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Passmed finals > ENT > Flashcards

ENT Flashcards

1
Q

Dental procedure, now has tender swelling in jaw and displaced tongue that he cannot protrude

A

Ludwig’s angina

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2
Q

What is Ludwig’s angina?

A

Cellulitis of floor of the mouth and soft tissues of the neck
Rare

Sx = neck swelling
Dysphagia
Fever

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3
Q

Why is Ludwig’s angina dangerous?

A

Can quickly cause airway compromise

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4
Q

Sx of simple ear infection (otitis MEDIA)

A

Acute onset
Bulging of tympanic membrane
Erythema
EFFUSION

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5
Q

Signs of otitis externa

A

Acute onset otalgia (ear pain)

Erythema of EXTERNAL canal

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6
Q

Samster’s triad

A

Aspirin sensitivity (allergy)
Nasal polyps
Asthma

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7
Q

Treatment to shrink nasal polyps

A

Steroids

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8
Q

Which scoring system to see if its strep throat?

A

Centor

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9
Q

Symptoms of tonsillitis

A

Tonsilar exudate
Cervical lymphadenopathy
Fever
Tendor cervical lymphadenopathy

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10
Q

Treatment for strep throat (centor >4)

A

Phenoxymethylpenicillin with analgesia

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11
Q

Treatment for sore throat Centor <4

A

Analgesia (paracetamol/ibuprofen)

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12
Q

Solutions for hearing impairment

A 
Cochlear implant (for severe)
Hearing aids
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13
Q

Causes of hearing loss

A 
Genetic (50%)
Idiopathic 
Infectious 
Viral induced 
Ototoxicity (aminoglycosides)
Meniere disease
Trauma
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14
Q

Meniere disease Sx

A

Sudden attacks of vertigo and tinnitus

Pressure felt deep inside the ear

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15
Q

Contraindications of cochlear implant

A

Repeated ear infections

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16
Q

Patient with congested nose (say hayfever), using nasal congestants for too long (>7days), what do they get?

A

Rhinitis medicamentosa!

Need to stop the decongestants (cold turkey)

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17
Q

Age related hearing loss features

A

Bilateral
Usually quite old
Loss of high frequency hearing

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18
Q

Perforated tympanic membrane symptoms

A

Acute onset and pain
Can cause tinnitus
Discharge

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19
Q

Ear wax impactation Sx

A

History of lots of earwax
CONDUCTIVE hearing loss
Tinnitus

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20
Q

Ear wax impactation treatment

A

Olive oil ear drops

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21
Q

Enlarged tonsils covered with a white film that bleeds on contact

A

Acute bacterial tonsillitis

22
Q

Pharyngitis and tonsillitis with splenomegaly and fatigue

A

Infectious mononucleosis

23
Q

Sore throat, severe throbbing pain on one side with swelling

A

Quinsy (pus collection)

24
Q

Painful, tender neck swelling

Foul taste in the mouth

A

Sialadentitis (inflammation of the salivary gland)

Pus is the bad taste

25
Q

3 main salivary glands

A

Parotid
Submandibular
Sublingual

26
Q

What causes gingivitis

A

Poor dental hygeine

27
Q

Symptoms of gingivitis

A

Can be painless, red swelling of the gum margin that bleeds on contact
OR
painful bleeding gums with halitosis and punched out ulcers on gums

28
Q

Complex ulcerative gingitivitis treatment

A

Refer to dentist
Oral metronidazole
Chlorhexidine wash
Simple analgesia

29
Q

Reactivation of herpes infection in the ganglion of facial nerve is called…

A

Ramsey Hunt syndrome

30
Q

Symptoms of Ramsey Hunt syndrome

A

Ear pain
Facial nerve palsy
Vesicular rash around the ear

31
Q

Management of Ramsey Hunt syndrome

A

Oral aciclovir and steroids

32
Q

Drug treatment of Meniere’s disease

A

Betahistine

33
Q

Recurrent, bilateral ear infections and Hx of Down’s syndrome, most likely Dx?

A

Glue ear

34
Q

A 9 year old boy has suffered with intermittent episodes of a painful right ear with suppurative discharge for five years. He currently is suffering from an episode which began two days ago. On otoscopy, there is mucosal oedema and profuse white-coloured debris within the external auditory meatus. Given the most likely diagnosis, what is the most appropriate management?

A

Ear wash out (aural toilet) and topical antibiotics

35
Q

A 52 year old man complains of a swollen right jaw that has progressed over five weeks. He also complains of numbness over the right side of his lips. On examination, there is hard swelling of the parotid gland. There is no apparent tethering to overlying skin. ENT examination is unremarkable. What is the most likely diagnosis?

A

Parotid carcinoma because of nerve involvement

If nerves weren’t involved it would probably be a pleomorphic adenoma

36
Q

Management of quinsy

A

Antibiotics and aspiration if the pt is relatively well and airway is not compromised
Incision and drainage if any signs of airway compromise

37
Q

Management of epiglottitis

A

Contact senior ENT and anaesthetics

Nebulised adrenaline and oxygen put near the patient but not putting the mask on

38
Q

How many episodes of tonsillitis do you need to be considered for a tonsillectomy?

A

5 or more per year for 2 years

39
Q

Treatment of centor 4 tonsillitis

A

1st line: Penicillin V 500mg PO QDS for 5-10 days

Alternative in pen allergy: Clarithromycin/Erythromycin 250-500mg PO BD for 5 days

40
Q

Stepwise management of epistaxis

A

Direct compression (pinch the nose and tip head forward) spit out any blood
Cautery
Nasal packing

41
Q

Rare condition that causes vascular malformations and predisposes to lots of nosebleeds

A

Osler-Weber-Rendu

Hereditary telangiectasia

42
Q

What actually is tympanosclerosis

A

Repeated damage results in scarring of the ear drum
Often seen in repeated ear infections
See calcified eardrum

43
Q

Causes of conductive hearing loss

A 
Wax impaction
Otitis media with effusion (glue ear)
Eustachian tube dysfunction
Ear infections
Perforations of the tympanic membrane
Chronic suppurative otitis media.
44
Q

What type of hypersensitivity is hay fever (allergic rhinitis)

A

Type 1 (IgE)

45
Q

Management of tonsillectomy that you have noticed has continued to bleed post surgery

A

Get them back to theatre

Can lose A LOT of blood

46
Q

Other name for tonsils

A

Adenhoids

47
Q

Features of Beurger’s syndrome

A

Like necrotic Raynaud’s

Inflammation of small vessels

48
Q

Pathophysiology of aortic dissection

A

Tear in the tunica intima

49
Q

Features of aortic dissection

A

Differing radial pressures

Radio-radio and radio-femoral delay

50
Q

Management of aortic dissection

A

Type A: Usually requires surgical management (e.g. aortic graft)
Type B: Normally managed conservatively with blood pressure control (IV labetalol). If there is evidence of end organ damage then endovascular/open repair may be performed.

51
Q

Classification of aortic dissection

A

Stanford A or B

52
Q

Initial management of aortic dissection with high BP

A

IV labetalol to reduce blood pressure

Passmed finals (17 decks)

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