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ENT > ENT SUMMARY > Flashcards

ENT SUMMARY Flashcards

1
Q

What is the most common benign tumor in the cerebellopontine angle?

A

Vestibular schwannoma (Acoustic neuroma)

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2
Q

First nerve affected in Vestibular schwannoma (Acoustic neuroma)?

A

Trigeminal nerve

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3
Q

Second nerve affected in Vestibular schwannoma (Acoustic neuroma)?

A

Sensory facial nerve

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4
Q

What are the results of Rinne’s test, Weber’s test, and Tympanometry in Vestibular schwannoma (Acoustic neuroma)?

A

Rinne’s test: Positive

Weber’s test: Lateralized to the contralateral side

Tympanometry: Type A (Normal)

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5
Q

What kind of hearing loss is expected in Vestibular schwannoma (Acoustic neuroma)?

A

SNHL

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6
Q

Investigation for Vestibular schwannoma (Acoustic neuroma)?

A

Cerebellopontine angle MRI

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7
Q

What are the 2 screening assessments for hearing?

A

1) Whispered voice test:
Normal hearing can repeat words whispered at 60 cm.

2) Tuning fork tests (Weber’s and Rinne’s test)

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8
Q

Normal Weber’s findings?

A

No laterization or Centralization

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9
Q

Normal Rinne’s findings?

A

Air conduction Better than Bone conduction

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10
Q

Cause of false negative Rinne’s test in right ear?

A

Profound sensorineural hearing loss in the right ear

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11
Q

Rinne’s conductive hearing loss means:

A

BC > AC

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12
Q

Rinne’s sensorineural hearing loss means:

A

AC > BC (False positive)

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13
Q

Differential diagnoses for type As tympanogram?

A

1) Otosclerosis
2) Malleus fixation
3) Scarred tympanic membrane

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14
Q

Differential diagnoses for type Ad tympanogram?

A

1) Ossicular discontinuity
2) Thin and lax tympanic membrane
3) Post-stapedectomy

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15
Q

Differential diagnoses for Type B (small ear canal volume) tympanogram?

A

1) Ear canal is occluded with wax/debris
2) The immittance probe is pushed against the side of the ear canal

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16
Q

Differential diagnoses for Type B (normal ear canal volume) tympanogram?

A

Otitis media with effusion

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17
Q

Differential diagnoses for Type B (large ear canal volume) tympanogram?

A

Perforation of the tympanic membrane

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18
Q

Differential diagnoses for Type C tympanogram?

A

1) Developing or resolving otitis media
2) Malfunctioning eustachian tube
3) Tympanic membrane retraction

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19
Q

The most three common causes of peripheral vertigo are:

A

1) Benign paroxysmal positional vertigo
2) Vestibular neuritis (Labrynthitis)
3) Meniere’s disease

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20
Q

How to test for Benign paroxysmal positional vertigo?

A

Dix-Hallpike test

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21
Q

How to treat Benign paroxysmal positional vertigo?

A

1) Epley maneuver
2) Surgery

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22
Q

Etiology of Benign paroxysmal positional vertigo?

A

1) Idiopathic (50%)
2) Head trauma
3) Chronic otitis media
4) Viral infection

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23
Q

Pathophysiology of Benign paroxysmal positional vertigo?

A

Dislodge of canalith from utricle to semicircular canal (posterior one most commonly)

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24
Q

Etiology of Vestibular neuritis (Labyrinthitis)?

A

Viral infection

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25
Q

Treatment for Vestibular neuritis (Labyrinthitis)?

A

1) IV Fluids
2) Steroids
3) Anti-emetic

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26
Q

Treatment for Meniere’s disease?

A

1) Lifestyle change: low salt intake
2) Thiazide diuretics
3) Anti-vertigo (Betahistine)
4) Intratympanic injection of aminoglycoside like Gentamycin (Ototoxic drug which damages the dark cells that produce the endolymph) can improve vertigo.
5) Surgery: Labyrinthectomy or Endolymphatic sac decompression.

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27
Q

Causes of Meniere’s syndrome?

A

1) Chronic otitis media
2) Viral infection
3) Syphilis

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28
Q

Causes of Meniere’s disease?

A

Idiopathic

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29
Q

Signs of otitis externa?

A

1) Narrowed external auditory canal
2) Edema and erythema of the external auditory canal
3) Conductive hearing loss may be evident
4) Discharge
5) Positive tragus sign

30
Q

Otomycosis symptoms?

A

1) Severe itching
2) Chronic discharge with inflammation of the mucosa of tympanic membrane

31
Q

Classic triad of otitis media?

A

1) Otalgia
2) Fever
3) Conductive hearing loss

32
Q

What are the phases of acute otitis media?

