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Trauma > ENT emergencies > Flashcards

ENT emergencies Flashcards

1
Q

Damage to cartilage is an…

A

ENT emergency

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2
Q

What can cause a haematoma?

A

Cartilaginous necrosis

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3
Q

How do you treat a haematoma?

A

Drain
Abx
Bulky dressing

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4
Q

Ear anaesthesis?

A

Block great auricular nerve in post-auricular region

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5
Q

Treatment of chondritis (cellulitis):

A

Difficult to treat due to poor blood supply
Cover S. Aureus and Pseudomonas
Extra care in diabetes

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6
Q

Differential of chondritis?

A

Inflammation from sero-ve arthritis

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7
Q

Features of otitis externa:

A

Ear canal infection and inflammation
Bacteria (pseudomonas and staph) and funghi
Treat with Abx-steroid drops
Use wick for tight canals

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8
Q

ENT diabetic complication:

A

Malignant otitis externa - granulation tissue

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9
Q

Management of FB in ear canal:

A

Kill bugs with mineral oil/lidocaine
Suction/tissue adhesive
Involve ENT specialist

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10
Q

What in the history can indicate tympanic membrane perforation?

A

History of drainage

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11
Q

When does perforation of the tympanic membrane warrant immediate referral?

A

Perforation with vertigo and facial nerve involvement

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12
Q

What causes tympanic membrane perforation?

A

Middle ear pressure

Fluid or barotrauma

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13
Q

Management of tympanic membrane perforation?

A

Oral Abx - drops for purulent but avoid gentamicin

Most heal but all need ENT follow up

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14
Q

Name 3 significant middle ear conditions:

A

Serous otitis media
Otitis media
Mastoiditis

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15
Q

Sign of mastoiditis?

A

Mastoid bulging and tenderness

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16
Q

What is serous otitis media and how do you manage it?

A

Eustachian tube dysfunction

Manage with decongestants and decompression

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17
Q

Sign of otitis media:

A

Fluid behind the tympanic membrane

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18
Q

Risk with mastoiditis:

A

Can lead to brain abscess/meningitis due to the venous connection with the brain

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19
Q

Name 2 types of vestibulopathy (peripheral vertigo):

A

BPPV

Labyrinthitis

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20
Q

Signs of vestibulopathy (peripheral vertigo):

A

Acute onset
No central signs
Young patient
Horizontal nystagmus

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21
Q

Symptoms of Meniere’s disease:

A

Vertigo
Sensorineural hearing loss
Tinnitus

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22
Q

Differential between Meniere’s and peripheral vertigo?

A

Meniere’s causes sensorineural hearing loss and tinnitus

23
Q

How do you treat Meniere’s disease?

A

Antihistamine
Prochlorpenazine
Fluids and rest
Epley manoeuvre

24
Q

What is the arterial supply to the anterior nose?

A

Internal carotid

25
Q

What is the arterial supply to the posterior nose?

A

Distal branches of the external carotid

26
Q

Where does anterior epistaxis originate 90% of the time?

A

Kisselbach’s plexus (Little’s area)

27
Q

What does anterior epistaxis require?

A

Abx prophylaxis, pressure +/- tamponade

28
Q

What may cause CNVII palsy?

A

Lyme disease

HSV

29
Q

Management of CNVII palsy?

A

60-80mg prednisone and antivirals

Surgical decompression if not improving by 2 weeks and electroneurography

30
Q

Treatment for sinusitis:

A

Amoxicillin, doxycycline

Decongestants and analgesia

31
Q

Complications of sinusitis:

A

Ethmoid sinusitis leading to orbital cellulitis and abscess

Frontal sinusitis may erode bone (Pott’s puffy tumour and brain abscess)

32
Q

Features of parotiditis:

A

Usually viral (paramyxovirus)
Bacterial in elderly and immunocompromised
Assoc with dehydration
Cover staph and anaerobes

33
Q

What organisms can cause pharyngitis?

A

Viruses: EBV, adenovirus, rhinovirus
Bacteria: Group A-beta haemolytic strep, mycoplasma, gonorrhoea, diphtheria

34
Q

What is a complication of suppurative tonsilitis?

A

Peritonsillar abscess

35
Q

Signs of peritonsillar abscess:

A

Inferior-medial displacement if tonsils and uvula

36
Q

Symptoms of peritonsillar abscess:

A 
Dysphagia
Ear pain
Muffled voice
Fever
Trismus
37
Q

Treatment of peritonsillar abscess?

A

Abx
I and D
+/- steroids

38
Q

Signs and symptoms of epiglottitis:

A 
Rapid onset, looks toxic
Prefer to sit
Muffled voice
Dysphagia
Drooling
Restlessness
Thumbprint of Vallecula sign
Epiglottis >8mm in adults for acute epiglottitis
39
Q

Treatment of epiglottitis?

A

Prepare for emergent airway
IV cefotaxime +/- steroids
Adrenaline nebulisers

40
Q

What causes breathing problems in retropharyngeal abscess?

A

Swelling in the retropharyngeal anterior to pre-vertebral space

41
Q

Why can retropharyngeal abscess occur in children <4?

A

Lymphoid tissue occupies the space

42
Q

Symptoms of retropharyngeal abscess:

A

Pain
Dysphagia
Dyspnoea
Fever

43
Q

Management of retropharyngeal abscess:

A

Lateral neck X-ray

CT with contrast

44
Q

Complication of retropharyngeal abscess?

A

Mediastinitis

45
Q

What is Ludwig’s angina?

A

Rapidly growing cellulitis on the floor of the mouth causing airway obstruction
History of dental procedures
Caused be strep. viridans and happens in the elderly

46
Q

Treatment of Ludwig’s angina?

A

Intubation/tracheostomy/airway-compromised-ICU admission

Abx

47
Q

What can cause angioedema?

A

Hereditary

ACE inhibitors

48
Q

Management of angioedema:

A

Antihistamines and steroids

Observe every 4-6 hours

49
Q

What does aphonia suggest?

A

Complete upper airway obstruction

50
Q

What does stridor suggest?

A

Incomplete upper airway obstruction

51
Q

What does wheezing suggest?

A

Incomplete lower airway obstruction

52
Q

Management of wheezing?

A

Salbutamol + ipratropium/steroids

53
Q

What does loss of breath sounds indicate?

A

Complete lower airway obstruction e.g. from fluid in the bronchus

Trauma (8 decks)

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