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General Flashcards

1
Q

does the inner ear feel pain?

A

no

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2
Q

if otalgia is coming from middle or outer ear, the drum looks dodge. if the drum is normal, it’s likely

A

referred pain

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3
Q

name 2 otological causes of otalgia

A

acute otitis media
otitis externa

furuncule
necrotising otitis media

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4
Q

name 3 referred causes of otalgia

A

dental pathology
TMJ dusfunction
OA of cervical spine

throat infection
oropharyngeal malig

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5
Q

what is most common organism causing otitis externa

A

pseudomonas

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6
Q

two signs of otitis externa on examination

A

debris (white/cheesy); oedema of canal

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7
Q

what condition is assoc w otitis externa?

A

eczema

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8
Q

treatment for otitis externa?

A

microsuction
gentamicin ear drops

+/- steroid

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9
Q

fungal otitis externa treatment?

A

clotrimazole 14ds

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10
Q

what can be used to prevent recurrent otitis externa

A

acetic acid ear spray (bad env for pseudomonas)

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11
Q

staph abscess on a hair follicle = what?

A

furuncule

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12
Q

what is treatment for furuncle?

A

oral fluclox

maybe incision and drainage

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13
Q

what is furuncule?

A

staph abscess on hair follicle

exquisitely tender

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14
Q

osteomyelitis of skull base extending into ear canal = what?

A

necrotising otitis externa

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15
Q

necrotising otitis externa = what?

A

osteomyelitis of skull base extending into ear canal

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16
Q

an elderly diabetic w white debris in ear canal, oedematous. TERRIBLY painful and unremitting, unresponive to topical gentamicin drops. diagnosis?

A

necrotising otitis externa

needs debridement in hosp and long course of IV Abx

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17
Q

name some common viral causes of otitis media

A

RSV, rhinovirus, parainfluenza

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18
Q

name some bac causes of otitis media

A

strep pneum, h.flu, moraxella

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19
Q

red bulging ear drum on examination makes you think

A

otitis media

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20
Q

name two complications of acute otitis media

A

mastoiditis
chronic suppurative otitis media (drum perforates permanent)

meningitis, brain abscess, labrynthitis

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21
Q

management of acute otitis media

A

self limiting within 72hrs

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22
Q

when to give Abx in acute otitis media? which Abx?

A

systemically unwell or worsening after 72hrs

amoxicillin 5ds

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23
Q

presentation of acute otitis media

A

children
cold/coryza / fever /cough –> deafness, earache, tugging
pain then discharges relieves

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24
Q

what is most common form of epistaxis?

A

anterior haemorrhage (95%)

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25
Q

most common area for nosebleeds?

A

little’s area (anastamosis of vessels in nasal septum)

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26
Q

are anterior or posterior nosebleeds worse?

A

posterior - elderly, riskier for airway compromise

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27
Q

name some causes of epistaxis

A 
trauma (xs nose blowing, foreign bod insertion)
drugs - cocaine, anticoags
coagulopathy 
malig 
wegener's

htn = rf

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28
Q

what kind of malignancy causes epistaxis

A

juvenile angiofibroma

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29
Q

bleeding from one nostril = what kind of haemorrhage

A

anterior haemorrhage

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30
Q

bleeding from both nostrils and throat?

A

posterior haemorrhage

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31
Q

what symptoms should you ask about in young males w epistaxis to rule out juvenile angiofibroma?

A

headache?
rhinorrhoea?
anosmia?

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32
Q

tell me some history questions for nosebleed

A 
time of onset
estimated blood loss
triggers 
facial pain /otalgia
headache/rhinorrhoea/anosmia

drug hx - coke, anticoags, aspirin
fhx - hereditary haemorrhagic telangiectasia

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33
Q

what symptoms should you ask about to establish risk of nasopharyngeal tumour in epistaxis?

A

facial pain / otalgia

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34
Q

tell me about what examination you do in epistaxis

A

A-E!!
esp airway and circulation

anterior rhinoscopy w headlight + suction
inspect in mouth too

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35
Q

most normal nosebleeds dont need blood tests, but in severe epistaxis what bloods do u take?

A

FBC, clotting, G&S/crossmatch

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36
Q

if haemodynamically unstable in epistaxis when you do A-E?

A

fluids

transfusion if nec

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37
Q

tell me how to do first aid for nosebleeds!

