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ENT > History > Flashcards

History Flashcards

1
Q

HPC

  • normal HPC (5)
  • important to ask for all ent (1)
A

main PCs

  • timings, nature, exac, reliev, Asx and relevant SR
  • bilateral or unilateral. unilateral conditions raise suspicious because tumours and malignancies are usually unilateral (initially at leasdt)
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2
Q

what to ask about in PMH (2)

A
  • current or previous medical conditions relevant to current PC
  • or those that may affect pts fitness for treatment - fit for anaesthesia
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3
Q

what to ask in DH

  • all medications
  • medications related to ENT PC eg (2)
  • also ask about (1)
A
  • all medications
  • drugs relevant to ENT PC

>eg anticoagulants in pt with nosebleed, aminiglycosides in pt with hearing loss

-ADRs, allergues

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4
Q

what to ask in SH(3)

A
  • occupation
  • home environment if relevant
  • alc and smoking
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5
Q

PC - nasal obstruction

  • what to ask in HPC(10)
  • what features suggest nasal tumour (3)
  • what features suggest foreign body in child (3)
A

-constant or intermittent

  • uni or bilatera
  • Asx sneezing, itching - hayfever
  • is there rinorhea. what quality and quantity - epistaxis=nose bleed. or post nasal drip
  • pressure or pain in face - sinus involvement
  • -*changes in smell. - anosmia=loss. cachosmia=unpleasant odors.
  • -*snoring

-sleep apneoea

nasal tumour

>unilateral epistaxis or polyp/blood stained discharge. facial pain, facial swelling.

-foreign body in child > unilat foul rhinorrhea

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6
Q

PC - hearing loss

  • HPC (1)
  • PMH children(4)
  • DH(1)
  • SH(1)
  • FH(1)
A

-bilateral or uniilateral tumour

  • PMH - children - congenital conditions, birth or neonatal trauma, anoxia, serious infections - meningitis
  • SH - noise exposure
  • FH - hearing problems
  • DH - aminiglycosides in pt with hearing loss
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7
Q

PCs in the ear

  • otalgia=(1). where may pain be referred to the ear from (6)
  • otorrhoea=(1) ask about (2)
  • itch
  • feeling of pressure. may suggest (1)
  • tinnitus. pulsitile may suggest (1) popping/cracking may suggest (1)
  • what asx may you have to ask specifically about (2)
A
  • this is pain in the ear. may be reffered from sinuses, teeth, temporomandibular joint, cervial spine, oropharynx, throat
  • quality - waxy, purulent, blood stainted, watery, foul smelling may suggest cholesteatoma. quantity
  • feeling of pressure may suggest eustacian tube defect
  • pulstitile tinnitus may suggest serious tumour. popping or cracking may suggest eustacian tube defect
  • alteration of taste or facial weakness. facial nerve and chorda tympani involvement .
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8
Q

pc - vertigo/dizziness

HPC (2)

PMH (1)

A
  • exaccerbators/triggers. assx and full sr
  • full pmh
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9
Q

PC - hoarse voice

important to distinguish malignant from non malignant cause.

HPC - timing, particularly (4). assx

SH (2)

A

-timing

> inc circumstances that preceded - eg URTI, overuse. onset gradual tumour. lasting more than 3 wks tumour. does it get better sometimes suggests not tumour.

  • -asx to ask about - stridor, otalgia =earache,* dysphagia
  • SH - professional voice user, smoking tumour, and alc
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10
Q

-PCs in the throat

  • these features usually innocent pathology but may suggest tumour*
  • feeling of a lump. HPC (1)
  • mucus
  • discomfort
  • disphagia
  • also ask about (1)
A
  • lump - ask about persistance may suggest tumour
  • also ask about features of acid reflux as these may contribute to throat problems
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11
Q

-PCs in mouth

-sore throat

-tonsillitis

-lesions on tongue and mouth - ulcers

^do full SR and general PMH for these. what conditions could be cause(2)

-swelling in mouth - what to ask in HPC (3) asx to consider (5)

A
  • conditions such as anaemia and HIV can present with oral manisfestations
  • swelling in mouth
  • >* ask pain or increase in size on eating, xerostomia. suggests salivary gland disease

> also asx facial palsy, runs through salivary glands, this asx raises suspicion of malig. dry and itchy eyes systemic conditions that affect sal glands can also affect lacrimal glands,systemic disease eg arthritissystemic disease can be ass with sal gland dis,trismus,displaced**tonsils

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12
Q

PC - lump in neck

  • nb could be a neoplastic node secondary to primary tumour*
  • what should you always do for pt with lump in neck (1) why(1)
  • what sites could be the primary tumour (7)
  • HPC - what to ask in SR (4)
  • PMH. what to ask (1)
A
  • must be referred to ent specialist as only they have equipment to examine the likely primary sites from which a secondary neoplastic node deposits may originate.
  • nasopharynx, oropharynx, tonsil, tongue base, pyriform fossa, larynx, upper oesophagus

-HPC, SR - fever, malaise, night sweats. these are features of lymphoma (a cancer), TB, AIDs. also ask about tyroid over or under Sx

-PMH - ask about recent infection - could suggest a ‘reactive’ node

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ENT (9 decks)

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