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ENT for Finals > High Yield Exam Cram > Flashcards

High Yield Exam Cram Flashcards

1
Q

What is the most common histological type of head and neck cancer?

A

squamous cell carcinoma

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2
Q

What are some of the risk factors associated with squamous cell carcinoma?

A
  • Chewing betel quid or tobacco
  • HPV 16 & EBV
  • Smoking and alcohol
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3
Q

What are the 2 most common causes of otitis externa

A

Pseudomonas aeruginosa & s. aureus

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4
Q

What is the treatment for mild otitis externa?

A

topical acetic acid 2%

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5
Q

What is the treatment for moderate otitis externa?

A

topical abx and steroid (Otomize spray = neomycin, dexamethasone and acetic acid)

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6
Q

What is the treatment for severe otitis externa?

A

oral or IV abx

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7
Q

What is the treatment for fungal otitis externa?

A

clotrimazole

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8
Q

How do pathogens get access to the middle ear in order to cause otitis media?

A

Pathogens enter from the back of the throat via the Eustachian tube

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9
Q

What are the two most common bacterial causes of otitis media?

A

strep pneumoniae & H. influenzae

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10
Q

How is otitis media managed?

A

Analgesia only unless :
* >4 days & not improving
* systemically unwell
* Ruptured eardrum
* <2 years old and bilateral

In cases as above, give Amoxicillin

Can give a Delayed prescription of abx (3 day delay) if suspect symptoms may worsen

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11
Q

what is the risk associated with mastoiditis?

A

can cause intracranial infection if left untreated

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12
Q

How are peripheral and central causes of vertigo differentiated?

A

HINTs test

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13
Q

What causes BPPV?

A

otolith crystal free in the semi-circular canal

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14
Q

How does BPPV present?

A

Short bursts of vertigo and nystagmus triggered by head movement

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15
Q

How is BPPV diagnosed?

A

Dix-Halpike manoeuvre

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16
Q

How is BPPV treated?

A

Eply manoeuvre

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17
Q

What causes labrynthitis?

A

Inflammation of the semi-circular canals, vestibule and cochlea (usually triggered by a recent viral URTI)

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18
Q

How does labrynthitis present?

A

Vertigo
Tinnitus
Hearing loss

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19
Q

How is labrynthitis managed?

A

Prochlorperazine
Antihistamines

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20
Q

What causes Ménière’s?

A

Excessive build-up of endolymph

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21
Q

How does Ménière’s present?

A

Episodic Vertigo
Tinnitus
Unilateral sensioneural
hearing loss
Unidirectional nystagmus

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22
Q

How is Ménière’s managed?

A

Manage symptoms during an attack
Prochlorperazine
Antihistamines

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23
Q

What drug is given as Ménière’s prophylaxis?

A

Betahistine

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24
Q

What causes vestibular neuritis?

A

Inflammation of the vestibular nerve (usually triggered by a recent viral URTI infection)

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25
Q

How does vestibular neuronitis present?

A

Vertigo
NO hearing loss!

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26
Q

How is vestibular neuronitis managed?

A

Prochlorperazine
Antihistamines

27
Q

What time frame counts as ‘rapid onset’ hearing loss?

A

<72 hours

28
Q

What should happen if a patient has rapid onset sensioneural hearing loss?

A

Refer to ENT

29
Q

What is the hearing test conducted in the newborn period (and what is the 2nd line test if they fail the first one?)

A

Otoacoustic Emissions then Auditory Brain stem responses if they fail the first test

30
Q

What is the hearing test conducted from 6-18 months?

A

Distraction test

31
Q

what is the hearing test conducted in children aged 1-3 years?

A

Visual reinforced audiometry

32
Q

What is the hearing test conducted in children aged 3-5 years?

A

Play audiometry

33
Q

What is the hearing test conducted in those >4 years old?

A

Pure tone audiometry

34
Q

How are Rinne’s and Weber’s interpreted?

