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RW ENT & Ophthalmology > ENT Clinical > Flashcards

ENT Clinical Flashcards

1
Q

What additional checks should be done if a baby has external ear abnormalities?

A

Chromosomal check

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2
Q

What is the most common bacterial cause of sore throat?

A

Streptococcus progenies (Group A haemolytic strep)

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3
Q

Which bacteria causes diphtheria?

A

Corynebacterium diphtheria

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4
Q

Which bacteria causes oral candida?

A

Candida albicans

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5
Q

What conditions does coxsackie virus cause?

A

Hand, foot and mouth, and herpangina

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6
Q

What is Rinne’s test?

A

Strike a tuning fork against an object, then press the vibrating fork on the pt’s mastoid bone. Normally, air conduction is better than bone conduction, however if there is a blockage then this will be reversed

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7
Q

What is Weber’s test?

A

Place the vibrating fork on the patients forehead and ask them where they hear it Normal: they hear it in the middle Abnormal: they hear it more on one side

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8
Q

What test findings will be found with conductive hearing loss?

A
  • Rinne’s: bone conduction > air
  • Weber’s: sound localises to affected ear
  • Tympanometry
    • Flat may indicate OME or fluid in the middle ear
    • High peak may indicate perforation
  • PTA – significant air-bone gap
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9
Q

What test findings can be expected with sensorineural hearing loss?

A
  • Weber test: sound localises to normal ear
  • Rinne test: air and bone conduction equally diminished
  • PTA - No difference between bone and air conduction
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9
Q

What is Carhart’s Notch and what does it indicate?

A

Dip in PTA at 2K Hz, and indicatres ostersclerosis

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10
Q

What are the different criteria for normal hearing and loss in PTA?

A
  • Normal: 0-25db
  • Mild: 25-45db
  • Moderate: 45-65dp
  • Severe: 65-85db
  • Profound: >85db
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11
Q

What is a tympanogram?

A

Put some sound in the ear then monitor the movement of the ear drum

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12
Q

What are the 6 D’s for symptoms of ear disease?

A
  • Deafness
  • Discomfort
  • Dizziness
  • Discharge
  • Din din (tinnitus)
  • Defective movement of face
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13
Q
A
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13
Q

What nerves can be involved in earache?

A
  • CN V
  • CN VII
  • CN IX
  • CN X
  • C2 C3
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14
Q

What causes the pain in acute otitis media?

A

Pus coming from the eustachian tube which applied pressure on tympanic membrane, sometimes causing perforation

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15
Q

What two things can cause a CSF leak from the ear?

A

May occur due to congenital causes (walls of the ear haven’t come together) or a head injury (eg. a fracture)

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16
Q

What are the 2 types of cholesteatoma?

A
  • Aquired
  • Congenital (Derlacki)
    • White mass behind an intact ear drum,
    • is an embryological remnant which should have cleared at 20weeks
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17
Q

What are important differences with peadiatrics to know for airway obstruction?

A
  • Floppy epiglottis
  • Large head
  • Neonates are obligate nasal breathers
    • If you block their nose, they cant breath
  • Relatively large tongue
  • Small, soft larynx in higher position (C1)
  • Weak neck muscles; floppy head
  • Narrow subglottis (3.5 mm at the cricoid
18
Q

What is the differences between stridora and stretor?

A
  • Stridor: High pitched harsh noise due to turbulent airflow resulting from airway obstructions
    • Lower that stretor
    • Can occur on inspiration or expiration.
  • Stretor: Low pitched sonorous sound arising from nasopharyngeal airway (like snoring)
    • Upper respiratory tract
19
Q

What is heliox?

A

Combination of helium and oxygen – which makes the air thinner and therefore easier to breath

20
Q

What is the managment for paedtriatic airway obsrtuction?

A
  • ABC: Resuscitation
  • Oxygen
  • Heliox
  • Steroi
  • Adrenalin
  • Flexible fibre-optic endoscopy
  • Secure airway with ET Tube/Tracheostomy
    • Secure airway before anything else
  • Treat underlying pathology
21
Q

What is the difference between dizziness and vertigo?

