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Final year Medicine > ENT > Flashcards

ENT Flashcards

1
Q

Discharge first
pain
eac swelling-> close.

A

Otitis externa

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2
Q

mx otitis externa

A 
analgesia, warm flannel
topical acetic acid
antibiotic drops 
Ciprofloxacin drops -> Pseudomonas. , debridement w microsuction. 
(neomycin), steroids

popewick dressing.

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3
Q

complications otitis externa

A

elderly/diabetic -> skull base osteomyelitis, facial cellulitis

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4
Q

acute otitis media

A

red ejected bulging (w fluid) eardrum,
Pain then Mucinous discharge
palpate neck

Beware: diabetic, I.C, teenage, headache.

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5
Q

complications otitis media

A

perforation - burst then heal. can become chronic if underlying eustatchian tube issue.
Effusion - glue ear
Mastoiditis - need admission -> CT (can form fistula, citelles abscess (anterior neck), Beszolds abscess (sternocleinomastoid) brain abscess, lateral sinus thrombosis.

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6
Q

Mx otitis media

A

Analgesia antipyrexials 24-48h.
no d/c -> oral amoxicillin
d/c-> oral + topical
systemic - coamoxiclav.

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7
Q

Loss of light reflex
conductive hearing loss
Pronunciation/language issues.

A

otitis media w effusion (glue ear)

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8
Q

Mx Effusion

A
  1. Watch and wait, 12 wks arrange hearing test. (most resolve by themselves)
  2. Steroid drops into nose.
  3. Otovents balloon.
  4. Grommets.
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9
Q

causes + Mx of perforation

A

infection
barotrauma
Chronic -> tympanosclerosis
Mx-Myringoplasty

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10
Q

Cheesy gunky appearance above eardrum - dizziness

A

cholesteatoma
mx: surgical
can erode important structures, chronic infections, facial nerve palsy

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11
Q

unilateral sensoneurinal hearing loss

A

vestibular schwannoma
Mx: MRI
neurosurgery

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12
Q

Non allergic vs allergic rhinitis

A

allergic - mucosa swollen blue and pale
itchy, runny nose, seasonal, variable severity. allergic salute/crease.

Non allergic: constant, unvarying, black, thick mucus, pink appearance of nose.

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13
Q

Classification of Allergic rhinitis

A 
Intermittent:
<4 days per week
<4 weeks
Persistent:
>/=4days per week
>4weeks.

Mild: normal sleep
no impairment daily activities.
Mod severe: abnormal sleep, impairment school, work, sport, leisure.

dx: examination
skin prick testing
serum igE

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14
Q

Mx AR

A

Mild, intermittent
Saline nasal douche, non sedating antihistamine (cetirizine/loratidine), allergen and irritant avoidance

Mod severe/intermittent
+IN steroid +/- LTRA

Mild persistent
+topical cromone/antihistamine

Mod severe persistent
+Immunotherapy

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15
Q 
Blocked nose
Facial pressure
hyposmia
swollen red mucosa
runny mucus for 12 weeks
endoscopy polyps
A

Rhinosinusitis

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16
Q

Ix rhinosinusitis

A

Anterior rhinoscopy

CT -increased density in sinuses.

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17
Q

Mx rhinosinusitis

A
  1. Saline douches, long term steroid drops

2. Surgery for polyps

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18
Q

Painful forehead/headache
maxillary pressure
purulent discharge
follow viral URTI

A

analgesia
saline douche/steroid spray
abx - PenV 500QDS
coamoxiclav if systemically unwell.

19
Q

why are Nasal decongestants bad

A

cause rhinitis medica mentosa - blocked nasal cavity

- requires steroids/surgery.

20
Q

RFs tonsil/oropharynx cancer

A

Smoking
HPV

Mx:

21
Q

south east asian , nasopharynx lump

A

cancer - > refer urgent endoscopy.

