Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3b specialties > ENT > Flashcards

ENT Flashcards

1
Q

what is BPPV?

A

vertigo triggered by change in head position e.g. rolling over in bed or gazing upwards

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

diagnosis of BPPV?

A

Dix hallpike manoeuvre

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

mx of BPPV?

A

Epley manoeuvre- moves debris out of semi-circular canals and back into utricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

causes of vertigo?

A

BPPV
Meniere’s disease
vetibular neuronitis
acoustic neuroma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is Meniere’s disease

A

excess fluid in the inner ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

features of Meniere’s disease?

A 
recurrent episodes of tinnitus and hearing loss
sensation of aural fullness
nystagmus
positive Romberg's test
episodes last minutes to hours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

mx of Meniere’s disease?

A

inform DVLA
acute attacks -> buccal or IM prochlorazone
prevention-> betahistine and vestibular rehab exercises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is vestibular neuronitis?

A

infection of vestibular nerve- may follow URTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Features of VN?

A

recurrent vertigo attacks lasting hours or days
N&V
horizontal nystagmus away from the affected side
no hearing loss or tinnitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

mx of VN?

A
  • vestibular rehab exercises
  • buccal or IM prochlorperazine is often used to provide rapid relief for severe cases

-a short oral course of prochlorperazine, or an antihistamine (cinnarizine, cyclizine, or promethazine) may be used to alleviate less severe cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is vestibular schwannoma?

A

benign tumour of the schwann cells of the vestibulocochlear nerve

also known as acoustic neuroma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

features of vestibular schwannoma?

A

cranial nerve VIII: hearing loss, vertigo, tinnitus
cranial nerve V: absent corneal reflex
cranial nerve VII: facial palsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is bilateral vestibular schwannomas associated with?

A

neurofibromatosis type 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Ix of vestibular schwannoma?

A

MRI of the cerebellopontine angle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

mx of vestibular schwannoma?

A

surgery, radiotherapy or observation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

other causes of vertigo?

A 
viral labyrinthitis
posterior circulation stroke
ototoxicity e.g. MS
MS
trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

differentials of facial pain?

A 
bell's palsy
sinusitis
trigeminal neuralgia
atypical facial pain
ramsey hunt syndrome
rhinosinusitis
TMJ syndrome
nasal injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is bell’s palsy?

A

LMN facial nerve palsy (forehead affected)

acute, unilateral and idiopathic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

RFs for bells palsy?

A

pregnant women

20-40 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

features of bell’s palsy?

A

LMN facial palsy- drooping face symptoms

post-auricular pain, altered taste, dry eyes, hyperacusis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

mx of bell’s palsy?

A

prednisolone 1mg/kg for 10 days within 72 hours on onset
eye care- artificial tears and eye lubricants
refer if suspicious

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is sinusitis?

A

inflammation of the mucous membranes of the paranasal sinuses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

common infectious agents of sinusitis?

A

strep pneumoniae
h. influenzae
rhinovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

features of sinusitis?

A
  • facial pain- typically frontal pressure pain which is worse on bending forward
  • nasal discharge: usually thick and purulent
  • nasal obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

mx of acute sinusitis?

A

analgesia
intranasal decongestants
oral Abx for severe presentations- phenoxymethylpenicillin or co-amoxiclav

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is trigeminal neuralgia?

A

a pain syndrome characterised by severe unilateral pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

causes of trigeminal neuralgia?

A

majority are idiopathic but compression of trigeminal roots by tumours or vascular problems may occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

features of trigeminal neuralgia?

A

electric shock-like pains brought on by light touch, washing, shaving etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

mx of trigeminal neuralgia?

A

1st line- carbamazepine

failure to respond to treatment or atypical features e.g. <50 years old should prompt referral to neurology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is atypical facial pain?

A

diagnosis of elimination, functional cause

iunilateral pain, poorly localised, continuous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is ramsay hunt syndrome?

A

herpes zoster oticus

caused by reactivation of the varicella zoster virus in the geniculate ganglion of the 7th cranial nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

features of ramsay hunt syndrome?

