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phase 4 > ENT > Flashcards

ENT Flashcards

1
Q

how does pure tone audiometry work

A

headphones deliver tones at different frequencies and strengths and a mastoid vibrator

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2
Q

what is tympanometry

A

measures stiffness of ear drum to evaluate middle ear function

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3
Q

what would a flat tympanogram mean

A

mid ear fluid or perforation

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4
Q

what would a shifted tympanogram mean

A

change in mid ear pressure

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5
Q

how does an evoked response audiometry work and when is it used

A

auditory stimulus to show measurement of elicited brain response by surface electrode, used for neonatal screening if otoacoustic emission testing negative

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6
Q

types of hearing tests

A

neonatal = otoacoustic screening, then evoked response audiometry

pure tone audiometry start at 4 years

fabers 512Hz

Rinnes (pinne) and webers (mastoid)

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7
Q

in regards to AC and BC, what is normal vs conductive HL vs sensorineural HL

A 
normal = AC > BC
conductive = BC > AC and localises to affected side
sensorineural = BC and AC both decreased and localises to unaffected side
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8
Q

definition of conductive hearing loss

A

impaired conduction anywhere between auricle and round window due to inadequate eustachian tube ventilation of middle ear

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9
Q

causes of conductive hearing loss

A 
OTO COTO
obstruction (wax, pus, foreign body)
TM perforation (trauma, infection)
ossicle defect (otosclerosis, infection, trauma)
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10
Q

cause of sensorineural hearing loss

A

defects of cochlea, cochlear nerve or brain
drugs (aminoclycosides, vancomycin, gentamycin, furosemide)
post infective (meningitis, measles, mumps, herpes)
menieres, trauma, MS, CPA lesion (acoustic neuroma), reduced B12, presbycusis, TORCH

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11
Q

what is presbyacussis

A

cochlear degeneration and loss of hair on ganglion cells due to age from noise toxicity/arteriosclerosis

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12
Q

investigations and treatment in presbyacussis

A

pure tone audiometry and treat with hearing aid

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13
Q

symptoms of presbyacussis

A

> 65, bilateral, slow onset, may have tinnitus, hard to follow convo, loss at high frequency

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14
Q

treatment of adult hearing loss and how do they work

A

hearing aid - amplify sound

cochlear implant - electrical stimulus to spiral ganglion of auditory nerve

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15
Q

what is an acoustic neuroma

A

a vestibular schwannoma - benign slow growing tumour of the superior vestibular nerve

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16
Q

symptoms of acoustic neuroma

A
  • slow onset, unilateral sensorineural HL, tinnitus and vertigo
  • headache due to increased ICP
  • CN palsies 5 (absent corneal reflex), 7 (facial palsy), 8 (hearing loss, vertigo, tinnitus)
  • cerebellar signs
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17
Q

investigations in acoustic neuroma

A

pure tone audiometry

MRI of cerebellopontine angle

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18
Q

treatment of acoustic neuroma

A

gamma knife
surgery
high dose dexamethasone

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19
Q

what is acoustic neuromas associated with

A

NF type 2 (c.22)

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20
Q

what is otosclerosis

A

AD condition, with fixation of stapes at the oval window, and replacement of bone with vascular spongy bone

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21
Q

symptoms of otosclerosis

A
  • early adult life with bilateral conductive deafness and tinnitus
  • HL is improved in noisy places (Willis paracousis) and worsened by pregnancy, menstruation and menopause
  • family history
  • normal tympanic membrane
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22
Q

investigations in otosclerosis

A

pure tone audiometry shows dip (charts notch) at 2kHz

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23
Q

treatment of otosclerosis

A

hearing aid

stapes implant

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24
Q

risk factors of otitis externa

A

diabetes, immunocompromised, swimming, contact dermatitis, trauma, absence of ear wax, hearing aid

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25
Q

main causative organisms in otitis externa

A

pseudomonas (staph aureus)

