ENT Flashcards
What are some of the causes of acquired hearing loss?
Age-related (presbyacusis)
Noise-induced
Otosclerosis
Meniere’s disease
Acoustic (vestibular) neuroma
How does presbyacusis typically present?
Most common acquired form of hearing loss
Patients are typically over the age of 65
Usually bilateral
May or may not present with tinnitus
Briefly describe the genetics of otosclerosis.
Who is more commonly affected?
What is the name of the sign that you might see on audiogram?
Autosomal dominant inheritence with variable penetrance
Women more commonly affected, can become worse during pregnancy/child birth
Presents with a conductive hearing loss in adulthood and on audiogram a classic dip may be seen around 2 kHz, known as Carhart’s notch
What is the classic triad associated with Meniere’s disease?
Deafness
Vertigo
Tinnitus with a sensation of aural fullness
How might Meniere’s disease present acutely?
Attacks leave patients feeling very unwell, and may result in nausea and vomiting
Chronically, multiple attacks leave patient’s hearing worse and worse. Sensorineural form of hearing loss
How is Meniere’s disease treated?
Typically managed conservatively - avoiding caffeine, salt and other associated triggers
Medical management includes grommet insertion (works, but unclear as to why) and prescribing gentamicin (ototoxic, but prevents future attacks)
What’s the diagnosis?
Duration - minutes
Hearing loss/tinnitus - no
Aural fullness - no
Positional trigger - yes
BPPV
What’s the diagnosis?
Duration - hours
Hearing loss/tinnitus - yes
Aural fullness - yes
Positional trigger - no
Meniere’s
What’s the diagnosis? Vertigo…
Duration - days-weeks
Hearing loss/tinnitus - yes
Aural fullness - no
Positional trigger - no
Preceeding upper respiratory tract infection
Labyrinthitis
What’s the diagnosis? Vertigo…
Duration - days-weeks
Hearing loss/tinnitus - no
Aural fullness - no
Positional trigger - no
Vestibular neuronitis
What’s the diagnosis?
Child presents with very sore ears that they keep rubbing. Had recently had an URTI and is febrile and crying in pain.
On otoscopy, tympanic membranes appear very red and inflamed and slightly bulging
How is this condition best treated?
Condition - acute otitis media
Treatment - analgesia (paracetamol) and antibiotics (amoxicillin)
What are some of the potential complications of acute OM?
Glue ear
Mastoiditis
Tympanic membrane perforation
What virus causes infectious mononucleosis (glandular fever/mumps)?
What tests do you perform and how is it treated?
Epstein Barr virus
Tested for by the monospot test, and also do WCC and LFTs
Treatment is supportive. Avoid treating with ABx (especially ampicillin) as this may cause a rash
Also caution against contact sports for 6 weeks due to risk of splenic rupture
What’s the diagnosis and how should it be dealt with?
Acutely unwell febrile child presents with stridor and excessive drooling
Epiglottitis (due to infection with HiB)
True airway emergency - contact anaesthetics and ENT straight away
DO NOT upset or try to examine airway as this may precipitate an acute airway obstruction
Treated with securing an artificial airway and giving IV antibiotics, usually 3rd gen cephalosporins
What L is a common cause of stridor in children and known as a ‘floppy airway’?
When does it usually present?
Laryngomalacia
Usually presents in the first two weeks of life, mother may report difficulty feeding child and/or failure to thrive