HN cancer MDT - radiotherapy

22
Q

voive change >3w
smoker
Alcohol

A 
SCC larynx cancer
Ix: Flexible naso-laryngoscopy. 
-most often glottic region
best prognosis - hoarsenss early. 
Tx: surgery, radiotherapy, or combo, MDT
23
Q

bunch of grapes/soap bubble

A

papillomatosis

-HPV

24
Q

25yo lump moves on swallowing /tongue protrusion

A

Thyroiglossal cyst

  • dx USS
  • mx: sistrunks procedure
25
Q

22yo smooth fluctuant swelling, 1/3 down anterior SCM

A

USS
Cholesterol crystals
Branchial cyst
surgery

26
Q

REd swollen ear , has otitis externa, piercing,

A

Perichondritis
can -> temporal osteomyeleitis
COamoxiclav
if severe -> IV

27
Q

foreign body

A

can leave in for days
if u can see it remove , if pt compliant
button battery emergency

28
Q

facial palsy .

A

Ix: otoscopy ,TM + -vesicles EAC - Ramsay hunt

Palpate parotid and neck
Movement of facial muscles.

Steroids + vaciclovir
eye drops/patch
ENT emergency clinic

29
Q

facial nerve path

A

skull base -> middle ear cavity, temporal bone -> stylomastoid foramen -> parotid gland

30
Q 
sarcoid
parotid enlargment
anterior uveitis
facial nerve palsy
low grade fever
A

Heerfordt syndrome

31
Q

RFs Bells palsy

A

Diabetes
URTI
Pregnancy

32
Q

mass in parotid

facial nerve paralysis

A

Mucoepidermoid tumour

33
Q 
Painless 
well circumscribed swelling
tail of parotid
bilateral 10%
male smoker 65
A

Warthins tumour

34
Q

Parotid tumours

A

80% benign
80% of benigns are pleomorphic adenomas

young children - Haemangioma

most common malignancy - mucoepidermoid carcinmoa - > lymph spread. PAIN, rapid growth, facial nerve palsy.

35
Q

Facial nerve

A

motor to stapedius - hyperacusis

superficial petrosal branch -> lacrimation. Geniculate ganglion lesion - shirmers test.

36
Q

recurrent ulcers, white + erythematous halo

ex smoker

A

apthous ulcers

failure of ulcers to respond spontanouesly -> biopsy (exclude SCC)

cmv, HSV, EBV, HIV

37
Q

Apthous ulcers mx

A

Paracetamol
NSAIDS
topical anaesthetics

38
Q

persistent Indurated ulcer, lateral tongue, smoking hx,

exophytic, submucosal mass.

A

squamous cell carcinoma.
examine lNs
Refer - max fax/onc , 2 w wait. -> biopsy

39
Q

Recurrent laryngeal nerve pasly causes

A 
Thyroid surgery
Aortic aneurysm repair
oesophageal cancer
bronchial carcinoma
Polio
40
Q

trismus , unilateral swelling, sore throat, pyrexia, sepsis

A 
quinsy
group A strep
Mx: IV benzylpenicllin 
\+/- metronidazole. 
Incision and drainage with mosquito artery forceps/needle aspiration

2 seprate episodes -> elective tonsilectomy

41
Q

infectious mononucleosis mx

A 
IV fluids
Get LFTs
Analgesia
?steroids
Avoid contact sport 6 weks (hepatitis/splenomegaly -> bleed)
42
Q

Infectious mononucleosis ix

A

Latex agglutination with paul bunnel antigen -> detect heterphile antibody.

Monospot - most sensitive at 6weeks. better than paul bunnel.

43
Q

Posterior epistaxis artery

A 
Sphenopalatine artery (branch of internal maxilalry). 
Ligate with trans nasal endoscopic approach if nasal packing unsuccessful.
44
Q

Epistaxis

A

Anterior: visible source. kisselbachs plexus.

Posterior: profuse. sphenopalatine.

Mx: 
Sit forward.
Pinch soft 20mins 
Cautery. (visible)
Packing (non visble)
Rapid rhino. 
Catheter.

Final year Medicine (18 decks)

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