A

digital pressure on nostrils
ice on forehead/bridge
keep head forward

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38
Q

why digital pressure on nostrils not bridge in nosebleeds

A

that’s little’s area

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39
Q

if first aid doesnt work, what next for nosebleed

A

cautery w silver nitrate

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40
Q

if first aid and cautery don’t work, what next for nosebleed?

A

nasal packing

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41
Q

what nasal packing to use for anterior haemorrhage?

A

rapid rhino

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42
Q

what nasal packing to use for posterior haemorrhage ?

A

foley catheter

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43
Q

if first aid and cautery and nasal packing dont work, what next?

A

theatre (ligation of artery)

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44
Q

what cream helps prevent further bleeding after nosebleeds?

A

Naseptin

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45
Q

what is vertigo?

A

sensation that surroundings are spinning

often w nausea + loss of balance

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46
Q

what is the labyrinth?

A

bony inner ear

semicircular canals + vestibule (utricle/saccule) + cochlea

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47
Q

name some central causes of vertigo

A

MIGRAINE ; EPILEPSY ; ACOUSTIC NEUROMA ; HEAD INJURY ; ALCOHOL INTOX

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48
Q

name some central causes of vertigo

A

VESTIBULAR NEURITIS ; VIRAL LABYRINTHITIS ; BPPV ; MENIERE’S ; RAMSAY HUNT ; VESTIBULAR MIGRAINE ; OTOTOXIC DRUGS

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49
Q

name 2 ototoxic drugs

A

furosemide

gentamicin

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50
Q

what is ramsay hunt syndrome?

A

herpes zoster in facial nerve

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51
Q

how does romberg’s test help in assessing vertigo?

A

shows proprioception - vestibular function

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52
Q

what is the Unterbergers test?

A

march on spot with eyes closed, if turn on spot then vestibular pathology

theres also Head Impulse Test for vestibular dysfunction

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53
Q

if balance problems long term with vertigo, what can be offered?

A

vestibular rehab!

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54
Q

vertigo is v sudden onset and not positional. management?

A

urgent referral to ENT

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55
Q

vertigo is causing such severe vomiting that can’t tolerate fluids. management?

A

admit

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56
Q

vertigo assoc w central neuro symps inc new headache. management?

A

neuro referral

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57
Q

vertigo in the GP with undetermined cause, pt stable. management?

A

refer to ENT / neuro, non urgent.

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58
Q

describe symptomatic treatment of vertigo - 3 drugs that sound rather similar

A

prochlorperazine
cyclizine
promethazine

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59
Q

what is vestibular neuritis?

A

inflammation of the vestibular nerve

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60
Q

infl of vestibular nerve = what?

A

vestibular neuritis

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61
Q

what causes vestibular neuritis?

A

reactivation of latent HSV1 in vestibular nerve

often preceded by URTI

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62
Q

what is labyrinthitis ?

A

inflammation of vestibular nerve plus labyrinth involvement (urticle, saccule, cochlea, semicircs) so may have hearing loss and tinnitus as well as vertigo

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63
Q

is most labyrinthitis viral?

A

yes

preceded by URTI

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64
Q

spontaneous sudden severe incapacitating vertigo not exacerbated by movement with hearing loss and tinnitus in someone who’s just had a cold

A

labyrinthitis

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65
Q

lie still in a dark room with your eyes closed and wait for it to pass when youve got

A

labyrinthitis

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66
Q

how long does labyrinthitis usually take to resolve itself?

A

days-wks

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67
Q

what can u give for symptomatic relief of vertigo in labyrinthitis?

A

prochloperazine / promethazine

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68
Q

too much endolymph in labyrinth aka endolymphatic hydrops aka…

A

meniere’s disease

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69
Q

what is meniere’s disease

A

too much endolymph. endolymphatic hydrops

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70
Q

what are the symptoms of meniere’s disease?

A

vertigo attacks 2-3hrs long (every few months)

tinnitus, hearing loss, sensation of aural fullness

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71
Q

joan is having attacks of vertigo every few months. they last about 2-3hrs and are assoc w tinnitus, hearing loss and aural fullness. diagnosis?

A

meniere’s disease

refer to ENT to confirm diagnosis

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72
Q

what will be seen on audiometry with meniere’s disease?

A

sensorineural hearing loss

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73
Q

what drug can be given as preventative for meniere’s disease?

A

betahistine

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74
Q

what is the pathophysiology of Benign Paroxymal Positional Vertigo?

A

otoliths detach from utricle and rattle in semicircular canals

mostly posterior semicircs bc anatomy :)

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75
Q

otoliths detach from utricle and rattle in semicircular canals. what’s this?

