ENT Summary Q's Flashcards
Patient walks into clinic with hoarseness, name 5 causes?
what examinations could be done IN CLINIC?
recurrent laryngeal nerve palsy, lung CA, acute laryngitis, gord, polyps,
head and neck exam, fibre optic laryngoscopy
causes of dysphagia? + Tests
Bengin Stricture (GORD, foreign body) Malig stricture (CA) achalasia bulbar palsy pharyngeal pouch
DDx for neck lump? how would you assess cause?
Central : thyroid (goitre / cyst), lipoma
Lat : branchial, abscess, lymph node, salvery gland, lipoma
clinical exam and Hx –> US –> CT/cxray –> FNA
causes of hearing loss (make sure to split them up)
conductive -
blockage (ottitis externa/media, earwax)
perf eardrum
faulty equipment (osteosclerosis, infection)
SN -
menieres, post-infection (meningitis), medication (gent)
DDx of otorrhea
external - ottitis externa
middle - AOM with effusion / cholesteoma
csf - fx basal skull
complications occuring after grommets inserted?
extrude after 3-12 months
infection (OM)
scarring
look into the ear and suspect cholesteoma, what signs would point to this diagnosis?
cottage cheese/ burnt scarring appearance
hearing loss, pain, facial palsy, smelly discharge +/- vertigo
otalgia DDx?
AOM, cholesteoma?? perf eardrum, ottitis externa
most common association with tinnitus (2)
menieres, acoustic neuroma
man walks in with droopy face, suspected 7th nerve palsy. 5 causes (2upper,3lower)
Upper - stroke, tumor,
Lower - Guillan Barre, bells, MS (both), polio
RED FLAGS for Ear / Nose / Throat
Ear - csf leakage, unilat effusion, sudden hearing loss,
Nose - lost tooth, uncontrolled bleeding, unilateral obsrtuction, face pain,
throat - dysphagia, lump, hoarse, pain, stridor
sensori neural deafness and ipsilateral tinnitus diagnosis?
vestibular schwannoma (aka acoustic neuroma)
what are 2 main tests done for hearing loss investigation?
AUdiometry (subjective test)
tympanometry (objective)
DDx for sore throat
infection (pharyngitis / tonsillitis) abscess/quinsy mono malignancy laryngopharyngeal reflux??
menieres triad?
tinnitus, hearing loss, vertigo
key words for Benign Positional Vertigo?
- head movments
- short duration epsiodes
best way to split up DDx for neck lymphadenopathy?
Infectious/Reactive - bact/viral
Autoimmune - sarcoid/ SLE
CA - lymphoma
patient walks in with central neck lump, what Q’s will you ask and what tests?
stick out tongue then ask about thyroid CF’s
do TFT’s and US
if symptomatic or abnormal TFT’s, refer to specialist
patient has itchy ear, on examination it looks flakey and red, what is your course of action?
Topical ABx’s and oral steroids then discahrge
what treatment is possible for nasal polyps? what would first course of action be if unilat obstruction?
intra nasal steroids –> systemic steroids –> surgery
refer immediately to ENT
how to tell AOM and AOM with effusion apart?
AOM - more red, eardrum doesnt have bubbles behind it, PAINFUL
AOM with effusion - more whitish, bubbly bulging drum, painless, hearing loss
treating AOM?
analgesia and amox
if you are going to prescribe ABx;s for sore throat what must be avoided?
amoxicillan
causes of vertigo (5)
BPV
menieres (assoc tinnitis + fullness)
vestibular neuronitis (no hearing loss/ vomiting)
acute labrinthytis (hearing loss, vomiting)
vestibular schwanoma (unilat/ tinnitus)
pt has bells palsy, what treatment?
oral pred and eye drops (lube)
what is most likely cause of tonsilitis? and what is main complication?
group A strep
quinsy - trismus, hot potato voice, dysphagia
