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Y3 revision boards > ENT > Flashcards

ENT Flashcards

1
Q

What are the 3 stages of the vestibular pathway?

A

Vestibulocochlear nerve (CN VIII)
Vestibular nuclei
Cranial nerves III, IV adn VI OR the vestibulospinal tract

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2
Q

Which axis are the otolith organs responsible for?

A

Utricle: horizontal lateral movement
Saccule: verticle lateral movement
Semicircular canals: rotational movement

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3
Q

List the organs that transmit/transduce sound to the brain

A 
External auditory canal
Tympanic membrane
Malleus
Incus
Stapes
Oval window
Perilymph of the cochlea
Endolymph of the cochlea
Hair cells
Vestibulocohlear nerve
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4
Q

What are the intrinsic muscles of the middle ear?

A

Tensor tympani; constricts the malleus to dampen sound
Stapedius; acts to soften vibration
Tensor vali paletini; muscles that function to open the eustachian tube

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5
Q

What is the commonest cause of vertigo?

A

Benign positional paroxysmal vertigo

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6
Q

What is the pathophysiology behind benign positional paroxysmal vertigo?

A

Displacement of the utricle otoconia to the semicircular canals

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7
Q

Which of the 4 common vertigo causing conditions causes vertigo lasting seconds/minutes?

A

Benign positional paroxysmal vertigo

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8
Q

Which of the 4 common vertigo causing conditions causes vertigo lasting hours?

A

Menier’s disease

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9
Q

Which of the 4 common vertigo causing conditions causes vertigo lasting days?

A

Vestibular neuronitis

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10
Q

Which of the 4 common vertigo causing conditions causes vertigo lasting varying amounts between episodes?

A

Vestibular migraine

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11
Q

What is the diagnostic test for benign positional paroxysmal vertigo?

A

Hallpike

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12
Q

What is the management of benign positional paroxysmal vertigo?

A

Epley manoeuvre

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13
Q

What is the pathophysiology of Menier’s disease?

A

Endolymphatic hydrops

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14
Q

How do you diagnose Menier’s disease?

A

History

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15
Q

How do you manage Menier’s disease?

A

Self-resolving

Restrict, alcohol, salt, caffeine and stress can help prevent episodes

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16
Q

What causes vestibular neuronitis?

A

Disruption of afferent neural input from 1 or 2 vestibular apparatus(es)

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17
Q

What is the Ix of vestibular neuronitis?

A

History

?otoscopy

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18
Q

How do you manage vestibular neuronitis?

A

Reassurance; use rule of 3 (3 days in bed, 3 weeks off work and 3 months off balance)

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19
Q

How do you manage vestibular migraine?

A

Triptans and propranolol

Amitriptyline if triptans fail; cyclizine only if nauseaus

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20
Q

Which condition is strongly associated with an acoustic neuroma?

A

Inherited neurofibromatosis type II

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21
Q

What are the 3 symptoms of an acoustic neuroma?

A

Sensorineural hearing loss
Tinnitus
Balance issues

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22
Q

What is the Ix for acoustic neuroma?

A

MRI (it’s a neuronal lesion)

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23
Q

What is the Mx of acoustic neuroma?

A

Surgery

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24
Q

What is presbycusis?

A

Physiological old age hearing loss

Reduction in action of hair cells

25
Q

What type of hearing loss is seen in presbycusis?

A

Sensorineural

26
Q

What is the diagnostic test for presbycusis?

A

Pure tone audiometry

27
Q

What is the definitive and symptomatic management of presbycusis?

A

Definitive: none
Symptomatic: hearing aids for amplification

28
Q

What is a cholesteatoma?

A

A keratin overgrowth of the tympanic membrane

Usually following trauma

29
Q

What are the 3 major symptoms of a cholesteatoma?

A

Conductive hearing loss
Facial palsy
Tinnitus

30
Q

What is the investigation used for cholesteatoma?

A

Otoscopy

CT (if bone involvement is suggested)

31
Q

How do you manage cholesteatoma patients?

A

Surgery (Canal wall up mastoidectomy)

32
Q

What is otosclerosis?

A

Fusion of the stapes footplate at the oval window?

33
Q

What type of hearing loss is seen in otosclerosis?

A

Slow progressive conductive hearing loss

34
Q

How do you investigate otosclerosis?

A

Pure tone audiometry

35
Q

What is the pathognomonic finding on PTA in otosclerosis

A

Carhart’s notch

36
Q

What procedure is done to treat otosclerosis?

A

Stapedectomy

37
Q

How do you diagnose a tympanic membrane perforation?

A

Otoscopy

PTA

38
Q

What is the commonest cause of tympanic membrane perforation?

A

Barotrauma (loud sounds)

39
Q

How do you treat a patient with a ruptured tympanic membrane?

A

Usually self-limiting 6/52

Failing this tympanoplasty

40
Q

What immune process is associated to allergic rhinitis?

A

IgE mediated histamine release from mast cells

41
Q

What is the management of allergic rhinitis?

A

non-sedating antihistamine (Cetirizine) +/- topical steroids)

42
Q

Give symptoms of bacterial tonsilitis not found in its vital variant?

A

Hallitosis
Systemic upset
white spots in the throat
duration over 2/3 days

43
Q

Which class of bacteria are of serious concern in tonsilitis?

A

Streps

44
Q

Give the management of viral and bacterial tonsillitis?

A

Viral: supportive
Bacterial: penicillin or clarithyromycin

45
Q

What are the criteria for tonsilectomy?

A

7 epi in 1 year
5 per year for 2 years
3 per year for 3 years

46
Q

What test is used for glandular fever?

A

Monospot test (EBV test)
Abnormal lymphocyte count on FBC
Low CRP

47
Q

What drug is given for glandular fever?

A

Hydrocortisone or prednisolone

48
Q

Which 2 bugs commonly cause acute otitis media?

A

Staph. aureus

Strep. pneumoniae

49
Q

Which 2 bugs are of concern in acute otitis media?

A

H.influenza

Moraxella

50
Q

Describe in short the classical description of acute otitis media on otoscopy?

A

A red swollen eardrum with loss of normal anatomy

51
Q

What is otitis media with effusion

A

AKA glue ear

A complication/continuation of otitis media in which the middle ear is full of fluid

52
Q

Describe the classical appearance of glue ear?

A

Bubbles on otoscopy

53
Q

How do you manage otitis media with effusion?

A

Watch and wait 6-12 (+ hearing aids)

Grommet insertion failing this

54
Q

What are the common bugs of otitis externa?

A

Staph.aureus

Pseudomonas

55
Q

Which 3 groups of people stereotypically get otitis externa?

A

Skin conditions (Eczema, psoriasis)
T1DM
Immunosupressed

56
Q

What’s the management of low-risk otitis externa?

A

Supportive

57
Q

What makes otitis exerna high risk?

A

T1DM
Immunosuppressed
Pus producing

58
Q

How do you manage high risk otitis externa?

A

Flucloxacillin

Pen allergic: clarythromycin

Y3 revision boards (6 decks)

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