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AMK > ENT Pathology > Flashcards

ENT Pathology Flashcards

1
Q

road traffic accident - Blood stained serous discharge, and blood behind the tympanic membrane
“halo sign”
what is it?

A

Basal skull fracture - CSF leaks into the auditory canal causes bruising of the mastoid

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2
Q

Mid line limp in the neck, voice hoarseness and difficulty swallowing
ascends on swallowing BUT NOT on protusion of the tongue
what is it?

A

Thyroid lump

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3
Q

A lump in the neck that ascends on swallowing AND protusion of the tongue

A

Thyroglossal lump

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4
Q

what are the clinical features of a head and neck cancer

A
  1. hoarseness
  2. throat pain
  3. tongue ulcers
  4. painless neck pain
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5
Q

prebycusis

A

age related hearing loss

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6
Q

what treatment is given for noise related hearing loss

A

hearing aids are given first
then cochlear implants

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7
Q

sensorineural deafness and tinnitus that is worse when falling asleep
what treatment is given?

A

hearing aids

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8
Q

what is sound therapy

A

treatment for tinnitus

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9
Q

what is sialdeninis

A

inflammation of the salivary glands

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10
Q

sore throat and difficulty swallowing, bulge of one tonsil and deviation of uvula
what is it? and management

A

Quinsy
antibiotics and aspiration

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11
Q

what may be a cause of regular of epistaxis

A

liver disease

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12
Q

dizziness and left sided hearing loss, vertigo, nausea, tinnitus and hearing loss and PROGRESSIVE
what is it?

A

acoustic neuroma/vestibular schwannoma

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13
Q

dizziness and left sided hearing loss, vertigo, nausea, tinnitus and hearing loss
INTERMETTIENT
what is it

A

Meniere’s disease

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14
Q

thyroid surgery complications

A
  1. hypocalcaemia
  2. hypothyroidism
  3. recurrent laryngeal nerve damage - causes voice hoarseness
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15
Q

swelling in right parotid gland and facial nerve palsy

A

right sided facial nerve palsy

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16
Q

discharge and hearing loss after having chronic Otitis media
what is it?

A

cholesteatoma - complication of otitis media
due to accumulation of skin in the mastoid air cells

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17
Q

hearing loss without discharge, common in children aged 2-5

A

otitis media with effusion

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18
Q

hoarseness, ear pain and weight loss

A

laryngeal tumour
commonly caused by HPV 16

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19
Q

reinkes oedema

A

vocal cords get surrounded by fluid
they become swollen and distended

can be due to longstanding smoking or thyroid disease

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20
Q

what is reinkes oedema is linked with what

A

hypothyroidism

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21
Q

nasal trauma and swelling in nasal septum and bruising and deviation to the left - when do you do emergency incision and drainage

A

if there is bilateral cherry red swelling in the nasal septum in anterior rhinoscopy

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22
Q

what drug causes sensorineural hearing loss due to damage to the cochlea

A

furosemide

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23
Q

if there is hearing loss in left ear and Webbers test goes more to the right

A

sensorineural hearing loss

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24
Q

which hearing loss is this?
air conduction is louder

A

sensorineural hearing loss

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25
Q

what hearing loss is this? if bone conduction is louder

A

conductive hearing loss

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26
Q

allergic rhinitis happens in hay fever due to?

A

type 1 hypersensitivity

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27
Q

examples of different type 1 hypersensitivity reactions

A
  1. anaphylaxis
  2. asthma
  3. hay fever
  4. eczema
  5. food allergies
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28
Q

fullness in nostril - single nasal polyp unilaterally

A

nasopharyngeal cancer - cancer of the tissues in the nasopharynx

the symptoms of this can be:

polyps in the nasal cavity
nose bleeds
lump in neck that doesn’t go after 3 weeks

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29
Q

Vestibular schwannomas - what is it

A

Benign, slow growing tumour of the Schwann cells

these cells normally wrap around the nerve fibres and insulate them to help with signals passing faster

when the tumour grows it affects hearing and balance and can cause:
tinnitus
dizziness
loss of balance

it can go onto interfering trigeminal nerve: sensation of the face
facial nerve: weakness of the facial muscles

if the tumour gets too big it can press on other structures like the cerebellum - this can present as other symptoms and be life-threatening

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30
Q

When is a vestibular schwannoma life threatening

A

When it is 40mm or more

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31
Q

Torrential epistaxis

A

Nose bleed

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32
Q

Telangiectasis

A

Widened blood vessels on the skin

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33
Q

Hereditary hemorrhagic telangiectasia

and symptoms

A

inherited condition that causes abnormal genetic vascular formations between arteries and veins

mostly these affects the nose, lungs, brain and liver

they can rupture and cause frequent nose bleeds
tiny red spots on the lips, mouth and tongue

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34
Q

Hoarseness
For over 3 weeks

Best management

A

Urgent ENT referral
Risk of laryngeal cancer

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35
Q

What is given in severe hayfever

A

Prednisone

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36
Q

How should nasal steroid spray for hay fever be taken

A

Head upside down

37
Q

Consequences of vestibular schwannoma

A

Build up of pressure can cause hearing loss and tinnitus
Palsy of the CNVIII
One sided occipital pain

38
Q

What is p16 a marker for

A

HPV and oropharyngeal squamous cell carcinoma

39
Q

How to manage blunt trauma to pinna

A

Incision with primary closure

40
Q

What is a benign neoplasm

A

Also known as Warthins tumour - tumour in the salivary gland

Progressive facial swelling without pain and weakness

41
Q

Thyroglossal cyst

A

Non tender and mobile cyst that moves in swallowing and tongue profusion

42
Q

what is quinsy

A

rare complication of acute tonsilitis
it is an abscess

43
Q

presentation of quinsy

A

sore throat
difficulty swallowing
uvula deviation
swelling inside mouth
earache
difficulty speaking

44
Q

conductive hearing loss - what is it

A

obstruction of sound waves in the outer ear
can be due to ear infection

inability of the sound waves to reach the inner ear

45
Q

patient has bilateral ear pain and lower facial pain
painful clicking when she opens her jaw

what is the best management

A

explanation and reassurance

46
Q

what is temporomandibular dysfunction

A

caused by stress
pain in the joint

TMJ joint pain

47
Q

what is ramsay hunt syndrome

A

happens with the varicella zoster/shingles virus is reactivated
affects the facial Nerve and can cause palsy

painful shingles rash
facial paralysis
hearing loss in affected ear
‘wonky smile’
unable to raise eyebrow

48
Q

what is flat tymopanogram indicative of?

A

fluid behind the tympanic membrane
- suggest middle ear congestion

49
Q

patient had recurrent episodes of the ‘world spinning’

what is it

A

BPPV

50
Q

what is done to diagnose BBPV

A

hallpike manoeuvre

51
Q

treatment of BPPV

A

epley manoeuvre

52
Q

what is Meniere’s disease

A

defined by 4 symptoms:
vertigo
hearing loss
tinnitus
feeling fullness in the ear

due to abnormal amount of fluid in the inner ear

53
Q

symptoms of reinke’s oedema

A

rough voice
hoarseness
low voice

54
Q

what is Quinsy

A

complication of acute tonsillitis
abscess forms in the tonsil and can spread to the walls of the throat

55
Q

symptoms of quinsy

A

severe and quickly worsening sore throat
swelling inside mouth
pain when swallowing
headache
earache
bad breath

56
Q

otitis media - quick overview

A
  • affects the eustachian tube
  • anything that is due to an infection is otitis media
  • painful middle ear infection
  • tympanic membrane looks red
  • there is pressure on the tympanic membrane due to fluid buildup which can burst and release pus
  • this leaves a hole in the tympanic membrane
57
Q

otitis externa - quick overview

A
  • anything that is outsider the tympanic membrane
  • common after swimming
  • congestion in the external ear
  • no pain
58
Q

what is the most common cause of tonsilitis

A

strep a

59
Q

tongue cancer characteristics

A

lump in the mouth or lip
unexplained ulcer that lasts longer than 3 weeks
persistent neck lumps
hoarseness of the voice
thyroid lump
difficulty swallowing

60
Q

what is leukoplakia

A

white patches on tongue - precancerous

61
Q

leukoplakia vs oral candiasis

A

leukoplakia CANNOT BE SCRAPED
oral candiasis - white spots on the tongue that CAN be scraped

62
Q

squamous cell carcinoma of the tongue - characteristics

A

will be raised and ulcerated
fast growing

63
Q

basal cell carcinoma of the tongue characteristics

A

slow growing

64
Q

melanoma of the tongue

A

dark and pigmented
management is dependent on Breslow Thickness

65
Q

tonsilitis - what are the 2 causes

A

group A strep - which is treated with penicillin
but the most common cause is viral

66
Q

how to score wether or not antibiotics are needed in tonsillitis

A

CENTOR score

no cough
fever > 38 degrees
exudates from the tonsils
inflammed

67
Q

test for EBV

A

IgM and IgG antibody test

68
Q

treatment for sinusitis

A

beclamethasone drops

69
Q

throat cancer risk factors

A

unilateral nasal polyps
smoker
difficulty swallowing
hoarseness of the voice
and PMH of glandular fever

70
Q

what is Ramsay hunt syndrome

A

when the shingles virus - varicella zoster - affects the ganglion in the facial nerve in the facial canal and causes facial drooping

71
Q

what is reinke’s oedema?

A

it is the gradual swelling and thickening of the vocal cords
it is linked with hypothyroidism

it can cause voice to get deeper

72
Q

bacterial rhinosinusitis

A

happens post cold
yellow discharge from nose
fever
local tenderness

give amoxilin

73
Q

what is the management for nose bleed if person is on warfarin

A

if INR is in the 5-8 range then stop warfarin and give Vit K

warfarin works by inhibiting vitamin K

74
Q

what is the most common cancer of the parotid gland?

A

muchpidermoid carcinoma
it can spread and cause facial nerve palsy

75
Q

sudden sensihoneural hearing loss - what is the next step

A

urgent referral to ENT as this is an emergency

76
Q

symptoms of Menieres disease

A

the inner ear has sudden attacks of vertigo and tinnitus
happen without a cause or warning
dizziness and nausea is often what’s seen

77
Q

vestibular schwannoma

A

it is a brain tumour of the shwan cells
causes unilateral hearing loss
tinnitus
balance issues

78
Q

brachial cyst

A

cyst that slowly gets larger
it moves easily
but does not move with swallowing
happens post infection

79
Q

what is otosclerosis

A

it is the thickening of the trabecular part of the bone
it causes generalised hearing loss
the stapes bone becomes fused with the surrounding bone - so it cannot move with the vibrations

patients present with talking quieter as their voice sounds louder in their head
they feel like they hear better when their is background noise

80
Q

what is CSF rhinnorhea

A

happens due to trauma to the face
the fronto-basal skull breaks and causes the leak of clear fluid - csf
from the nose

81
Q

what is tympanoslceoris

A

it is the chronic inflammation and scarring of the tympanic membrane
due to frequent ear infections
it presents with a chalky white patch on the tympanic membrane due to the collagen deposit

present with hearing loss

82
Q

what is adenoid cystic carcinoma

A

it is a salivary tumour of the parotid gland
it can invade the facial nerve
causing facial nerve palsy and facial pain
and swelling of the parotid gland

83
Q

what is the most common parotid malignant cancer

A

Mucoepidermoid carcinoma
- a hard mass
- facial nerve palsy and drooping
-

84
Q

what are the risk factors for nasopharyngeal cancer

A

EBV that presents as ‘bad tonsillitis’
frequent nose bleeds
unilateral glue ear

do a flexible nasoendoscopy

85
Q

what is a risk factor for paranasal cancer

A

rhinorrhea for more than 12 weeks
swelling
and blood stained nasal discharge

86
Q

management for bells palsy

A

oral prednisolone and eye drops

because the prednisolone will reduce the inflammation of the facial nerve and the eye drops stop the eye from drying out

87
Q

what infection increases the risk of oropharyngeal cancer

A

HPV 16/18
HPV is associated with:

  1. Cervical cancer (HPV 16/18 most common)
  2. Anal cancer
  3. Penile cancer
  4. Vulval cancer
  5. Oropharyngeal cancer
88
Q

Which cranial nerves does acoustic neuroma affect

A

cranial nerve VIII: vertigo, unilateral sensorineural hearing loss, unilateral tinnitus
cranial nerve V: absent corneal reflex
cranial nerve VII: facial palsy

89
Q

Vestibular mononeuritis - what is it

A

inflammation of the vestibular nerve, following an infection

which causes loss of balance - only affects the vestibular nerve

AMK (27 decks)

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