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1. 4th year > ENT treatments > Flashcards

ENT treatments Flashcards

1
Q

cholesteatoma

A

surgery

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2
Q

otosclerosis

A

1st line - hearing aid

stapedectomy, CO2 laser, cochlear implant

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3
Q

treatment of OME (glue ear) in < 3 year olds

A

grommets

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4
Q

treatment of OME (glue ear) in > 3 year olds 1st episode

A

grommets

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5
Q

treatment of OME (glue ear) in > 3 year olds 2nd episode

A

grommets and adenoidectomy

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6
Q

presbycusis

A

hearing aid

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7
Q

ix vestibular schwannoma

A

contrast MRI of cerebellopontine angle

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8
Q

tx vestibular schwannoma

A

watchful waiting
radiotherapy
surgical excision

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9
Q

ix if persistent unilateral otitis externa

A

biopsy - may be maligancy

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10
Q

tx mild otitis externa

A

topical acetic acid (OTC) + topical antibiotic +/- topical steroid

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11
Q

tx moderate otitis externa

A

topical otomize (dexamethasone + neomycin + acetic acid)

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12
Q

are swabs usually taken in otitis externa

A

no - only in non-resolving cases

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13
Q

tx otitis externa that is spreading despite treatment

A

oral flucloxicillin

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14
Q

tx malignant otitis externa

A

refer urgently to ENT and IV ciprofloxacin

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15
Q

1st line treatment in acute otitis media

A

rest analgesia and fluids - usually self limiting

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16
Q

when are antibiotics given in acute otitis media

A

o >4 days or not improving
o Systemically unwell
o Younger than 2 years old with bilateral OM and marked symptoms
o Otitis media with perforation
o Immunocompromise or high risk of complications due to significant heart/lung/kidney/liver/neuromuscular disease

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17
Q

antibiotic of choice in acute otitis media if being given

A

500mg Amoxicillin TDS 5-7 days

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18
Q

2nd line antibiotic of choice in acute otitis media if being given

A

500mg Clarithromycin or erythromycin TDS 5 days

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19
Q

tx ruptured tympanic membrane

A

majority heal on own, review in 6-8 weeks

if fails to heal - myringoplasty

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20
Q

tx mastoiditis

A

IV tazocin +/- mastoidectomy

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21
Q

tx epiglottitis/supraglottitis

A

IV ceftriaxone

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22
Q

tx acute attack menieres

A

buccal or IM prochlorperazine

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23
Q

tx preventing menieres

A

beta histine and vestibular rehabilitation exercises

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24
Q

life style advice for menieres

A

reduce salt, alcohol, caffeine and stress

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25
Q

dx BPPV

A

dix hallpike - rotational nystagmus

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26
Q

tx BPPV

A

epley

teach patient exercises to do at home

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27
Q

tx vestibular neuronitis

A
  • buccal or IM prochlorperazine for rapid relief

- short course oral prochlorperazine or antihistamine

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28
Q

tx chronic vestibular neuronitis

A

vestibular rehab exercises

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29
Q

tx labyrinthitis

A

prochlorperazine or antihistamine may help

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30
Q

what nystagmus is seen in labyrinthitis and vestibular neuronitis

A

horizontal

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31
Q

1st line nose bleed treatment haemodynamically stable

A

first aid measures:
sit forward and mouth open
pinch cartilaginous area of nose firmly for 20 mins
breath through mouth

o Avoid blowing or picking the nose, heavy lifting, exercise, lying flat, drinking alcohol or hot drinks

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32
Q

2nd line nose bleed treatment

A

naseptin cream (chlorhexidine and neomycin)

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33
Q

when is naseptin contraindicated

A

peanut soy or neomycin allergy

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34
Q

what is an alternative to naseptin cream in peanut allergy

A

mupirocin

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35
Q

treatment nosebleed rhyme

A 
NCP-SLE
naseptin
cautery
packing 
sphenopalatine
ligation
embolisation
36
Q

treatment nosebleed after naseptin/bleeding continuing after 10-15 mins

A

cautery - if source of bleed is visible

37
Q

do you cauterise both sides of septum

A

no just one - risk of perforation

38
Q

treatment nosebleed after cautery or if bleeding source not visible

A

admit to hospital and packing

- anterior then posterior

39
Q

how long does anterior packing stay in for

A

24 hours

40
Q

how long does posterior packing stay in for

A

48 hours

41
Q

treatment nosebleed if haemodynamically unstable

A

admit to A+E

42
Q

treatment nosebleed after packing / all other treatment failed

A

sphenopalatine artery ligation

43
Q

treatment nosebleed after sphenopalatine ligation

A

ligation of ECA

44
Q

treatment nosebleed after ligation of ECA

A

embolisation

45
Q

symptomatic tx rhinosinusitis

A

analgesia
intranasal corticosteroids
nasal irrigation with saline
decongestants - pseudophedrine,oxymetazoline