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26
Q

symptoms of otitis externa

A

watery discharge, itch, pain and tragal tenderness, mobile tympanic membrane

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27
Q

investigations in otitis externa

A

otoscopy - red, swollen, erythematous

CT scan if suspect malignant

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28
Q

treatment of otitis externa

A

antibiotics to cover pseudomonas

betamethosone if non infected but eczematous

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29
Q

complications of otitis externa

A

malignant otitis externa (skull osteomyelitis) which can occur if diabetic or immunocompromised, can lead to CN palsy

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30
Q

symptoms of malignant otitis external

A

unresolving severe otitis externa, otalgia worse at night, copious otorrhoea and granulation tissue in canal

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31
Q

treatment of malignant otitis external

A

surgical debridement and systemic antibiotics IV

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32
Q

what is bullies myringitis

A

painful haemorrhage blisters on deep mental skin and TM, associated with influenza infection

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33
Q

what is chondrodermatitis nodular helicans

A

benign nodule putting pressure on ear caused by repeated pressure on ear

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34
Q

treatment of chondrodermatitis nodular helicans

A

cryotherapy, steroids and surgery

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35
Q

what is temporo-mandibular joint dysfunction and the symptoms

A

chronic joint tenderness exacerbated by lateral movements of an open jaw
- ear ache referred pain from auriculotemporal nerve, facial pain, joint clicking, teeth grinding, stress

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36
Q

management of TMJ dysfunction

A

MRI
Nsaids
jaw rest
stabilising orthodontic occlusal prostheses

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37
Q

main organisms in otitis media

A

viral (rhinovirus), pneumococcus, haemophillis influenza, moraxella, s. peumoniae

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38
Q

risk factors of acute otitis media

A

smoking, winter, children, post viral URTI, eustachian tube dysfunction, immunocompromised

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39
Q

symptoms of acute otitis media

A

rapid onset ear pain, tugging ear, irritability/anorexia/vomiing in children, purulent discharge if perforation, building red tympanic membrane, fever

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40
Q

treatment of acute otitis media

A

usually resolves spontaneously, give paracetamol
if >4 days, systemic illness of perforation, maybe need amoxicillin (delayed prescription)
if perforation does not heal may need myringoplasty

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41
Q

complications of acute otitis media

A 
otitis media with effusion
perforation
mastoiditis
facial nerve palsy
meningitis/encephalitis
brain abscess
sub/epidural abscess
bacteraemia
septic arthritis
infective endocarditis
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42
Q

what is otitis media with effusion

A

glue ear

caused by overproduction of secretions and eustachian tube dysfunction

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43
Q

symptoms of otitis media with effusion

A

inattention at school, poor speech development, conductive hearing loss, retracted dull tympanic membrane, bubbles behind ear drum, fluid level, recurrent otitis media

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44
Q

investigations in otitis media with effusion

A

audiometry shows flat tympanogram

otoscopy

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45
Q

treatment of otitis media with effusion

A

1) usually spontaneous
2) grommets if >3 months
3) bilateral hearing aids
4) adenoidectomy

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46
Q

side effects of grommets

A

infections and tympanosclerosis

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47
Q

causes of chronic otitis media

A

recurrent AOM, smoking, cranial facial abnormality (cleft palate)

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48
Q

symptoms of chronic otitis media

A

painless discharge and hearing loss, perforated tympanic membrane

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49
Q

treatment of chronic otitis media

A

aural toilet clean
antibiotics
topical steroids

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50
Q

investigations in chronic otitis media

A

CT to rule out cholesteatoma

otoscopy

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51
Q

complications of chronic otitis media

A

cholesteatoma

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52
Q

what is mastoiditis

A

middle ear inflammation leading to destruction of mastoid air cells and abscess formation

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53
Q

symptoms of mastoiditis

A

fever/systemically unwell, mastoid tenderness with boggy mass causing protruding auricle, thick hyperaemic tympanic membrane

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54
Q

investigations and treatment of mastoiditis

A

CT for abscess and treat with IV Abx for 2 weeks and myringotomy +/- mastoidectomy

