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ENT > Non-Malignant Head and Neck > Flashcards

Non-Malignant Head and Neck Flashcards

1
Q

What are the two main questions to ask about a sore throat?

A

Can you swallow spit?

Can you swallow food?

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2
Q

Definition of odynophagia

A

Painful to swallow

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3
Q

Definition of dysphagia

A

Cannot swallow

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4
Q

Drainage of the middle ear

A

Middle ear -> eustachian tube -> adenoids

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5
Q

What antibiotic should be given usually for infections? What antibiotic should be avoided?

A

Penicillin V should be given

Amoxicillin avoided

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6
Q

What will FBC tell you in terms of infection?

A

The type of infection

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7
Q

What should you check to see if the patient is dehydrated?

A

Renal function

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8
Q

What is a monospot a test for?

A

Glandular fever

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9
Q

What is CRP a marker of?

A

Inflammation

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10
Q

Which type of infection does CRP tend to be higher in, bacterial or viral?

A

Bacterial

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11
Q

What other organs can glandular fever affect?

A

Liver

Spleen

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12
Q

What additional test should be done in glandular fever?

A

LFTs

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13
Q

What is penicillin IV?

A

Benzylpenicillin

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14
Q

Where do you get very sore pain in quinsy?

A

Throat

Up to ear

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15
Q

Symptoms of quinsy

A

Very painful
Pain spread up to ear
Cannot open mouth very well

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16
Q

Why is it difficult to open your mouth when you have a quinsy?

A

The pterygoid can go into spasm

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17
Q

Treatment of quinsy

A

Analgesia
Antibiotics
May need to drain

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18
Q

What is there a significant risk of during tonsillectomy? What % of people struggle with this after the operation and have to come back into hospital?

A

Bleeding

10%

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19
Q

What % of patients need a further operation or transfusion after tonsillectomy?

A

1%

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20
Q

Why is it important to give good painkillers after tonsillectomy?

A

If the throat is sore, patients tend not to eat. This means the mouth isn’t cleaned properly naturally, which leads to infection and bleeding

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21
Q

Progression to get OSA

A

Hypotonic collapsing of airway
Leads to snoring
Then get OSA

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22
Q

Definition of apnoea

A

A pause in the breath

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23
Q

What does OSA stand for?

A

Obstructive sleep apnoea

24
Q

What level does a sturtor come from?

A

Oropharyngeal

25
Q

What does a sturtor produce?

A

A snoring noise

26
Q

What level does a stridor come from?

A

Laryngeal level

27
Q

What level does a wheeze come from?

A

Lungs

28
Q

What does nebulised adrenaline do?

A

Reduces oedema

29
Q

What causes supraglottitis?

A

Haemophilus type B

30
Q

Causes of hoarseness

A 
Age
Infective laryngitis
Voice overuse
Reflux laryngitis
Emotional factors 
RLN palsy (iatrogenic or neoplastic)
CVA
Fixation of joint e.g. RA
Laryngeal tumour
31
Q

Indications for consideration for recurrent acute sore throat in both children and adults

A

Sore throat due to acute tonsillitis
The episodes of sore throat are disabling and prevent normal functioning
Seven or more well documented, clinically significant, adequately treated sore throats in the preceding year or
Five or more such episodes in each of the preceding two years or
Three or more such episodes in each of the preceding 3 years

32
Q

What should be done when there is doubt whether tonsillectomy would be beneficial?

A

A six month period of watchful waiting

33
Q

The pain can increase for how long after a tonsillectomy?

A

6 days

34
Q

What drugs are recommended after tonsillectomy?

A

Analgesics
Anti emetics
NSAIDs

35
Q

What is recommended to be given intraoperatively in children having a tonsillectomy or adenoidectomy to prevent post op vomiting? And at induction of anaesthesia in adults

A

Single dose of dexamethasone

36
Q

What feature favours a diagnosis of tonsillitis?

A

ABSENCE of a cough

37
Q

What criteria is used to determine if a tonsillitis episode is bacterial?

A

Centor criteria

38
Q

What is the Centor criteria for bacterial tonsillitis?

A

3 out of 4 of

  • Temp > 38 C
  • Tender anterior cervical lymphadenopathy
  • Absence of a cough
  • Exudate present on the tonsils
39
Q

Antibiotic of choice for acute sinusitis

A

Oral phenoxymethylpenicillin

40
Q

Cause of ramsey hunt syndrome

A

Reactivation of the VZV in the geniculate ganglion of the seventh CN

41
Q

Another name for ramsey hunt syndrome

A

Herpes zoster oticus

42
Q

Presentation of ramsey hunt syndrome

A 
Auricular pain often first feature 
Facial nerve palsy 
Vesicular rash around the ear
Vertigo 
Tinnitus
43
Q

Treatment of ramsey hunt syndrome

A

Oral acyclovir

Corticosteroids

44
Q

What is the FEVERPAIN score and what does it predict?

A

Likelihood of sore throat caused by isolating strep
Criteria
- Fever > 38C
- Purulence (pharyngeal/tonsillar exudate)
- Attend rapidly (3 days or less)
- Severely inflamed tonsils
- No cough or coryza

45
Q

What is sialadenitis?

A

Inflammation of the salivary gland

46
Q

What is sialadenitis usually due to?

A

A stone impacted in the duct

47
Q

Causes of swelling of the submandibular gland

A

Obstruction by stone

Tumour - benign or malignant

48
Q

Most common cause of inflammation of parotid gland

A

Tumours

49
Q

Most common cause of inflammation of submandibular gland

A

Stones

50
Q

Who gets pleomorphic adenomas?

A

Middle aged

51
Q

Presentation of pleomorphic adenoma

A

Slow growing

Painless lump

52
Q

Presentation of salivary duct stones

A

Recurrent unilateral pain and swelling on eating

53
Q

Which salivary gland are 80% of stones found in?

A

Submandibular gland

54
Q

Causes of salivary gland enlargement

A 
Stone
Tumour
Acute viral infection e.g. mumps
Acute bacterial infection e.g. secondary to dehydration DM
Sicca syndrome and sjrogens (e.g. RA)
55
Q

Treatment of quinsy

A

IV antibiotics
Surgical drainage
Tonsillectomy should be considered within 6 weeks

ENT (17 decks)

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