46
Q

tx rhinosinusitis if symptoms last longer than 10 days

A

inhaled steroids

47
Q

what is the problem with use of decongestants e.g. pseudophedrine, oxymetazoline

A

cause rebound congestion and necrosis of septum if used LT (rhinitis medicamentosa)

48
Q

treatment chronic rhinosinusitis

A

avoid allergens
intranasal corticosteroids
nasal irrigation

49
Q

1st line treatment allergic rhinitis

A

allergen avoidance

50
Q

treatment mild/moderate allergic rhinitis

A

oral or intranasal antihistamine

51
Q

treatment severe allergic rhinitis

A

intranasal steroids

52
Q

treatment allergic rhinitis if important life event coming up

A

short course oral steriod

53
Q

when should antibiotics be used in sinusitis

A

symptoms persist / worsening after 7-10 days

54
Q

1st line treatment of infective sinusitis

A

penicillin V 500mg TDS 7 days

55
Q

2nd line treatment infective sinusitis

A

doxycycline 100mg

56
Q

tx infective sinusitis if high risk of comps or very serious illness

A

co-amox

57
Q

tx vasomotor rhinosinusitis

A

inhaled ipratropium

58
Q

tx nasal polyps 1st line

A

topical steroid +/- montelukast

59
Q

2nd line tx nasal polyps

A

endoscopic polypectomy

60
Q

tx viral tonsillitis

A

paracetamol bed rest

difflam analgesic spray can help

61
Q

tx bacterial tonsillitis

A

penicillin V 10 days

62
Q

2nd line treatment bacterial tonsillitis

A

clarithromycin 5 days

63
Q

tx quinsy

A

needle aspiration and drainage and IV antibiotics

64
Q

cause of infectious mononucleosis

A

EBV

65
Q

scoring system for bacterial tonsillitis

A

centor

  • tender anterior lymphadenopathy
  • absence of cough
  • fever
  • enlarged tonsils with exudate
66
Q

tx of infective mononucleosis

A

supportive

avoid contact sport for 4 weeks

67
Q

white pseudomembrane
systemically very unwell
bull neck appearance

A

diphtheria

68
Q

ix diphtheria

A

throat swab for culture - tellurite agar or loefflers media

69
Q

tx diphtheria

A

diphtheria antitoxin + IM penicillin

70
Q

salivary gland infection

A

flucloxicillin + metronidazole if bacterial

71
Q

ix parotid gland tumour

A

plain x-ray - exclude calculi
FNAC
superficial parotidectomy - diagnostic and therapeutic
CT/MRI staging in cases of malignancy

72
Q

ix submandibular tumour

A

FNAC
CT and MRI
all should be excised

73
Q

RF for nasopharyngeal (SCC) cancer

A

EBV

asian populations

74
Q

RF for oral, oropharyngeal and oesophageal cancer

A

HPV

75
Q

IX for nasal and nasopharyngeal cancers

A

combined CT and MRI

76
Q

tx nasopharyngeal cancers

A

radiotherapy

77
Q

ix oropharyngeal cancer

A

biopsy

78
Q

tx oropharyngeal cancer

A

o Early, small: radical radiotherapy or surgery.
o Locally advanced but resectable: surgery + post op radiotherapy.
o Locally advanced but not resectable: chemo-radiotherapy.

79
Q

ix for laryngeal cancer

A

laryngoscopy and biopsy

80
Q

tx largyneal cancer

A

surgery

  • laryngeal sparing (T1 or T2)
  • total or partial laryngectomy

chemo-radiotherapy can be used as an alternative to surgery in advanced disease

81
Q

tx motion sickness and vertigo

A

prochlorperazine

82
Q

SE of LT use of prochlorperazine

A

EPSEs

83
Q

auricular haematoma

A

urgent incision and drainage - same day ENT assessment

84
Q

ear wax impaction treatment

A

ear drops - olive oil, sodium bicarb

syringing

85
Q

tx ramsay hunt

A

oral aciclovir and steroids

86
Q

tx bells palsy

A

< 72 hours - oral prednisolone

1. 4th year (23 decks)

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