A

1) Exudative inflammation – 1-2 days
2) Resistance & Demarcation – 3-8 days
3) Healing phase – 2-4 weeks

33
Q

First line antibiotic treatment for otitis media?

A

Amoxycillin

34
Q

What should you do if otitis media persists despite antibiotic treatment?

A

Myringotomy

35
Q

What is the most common cause of otitis media with effusion?

A

Adenoid hypertrophy → Eustachian tube dysfunction → negative pressure → retraction pocket → prevents adequate drainage → accumulation of
fluid.

36
Q

What is the most common symptom of otitis media with effusion?

A

Mild conductive hearing loss

37
Q

Rinne’s test on Otitis media with effusion is:

A

Negative

38
Q

Indications of grommet insertion?

A

1) 3 or more episodes of acute otitis media in 6 months

2) 4 or more attacks of acute otitis media in a year with at least one episode in the preceding 6 months

3) Otitis media with effusion with conductive hearing loss persists for 3 months or if there is recurrent pain

39
Q

Complications of grommet insertion?

A

Otorrhea

40
Q

Treatment of dry perforated tympanic membrane?

A

1) Conservative
2) Myringoplasty (Type one Tympanoplasty) ← Definitive treatment

41
Q

Treatment of perforated tympanic membrane with discharge?

A

1) Aural toilet (regular suction)
2) Swab culture
3) Ear drop with antibiotic
4) Myringoplasty (Type one Tympanoplasty) ← Definitive treatment

42
Q

Causes of recurrent facial palsy?

A

1) Melkersson-Rosenthal syndrome
2) Sarcoidosis
3) Parotid tumors

43
Q

Most common cause of Ramsay hunt syndrome?

A

Varicella zoster virus (VZV)

44
Q

What is the cause of otalgia in Ramsay hunt syndrome?

A

Severe pain precedes herpetic eruption

45
Q

What drains into the superior meatus?

A

1) Sphenoid sinus
2) Posterior ethmoid

46
Q

Common causes of chronic cough?

A

1) Postnasal drip due to adenoid or sinusitis
2) Bronchial asthma / COPD
3) GERD

47
Q

Vasomotor rhinitis is due to:

A

Excessive parasympathetic activity

48
Q

What is rhinitis medicamentosa?

A

Rebound nasal congestion suspected to be brought on by extended use of topical decongestants (more than 2 weeks)

49
Q

Findings in allergic rhinitis?

A

1) Hypertrophied & pale turbinate
2) Edematous mucosa
3) Watery secretion

50
Q

Best investigation for sinusitis?

A

CT scan

51
Q

Best investigation for fungal sinusitis?

A

MRI

52
Q

Treatment for chronic sinusitis?

A

Metronidazole (For anaerobes)

53
Q

What is Samter’s triad?

A

1) Nasal polyps
2) Aspirin allergy
3) Asthma

54
Q

The Nasal polyps are most commonly from the:

A

Ethmoidal sinuses

55
Q

Most important artery for embolization in case of epistaxis?

A

Sphenopalatine

56
Q

Most important cause of toxic shock syndrome?

A

Nasal packing

57
Q

What is Trotters Triad of Nasopharyngeal tumors?

A

1) Ipsilateral conductive hearing loss
2) Ipsilateral ear pain + facial pain
3) Ipsilateral paralysis of soft palate

58
Q

Most common site for Adenocarcinoma is:

A

Ethmoidal

59
Q

Most common sinus for neoplasms are:

A

Maxillary sinus

60
Q

What does Ohngren’s line connect?

A

Medial canthus of the eye to angle of the mandible

61
Q

Tumors above Ohngren’s line have __(good/poor) prognosis.

A

Poor

62
Q

Most common paranasal sinus malignancy in children < 5 years is?

A

Rhabdomyosarcoma

63
Q

Most common neoplasm of nose and sinus?

A

Non-Hodgkins lymphoma

64
Q

The most common cause of tonsillitis is:

A

Viral

65
Q

Most common pathogen in bacterial tonsillitis?

A

Streptococcus pyogenes “GAS”

66
Q

Peritonsillar abscess symptoms?

A

1) Unilateral bulging with pus and exudate
2) Trismus
3) Drooling of saliva

67
Q

What is the second step in recurrent laryngeal nerve palsy management after examination?

A

CT scan from skull base to chest

68
Q

What is the most common cause of stridor in the neonatal period and early infancy?

A

Laryngomalacia

69
Q

What is the most common benign tumor of the larynx?

A

Papilloma

70
Q

What is the most common indication for tracheostomy?

A

Prolonged endotracheal intubation

71
Q

mall disc batteries cause tissue destruction via:

A

Low-voltage electrical currents and liquefactive necrosis

ENT (6 decks)

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