ENT REVISION NIGHT Flashcards
70 year old man recently had a synthetic mitral valve replacement. Presents with recurrent prolonged nose bleeds since coming out of hospital. Most likely diagnoses?
f - Drug induced - probs on warfarin as prophylactic to clots
A toddler has bleeding from the right nostril. Mum says there has been a foul smell discharge from that side for the past week. Examination shows inflamed mucous membranes on the right side. Diagnosis?
e) - Foreign body
Middle aged man presents with heavy bleeding from the nose. On rhinoscopy there are several red spots. On further examination it is noted he has dilated capillaries on his face and skin. He has had a number of hospital admission for epistaxis throughout his life. Diagnosis?
Hereditary telangiectasia - typically presents with persistent nosebleeds
A young man has been unwell for a number of weeks. He is lethargic and has had a few nose bleeds over this time. Full blood count results show Hb6.9, WCC 22.1x10^9 with immature myeloblasts on the blood film. Diagnosis?
d - Leukaemia Normal Hb for man -14-17, for woman - 12-15 Normal WCC - 3.6-11
What is leukaemia?
Leukaemia is a cancer of the white blood cells causing the production of immature cells which cannot fight infection (known as meyloblasts or lymphoblasts)
8 year old boy presents to the GP with recurrent nose bleeds. He has no past medical history or family history and is otherwise fit and well. Diagnosis?
b) - repeated minor trauma (picking his nose)
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1 - temporal bone 2 - external auditory canal 3 - pinna 4 - tympanic membrane 5 - oval window 6 - malleus 7 - incus 8 - stapes 9 - semicircular canals 10 - cochlea 11. conchlear nerve 12. Eustachian tube
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C - most likely acute otitis media
The neck dissection is a surgical procedure for control of neck lymph node metastasis
F - remove surgical clips
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C - Age 5-15 (modified centor criteria)
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Pre-septal cellulitis
What forms the orbital septum?
The orbital spetum is a membranous sheet that fuses with the tarsal plates
What are the glands in the tarsal plates which produce which layer of the tears?
Meibomian glands which produce meibum - the outer lipid layer of the tears
What are the layers of the eyelid?
SKin Subcutaneous tissue Orbicularis oculi muscle Orbital septum/tarsal plate Palpebral conjunctivae
Acute onset of swelling, redness, warmth and tenderness of the eyelid. Acute onset of unilateral swelling of conjunctiva and lids. Oedema, erythema, pain, chemosis. Orbital or preseptal cellulitis for both?
Acute onset of swelling, redness, warmth and tenderness of the eyelid. - preseptal cellulitis Acute onset of unilateral swelling of conjunctiva and lids. Oedema, erythema, pain, chemosis. - orbital cellulitis
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Phenol cautery - used for toenail ingrowing
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Labrynthitis
How is labrynthitis differentiated from vestibular neuronitis?
Labrynthitis presents with heairng loss and tinnitus also
Lump presents superior of the anterior traingle (lateral neck) in a paients neck, what is this likely to be?
Branchial cyst
Patient presents with a diffuse midline swelling, what is this known as?
Goitre
Lump in neck arises when patient sticks out their tongue, what is this likely to be?
Thyroglossal duct cyst
When a patient presents with sudden onset hearing loss it is important to examine them carefully to differentiate between conductive and sensorineural hearing loss What is the most appropriate management in a patient presenting with sudden onset sensorineural hearing loss?
The management of sudden-onset sensorineural hearing loss is urgent referral to ENT, high-dose oral corticosteroids, and investigation for causes. * → sudden-onset sensorineural hearing loss (SSNHL) requires urgent referral to ENT. The majority of SSNHL cases are idiopathic.
Why are high dose oral steroids given in the treatment of sudden sensorineural hearing loss?
Steroids are commonly used to treat patients with sudden hearing loss of an unknown origin. The specific action of the steroids in the hearing apparatus is uncertain. It is possible that the steroid treatment improves hearing because of its ability to reduce inflammation and oedema (swelling) in the hearing organs
