ENT medicine incorrects Flashcards
Patient comes in with rhinitis, no eye symptoms, ear symptoms, itching, wheezing of skin rash. Antihistamines have not helped. Next step in management?
Intranasal glucocorticoids!! - first line for non allergic rhinitis in this case AND Allergic rhinitis.
Note NAR can have behavioural triggers eg walking into cold air, eating
Skin allergy test etc not used in NAR
Ear pain. Granulation tissue in right ear canal with white drainage. Normal tympanic membrane. Facial palsy and drooling. Most likely causative organism? And diagnosis?
Pseudomonas aueriginosa
Patient hasnecrotising/ malignant otitis externa - complication of acute otitis externa - osteomyelitis of the skull base. Old age and diabetes are risk factors. Treat with IV ciprofloxacin
Contrast to varicella zoster/Ramsay hunt = vesicles in ear not granulation tissue
Ménière’s disease pathology?
Elevated endolymphatic pressure causing damage
What is labyrinthitis? Symptoms
Contrast to menieres
Inflammation of labyrinth and vestibule nerve
Acute onset hearing loss and vertigo. Nausea may occur
Usually occurs in a single episode vs recurring in Ménière’s disease!!!
And usually has a viral trigger
if it is vertigo alone = vestibular neuritis
vertigo + hearing loss = labyrinthitis
white mucosal lesion that cannot be wiped off is what?
,management?
oral leukoplakia
stop smoking and alcohol & biopsy as potentially premalignant
persistent nasal congestion and dripping in back of throat. food tasted bland recently. severe wheezing after using naproxen in the past.
why does the patient have nasal polyposis?
patients condition is aspirin-exacerbated respiratory disease
= triad of chronic rhinosinusitis with nasal polyps (polyps=congestion and anosmia), bronchospasm or nasal congestion following aspirin or NSAIDs use, asthma in adulthood
what is TMJ disorder?
referred pain to ear worse with chewing
history of nocturnal teeth grinding
patient with multiple hospitalisations for acute heart failure. now experiencing bilateral sensorineural hearing loss. most likely drug causing this?
name other ototoxic drugs
(IV) furosemide!!! -> ototoxic!!
other ototoxic drugs : aminoglycoside antibiotics, cisplatin/chemo, high dose salycilates/aspirin
A 18 year old woman has 6 hours of severe dizziness and nausea. She says
that the room is constantly spinning round and she has vomited several times.
The dizziness is worse when she opens her eyes. She reports that her
hearing has not changed.
She has nystagmus with the fast phase to the left, which does not fatigue
most likely diagnosis?
vestibular neuronitis!! as it is a 1 off episode
need recurrent episodes to diagnose BPPV