A
  • Dizziness: Non-specific term, which may cover vertigo, pre-syncope, disequilibrium, etc.
  • Vertigo: a sensation of movement, usually spinning.
22
Q

What is the main symptom for vestibular pathology?

A

Nystagmus

23
Q

BPPV is the commonest cause of vertigo when looking in which direction?

A

Looking up

24
Q

How can BPPV be distinguished from Vertebrobasilar insufficiency?

A

For a diagnosis of VBI need other symptoms of impaired circulation in posterior brain associated with the vertigo e.g. visual disturbance, Weakness, Numbness

25
Q

What must be ruled out in nasal trauma and why?

A

Septal haematoma.

  • Emergency because cartilage is avascular so takes nutrients from perichondrium
  • If a haemorrhage occurs and the perichondrium strips off, then it may become necrosed and form an abscess
  • This can lead to intra-cranial infection
26
Q

How can temporal bone traum cause hearing loss?

A
  • Conductive
    • Fluid (blood or CSF) in ear canal/middle ear cavity
    • Tympanic membrane rupture
    • Ossicular damage
  • Sensorineural
    • Damage to cochlea
    • Avuslion of CN VIII
27
Q

What causes baggy eyes in age?

A

Weakening connective tissue in the orbital septum in lower lids, resulting in herniation of the fat pad forming bags

28
Q

What does botulinium toxin (botox) do to combat ageing?

A

Paralses the muscles pulling on the skin causing wrinkles, eg. corrugator m. above bridge of nose

29
Q

When should you carry out a primary closure vs a delayed primary closure?

A
  • Primary closure: If it is small, superficial, non-infected or in an area where the scars are in a well hidden place
  • Delayed primary closure: If larger, not clean edges or infected. Also need to ensure blood supply is enough.

If in doubt, leave it open

30
Q

What is the difference between a skin graft and a skin flap?

A

Skin graft has no vascular connection (completely devascularised), free tissue movement, while skin flap has vascular connection

31
Q

Which type of imaging modality is used for which type of hearing loss?

A
  • MRI used in the imaging investigation of sensorineural deafness (?vestibular schwanoma)
  • CT used in the investigation of conductive deafness (?choleasteatoma)
32
Q

What is contained in the masticator space, and what pathologies affect it?

A

Contents:

  • Mandible
  • Muscles of mastication
  • CN V

Pathologies:

  • Dental abscess / cyst
  • Invasion from oral cavity
33
Q

What is contained in the carotid space, and what pathologies affect it?

A

Contents:

  • Carotid artery
  • Jugular vein
  • Cranial & sympathetic n.
  • Lymph nodes

Pathologies:

  • Schwannoma
  • Paraganglioma
  • Lymph nodes
34
Q

What are the 4 core S’ symptoms in nose codnitions?

A
  • Stuff (blockage)
  • Snot (discharge)
  • Sore (facial pain)
  • Smell (loss of)
35
Q

What are the two classifications of allergic rhinitis?

A
  • Persistant (dust mites, animal hair)
  • Seasonal (pollen, fungal spores)
36
Q

What are the three pillars of treatment of allegic disease?

A
  1. Allergen avoidance
  2. Symptomatic therapy
  3. Immunotherapy
37
Q

Samter’s triad

A
  • Nasal polyps
  • Asthma (non-allergic)
  • Aspirin intolerance
38
Q

What are the common causes for unilateral ansal discharge in children and adults?

A
  • Children = foreign body
  • Adults = Nasal or paranasal tumour

Both require urgent referral

39
Q

What is an important complication of infective rhinosinusitis?

A

Orbital cellulitis - ethmoidal sinuses are adjacent to the orbit so may cause eye swelling with pus. Risk of blindness

40
Q

Where are cancers of the tongue most commonly located?

A

Side of the tongue

41
Q

What type of the cancer are the majority of head and neck cancers?

A

Squamous

42
Q

What are the red flag symptoms for head and neck cancer?

A
  • Sore throat
  • Hoarseness
  • Stridor
  • Difficulty swallowing
  • Lump in neck
  • Unilateral ear pain
43
Q
A

RW ENT & Ophthalmology (5 decks)

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