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55
Q

what is cholesteatoma

A

locally destructive expansion of keratising stratified squamous epithelium in middle ear

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56
Q

symptoms of cholesteatoma

A
  • chronic foul smelling white discharge
  • headache and pain
  • cranial nerve involvement (vertigo, deafness, facial paralysis)
  • pearly white attic crust in upper ear drum
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57
Q

complications of cholesteatoma

A

deafness (due to ossicle bone destruction)
meningitis
cerebral abscess

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58
Q

treatment of cholesteatoma

A

surgical removal

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59
Q

what is tinnitus

A

sensation of sound without external sound stimulation

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60
Q

causes of tinnitus

A 
menieres
acoustic neuroma
otosclerosis
noise induced
head injury
hearing loss
drugs (aspirin, ahminoglycosides, loop diuretics)
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61
Q

what would unilateral tinnitus suggest

A

acoustic neuroma

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62
Q

what would tinnitus with vertigo suggest

A

menieres or acoustic neuroma

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63
Q

what would tinnitus with deafness suggest

A

menieres or acoustic neuroma

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64
Q

investigations in tinnitus

A 
otoscopy
tuning forks
pulse and BP
auditometry
tympanogram
MRI if unilateral
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65
Q

treatment of tinnitus

A

treat cause
psych support with tinnitus retraining therapy
hypnotics at night

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66
Q

what is vertigo

A

the illusion of movement

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67
Q

causes of vertigo

A 
menieres
BPPV
labyrinthitis 
acoustic neuroma 
MS
vertebrobasilar insufficiency 
stroke
head injury
inner ear syphilis 
drugs (gentamicin, loop diuretics, metronidazole, co-trimoxazole)
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68
Q

investigations in vertigo

A 
hearing test
cranial nerves
cerebellum and gait
rombergs
hallpike
audiometry 
calorimetry
LP
MRI
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69
Q

in vertigo, what does a positive rombergs test suggest

A

vestibular or proprioception cause

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70
Q

pathophysiology of meniere’s disease

A

dilation of endolymph spaces of membranous labyrinth (endolymphatic oedema)

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71
Q

symptoms of menieres

A
  • attacks of minutes to hours in clusters, up to 12 hours
  • progressive sensiuroneural hearing loss
  • vertigo
  • tinnitus
  • aural fullness
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72
Q

investigations of menieres

A

audiometry shows low frequency SNHL which fluctuates

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73
Q

treatment of menieres

A 
acute = buccal/IM prochlorperazine 
prevention = betahistine 
antiemetic = sentinel 
lifestyle =  furosemide and low salt
surgery (grommets or saccus decompression)
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74
Q

side effects of prochlorperazine

A

interferes with central compensatory mechanisms, a D2 antagonist therefore causes EPSE

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75
Q

presentation of viral labyrinthitis

A

post URTI leading to sudden unilateral loss of vestibular function, nausea and vomiting, vertigo, hearing loss
aggravated by head movement

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76
Q

difference between viral labyrinthitis and vestibular neuronitis

A

neuronitis is the same but just CN8 involved, so no hearing loss

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77
Q

treatment of viral labrynthitis /vestibular neuronitis

A

acute = prochlorperazine
avoid triggers
improves in days

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78
Q

pathophysiology of BPPV

A

displacement of otoliths in semicircular canals, common after head injury

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79
Q

symptoms of BPPV

A

sudden rotational vertigo for <30s causing by change in head position
nystagmus

80
Q

causes of BPPV

A

idiopathic, head injury, otosclerosis, post viral labrynthitis

81
Q

investigations in BPPV

A

hallpike manoeuvre - causes upbeat torsional nystagmus and vertigo

82
Q

treatment of BPPV

A

self limiting
epley manoeuvre
betahistine
DVLA

83
Q

differentiating nystagmus causes

A 
horizontal = ear
vertical = cerebellum
84
Q

what causes vertigo on full neck extension in elderly

A

vertebrobasilar ischaemia

85
Q

conductive causes of hearing loss in children

A

congenital cholesteatoma
pierre robin
anomalies of pinna
external auditory canal

86
Q

sensorineural causes of hearing loss in children

A

TORCH
ototoxic drugs
waardenburgs
alports

87
Q

pinna haematoma

exostoses

A

?

