Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ENT > ENT P3 > Flashcards

ENT P3 Flashcards

1
Q

Haemorrhage post-operative tonsillectomy:

A
  • all should be assessed by ENT
  • primary or reactionary haemorrhage most commonly in first 6-8 hours after
  • immediate return to theatre
  • secondary between 5-10 days after - associated with wound infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is presbycusis?

A
  • sensorinueral hearing loss
  • elderly
  • high frequency affected bilaterally
  • conversational difficulties
  • progresses slowly
  • sensory hair cells and neurons in cochlea atrophy over time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causes of presbycusis:

A
  • multifactorial
  • arteriosclerosis
  • diabetes
  • accumulated exposure to noise
  • drugs (salicylates, chemotherapy)
  • stress
  • genetic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Presenting features of presbycusis:

A
  • speech becoming difficult to understand
  • need for increased volume on TV or radio
  • difficulty using telephone
  • loss of directionality of sound
  • worsening of symptoms in noisy environments
  • hyperacusis: heightened sensitivity to certain frequencies of sound (less common)
  • tinnitus (uncommon)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Signs and investigations of presbycusis:

A
  • possible Weber’s test bone conduction localisation to one side if sensorineural hearing loss not completely bilateral
  • otoscopy normal
  • tympanometry
  • audiometry
  • blood tests: inflammatory markers and specific antibodies normal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is Ramsay Hunt Syndrome:

A
  • herpes zoster oticus

- caused by reactivation of VZV in geniculate ganglion of seventh cranial nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Features of Ramsay Hunt syndrome:

A
  • auricular pain often first feature
  • facial nerve palsy
  • vesicular rash around ear
  • vertigo and tinnitus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Management Ramsay Hunt syndrome:

A
  • aciclovir

- corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Rinne’s test:

A
  • tuning fork placed over mastoid until sound no longer heard, reposition over external acoustic meatus
  • positive: air conduction normally better than bone conduction
  • negative: if bone conduction louder than air, conductive deafness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Weber’s test:

A
  • tuning fork on middle of forehead
  • unilateral sensorineural deafness: sound localised to unaffected side
  • unilateral conductive: sound localised to affected side
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

3 pairs of salivary glands:

A
  • parotid (serous) - most tumours
  • submandibular (mixed) - most stones
  • sublingual (mucous)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Pleomorphic adenomas:

A
  • benign, mixed parotid tumour, 80%
  • middle age
  • slow growing, painless lump
  • superficial parotidectomy; risk = CN VII damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Warthin’s tumour:

A
  • benign, denolymphomas, 10%
  • males, middle age
  • softer, more mobile and fluctuant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Salivary gland stones:

A
  • recurrent unilateral pain and swelling on eating
  • may become infected - ludwig’s angina
  • 80% submandibular
  • plain x-rays, sialography
  • surgical removal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Other causes of salivary gland enlargement:

A
  • acute viral infection
  • acute bacterial infection
  • sicca sindrome and Sjogren’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What causes sore throat:

A
  • pharyngitis
  • tonsillitis
  • laryngitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Management sore throat:

A
  • paracetamol or ibuprofen

- antibiotics not routinely indicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Antibiotic indications for sore throat:

A
  • marked systemic upset secondary to acute sore throat
  • unilateral peritonsillitis
  • history of rheumatic fever
  • increased risk form acute infection
  • acute sore throat/acute pharyngitis/acute tonsillitis when 3 or more centor criteria present
  • phenoxymethylpenicillin or erythromycin (if patient penicillin allergic)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How much saliva do submandibular glands secrete per day?

A

800-1000ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Nervous supply to submandibular glands:

A
  • parasympathetic: chordates tympanic nerves and submandibular ganglion
  • sensory: lingual branch of mandibular nerve
21
Q

What is sialolithiasis:

A
  • 80% salivary gland calculi in submandibular gland
  • 70% radio opaque
  • calcium phosphate or calcium carbonate
  • colicky pain and post prandial swelling of gland
  • sialography to show obstruction and associated other stones
  • stones impacted in distal aspect of wharton’s duct removed orally, others require gland excision
22
Q

What is sialadenitis:

A
  • staph aureus infection
  • pus leaking from duct, erythema
  • sub mandibular abscess serious complication - can spread to deep fascial spaces and occlude airway
23
Q

Sudden onset sensorineural hearing los:

A
  • urgent referral to ENT
  • majority idiopathic
  • mRI scan to exclude vestibular schwannoma
  • high does oral corticosteroids for all cases
24
Q

How do thyroglossal cysts develop?

A
  • develops from floor of pharynx and descends into neck during development
  • connected to tongue by thryoglossal duct
  • forman cecum point of attachment to tongue
  • duct normally atrophies but can persist and give rise to cyst
25
Q

Presentation of thyroglossal cyst:

A
  • <20yo
  • midline between isthmus of thyroid and hyoid bone
  • moves upwards with protrusion of tongue
  • painful if infected
26
Q

What nerve can be damaged in thyroid surgery?

