Minimum criteria Flashcards
- Symptoms and clinical features of diffuse otitis externa
Symptoms •Earache •The external part of the ear canal is painful, especially the tragus •Discharge, itching •Ear congestion, hearing loss •Fever is uncommon
Clinical findings •Swelling and hyperemia of the skin of the ear canal •Serous or purulent discharge •Accumulation of debris in the ear canal •Tympanic membrane appears to be normal
- Symptoms and clinical features of acute otitis media (AOM) – suppurative form
Symptoms • Earache; • Hearing loss; • Nasal discharge and congestion; • Fever, malaise; • If perforation is present: otorrhea
Clinical findings
• Ear canal appears to be normal;
• Hyperemia of tympanic membrane;
• Later in the course of the disease: marked bulging of the tympanic membrane, subsequently spontaneous perforation can develop.
- Causes of acute hearing loss
Conductive type:
• wax, foreign body;
• acute tubal occlusion, otitis media (OME/AOM);
• trauma (e.g. perforation of the tympanic membrane).
Sensorineural type: • Noise (acute) induced hearing loss; • Viral infection; • Vascular causes; • Toxical damage (medication, chemicals); • Traumas.
- What is to be done in case of acute sensorineural hearing loss?
In case of acute sensorineural hearing loss, immediate intravenous nootropic/vasodilatating therapy or steroid bolus treatment is necessary with hospitalization.
Meanwhile detailed investigation must be done to clarify the etiology. The earlier the treatment is started, the better the outcome is.
- Recognition of hearing loss in childhood
Signs of hearing loss in childhood: • the newborn does not react to sounds • tone of crying is unusual • babbling period does not appear • visual orientation is dominant • speech development is delayed • tone, pitch, intensity, melody and rhythm of the speech is pathologic • articulation disorders • worse reading and writing skills
- Causes of ear pain
Primary otalgia
• Otitis
• Tumors of the ear
Referred ear pain
• Tumors and inflammations of the larynx, pharynx, tonsils, base of the tongue
• Dental inflammations, temporomandibular joint syndrome, neuralgic pain.
- Complications of acute otitis media (AOM)
1) Extracranial
-Intratemporal
• Acute mastoiditis
• Zygomaticitis
• Petrositis
• Facial nerve palsy
• Labyrinthitis
-Extratemporal
• Abscess: subperiosteal, preauricular, suboccipital, Bezold’s abscess
2) Intracranial
- Extradural abscess
- Sinus phlebitis - sinus thrombosis
- Subdural abscess
- Meningitis, encephalitis
- Brain abscess
3) General: sepsis.
- Clinical features and symptoms of acute mastoiditis
Associated with, or following acute otitis media;
The pinna is pushed forward;
Retroauricular pain, erythema;
The posterior wall of the external ear canal is swollen, seems to be lowered;
Pulsating, severe pain;
Pulsating otorrhea.
- Causes of unilateral otitis media with effusion (OME) in adults and childhood
Chronic dysfunction of the Eustachian tube (adenoid vegetation or nasopharyngeal tumor)
In adults, the possibility of a nasopharyngeal tumor must not be left out of consideration!
- How to diagnose vertigo caused by vestibular disorders
Patient history:
• Type of vertigo (sensation of spinning or falling)
• Vegetative symptoms, nausea, vomiting.
Examination:
• deviation, tilting
• spontaneous nystagmus and nystagmus provoked by head movements.
- Causes of peripherial facial palsy (list)
Bell’s palsy
Herpes zoster oticus
Other viral or bacterial infections (HSV, EBV, Lyme)
Acute and chronic middle ear diseases (acute and chronic middle ear infections, cholesteatoma, rarely tumors)
Tumors of the pontocerebellar angle, vestibular schwannoma
Malignant tumors of parotid gland.
Cranial traumas (pyramid bone fractures), extratemporal traumas
- Primary management of epistaxis/nosebleeding (at home/ambulance/by GP)
The patient should lean forward with open mouth, firm digital pressure should be applied to both nasal alae for 10 minutes;
Ephedrine/nasal drop/vasocontrictor solution-imbibed cotton or spongostan should be applied in nasal cavity;
Cold compress should be applied to the nape of the neck and to the nasal dorsum;
Blood pressure-measurement, antihypertensive treatment if needed.
- Management of epistaxis/nosebleeding (anterior, posterior) by ENT professionals
Blood pressure-measurement, antihypertensive treatment - if needed
Visible bleeding source: chemical cauterization (trichloroacetate, silver nitrate) or coagulation (bipolar electrocoagulation)
Anterior nasal bleeding: anterior nasal packing
Posterior nose bleeding: posterior nasal packing (Bellocq tamponade), balloon catheter.
- Management and complications of nasal folliculitis and furuncles
Circumscript folliculitis: local therapy with antibiotic and steroid containing creams, vapor coverage;
The patient should be told not to pick or squeeze the lesions;
For furunculosis and/or phlegmonous reaction, parenteral antibiotics should be administered, along with vapor coverage;
The infection is usually caused by Staphylococcus aureus;
Possible complications: Facial phlegmone, angular vein thrombophlebitis, cavernous sinus thrombosis.
- Types of rhinitis (list)
Common infections: Simple acute rhinitis, purulent rhinitis
Specific forms of Rhinitis: TB, syphilis, sarcoidosis
Allergic rhinitis
Atrophic rhinitis (oezena)
Rhinitis sicca anterior.
Other causes: idiopathic, vasomotoric, hormonal, drug-induced, rhinitis medicamentosa, occupational (caused by irritants) foodstuffs. (3 causes are required from the “other” group)
