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Medicine and Surgery Mushkies > Passmed ENT Mushkies > Flashcards

Passmed ENT Mushkies Flashcards

1
Q

What is an autosomal dominant cause of deafness affecting young adults?

A

Otosclerosis

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2
Q

What kind of hearing loss does otosclerosis cause?

A

Conductive

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3
Q

What kind of hearing loss do acoustic neuromas cause?

A

Sensorineural

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4
Q

How does Menieres disease usually present?

A
  1. Episodic vertigo
  2. Hearing loss
  3. Tinnitus
  4. Fullness/pressure in one or both ears
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5
Q

What is otosclerosis?

A

Replacement of normal bone in the ear by vascular spongy bone, causing progressive conductive deafness due to fixation of the stapes at the oval window

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6
Q

What are some features of otosclerosis?

A
  1. 20-40 y/o
  2. Conductive deafness
  3. Tinnitus
  4. Normal tympanic membranes
  5. Positive FHx
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7
Q

What is the management of otosclerosis?

A
  1. Hearing aid

2. Stapedectomy

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8
Q

How can you classify the causes of otitis externa?

A
  1. Infection
  2. Seborrhoeic dermatitis
  3. Contact dermatitis (allergic and irritant)
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9
Q

What are the infective causes of otitis externa?

A
  1. Bacterial = S. aureus, P. aeruginosa
  2. Viral
  3. Fungal
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10
Q

What are some features of otitis externa?

A
  1. Ear pain
  2. Itch
  3. Discharge
  4. Otoscopy = red, swollen, or eczematous canal
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11
Q

What is the first line management of otitis externa?

A
  1. Topical Abx/combined topical Abx with steroid e.g. topical gentamicin + hydrocortisone drops
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12
Q

What can be inserted to manage an extensively swollen ear canal due to otitis externa?

A

Ear wick

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13
Q

What are second line treatments for otitis externa?

A
  1. Spreading infection = oral flucloxacillin

2. Empirical antifungal

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14
Q

What should you do with otitis externa that fails to respond to topical Abx?

A

Referral to ENT

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15
Q

What is malignant otitis externa, and what pt group do you typically see it in?

A
  1. Extension of infection into bony ear canal and soft tissues deep to the bony canal
  2. Found in immunocompromised individuals (90% diabetics)
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16
Q

What causes an elderly pt that becomes dizzy upon extending his neck?

A

Vertebrobasilar ischaemia

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17
Q

What is vertigo?

A

The false sensation that the body or environment is moving

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18
Q

What are features of viral labyrinthitis?

A
  1. Recent viral infection
  2. Sudden onset
  3. N&V
  4. Hearing may be affected
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19
Q

What are features of vestibular neuronitis?

A
  1. