ENT random facts Flashcards
Unilateral nasal polyp
Red flag
Management of unexplained unilateral earache for > 4weeeks
Urgent referral
What happens to a thyrglossal cyst on sticking tongue out?
Moves up
Drug causes of tinnitus
Aspirin
NSAIDs
Aminoglycosides
Quinine
Loop diuretics
Describe a branchial cyst
Mobile cystic lesions between SCM and pharynx
AIR BONE GAP on audiogram
Conductive hearing loss
Which one of out labyrinthitis and vestibular neuroniits do you get hearing loss
labyrinthitis = hearing loss
VN = no hearing loss
Management of otitis external in a diabetic
Ciprofloxacin
Manategemt of otitis externa generally?
Topical Abx and steroid
Management of Ramsey hunt
steroids and aciclovir
Sore throat for > 4weeks
USOC referral
Particularly in those with smoking Hx
Glue ear risk factors
male sex
siblings with glue ear
higher incidence in Winter and Spring
bottle feeding
day care attendance
parental smoking
Management of uncomplicated sinusitis
Analgesia and abundant fluids
1st line Abx for severe sixnutiis
1) Phenoxymethylpenicllin
2) Co-amox
When can you use intransal steroids for sinusitis
If symptoms there for >10 days
Centor criteria
tonsillar exudate
Cervical lymphadenopathy
No cough
Fever
Abx for tonsillitis
Penicillin or clarithromycin (pen allergic)
Cholesteatoma facts
Cholesteatoma is a non-cancerous growth of squamous epithelium that is ‘trapped’ within the skull base causing local destruction. It is most common in patients aged 10-20 years. Being born with a cleft palate increases the risk of cholesteatoma around 100 fold.
Main features
foul-smelling, non-resolving discharge
hearing loss
Other features are determined by local invasion:
vertigo
facial nerve palsy
cerebellopontine angle syndrome
Otoscopy
‘attic crust’ - seen in the uppermost part of the ear drum
Management
patients are referred to ENT for consideration of surgical removal
Nasal polyp associations
Associations
asthma (particularly late-onset asthma)
aspirin sensitivity
infective sinusitis
cystic fibrosis
Kartagener’s syndrome
Churg-Strauss syndrome
The association of asthma, aspirin sensitivity and nasal polyposis is known as Samter’s triad.
Features
nasal obstruction
rhinorrhoea, sneezing
poor sense of taste and smell
Unusual features which always require further investigation include unilateral symptoms or bleeding.
Management
all patients with suspected nasal polyps should be referred to ENT for a full examination
topical corticosteroids shrink polyp size in around 80% of patients
Causes of gum hypertrophy (4)
AML
Ciclosporin
Phenytoin
CCBs (especially nifedipine)
1st line Rx of otitis externa?
Topical Abx with or without steroid
In what condition do you get bilateral acoustic neuromas?
Neurofibromatosis type 2
Cause of bacterial otitis media?
H Influenzar
Rx of otitis external?
topical antibiotic or a combined topical antibiotic with a steroid