A

auricular pain is often first feature
facial nerve palsy
vesicular rash around ear
other features include vertigo and tinnitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

mx of ramsay hunt syndrome?

A

oral acyclovir and corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

RFs for ramsay hunt syndrome?

A

elderly, immunocompromised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what is rhinosinusitis?

A

inflammation in the nose and paranasal sinuses with >2 of :

  • nasal blockage
  • facial pressure
  • loss of smell
  • endoscopic or CT changes

also runny nose, sneezing, headaches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

when to refer for biopsy in rhinosinusitis?

A

a single unilaterl polyp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

mx of rhinosinusitis?

A

with polyps- beclomethasone, fluticasone, long term Abx, endoscopic sinus surgery

w/o polyps- intranasal corticosteroids, nasal saline irrigation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what is allergic rhinosinusitis?

A

caused by IgE mediated inflammation, can have nasal polyps and swollen turbinates
tx= loratadine, saline irrigation, intranasal corticosteroids (mometasone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what is TMJ syndrome?

A

biopsychosocial disorder

earache, facial pain and joint clicking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

tx of TMJ syndrome?

A

simple analgesia
PT
CBT
oral splinting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what is Samter’s triad?

A

association of asthma, aspirin sensitivity and nasal polyps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what is nasal septal haematoma?

A

an important complication of nasal trauma that should be looked for
describes the development of a haematoma between the septal cartilage and overlying perichondrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

features of nasal septal haematoma?

A

nasal obstruction
pain and rhinorrhoea
bilateral red swelling from nasal septum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

mx of septal haematoma?

A

surgical drainage
IV antibiotics
if suspect CSF rhinorrhoea- test for glucose in fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

complications of septal haematoma?

A

irreversible septal necrosis -> saddle-nose deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

differentials for deafness

A 
ear wax
otitis media (+ glue ear)
otitis externa
presbycusis
otosclerosis
Meniere's disease
drug ototoxicity
noise damage
acoustic neuroma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what is conductive deafness?

A

pathology in outer or middle ear e.g. glue ear, otosclerosis
bone conduction> air conduction on Rinnes

sound is localised to the affected side on webers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what is sersorineural deafness?

A

Sensorineural hearing loss occurs due to abnormalities in the cochlea, auditory nerve or other structures in the neural pathway leading from the inner ear to the auditory cortex.
ac>bc
Sound is localised to the unaffected side if unilateral sensorineural deafness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

unilateral causes of sersorineural deafness?

A

Meniere’s disease

acoustic neuroma

50
Q

bilateral causes of sersorineural deafness?

A 
ototoxic antibiotics
chemo
measles
mumps
meningitis
noise exposure
trauma
51
Q

what is otosclerosis?

A

AD
replacement of normal bone by vascular spongy bone
causes conductive deafness and tinnitus

52
Q

name some ototoxic drugs?

A

aminoglycosides (e.g. Gentamicin), furosemide, aspirin and a number of cytotoxic agents e.g. cisplastin

53
Q

what is presbycusis?

A

age-related sensorineural hearing loss

audiometry shows bilateral high-frequency hearing loss

54
Q

what is acute otitis externa?

A

infection of the outer ear canal

known as SWIMMERS ear

55
Q

causes of otitis externa?

A
  • infection: bacterial (Staphylococcus aureus, Pseudomonas aeruginosa) or fungal
  • seborrhoeic dermatitis
  • contact dermatitis (allergic and irritant)
56
Q

features of otitis externa?

A

discharge, itch, pain, tragal tenderness

57
Q

Ix for otitis externa?

A

otoscopy

swab for microscopy

58
Q

tx of otitis externa

A

topical antibiotic or a combined topical antibiotic with a steroid
if the tympanic membrane is perforated aminoglycosides are traditionally not used*
if there is canal debris then consider removal
if the canal is extensively swollen then an ear wick is sometimes inserted

Second-line options include
consider contact dermatitis secondary to neomycin
oral antibiotics (flucloxacillin) if the infection is spreading
taking a swab inside the ear canal
empirical use of an antifungal agent

59
Q

causes of chronic otitis externa?