A

BPPV

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76
Q

rugby players and elderly women stereotypically get which ENT condish

A

BPPV

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77
Q

name some symptoms of BPPV

A 
vertigo attacks lasting 20-30 seconds
better if head still
rolling over in bed 
no hearing loss 
no tinniturs
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78
Q

do you get hearing loss and tinnitus in BPPV?

A

no

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79
Q

do you get hearing loss and tinnitus in meniere’s disease?

A

yes

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80
Q

do you get hearing loss and tinnitus in labyrinthitis?

A

yes

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81
Q

describe the dix-hallpike test

A

hoosh down onto couch + look for upbeating nystagmus+ pt experiences vertigo

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82
Q

you do the dix-hallpike test on a pt you suspect might have BPPV. you see downbeating nystagmus. management?

A

refer rapidly. its a red flag

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83
Q

a pt thinks they have BPPV but then they tell you they only have unilateral hearing loss and tinnitus. management

A

refer rapidly. unilateral is a red flag

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84
Q

name some red flags that mean its something more worrying than BPPV

A

downbeating nystagmus
new onset headache
focal neuro/gait ataxia
unilateral hearing loss/tinnitus

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85
Q

how does the epley manoevre actually work its magic?

A

hooshes otoliths back into utricle

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86
Q

y’alright kate hun?

A

yeh :)

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87
Q

which nerve supplies all the intrinsic muscles of the larynx exc cricothyroid?

A

recurrent laryngeal

cricothyroid supplied by superior laryngeal

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88
Q

hoarsness may be a warning of impending ariway obstruction, in….

A

acute epiglottitis
anaphylaxis
trauma

  • dont examine throat. call anaesthetics/ENT
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89
Q

name a few malignant causes of hoarseness

A

laryngeal ca

thyroid ca, lung ca, lymphoma

90
Q

hoarseness = dysphonia = impaired quality of voice. commonest cause is?

A

muscle tension dysphonia

stress + reflux. SALT

91
Q

name 3 neuro causes of hoarseness

A

stroke
parkinsons
MND

92
Q

contributing factors to hoarseness include URTI, GORD, voice overuse. also name 2 iatrogenic causes of hoarseness

A

thyroid / cardiothoracic surgery

tracheal intubation

93
Q

name 4 benign lesions of vocal cords causing hoarseness?

A

vocal cord nodules
polyps
laryngeal papillomas (HPV)
Reinke’s oedema

94
Q

what do singers get from overuse?

A

vocal cord nodules

95
Q

deep hoarse voice in smokers?

A

reinke’s oedema

96
Q

what HPV strains increase risk of laryngeal carcinoma?

A

HPV 16, 18

97
Q

what kind of cancer is laryngeal carcinoma?

A

squamous cell

mainly affects glottis.

98
Q

name some RFs for layngeal carcinoma?

A 
smoking
alcohol
male
>40
low fruit/veg
HPV 16/18
99
Q

when to refer for hoarseness?

A

hoarseness >3wks - urgent CXR in GP to decide to refer to ENT or lung Ca

100
Q

investigation for layngeal carcinoma in ENT?

A

flexible laryngoscopy

CT

101
Q

how does laryngeal carcinoma present?

A

chronic hoarseness

+/- persistent cough, lump in neck, dysphagia

102
Q

surgery for advanced laryngeal carcinoma?

A

partial/total laryngectomy

103
Q

general management advice for benign vocal cord lesions?

A 
vocal hygiene (hydration, avoid straining voice, stop smoking/alcohol)
SALT
104
Q

tell about acute laryngitis.

A

mostly viral.
hoarseness / cough / fever / sore throat/neck
self limiting, reassurance.

105
Q

usual viral culprits causing sore throat?

A

rhinovirus, coronavirus, adenovirus, influenza, para

106
Q

sore throat =

A

inflammation of upper resp tract. - pharynx, larynx, tonsils, epiglottis

107
Q

name 4 complications of tonsilitis

A

quinsy
scarlet fever
rheumatic fever
post-strep glomerulonephritis

108
Q

what are the 4 criteria of the Centor score

A

Fever
Exudates
Absent cough
Tender anterior cervical lymphadenopathy

109
Q

what does a score of 3/4 on Centor indicate?

A

consider Abx for strep throat

might want to give delayed (e.g. if symps not settled in wk)

110
Q

are throat swavs recomended in tonsilitis?