A

recurrent laryngeal nerve

27
Q

Causes of tinnitus:

A
  • Meniere’s disease
  • otosclerosis
  • sudden onset sensorineural hearing los
  • hearing los
  • drugs
  • impacted ear wax
28
Q

What is Meniere’s disease associated with?

A
  • hearing loss
  • vertigo
  • tinnitus
  • sensation of fullness or pressure in one or both ears
29
Q

What is otosclerosis?

A
  • 20-40 years
  • conductive deafness
  • tinnitus
  • normal tympanic membrane
  • 10% flamingo tinge caused by hyperaemia
  • family history
30
Q

What is SSNHL associated with?

A

neurofibromatosis type 2

31
Q

Drugs causing tinnitus:

A
  • aspirin/NSAIDs
  • aminoglycosides
  • loop diuretics
  • quinine
32
Q

Assessment of tinnitus:

A
  • audiological assessment
  • imaging: non pulsatile does not require unless unilateral or other neurological or ontological signs, MRI of internal auditory meatuses first line
  • pulsatile tinnitus requires imaging as may be underlying vascular cause - MRA often used
33
Q

Management of tinnitus:

A
  • investigate and treat underlying cause
  • amplification devices if associated hearing loss
  • psychological therapy e.g. CBT
34
Q

Complications of tonsillitis:

A
  • otitis media
  • quinsy - peritonsillar abscess
  • rheumatic fever and GN rarely
35
Q

Indications for tonsillectomy:

A
  • sore throats due to tonsillitis (not recurrent upper respiratory tract infections)
  • 5 or more episodes of sore throat per year
  • symptoms occurring for at least a year
  • episodes of sore throat are disabling and prevent normal functioning
  • recurrent febrile convulsions secondary to tonsillitis
  • OSA, stridor or dysphagia secondary to enlarged tonsils
  • peritonsillar abscess if unresponsive to standard treatment
36
Q

Causes of vertigo:

A
  • viral labyrinthitis
  • vestibular neuronitis
  • benign paroxysmal positional vertigo
  • Meniere’s disease
  • vertebrobasilar ischaemia
  • acoustic neuroma
  • posterior circulation
  • trauma
  • multiple sclerosis
  • ototoxicity e.g. gentamicin
37
Q

Symptoms of viral labyrinthitis:

A
  • recent viral infection
  • sudden onset
  • nausea and vomiting
  • hearing may be affected
38
Q

Symptoms of vestibular neuritis:

A
  • recent viral infection
  • recurrent vertigo attacks lasting hours or days
  • no hearing loss
39
Q

Symptoms of benign paroxysmal positional vertigo:

A
  • gradual onset
  • triggered by change in head position
  • each episode lasts 10-20 years
40
Q

Symptoms of vertebrobasilar ischaemia:

A
  • elderly

- dizziness on extension of neck

41
Q

How does vestibular neuronitis come about?

A

often following viral infection

42
Q

Features of vestibular neuronitis:

A
  • recurrent vertigo attacks lasting hours or days
  • nausea and vomiting
  • horizontal nystagmus
  • no hearing loss or tinnitus
43
Q

Differential diagnosis of vestibular neuronitis:

A
  • viral labyrinthitis

- posterior circulation stroke

44
Q

Management of vestibular neuronitis:

A
  • vestibular rehabilitation exercises preferred treatment
  • buccal or IM prochlorperazine for rapid relief
  • short oral course of prochlorperazine or antihistamine (cinnarizine, cyclising or promethazine) for severe cases
45
Q

What is labyrinthitis?

A
  • inflammatory disorder of membranous labyrinth
  • affects both vestibular and cochlear end organs
  • can be viral, bacterial or associated with systemic diseases
  • viral most common
46
Q

Difference between viral labyrinthitis and vestibular neuritis:

A
  • vestibular neuritis where only vestibular nerve involved so no hearing impairment
  • labyrinthitis when nerve and labyrinth involved so vertigo and hearing impairment
47
Q

Presentation of viral labyrinthitis:

A
  • vertigo - not triggered by movement
  • nausea and vomiting
  • hearing loss: unilateral or bilateral
  • tinnitus
  • preceding or concurrent symptoms or URTI
48
Q

Signs of labyrinthitis:

A
  • spontaneous unidirectional horizontal nystagmus towards unaffected side
  • sensorineural hearing loss
  • abnormal head impulse test: signifies impaired vestibulo-ocular reflex
  • abnormal head impulse test: impaired vestibulo-ocular reflex
  • gait disturbance: may fall towards affected side
49
Q

Management of viral labyrinthitis:

A
  • usually self limiting

- prochlorperazine or antihistamines to reduce sensation of dizziness

ENT (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions