ENT Flashcards
Difference between intermittent and persistent rhinitis?
Intermittent - symptoms <4 days per week or symptoms for less than 4 weeks
Persistent - symptoms >4 days per week or symptoms for more than 4 weeks
What is the most common bacterial cause of sore throat?
Group A Beta Heamolytic Streptococcus (GABHS) - e.g. Streptococcus pyogenes
Treatment of GABHS sore throat
Penicillin
Which organism causes a grey-white membrane across the pharynx?
Corynbacterium diphtheriae –> Diphtheria
Treatment of oral candiadiasis
Nystatin
Management of Acute Otitis Media
Amoxicillin (or Clarithromycin)
Amoxicillin medication for treating otitis media at 500mg TDS for 7 days.
Co-amoxiclav is used as a second line agent if amoxicillin doesn’t work
Common cause of Acute Otitis Media
Strep pneumo
Management of acute sinusitis
Penicillin V
Doxycycline
Main risk factor for malignant otitis externa
Diabetes
EBV testing
Paul-Bunnell test or Monospot
Cause of Hand, Foot and Mouth Disease
Coxsackie virus
Centor Criteria
Tender anterior cervical lymphadenopathy
No cough
Tonsilar exudate
Fever >38
Which condition is associated with trismus (lockjaw)?
Quinsy
Dizziness for months associated with tinnitus and viral illness
Labyrinthitis
Dizziness for hours associated with tinnitus, hearing loss and fullness in ear
Meniere’s disease
Investigate BPPV
Hallpike’s test (if nystagmus observed go on to perform Epley Manouvre)
Nasal polyps in the young consider …
Cystic Fibrosis
Associated factors of nasopharyngeal cancers
EBV and volatile nitrosamines in food
Most common salivary gland tumour
pleomorphic adenoma
Second most common salivary gland tumour
Warthin’s
Warthin’s Tumour features
Benign usually parotid gland tumour
Males >50
Associated with smoking
Bilateral and multi-centric
Most common malignant salivary gland tumour
Worldwide -> Mucoepidermoid Carcinoma
UK -> Adenoid Cystic Carcinoma
Throat tumour in <5 year olds associated with HPV
Squamous papilloma
Which individuals are at an increased risk of getting cholesteatoma?
Children born with cleft lip (100x)
Choleasteatoma features
Main features
foul-smelling, non-resolving discharge
hearing loss
Other features are determined by local invasion:
vertigo
facial nerve palsy
cerebellopontine angle syndrome
Bilateral vestibular schwannomas
NF type 2
Features and Management of otosclerosis
Family history of condition Conductive Hearing Loss Tinnitus Audiometry -> Carhart's Notch at 2kHz Treatment -> Oval Window Fixation
Which type of hearing loss is associated with low frequency hearing loss?
CHL
Which type of hearing loss is associated with high frequency hearing loss?
SNHL
Features of hypocalcaemia
Features tetany: muscle twitching, cramping and spasm perioral paraesthesia if chronic: depression, cataracts ECG: prolonged QT interval
What can be seen in a branchial cyst biopsy?
cholesterol crystals
Treatment of Ramsay Hunt syndrome
oral aciclovir and corticosteroids
‘flamingo tinge’ tympanic membrane
otosclerosis
Onset of otosclerosis, inheritance
20-40yo - autosomal dominant
Otitis externa in diabetics . Treatment
Ciprofloxacin for pseudomonas cover
Otitis externa. Treatment
Fluclox
Adults with otitis media with effusion consider …
rhinosinusitis
nasopharyngeal carcinoma
nasopharyngeal lymphoma
Conductive Hearing Loss + Flat Tympanogram
OME
Conductive hearing loss which worsens dramatically during pregnancy or HRT
Otosclerosis
Trauma and “battlesign” bruising behind ear
Temporal bone fracture
What are the 5 cardinal ear symptoms?
Hearing loss, Otalgia, Discharge, Tinnitus, Vertigo
TMJ Cardinal Symtoms
Pain
Trismus
Crepitus
Muscle tenderness
ENT Red Flags
Hoarseness Lumps Dysphagia Weight loss Stridor Fatigue Haemoptysis Unilateral nasal polyps Persistent Otalgia Persistent Sore Throat Unilateral Tinnitus
If first aid fails to control epistaxis, what are the next options? (in treatment ladder order)
Silver nitrate Cautery Nasal packing Ligation of the sphenopalatine artery Ligation of the external carotid Embolisation
Ligation of the sphenopalatine artery - risks (3)
The patient should be warned about the risks of continued bleeding, visual disturbance and CSF leak.
Which area of the nose is the principal region supplied by the sphenopalatine artery, and therefore the area best treated by its ligation?
Lateral wall of nose
How long do symptoms have to persist to be diagnosed with chronic otitis media with effusion?
3 months
Retracted and dull tympanic membrane
Otitis media with effusion (glue ear)
Audiogram of Meniere’s disease
Low frequency SN loss
