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ENT Flashcards

1
Q

What are the causes of conductive hearing loss?

A 
External canal obstruction
Tympanic membrane perforation
Acute mastoiditis
Otosclerosis
Cholesteatoma
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2
Q

Which inherited condition causes slowly progressive bilateral hearing loss?

A

Otosclerosis

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3
Q

When does otosclerosis typically worsen?

A

Around menstruation and pregnancy

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4
Q

What test is done to assess hearing?

A

Audiogram

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5
Q

What are the causes of sensorineural hearing loss?

A 
Ototoxicity
Menieres disease
Infections
Presbyacusis
Noise-induced
Acoustic neuroma
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6
Q

How do you distinguish noise-induced hearing loss from presbyacusis?

A

Nose induced is not progressive

+ trough on audiogram at 4000Hz

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7
Q

Which drugs are ototoxic?

A

Aminoglycosides (gentamicin)
Loop diuretics (furosemide)
Platinum based drugs (e.g. cisplatin)
Macolides (clarithromycin)

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8
Q

What frequency sounds are lost first in presbyacusis?

A

High frequency

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9
Q

How is acoustic neuroma dx?

A

Audiology and MRI

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10
Q

What are the mx options for acoustic neuroma?

A

Watch and wait
Radiotherapy
Microsurgery

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11
Q

What are the central causes of vertigo?

A

Acoustic neuroma
MS
Head injury

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12
Q

What type of crystals cause BPPV?

A

Otoliths formed from calcium carbonate

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13
Q

What conservative measures can help improve BPPV?

A

Reduce alcohol
Get out of bed slowly
Head turning

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14
Q

What drug can be used as prophylaxis in menieres?

A

Betahistine

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15
Q

What drug can be used in an acute menieres attacks to relieve sx?

A

Antihistamines (e.g. cinnarizine)

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16
Q

Which type of bacteria most commonly cause otitis externa?

A

Pseudomonas aeruginosa

S.Aureus

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17
Q

Which fungi most commonly cause otitis externa?

A 
ASPERGILLUS NIGER
Candida albicans (less commonly)
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18
Q

RFs for otitis externa

A 
Swimming
Cotton buds
Eczema/psoriasis
Immunocompromised/DM
Allergies
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19
Q

What is the tx for otitis externa?

A

Topical abx (gentamicin) + topical steroid (e.g. dexamethasone)

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20
Q

How does Ramsey-Hunt syndrome px?

A

Bells palsy + very painful vesicular rash in ear and anterior 2/3 of tongue
Ipsilateral HEARING LOSS and vertigo

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21
Q

How is ramsey hunt syndrome tx?

A

Pred
Aciclovir
Artificial tears

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22
Q

What should you suspect if otitis externa is accompanied with a CN VII palsy?

A

Necrotising otitis externa

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23
Q

How does necrotising otitis externa px?

A

Severe pain out of keeping with ear findings
Temporal headaches
CN VII palsy

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24
Q

What organism mainly causes necrotising otitis externa?

A

Pseudomonas aeruginosa

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25
Q

What is a big risk factor for necrotising otitis externa?

A

DIABETES

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26
Q

Define necrotising otitis externa?

A

External otitis media that progresses into osteomyelitis of temporal bone

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27
Q

What might you find on exam in necrotising otitis externa?

A

Granulations in ear canal

28
Q

Which organisms most commonly cause AOM?

A

RSV
Rhinovirus
S.PNEUMONIAE
H.influenzae

29
Q

How does AOM px?

A

Otalgia followed by discharge

30
Q

What are the comps of AOM?

A

Mastoiditis

Meningitis

31
Q

What must you exclude if an adult presents with unilateral otitis media with effusion?

A

Head and neck tumour

32
Q

What does otitis media with effusion look like on exam?

A

Yellow retracted tympanic membrane with loss of light reflex

33
Q

What test can be done to test the mobility of the ear drum?

A

Tympanogram

34
Q

What is the tx for cholesteatoma?

A

Surgery

35
Q

What forms the vestibular system?

A

Semicircular canals (rotation)
Utricle (horizontal)
Saccule (vertical)

36
Q

Before thinking of an ENT causes, what should you rule out in the patient px with dizziness?

A

Cardiac causes and stroke

37
Q

What test can be done to determine whether a central cause of vertigo?

A

Head thrust test

38
Q

What are the symptoms of menieres?

A

Tinnitus

Low frequency sensorineural hearing loss

39
Q

What are the symptoms of labyrinthitis?

A

Preceding URTI
Sudden, severe vertigo (no triggers)
Sensorineural hearing loss
N & V

40
Q

What is the main difference between vestibular neuronitis and labyrinthitis?

A

No hearing loss in vestibular neuronitis (cochlear not affected)

41
Q

What should you suspect in a patient with unilateral nasal obstruction/rhinorrhoea?

A

Benign/malignant neoplasm

42
Q

What does bone conduction louder than air conduction mean on Rinnes test?

A

Means that there is CHL in that ear

43
Q

What majority is commonly responsible for bacterial tonsillitis?

A

Group A beta haemolytic strep (S.pyogenes)

44
Q

When should you do a monospot test if suspect EBV?

A

2 weeks after onset of sx

45
Q

What is it important to advise people post EBV infection?

A

No contact sports for 8 weeks due to risk of splenic rupture

46
Q

How does quinsy px?

A 
Severe sore throat
Drooling
Bad breath
Trismus
Fever
47
Q

What are the comps of bacterial tonsillitis?

A

Rheumatic fever
Glomerulonephritis
Scarlet fever
Quinsy

48
Q

Which symbol on an audiogram inducates bone conduction?

A

Triangle

49
Q

In what condition would you get a flat tympanogram?

A

Otitis media with effusion

50
Q

What examination is uselful to distinguish labyrinthitis from stroke?

A

HINTS test

51
Q

What does the HINTS test involve?

A

Head impulse test
Nystagmus type
Skew

52
Q

Which organisms are the main bacterial causes of acute sinusitis?

A

S.pneumoniae

H.influenzae

53
Q

Should you admit a patient with quinsy?

A

Yes

54
Q

How can the history suggest salivary duct stone over a tumour?

A 
Stone = pain exacerbated by eating
Tumour = pain constant and slowly progressing
55
Q

Which type of malignancy most commonly affects the naso and oropharynx?

A

Squamous cell carcinoma

56
Q

What does unilateral parotid swelling with CN VII palsy suggest?

A

Neoplasm

57
Q

What is the most common type of salivary neoplasm?

A

Pleomorphic adenoma (benign)

58
Q

What is the name for inflammation of the salivary glands?

A

Sialoadenitis

59
Q

What Ix can be used to visualise salivary stones?

A

Sialography

60
Q

What virus is responsible for bilateral parotid involvement?

A

Mumps

61
Q

When does obstructive sleep apnoea most commonly px and what is the mx?

A

children (2-6)

Adenotonsillectomy

62
Q

What is the only way to exclude foreign body in the trachea?

A

Bronchoscopy

63
Q

When to refer nasal #?

A

Deformity at 5-7 days

Septal haematoma

64
Q

What is Pott’s puffy tumour?

A

Osteomyelitis of the frontal bone

65
Q

What are the differentials for salivary gland swelling?

A 
Viral parotitis
stone in salivary duct
Tumour
Sjogren syndrome 
HIV
66
Q

Which conditions is sialadenosis (generalized swelling of the salivary glands) associated with?

A

Sjogrens syndrome
Bulimia
Anorexia

67
Q

Which viruses can cause congenital hearing loss?

A

Rubella

CMV

med (25 decks)

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