneumoniae and Moraxella.

A

Otitis media

44
Q

NICE guidelines recommend sinusitis treatment with intra-nasal corticosteroids if the symptoms are severe or have lasted for ___ or more days.

A

10

45
Q

Prebycusis is age related, bilateral, _____ frequency SNHL.

A

High

46
Q

What is the scan of choice if an acoustic neuroma is suspected in a patient?

A

MRI

47
Q

Nasopharyngeal cancer has lymphadenopathy in the ______ area in 90% of patients.

A

Cervical

48
Q

Younger patients with laryngeal cancer are typically positive for which virus?

A

HPV

49
Q

Sialadenitis is acute infection of which 2 glands?

A

Submandibular salivary glands

Parotid salivary glands

50
Q

Sialolithiasis (salivary stones) usually affect which gland?

A

Submandibular (thickest secretion)

51
Q

Are pleomorphic adenomas and Warthin’s tumour benign or malignant salivary gland tumours?

A

Benign

52
Q

Squamous cell carcinomas, adenocarcinomas and adenoid cystic carcinomas are __________ types of salivary gland tumour.

A

Malignant

53
Q

Otosclerosis may cause tinnitus and ________ hearing loss.

A

Conductive / bilateral

54
Q

Which antibiotic should be prescribed in patients with Acute Otitis Media (AOM) who are unwell or under 2 years?

A

Amoxicillin

55
Q

Which cranial nerve must be affected by an acoustic neuroma in order to cause an absent corneal reflex?

A

Trigeminal (CNV) as this controls the corneal reflex

56
Q

Which type of hearing loss is usually treatable and can resolve?

A

Conductive

57
Q

_________________ hearing loss makes up around 90% of hearing loss.

A

Sensorineural

58
Q

Otitis externa is usually caused by which bacteria?

A

Pseudomonas

59
Q

Cholesteatoma can lead to which type of hearing loss?

A

Conductive

60
Q

A CT scan of which bone is indicated in cholesteatoma?

A

Temporal bone

61
Q

Which condition may present as treatment resistant otitis externa and can result in osteomyelitis of the temporal bone and facial palsy?

A

Malignant (necrotising) otitis externa

62
Q

Which antibiotic is usually given for malignant (necrotising) otitis externa?

A

Ciprofloxacin

63
Q

_____________ causes vertigo and may follow an URTI. It can be treated with fluids, rest, and vestibular suppressants such as Cyclizine and Prochlorperazine.

A

Labyrinthitis

64
Q

What are likely features of Meniere’s disease that are usually NOT found in BPPV?

A

Tinnitus
Nausea
Nystagmus

65
Q

____________ is caused by distension of the endolymphatic spaces in the ear, and results in a triad of vertigo, nystagmus and sensorineural hearing loss.

A

Meniere’s disease

66
Q

Give 2 or more causes of tinnitus.

A
  1. Ototoxic drugs
  2. Any cause of sensorineural deafness
  3. Impacted wax
  4. Acoustic neuroma
  5. Otosclerosis
67
Q

25% of vocal cord palsies are iatrogenic, 15% are idiopathic and 30% are caused by _________.

A

Malignancy

Larynx, bronchus, thyroid, oesophagus

68
Q

If a patient has breathing difficulty and aspirated, are they more likely to have a unilateral or bilateral vocal cord palsy?

A

Bilateral vocal cord palsy

69
Q

Stirtor (snoring) is an abnormal breathing sound due to obstruction _______ the larynx.

A

Above

70
Q

______________ can present as sudden onset stridor, with fever, drooling of saliva, a muffled voice and absence of cough.

A

Epiglottitis

71
Q

Croup (laryngotracheobronchitis) usually self resolves although patients can be prescribed a one off dose of _______.

A

Steroid (decamethasone/ prednisolone)

72
Q

In the grading of Thyroid cytology, a “Thy 5” specimen means the patient has ___________.

A

Thyroid malignancy

73
Q

Which type of thyroid cancer may be related to the MEN syndromes (Multiple Endocrine Neoplasias)?

A

Medullary thyroid cancer

74
Q

To diagnose rhinosinusitis, a patient must have inflammation of the nose and paranasal sinuses with 2 or more symptoms. Give examples of these symptoms.

A
  1. Blocked nose
  2. Nasal discharge
  3. Anosmia/ reduction in smell
  4. Facial pain/ pressure

Findings on endoscopy/ CT

75
Q

Name 2 or more potential complications of sinusitis.

A
  1. Pre septal orbital cellulitis
  2. Orbital cellulitis
  3. Cavernous sinus thrombosis
  4. Meningitis, encephalitis
  5. Otitis media
  6. Mucocele/ pyocoele
76
Q

Pott’s puffy tumour is a sub-periosteal _______ which arises from osteomyelitis and is a potential comlication of sinusitis.

A

Abscess

77
Q

If a patient presents with eye proptosis and diplopia, with painful eye movements, eyelid swelling and reduced vision, which potential complication of sinusitis may they have?

A

Orbital cellulitis

78
Q

The monospot test and Paul Bunnell test can be used to diagnose ____________.

A

Glandular fever (Infectious mononucleosis)