A

combined staphylococcal and fungal infection

60
Q

tx of otosclerosis?

A

stapedectomy and insertion of prosthesis

61
Q

what is malignant otitis externa?

A

life-threatening
can progress to temporal bone osteomyelitis
needs CT, IV Abx and surgical debridement

62
Q

RFs for malignant otitis externa?

A

diabetes, elderly, immunosuppression

63
Q

causes of acute otitis media?

A

pneumococcus
H.influenzae
Moraxella catarrhalis

64
Q

RFs for acute otitis media?

A 
URTI
Bottle feeding
passive smoking
GORD
raised BMI
65
Q

symptoms of acute otitis media?

A

otalgia, fever, irritability, anorexia, vomiting, discharge

66
Q

Ix of acute otitis media?

A

otoscope- bulging tympanic membrane

67
Q

tx of acute otitis media?

A

analgesia, decongestants

amoxicillin if symptoms lasting more than 4 days or not improving, systemically unwell or immunocompromised

68
Q

what is glue ear?

A

otitis media with effusion

69
Q

causes of glue ear?

A

URTI, oversized adenoids, post-nasal space, tumour

70
Q

Ix of glue ear?

A

otoscopy- fluid levels behind the ear drum, bulging drum or retracted

71
Q

tx of glue ear?

A

usually mild and resolves spontaneously
popping ears
hearing aids
grommets or tympanostomy tube

72
Q

what is a complication of chronic otitis media?

A

cholesteatoma

73
Q

what is mastoiditis?

A

infection of the mastoid bone that often follows an ear infection

74
Q

features of mascoiditis?

A

otalgia: severe, classically behind the ear
fever
unwell
swelling, erythema and tenderness over the mastoid process
the external ear may protrude forwards
ear discharge if the ear has perforated

75
Q

Ix of mastoiditis?

A

increased ESR, FBC, blood cultures

tympanocentesis- sample of fluid

76
Q

tx of mastoiditis?

A

IV Abx for 1-2 days then oral Abx
ENT referral- surgical drainage
mastoidectomy

77
Q

what is cholesteatoma?

A

an abnormal skin growth that develops in the middle ear behind the ear drum
build up of squamous epithelium

78
Q

features of cholesteatoma?

A

foul discharge +/- deafness, headache, pain, facial paralysis, vertigo

79
Q

tx of cholesteatoma?

A

surgery

80
Q

what is furunculosis?

A

a very painful abscess arising from a hair follicle within the ear canal
caused by staphylococcus
tx= lancing (cut open)

81
Q

mx of cellulitis of pinna

A

flucloxacillin

82
Q

differentials of tinnitus?

A

otosclerosis
acoustic neuroma
hearing loss
drugs- aspirin, aminoglycosides, loop diuretics, quinine

83
Q

red flag of tinnitus?

A

unilateral tinnitus= acoustic neuroma

84
Q

tx of tinnitus

A

treat underlying cause

85
Q

red flag for oral cancer

A

unexplained ulceration in the oral cavity lasting for more than 3 weeks or
a persistent and unexplained lump in the neck.

86
Q

RFs for oral cancer?

A

smoking, alcohol

87
Q

features of oral cancer?

A

non-healing ulcer, red/white plaques inside the mouth, painful lump, bleeding, numbness

88
Q

ix of oral cancer?

A

biopsy

CT/MRI

89
Q

Tx of oral cancer?

A

surgery-excision

photodynamic therapy

90
Q

causes of epistaxis?

A 
trauma
platelet disorders- thrombocytopenia, splenomegaly, leukaemia, ITP
Juvenile angiofibroma- benign tumour
Drug use
HHT
Granulomatosis with polyangiitis
91
Q

origin of epistaxis?

A

anterior nasal septum (little’s area) as it the confluence of 4 arteries

92
Q

tx of epistaxis?

A

pinch lower nose
nasal packing
cauterise with silver nitrate
if setpal haematoma -> drain in theatre

93
Q

name some viral causes of tonsillitis?