88
Q

function of wax

A

to prevent maceration and exposure to water

89
Q

complications of wax in ear

A

conductive deafness

90
Q

treatment of accumulation of wax in ear

A

function under direct vision using microscope and syringing after one week of softening with olive oil

91
Q

pathophysiology of sinusitis

A

viruses cause mucosal oedema and decreased mucosal ciliary actions, leading to mucus retention and secondary bacterial infection

92
Q

causation organisms in sinusitis

A

acute = pneumococcus, haemophiliac influenza, moraxella

chronic = s.aureus, anaerobes

93
Q

risk factors of sinusitis

A
  • secondary to viral infection
  • secondary to dental root infection
  • diving/swimming in infected water
  • deviated septum
  • polyps
  • immunodeficiency
  • allergies, asthma, smoker
94
Q

symptoms of sinusitis

A
  • maximally and ethmoidal pain on bending and straining
  • discharge from nose and post nasal drip
  • nasal obstruction/congestion
  • anosmia or cacosmia (bad smell without external source)
  • systemic symptoms
95
Q

investigations in sinusitis

A

nasendoscopy +- CT

96
Q

treatment of sinusitis

A

acute = bed rest, decongestants, analgesia
>10 days = nasal douching and intranasal corticosteroids, abx (phenoxymethylpenicllin)
chronic = usually a functional cause so stop smoking, fluticasone nasal spray and functional endoscopic sinus surgery if medical failed

97
Q

complications of sinusitis

A

mucoceles
orbital cellulitis
osteomyelitis
intracranial infection

98
Q

pathophysiology of allergic rhinosinusitis

A

T1HS IgE mediated inflammation from allergen (pollen, dust mites) exposure leads to mediator release from mast cells

99
Q

types of allergic rhinosinusitis

A

seasonal (hayfever)
perennial
occupational

100
Q

symptoms of allergic rhino sinusitis

A 
sneezing
bilateral nasal obstructing 
pruritus
rhinorrhoea 
post nasal drip
swollen, pale, boddy turbinates
nasal polyps
101
Q

investigations in allergic rhino sinusitis

A

skin prick test

RAST test

102
Q

management of allergic rhinosinusitis

A

1) avoid allergy
2) antihistamines (cetirazine) or beclometasone spray
3) intranasal steroids
4) zafirlukast
5) immunotherapy

nasal decongestants for symptoms

103
Q

what is a complication of nasal decongestants

A

extended use can lead to rebound nasal decongestion, therefore do not use for >7days

104
Q

causes of nasal polyps

A 
allergic/non allergic rhinitis 
CF
aspirin hypersensitivity
asthma 
churg strauss (asthma sinusitis, pANCA +ve, dyspnoea, eosinophilia)
downs
105
Q

symptoms of nasal polyps

A 
watery anterior rhinorrhoea 
purulent post nasal drip
nasal obstruction 
sinusitis
headaches
snoring 
mobile, pale, insensitive
106
Q

what could unilateral nasal polyp mean

A

red flag for cancer e.g. nasopharyngeal, glioma, lymphoma, neuroblastoma, sarcoma

therefore do CT and get histology and referrer all nasal polyps

107
Q

what is samters triad

A

asthma
allergic sinusitis
nasal polyps

108
Q

treatment of nasal polyps

A 
betamethosone drops for 2 days 
short course of oral steroids 
flexible endoscopic polypectomy
refer 
antihistamines
109
Q

questions to ask in nasal fracture

A

time, LOC, CSF rhinorrhoea, epistaxis, previous nose injury, obstruction, facial fracture symptoms (teeth malocclusion, piplopia)

110
Q

management of nasal fracture

A
  • dont X-ray as cartilaginous injury won’t show and also don’t alter managemnt
  • exclude septal haematoma
  • re examine after 1 week when swelling dreased
  • reduction under GA with post op splinting within 2 weeks
111
Q

symptoms of septal haematoma

A

boggy swelling bilaterally, pain, rhinorrhoea, nasal obstruction sensation

112
Q

treatment of septal haematoma

A

evacuation, drainage and abx under GA for packing and suturing

113
Q

complications of septal haematoma

A

septal necrosis
nasal collapse
saddle nose deformity

114
Q

causes of epistaxis

A

nose picking, URTI, pyogenic granuloma, osler weber rendu/HHT, warfarin, saids, haemophilia, reduce platelets, von williebrands, neoplasm, cocaine, trauma

115
Q

initial management of epistaxis

A

ABCDE

1) sit up, head tilt down, squeeze bottom for 20 mins
2) remove clots by suction if bleeding not controlled

116
Q

anterior epistaxis management

A

1) gauze soaked with vasoconstrictor and local anaesthetic
2) silver nitrate cauterisation
3) packing
4) ENT referral

117
Q

posterior / major epistaxis management

A

1) posterior with 18/18G foley catheter through nose into nasopharynx and inflate with water
2) endoscopic visualisation and cautery or ligation

118
Q

advice for after epistaxis

A

don’t pick, sit upright, avoid sun/bending/lifting, sneeze through mouth, no hot food/drink

119
Q

symptoms of HHT

A 
AD
telangiectasia in mucosa
recurrent spontaneous epistaxis
GI bleed painless
internal telangiectasia 
rarely pulmonary HTN
colon polyps
120
Q

what is little’s area/kisselbachs plexus

A 
LEGS - arteries in anterior nose
labial artery
ethmoid artery
greater palatine artery
sphenoid palatine after
121
Q

symptoms of tonsillitis

A

sore throat, fever, malaise, lymphadenopathy, inflamed tonsils, oropharynx, exudates

122
Q

common organisms of tonsillitis

A 
virus = adenovirus, influenza, coxsackie, coronavirus 
bacterial = group a beta haemolytic strep (pyogenes), staphs, moraxella
123
Q

centor criteria

A
  • history of fever
  • tonsillar exudates
  • tender anterior cervical adenopathy
  • no cough

1 point for each

124
Q

treatment of tonsillitis

A

analgesia
centor criteria
antibiotics (pen v 250mg PO QDS) (erythromycin in allergic)
surgery

125
Q

when should you do surgery for tonsillitis

A
  • > 7 a year
  • OSA/airway obstruction/stridor
  • quinsy
  • malignancy
  • recurrent febrile convulsions
  • symptoms >1year
126
Q

complications of surgery for tonsillitis

A
  • reactive haemorrhage

- tonsillar gag may damage teeth, TMJ, posterior pharyngeal wall

127
Q

complications of strep throat

A 
PPRRS
peritonsillar abscess (quinsy)
retropharyngeal abscess 
lemierre's syndrome 
scarlett fever
rheumatic fever
post strep glomerulonephritis
128
Q

methods of tonsillectomy

A

cold steel

cautery

129
Q

symptoms of peritonisllar abscess

A 
trisumus 
odonophagia (can't swallow saliva)
halitosis 
tonsillitis 
unilateral tonsillar enlargement 
contralateral uvula displacement 
cervical lymphadenopathy
130
Q

treatment of peritonsillar abscess

A

admit
IV Abx
tonsillectomy under GA

131
Q

functions of the larynx

A

phonation
positive thoracic pressure
respiration
prevention of aspiration

132
Q

symptoms of laryngitis

A

pain, hoarseness, fever, dysphagia, red and swollen vocal cords

133
Q

causative organisms of laryngitis

A 
usually viral (coronavirus)
bacterial = Hib, s.pneumonia
fungal = candidiasis
134
Q

investigations in laryngitis

A

CXR

sputum

135
Q

treatment of laryngitis

A

supportive

pen V

136
Q

what is laryngeal papilloma

A

pedunculated vocal cord swellings caused by HPV

137
Q

treatment of laryngeal papilloma

A

laser removal

138
Q

function of the recurrent laryngeal nerve

A

supplies all intrinsic muscles of the larynx except the cricothyroideus (an extended branch of the superior laryngeal nerve)

139
Q

symptoms of recurrent laryngeal nerve palsy

A

hoarseness, breathy voice with bovine cough, repeated coughing from aspiration (decreased supraglottic sensation), exertion dyspnoea (due to narrow glottis)

140
Q

cause of recurrent laryngeal nerve palsy

A

cancers (larynx, thyroid, oesophagus, hypo pharynx, bronchus)
para/thyroidectomy, carotid endarterectomy
aortic aneurysm, bulbar/pseudobulbar palsy

141
Q

risk factors of laryngeal SCC

A

smoking, alcohol, male

142
Q

symptoms of laryngeal SCC

A

male smoker with progressive hoarseness leading to stridor, dys/odonophagia, weight loss

143
Q

investigations in laryngeal SCC

A

laryngoscopy and biopsy including nodes

MRI staging

144
Q

treatment of laryngeal SCC

A

based on stage
radiotherapy
laryngectomy
after laryngectomy patients have permanent tracheostomy and need regular follow up for reoccurrence

145
Q

complications of laryngeal SCC

A

need tracheostomy

recurrence

146
Q

what is laryngomalacia

A

immature and floppy aryepiglottic folds and glottis lead to laryngeal collapse on inspiration in children

147
Q

presentation of laryngomalacia

A

stridor in first weeks of life particularly lying back, feeding, excited/upset

148
Q

treatment of laryngomalacia

A

no treatment needed but if severe may need surgery

149
Q

symptoms of epiglottitis

A

sudden onset continuous stridor with drooling and dysphagia

150
Q

organisms in epiglottitis

A

haemophilus and group a strep (pyogenes)

151
Q

treatment of epiglottitis

A
  • don’t examine throat, refer to ENT and anaesthetists
  • O2 and nebuliser adrenaline
  • IV dexamethasone
  • ABX - cefotaxime
  • cricothyroidectomy/tracheostomy
152
Q

what is a subglottic stenosis

A

sublottis in narrowest part of resp tract in children leading to stridor and failure to thrive

153
Q

causes of subglottic stenosis

A

prolonged intubation

congenital abnormalities

154
Q

treatment of subglottic stenosis

A 
mild = conservative 
severe = tracheostomy or partial tracheal resection
155
Q

what is ramsay hunt syndrome

A

reactivation of the varicella zoster virus in the geniculate ganglion of CN7

156
Q

symptoms of ramsay hunt syndrome

A
  • preceding ear pain or stiff neck
  • vesicular rash in auditory canal +/- TM/pinna/tongue/hard palate
  • ipsilateral facial weakness, ageusia, hyperacuisis
  • may affect CN7 palsy - vertigo, tinnitus, deafness
157
Q

treatment of ramsay hunt syndrome

A

acyclovir
prednisolone
analgesia
eye care

treat within 72hrs to ensure better recovery

158
Q

risk factors of tonsillar SCC

A

HPV, smoking, alcohol, poor oral hygiene

159
Q

risk factors of vocal cord nodules

A

teachers and singers - leads to bilateral nodules and a breathy harsh voice

160
Q

treatment of vocal cord nodules

A

speech therapy

surgery

161
Q

risk factors of obstructive sleep apnoea

A

obese, male, middle age, smoking, sedatives, alcohol, family history

162
Q

symptoms of OSA

A

snoring, daytime sleepiness, macroglossia, apnoea

163
Q

treatment of OSA

A

Epworth sleepiness score

1) behavioural
2) CPAP
3) modafinil for daytime sleepiness
4) surgery

164
Q

what is bells palsy

A

inflammatory oedema from entrapment of CN7 in narrow facial canal, usually of viral origin (HSV1), causes 75% of facial palsy

