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Finals > ENT > Flashcards

ENT Flashcards

1
Q

What are the red flags for a local neck lump? (7)

A 
Dysphagia or odynophagia
Persistent sore throat 
Loose or misaligned teeth
Cough
Haemoptysis
Ipsilateral otalgia, nasal obstruction or epistaxis
Sensation of lump in throat
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2
Q

What are the red flags for a haematological malignancy and neck lump? (5 groups)

A

B symptoms: night sweats, fever, weight loss, fatigue
Unexplained bleeding, bruising or petechiae
Unexplained recurrent infections
Alcohol induced pain
Bone pain

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3
Q

What are some causes of neck lumps? (7)

A 
Congenital
Neoplasm - benign e.g. lipoma
Neoplasm - malignant e.g. lymphoma, salivary gland
Vascular - aneurysm, tumour
Infection
Inflammatory e.g. sarcoidosis
Thyroid
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4
Q

Over what age would you be more concerned about a neck lump?

A

40 years

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5
Q

Where do most nose bleeds arise from?

A

Little’s Area

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6
Q

After how long would you consider admitting for a nosebleed?

A

20 mins - admit to ENT ward

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7
Q

What are the initial management options for a nose bleed?

What should you do next if you successfully controlled bleeding?

A

Pressure, ice packs, cautery if can visualise bleeding
If not, can use an anterior pack. If still bleeding, use a posterior pack
Advice - do not blow nose for a week, no hot drinks or baths/showers, no strenuous exercise
Naspetin ointment BD for 2 weeks to keep crust-free

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8
Q

What do you need to consider if using a posterior pack for nosebleeds?

A

If in place for >48h, need antibiotics

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9
Q

What are some causes of nasal blockage? (6)

A

Infection
Allergy +/- polyps
Septal deviation
Drugs - chronic decongestants, cocaine abuse
Neoplasm
Inflammatory - sarcoidosis, vasculitis, Kartagener’s

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10
Q

What are the management options for allergic rhinitis?

A

Nasal douching
Avoid allergen
Steroid sprays
Antihistamines

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11
Q

What is the diagnostic criteria for acute sinusitis?

A

Symptoms present for <12 weeks

Have one of nasal blockage or discharge PLUS either facial pressure/pain or reduction in smell

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12
Q

What is the mangement for acute sinusitis? (4)

What are the certain requirements for the medication used?

A

Analgesia
Nasal saline irrigation
Nasal decongestant (<5 days)
Intranasal steroids (if symptoms lasting >10 days or worsen after 5 days)

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13
Q

What are the complications of acute sinusitis?

  1. Intracranial (3)
  2. Extracranial (3)
A
  1. meningitis, cavernous sinus thrombosis, intracranial abscess
  2. osteomyelitis, orbital cellulitis or abscess
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14
Q

What is the diagnostic criteria for chronic sinusitis? (3 components)

A

Symptoms present for >12 weeks
Must have one of nasal obstruction OR nasal discharge PLUS one of either facial pain/pressure or reduction in smell
PLUS endoscopic polyps, oedema or discharge OR CT shows mucosal changes

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15
Q

What diagnostic tests are there for chronic sinusitis? (2)

A

CT sinuses

Endoscopy

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16
Q

What is the management for chronic sinusitis? (4)

What is the option if medical management fails?

A 
Nasal saline irrigation
Short term nasal decongestants
If no polyps, intranasal steroids
If polyps, oral steroids followed by intranasal steroids
Antibiotics if infection

Surgery - functional endoscopic sinus surgery

17
Q

What is the management for otitis externa? (3)

What is the management for malignant otitis externa? (3)

A

Keep ear dry, Topical antibiotics and steroids for <1 week, Analgesia

MRI skull base, surgical debridgement, IV antibiotics for 6w

18
Q

What is the management for otitis media?
How long dose it take to resolve?
When should you consider antibiotics?
What is the criteria for recurrent otitis media?

A

Analgesia - most resolve within 3-7 days
Consider antibiotics after 4 days or immunocompromised
More than 4 episodes in 6 months

19
Q

What are the causes of otitis media with effusion? (2)
How would you investigate OME? (3)
What is the management of OME in children? (4)

A

Eustachian tube dysfunction, nasopharyngeal tumour

Audiometry, tympanometry, nasoendoscopy (adults)

Watch and wait, hearing aid, grommets, adenoidectomy

20
Q

What is the management of chronic otitis media? (4)

A

Topical antibiotics and steroids if perforation
Aural cleaning (microscope)
Strict water precautions
Myringoplasty if not resolving or socially embarassing

21
Q

What are the complications of otitis?

  1. Internal (4)
  2. External (3)
A
  1. Vertigo, hearing loss, otitis externa, facial weakness

2. Meningitis, abscess, sigmoid sinus thrombosis

22
Q

What is the initial management of cholesteatoma? (3)

What is the definitive management of cholesteatoma?

A

Audiogram, aural cleaning, antibiotics and steroids if infection
Mastoidectomy

Finals (23 decks)

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