A

Rinne’s
* Positive test = normal

Weber’s
* Sensioneural = louder in normal ear
* Conductive = louder in abnormal ear

35
Q

Name three medications/types of medication that cause sensioneural hearing loss

A
  • Loop diuretics
  • Gentamycin (aminoglycoside abx)
  • Chemotherapy (cisplatin)
36
Q

What is plotted on the x and y axis of an audiogram

A

X = Frequency
Y = Volume

37
Q

Above what decibels is considered a normal hearing range?

A

> 20dB

38
Q

What does conductive hearing loss look like on an audiogram?

A

Gap between the lines

39
Q

What does sensioneural hearing loss look like on an audiogram?

A

drops off

40
Q

what is the name given to age related hearing loss

A

Presbycusis

41
Q

Which pitch of sounds are lost first in presbycusis?

A

High pitched sounds

42
Q

Which pitch of sounds are lost first in otosclerosis:?

A

Low pitched sounds

43
Q

How is otosclerosis managed?

A

Hearing aids, stapedectomy or stapedotomy

44
Q

What condition is associated with bilateral acoustic neuromas?

A

Neurofibromatosis Type II

45
Q

Where in the brain are acoustic neuromas found?

A

Cerebellopontine angle

46
Q

How can acoustic neuromas be managed?

A

conservative management, surgery or radiotherapy

47
Q

Name 4 causes of sinusitis

A
  • Infection
  • Allergy
  • Obstruction of drainage (trauma, polyp, foreign body)
  • Smoking
48
Q

How should acute sinusitis be managed?

A

Watch and wait for first 10 days

Then 14 days of steroid nasal spray and a 7 day delayed abx prescription

49
Q

How should chronic sinusitis be managed?

A
  • Saline nasal irrigation
  • Steroid nasal sprays
  • Functional endoscopic sinus surgery
50
Q

Name 6 causes of nasal polyps

A
  • Asthma
  • chronic rhinitis
  • sinusitis
  • Cystic fibrosis (test for this using the sweat test)
  • Allergic fungal sinusitis
  • Churg-Strauss syndrome
51
Q

How are nasal polyps managed?

A

Bilateral = nasal steroids to shrink themor polypectomy

Unilateral = urgent referral to ENT

52
Q

What is the most common cause of tonsillitis

A

Viral cause

53
Q

What is the most common bacterial cause of tonsillitis?

A

Group A strep (strep pyogenes)

54
Q

What is the antibiotic of choice in bacterial tonsillitis? How long should the course be?

A

Phenoxymethylpenicillin (10 days)

55
Q

What are the indications of antibiotic prescription in patients with bacterial tonsillitis?

A

Centor score ≥ 3
FeverPAIN score ≥ 4
immunocompromised
very young
co-morbid
rheumatic fever

56
Q

What are the indications for tonsillectomy?

A
  • 7 or more in 1 year
  • 5 per year for 2 years
  • 3 per year for 3 years
  • > 2 episodes of quinsy
  • Enlarged tonsils causing difficulty breathing, swallowing or crying
57
Q

How should a post tonsillectomy bleed be managed
A) within 24 hours of tonsillectomy
B) >24 hours post tonsillectomy

A

A) return to theatre
B) admit for IV ABx

58
Q

What should you worry about if you see a patient with leukoplakia or eryhtoplakia?

A

They are pre-cancerous lesions- refer!!

59
Q

What causes gingival hyperplasia?

A

vit C deficiency
pregnancy
AML
gingivitis

60
Q

What causes glossitis?

A

iron deficiency anaemia
B12 deficiency
folate deficiency
coeliac disease

61
Q

What causes geographic tongue?

A

stress
mental illness
psoriasis
atopy
diabetes

62
Q

What causes strawberry tongue?

A

Kawasaki disease and scarlet fever

63
Q

What causes black hairy tongue?

A

dehydration
dry mouth
poor oral hygiene
smoking

64
Q
A

ENT for Finals (1 decks)

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