A

no

might want monospot for glandular fever tho

111
Q

name some safety nets for tonsilits

A

difficulty breathing
stridor
cant swallow fluids
systemically unwell

112
Q

when do you qualify for tonsillectomy?

A

7 eps in past yr

5 eps in past 2yrs

113
Q

what Abx do you give for Centor 3/4 tonsillitis?

A

Pen V 10 days

or clarithromycin

114
Q

Fever
Exudates
Absent cough
Tender anterior cervical lymphadenopathy

this is what?

A

Centor score

115
Q

what can FBC show in glandular fever?

A

lymphocytosis

116
Q

glandular fever aka

A

infectious mononucleosis

117
Q

if im saying to you…. low grade fever, sore throat w exudative enlarged tonsils, cervical lymphadenopathy, maybe even hepatosplenomegaly… you’re thinking

A

infectious mononucleosis

118
Q

heterophile antibodies =

A

monospot test, glandular fever

119
Q

why shouldnt you play rugby when youve got glandular fever?

A

dont want to squish your enlarged spleen

120
Q

what virus causes infectious mononucleosis?

121
Q

name 3 srs complications of glandular fever

A

splenic rupture
airway obstruction
guillain barre

122
Q

treatment for glandular fever?

A

paracetamol + ibuprofen
plenty of fluids
safety netting
may need steroids if difficulty breathing/swallowing

123
Q

how long does glandular fever usually take to resolve itself

A

2-4wks

fatigue is last to go

124
Q

quinsy aka

A

peritonsillar abscess

125
Q

pus btw tonsilar capsule + lateral pharyngeal wall =

A

quinsy / peritonsillar abscess

126
Q

quinsy can be complication of what

A

tonsilitis

infectious mononucleosis

127
Q

fetid breath, sore throat bad on one side, drooling, trismus, “hot potato voice” = ?

A

peritonsillar abscess

128
Q

name some symptoms of peritonsillar abscess

A 
fetid breath
sore throat unilateral
drooling
trismus
hot potato voice
129
Q

what is trismus ?

A

cant open mouth because of inflammation

lockjaw

130
Q

you examine a young woman who has cervical lymphadenopathy on the left, a bulge above and lateral to her left tonsil, and her uvula displaced to the right. she’s trying to complain of left sided sore throat but her voice sounds like a hot potato. diagnosis?

A

peritonsillar abscess/quinsy

–> SAME DAY ENT REFERRAL

131
Q

management of peritonsillar abscess ?

A

SAME DAY ENT REFERRAL
IV fluids, analgesia, IV penicillin
incision & drainage or needle aspiration

132
Q

name two complications of peritonsillar abscess

A

rupture of abscess - aspiration pneum :~(

necrotising fascitis :~(

133
Q

SAME DAY ENT REFERRAL
IV fluids, analgesia, IV penicillin
incision & drainage or needle aspiration

this is the management of what?

A

peritonsillar abscess

134
Q

name the 4 sets of sinuses

A

frontal
maxillary
sphenoid
ethmoid

sinusitis = infl of their membranous lining

135
Q

findings on examination in sinusitis?

A

not much to find except pain on pressure

136
Q

acute facial discomfort, blocked nose, reduced smell. sounds like what ? (a non-resolving cold.. )

A

acute sinusitis

137
Q

acute sinusitis is defined as what

A

7-30ds

viral usually is quicker (<10ds)

138
Q

management of acute sinusitis?

A

paracetamol/ibuprofen
warm face packs
nasal decongestants

> 10ds - consider nasal corticosteroids or rarely Abx

refer if imm comp, recurrent, systemic inf severe

139
Q

name some complications of sinusitis?

A

orbital cellulitis!!
meningitis
pott’s puffy tumour (osteomyelitis of frontal bone, heck)

140
Q

define chronic sinusitis plz

141
Q

dull facial ache and nasal purulence for months. sounds like what?

A

chronic sinusitis

142
Q

what structural factor can lead to chronic sinusitis

A

nasal polyps

narrow openings

143
Q

what is the treatment for chronic sinusitis?

A

nasal steroids

if severe/unresponsive, oral pred
(ENT surgery to widen openings)

144
Q

dark ulcers in nose in a diabetic pt

A

invasive fungal sinusitis!

aspergillus. ENT refer.

145
Q

who gets barosinusitis

A

scuba diverz

146
Q

women clarinet players aged 20-50 yrs with schizophrenia get

A

Temporomandibular joint dysfunction

pathophysiology poorly understood

147
Q

what are the three cardinal symptoms of temporomandibular joint dysfunction ?