A 
rhinovirus
coronavirus
parainfluenza
adenovirus
HSV
EBV
94
Q

bacterial causes of tonsillitis

A

group A beta-haemolytic strep

95
Q

what is the centor criteria?

A 
guidance for Abx prescribing
fever
absence of cough
tonsillar exudate
cervical lymphadenopathy
96
Q

tx of tonsillitis?

A

phenoxymethylpenicillin clarithromycin if allergic

tonsillectomy

97
Q

what is quinsy?

A

peritonsillar abscess

98
Q

features of quinsy?

A

deviated uvula
purulent tonsils
difficulty opening jaw
painful swallowing

99
Q

tx of quinsy?

A

Abx and aspiration

tonsillectomy considered in 6 weeks

100
Q

what is the most common type of oropharyngeal neoplasm?

A

> 90% are SCC

Occur anywhere from the oral cavity to the trachea

101
Q

RFs for oropharyngeal neoplasm?

A

smoking, alcohol, vitamin A and C deficiency, HPV 16 and 18, GORD

102
Q

Features of oropharyngeal neoplasm?

A

neck lump
hoarseness
persistent sore throat
persistent mouth ulcer

103
Q

2 week wait for laryngeal cancer for ENT referral?

A

In people aged 45 and over with:
persistent unexplained hoarseness or
an unexplained lump in the neck

104
Q

causes of stridor?

A
  1. Congenital- laryngomalacia
  2. Inflammatory/infective- laryngitis, croup, acute epiglottitis, anaphylaxis
  3. Tumours- haemangionas, papillomas, oesophageal cancer
  4. Trauma- intubation, burns
105
Q

what is laryngomalacia?

A

cartilage of the upper larynx collapses inwards during inhalation, causing airway obstruction

106
Q

what is laryngeal nerve palsy?

A

paralysis/impingement of the recurrent laryngeal nerve- responsible for movement of vocal cords

30% due to cancer
25% iatrogenic
15% idiopathic
CNS disease
TB
107
Q

differentials of neck lumps in children?

A

congenital- brachial cyst, thyroglossal cyst, dermoid cyst
inflammatory- reactive lymphadenopathy, lymphadenitis
neoplastic- lymphoma, thyroid tumour, salivary gland tumour

108
Q

what is the most common cause of neck lump?

A

archive lymphadenopathy

109
Q

what is a red flag for 2 week referral for suspected thyroid cancer?

A

unexplained thyroid lump

110
Q

what are the features of lymphoma?

A

rubbery, painless lymphadenopathy

  • can get pain while drinking alcohol
  • associated B symptoms
111
Q

what happens to a thyroid swelling on swallowing?

A

moves upwards

112
Q

features of a thyroglossal cyst?

A

most common in patients >20 years old

usually midline, between the isthmus of the thyroid and the hyoid bone

Moves upwards with protrusion of the tongue

May be painful if infected

113
Q

what is a pharyngeal pouch?

A

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

Usually not seen but if large then a midline lump in the neck that gurgles on palpation
Typical symptoms are dysphagia, regurgitation, aspiration and chronic cough

114
Q

what is a cystic hygroma?

A

a congenital lymphatic lesion typically found in the neck, classically on the left side
90% present before the age of 2

115
Q

what is a brachial cyst?

A

An oval, mobile cystic mass that develops between the sternocleidomastoid muscle and the pharynx
Develop due to failure of obliteration of the second branchial cleft in embryonic development
Usually present in early adulthood

116
Q

what is a carotid aneurysm?

A

a pulsatile lateral neck mass which doesn’t move on swallowing

117
Q

what are the borders of the anterior triangle in the neck?

A

clavicle
sternocleidomastoid
mandible

118
Q

what are the borders of the posterior triangle in the neck?

A

skull base
trapezius
sternocleidomastoid

119
Q

what is a sialadenitis?

A

infection of the submandibular or parotid glands
usually in the elderly
tx- abx

120
Q

what is sialolithiasis?

A

salivary gland stones

pain after eating in the submandibular glands

3b specialties (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions