ENT Flashcards
Classical History of vestibular schwannoma (4 things)
Vertigo, sensory hearing loss, tinnitus, absent corneal reflex
Causes of Sensorineural Hearing loss (5)
Drug toxicity Meniere's disease Noise damage Presbycusis Vestibular Schwannoma
Causes of Conductive Hearing Loss (5)
Excessive ear wax Otitis externa otitis media otitis media with effusion otosclerosis
Causes of midline neck lumps (2)
thyroid goitre
pharyngeal pouch
causes of lateral neck lumps (6)
reactive lymphadenopathy lymphoma cystic hygroma branchial cyst cervical rib carotid aneurysm
Ix and referral for suspected laryngeal cancer?
Chest X-ray to rule out apical lung tumour
urgent ENT referral
ABX for malignant otitis externa
Ciprofloxacin
Features of malignant otitis externa? (4)
Diabetes (90%) or immunosuppression (illness or treatment-related)
Severe, unrelenting, deep-seated otalgia
Temporal headaches
Purulent otorrhea
Causes of gingival hyperplasia (4)
Drug causes of gingival hyperplasia
phenytoin
ciclosporin
nifedipine
Other causes of gingival hyperplasia include
acute myeloid leukaemia
What is Cholestoma? Who gets it?
A non-cancerous growth of squamous epithelium that is ‘trapped’ within the skull base causing local destruction.
Aged 10-20 years
Cleft palate increases the risk 100 fold.
Features of Cholestoma (4)
foul-smelling, non-resolving discharge
hearing loss
Symptoms due to local invasion - vertigo, facial nerve palsy, cerebellopontine angle syndrome
On Otoscopy - ‘attic crust’ - seen in the uppermost part of the ear drum
Management of Cholestoma
patients are referred to ENT for consideration of surgical removal
Why aren’t topical decongestants used for prolonged periods in allergic rhinitis?
higher doses are required for same effect - tachyphlaxis
otitis media - when to start abx and which is first line?
Amoxicillin
- 5 days or not improving
- Systemically unwell but not requiring admission
- Immunocompromise or significant comorbidity
- Younger than 2 years with bilateral otitis media
- Otitis media with perforation and/or discharge in the canal
Management of Menier’s Disease
ENT assessment to confirm the diagnosis
patients should inform the DVLA
acute attacks: buccal or intramuscular prochlorperazine.
prevention: betahistine and vestibular rehabilitation exercises may be of benefit
