ENT Emergencies Flashcards
Which parts of the body can lose loads of blood?
Pelvic cavity
Abdominal cavity
Long bones e.g. femur
Chest cavity
What % of blood can be lost and you can still be physiologically fine?
0 - 15%
What % of blood can be lost and you become hypotensive, your breathing changes etc?
15 - 30%
Types of stridor
Inspiratory
Expiratory
Biphasic
Features of croup
Stridor - hoarse and biphasic
Characteristic cough - barking
What is a laryngeal papilloma?
Viral tumour growth like a wart
Causes of SIRS
Trauma
Burns
Anaphylaxis
Infection
What is septic shock?
Hypoperfused / hypotensive despite adequate fluid replacement
How does the ear classically point in mastoiditis?
Forward
Down
What % of epistaxis occurs from littles area?
95%
How are you meant to put pressure on the nose to treat epistaxis?
Pinch top part of soft part and lean forwards
Treatment of epistaxis
1st aid Naseptin cream (heels the area) Silver nitrate cautery (superficial burn) Nasal packing Surgery or embolization of arteries
What is usually the causative organism of tonsillitis?
Virus
What causes glandular fever?
EBV
Another name for glandular fever
Infectious mononucleosis
After glandular fever, what is usually not allowed for 6 weeks?
Contact sports
Alcohol
Who gets croup?
6 months - 3 y/o
Treatment for croup
No treatment
Supportive
- humidification
- adrenaline / neb steroids
Causative organisms of croup
RSV
Flu
Paraflu
What do children get now that prevents epiglottitis?
HIB vaccine
Who gets epiglottitis?
Age 1 - 5 y/o
Presentation of epiglottitis
Red + flushed Drooling (cant swallow) Tripoding Dysphagia Sore throat Muffled voice
What is tripoding?
Propping airway forwards
Leaning forwards
Leaning on something
Treatment of epiglottitis
Intubate
IV access
Antibiotics
Steroids
Treatment of airway obstruction
ABCDE Oxygen / heliox Nebulised adrenaline IV dexamethasone IV antibiotics
What do adrenaline neb and IV dex do in the treatment of airway obstruction?
Reduce swelling
What is a tracheostomy?
A stoma / hole in the trachea
Does a tracheostomy change the anatomy?
No
What are the anatomical changes with a laryngectomy?
Taken everything out above
The mouth is not connected to the lungs
Where can infection easily spread from to give periorbital cellulitis?
Sinuses
Complications of periorbital cellulitis
Abscess
Compromised nerves and blood supply
What is tonsillar SSC associated with?
HPV infection
Where is the most common site for SCC in the oropharynx?
Tonsils
Risk factors for tonsillar SCC
Smoking
High levels of alcohol intake
Poor oral hygiene
HPV (HPV-16)
What is the HTLV1 (human T cell lymphotropic virus) associated with?
Adult T cell leukaemia
Complications of thyroid surgery
Recurrent laryngeal nerve damage
Bleeding
Damage to the parathyroid glands resulting in hypocalcaemia
How can bleeding after thyroid surgery lead to respiratory compromise?
Venous return impaired
Resulting in laryngeal oedema and resp compromise
What is otalgia in the absence of ear signs a red flag for?
Head and neck malignancy
Any patient presenting with hoarseness who are being referred down the suspected cancer pathway should have what test and to exclude what?
CXR
Apical lung pathology
What should persistent hoarseness in a smoker indicate?
Lung cancer
Laryngeal cancer