A

pain
restricted jaw motion
joint noise

+/- otalgia / headache

148
Q

a 45 yr old clarinet player presents w pain in jaw, restricted jaw motion, and joint noise. diagnosis?

A

TMJ dysfunction

149
Q

name some conditions which predispose to TMJ dysfunction

A

chronic pain
bruxism / over/underbite
OA and RA
gout

150
Q

how do you palpate temporomandibular joint?

A

fingers in pre-auricular area, ask pt to open mouth
- joint clicks/grating

palpate head and neck for tenderness

measure distance of painless vertical mouth opening

151
Q

give me four differentials for TMJ dysfunction

A

dental pain
trigeminal neuralgia
migraine
giant cell arteritis

152
Q

Kate, talk to me about management of TMJ dysfunction

A 
reassurance
rest jaw - soft food, massage
relaxation techniques
bite guards for bruxism 
NSAIDs... even amitryp

~~ IA steroids

153
Q

profound hearing loss =

154
Q

conductive hearing loss is where

A

external to middle ear

155
Q

sensorineural hearing loss is where

A

inner ear (cochlea, cochlear nerve), brainstem

156
Q

name 2 viruses that can cause hearing loss congenitally

A

rubella

CMV

157
Q

name 2 viruses that can cause hearing loss postnatally

A

mumps, measles

158
Q

you can categorise causes of conductive deafness into occlusion, infection, perforation and growths. give an example of occlusion.

A

wax, foreign bod

159
Q

you can categorise causes of conductive deafness into occlusion, infection, perforation and growths. give an example of infection.

A

otitis externa, otitis media, sinusitis

160
Q

you can categorise causes of conductive deafness into occlusion, infection, perforation and growths. give an example of perforation.

A

chronic otitis media, trauma

161
Q

you can categorise causes of conductive deafness into occlusion, infection, perforation and growths. give an example of growths.

A

tumours, cysts,

otosclerosis, cholesteatoma

162
Q

describe Weber’s

A

fork on forehead

163
Q

describe Rinne’s

A

fork on mastoid then ear

164
Q

bone conduction >air conduction = ?

A

conductive

165
Q

what is otosclerosis?

A

normal bone replaced by vascular spongy bone - conductive deafness

166
Q

normal bone replaced by vascular spongy bone = ?

A

otosclerosis

167
Q

flamingo tinge on tympanic membrane…

A

otosclerosis

168
Q

what is cholesteatoma?

A

keratinising squamous epithelium within middle ear - may be locally destructive to bones

169
Q

keratinising squamous epithelium in middle ear = ?

A

cholesteatoma

170
Q

cholesteatoma erodes bones w osteolytic enzymes. leads to foul smelling otorrhoea and what kind of hearing loss?

A

conductive

171
Q

sensorineural deafness can be categorised into noise-induced, ototoxic, immunological and infection. describe noise-induced.

A

bilateral, gradual. assoc w tinnitus. refer for legal if occupational.

172
Q

sensorineural deafness can be categorised into noise-induced, ototoxic, immunological and infection. give an example of ototoxic

A

furosemide, gentamicin, quinine

+/- tinnitus and balance probs

173
Q

sensorineural deafness can be categorised into noise-induced, ototoxic, immunological and infection. give an example of immunological.

A

HIV WITH CMV

responds to oral pred

174
Q

sensorineural deafness can be categorised into noise-induced, ototoxic, immunological and infection. give an example of infection.

A

otitis interna, encephalitis, meningitis

175
Q

apart from noise-induced, ototoxic, immunological and infection, give 2 more examples of causes of sensorineural deafness.

A

presbyacusis (age related!)

MS

176
Q

age related sensorineural hearing loss = ?

A

presbyacusis

177
Q

give three investigations used to investigate hearing loss

A

pure tone audiometry
tympanometry
otoacoustic emission testing

178
Q

which investigation measures cochlear function?

A

otoacoustic emission testing

179
Q

which investigation measures whether conductive, sensorineural or mixed?

A

pure tone audiometry

‘air-bone gap’

180
Q

which investigation measures stiffness of eardrum to evaluate middle ear function?

A

tympanometry

181
Q

what does tympanometry measure?

A

stiffness of eardrum to evaluate middle ear function

182
Q

what does pure tone audiometry measure

A

whether conductive sensorineural or mixed hearing loss

‘air-bone gap’

183
Q

what does otoacoustic emission testing measure?

A

cochlear function

184
Q

if suspect presbyacusis, refer where?