165
Q

symptoms of bells palsy

A
  • sudden onset complete unilateral facial feature
  • bells sign (failure of eye closure) leading to dryness and conjunctivitis
  • numbness or pain around ear
  • reduced taste (ageusia)
  • hyperacuisis (stapedius palsy)
166
Q

investigations of bells palsy

A

serology - borrelia or VZV antibodies
MRI - SOL, stroke, MS
LP

167
Q

treatment of bells palsy

A
  • protect eye = dark glasses/artificial tears/tape closed at night
  • prednisone in 72 hours
  • acyclovir if zoster suspected
  • plastic surgery
168
Q

prognosis of bells palsy

A
  • incomplete paralysis usually recovers completely within weeks
  • complete lesions may have delayed recovery or neurological/cosmetic abnormalities
169
Q

complications of bells palsy

A

aberrant neural connections

  • synkinesis = blinking causes up turning of mouth
  • crocodile tears = eating stimulates unilateral lacrimation, not salivation
170
Q

treatment of croup

A

O2 and neb adrenaline and dexamethasone

171
Q

causes of stridor

A

croup, epiglottitis, cancer in adults, inhaled foreign body, post op

172
Q

what is gingerval hyperplasia

A

overgrowth of gums caused by phenytoin, ciclosporin and AML

173
Q

what is necrotising ulcerative gingivitis symptoms and causes

A

caused by poor dental hygiene, leading to bleeding gums, ulcers, halitosis

174
Q

treatment of necrotising ulcerative gingivitis

A

metronidazole, chlorhexide mouthwash, analgesia

175
Q

risk factors of mouth ulcer

A

> 40 years, smokers, heavy drinkers, chewing tobacco

176
Q

when to refer mouth ulcers

A

> 3 weeks, red/white patches, one sided pain in head/neck, unexplained neck lump, persistent sore throat

177
Q

symptoms of mumps

A

parotitis, pancreatitis, orchitis, reduced hearing, meningoencephalitis

178
Q

what is a black hairy tongue, its causes and treatment

A

destructive desquamation of the filiform papillae
caused by poor oral hygiene, antibiotics, head and neck radiation, HIV, IVDU
tongue scrapings and antifungals if candida

179
Q

the 3 ossicles

A

malleus, incus, stapes

180
Q

function of the ossicles

A

transmit sound from tympanic membrane to the cochlear, then amplify sound waves and hair cells in the basilar membrane detect vibrations

181
Q

3 salivary glands

A

parotid
mandibular
sublingual

182
Q

3 unpaired cartilage in larynx

A

cricoid, thyroid, epiglottis

183
Q

nerves innervating the larynx

A

superior and recurrent laryngeal nerves

184
Q

blood supply of the thyroid gland

A

superior and inferior thyroid arteries

185
Q

function of the semicircular canals

A

for balance

186
Q

blood supply and nerves innervating the pharynx

A

external carotid artery

innervated by the vagus and glossopharyngeal nerve

187
Q

investigations for lump in neck

A

non contrast CT
US and cytology
TFTs
FBC

188
Q

what is sialandetis

A

blocked/ inflamed salivary gland caused by stone/tumour

189
Q

symptoms of sialandetis

A

pain in neck on eating and lump in neck

190
Q

differentiating between thryoglossal cyst and thyroid swelling

A

cyst - moves on swallow and tongue out as connected to foramen caecum
swelling - moves on swallow only

191
Q

types of thyroid cancer

A

parathyroid
papillary
medullary - calcitonin
follicular

192
Q

red flags of neck lump

A 
change in voice
swallowing with referred pain
haemoptysis
dyspnoea
weight loss
night sweats
193
Q

symptoms of dermoid cyst

A

teratoma with hair and teeth in <20years usually

194
Q

symptoms of virchows node

A

trosiers sign - enlarged left sided supraclavicular lymph node - appears in gastric cancer

195
Q

symptoms of cynic hygroma

A

congenital, transilluminates, recurrence, fluctuate on L side

196
Q

symptoms of brachial cyst

A

benign unilateral in young adults, contains acellular fluid ad cholesterol crystals

phase 4 (19 decks)

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