ENT Cases Flashcards
A 56-year-old male was admitted with an acute headache and sudden ptosis on the right side. No ophthalmological or neurological etiologies were apparent
Ethmoidal mucocele d/t benign lesion caused by the retention of mucous secretions. Expansion to nearby structures produce common symptoms of =
- exophthalmos,
- limited eye movement,
- and headache
*MRI, CT = right posterior ethmoid sinus lesion
> Endoscopic sinus surgery was performed under general anesthesia
“I woke up this morning and got a huge shock when I looked in my bathroom mirror, one half of my face was drooping! I immediately panicked and called an ambulance!”
https://geekymedics.com/a-lady-with-a-drooping-face/#:~:text=Bell’s%20palsy%20involves%20a%20lower,ipsilateral%20side%20of%20the%20face.
Which causative agent is most associated with acute rhinosinusitis?
S. pneumoniae
Which of the following is a commonly used scoring system for the assessment of a child with a sore throat in primary care?
CENTOR
What is the mainstay of treatment of treatment for nasal polyps?
> Nasal Steroids
> then Sx
Rhinitis severity is classified according to ARIA (Allergic Rhinitis and its Impact on Asthma). Which of the following is required to be classed as persistent symptoms?
> 4 days/week and >4 consecutive weeks
A thyroglossal duct cyst is a congenital defect which develop due to failure of the obliteration of the thyroglossal duct during development. Which of the following is the most characteristic feature of a thyroglossal cyst?
Moves up with protrusion of the tongue
Nasal polyps are very commonly associated with other conditions. Which of the following is NOT associated with nasal polyps?
Rheumatoid arth.
associated with:
asthma; churg-strauss syndrome; CF; allergic rhinitis
What is the commonest cause of epistaxis in paediatrics?
Trauma
What method of hearing assessment would be recommended for a 6 month old child?
Distraction test
Thyroglossal Cyst
A thyroglossal cyst is a congenital fluid filled sac, commonly presenting in younger patients (typically <20yrs) and have equal incidence between men and women.
- painless midline mass
- moves with protrusion of the tongue
> sx intervention
Considering cavernous sinus thrombosis, which cranial nerves are likely to be affected and what to test for CN examination?
- infective nature, URI spread to cavernous sinus
- cavernous sinus = CNIII, CNIV, CNV1, CNV2, and CNVI
- therefore test
CNIII, IV, VI = H test and nystagmus, diplopia, palsies, strabismus
CNV = sens funct, and motor = masseter muscles & opening mouth against resistance (pterygoid funct.)
Marjory Dawes is a 38 year old teacher with a 5 day history of blocked nose, pain across her cheeks and between her eyes. It is a very busy time at school and she hopes that you can give her some antibiotics.
tried nasal spray no avail, paracetamol
reduced unilat airflow, unilateeral yellow +blood discharge, pyrexic, tender maxillary and frontal sinus
Rhinosinusitis
?red flag/systemics = epistaxis, sore throat, gum/tooth/jaw pain, anosmia, headache, photophobia, vis disturbance
= ACUTE BACTERIAL RHINOSINUSITIS
+CRP
> ORAL ABX if systemically unwell
nasal saline spray to alleviate symptoms
Red flags for presenting nasal blockage and discharge
High fever Visual symptoms Orbital swelling/bruising Altered consciousness Unilateral bloody discharge
M, 40, presents with Left side of neck LUMP, fixed hard swelling @ level 2 (left)
+ base of tongue tenderness (L)
+ normal ear
1w hx, sore tongue prior, nnil other swellings, SORE L. EAR, 24 yr smoking, hx of alcohol xs
back of throat discomfort caan feel in leeft ear when swallowing
nil systemic
?next steps
URGENT REFERRAL THROUGH SUSPECTED CANCER ROUTE