A

audiology

if absence of underlying pathology, hearing aids

185
Q

if sudden hearing loss, or hearing loss in imm comp, or hearing loss assoc focal neuro, refer where?

186
Q

neck lumps =

A

cancer until proven otherwise

187
Q

what’s the most common cause of neck lumps ?

A

reactive lymph nodes

but cancer until proven otherwise

188
Q

give me 3 categories of neck lumps

A

malignant
reactive lymphadenopathy
congenital/developmental

189
Q

name 2 features of a malignant neck lump

A

hard mass
rapid enlargement

lymph nodes are soft and mobile

190
Q

name some malignant causes of lymph nodes

A 
laryngeal cancer
thyroid cancer
virchows node met
skin cancer
lymphoma
leukaemia
191
Q

name some causes of reactive lymphadenopathy

A

TB

HIV, EB

192
Q

name some congenital/developmental causes of neck lumps

A

thyroglossal cyst
branchial cyst
pharyngeal pouch

193
Q

a developmental neck lump presents in late teens, big painless mobile

A

branchial cyst

194
Q

neck lump moves when stick tongue out, its in the midline.

A

thyroglossal cyst

195
Q

neck lump in old man with halitosis, gurgles on palpation

A

pharyngeal pouch

196
Q

apart from malignant, reactive lymphadenopathy, and congenital/developmental causes, name another cause of neck lumps

A

salivary gland infection

  • mumps (parotid)
  • acute sildadenitis
  • sialolithiasis
197
Q

what is sialolithiasis?

A

stone in salivary gland, meal time pain, submandibular

198
Q

throw around some investigations that might be useful for neck lumps, depending on presentation. just throw them around

A 
FBC and ESR
TFTs
viral serology e.g. EBV, HIV
throat swab
CXR 
US + fine needle aspiration thyroid
199
Q

any new neck mass persisting beyond __ wks should be referred.

200
Q

any new neck mass persisting beyond 6 wks should be referred. true or false

201
Q

67 yr old man presents with new neck lump, weight loss and hoarsness

A

2ww (laryngeal ca, lung ca?)

202
Q

75yr old woman presents with new neck lump, night sweats, weight loss, fever and pruritis

A

2ww (lymphoma)

203
Q

oral cancer are mainly what kind

A

squamous cell carcinoma

204
Q

oral cancer secondaries come from

A

lung GI or lymphoma

205
Q

5 RFs for oral cancer

A

> 50 male smoking alcohol low fruit/veg

206
Q

talk to me about oral cancer presentation

A

sore ulcer not healing
lump in mouth/neck

leukoplakia
erythroplakia

207
Q

what is erythroplakia ?

A

red patches in mouth

208
Q

what is leukoplakia?

A

white patches in mouth

209
Q

56 yr old male presents with sore ulcer on buccal mucosa not healing for the past 7wks. you also notice some leukoplakia on the underside of his tongue. you refer on 2ww for suspected oral ca. first investigation?

A

biopsy

then if cancer, CT thorax (for all head/neck cancers)

210
Q

2ww for suspected oral cancer IF:

A

unexplained ulcer in oral cavity >3wks

persistent unexplained lump in neck

211
Q

2ww referal to dentist for assessment if lump on lip/oral cavity or

A

red/white patch (erythroleukoplakia)

212
Q

management of early oral ca?

A

surgical resection, brachytherapy + cisplatin

213
Q

management of advanced oral ca?

A

surgical resection + reconstruction
external beam radio
cisplatin

214
Q

does oral cancer have a high recurrence?

215
Q

tell me briefly about nasopharyngeal carcinoma

A

EBV!! Asians, smoking.

blood tinged sputum. nasal obstruction. tinnitus/unilateral conductive hearing loss.

216
Q

name a cancer that can cause unilateral conductive hearing loss

A

nasopharyngeal carcinoma

EBV

217
Q

pharyngeal ca is less common than nasopharyngeal. risk from smoking and HPV. can present w otalgia or hoarseness, dysphagia.

218
Q

how can you distinguish between viral labrynthitis and vestibular neuritis?

A

labrynthitis is hearing loss and tinnitus as well as vertigo (involves whole labrynth), vestibular neuritis is just vertigo

219
Q

preventing vertigo attacks

A

betahistine, vestibular rehab

220
Q

managing vertigo acute attacks

A

buccal or IM prochlorperazine

221
Q

what kind of nystagmus might you see in vestibular neuritis

A

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ENT (1 decks)

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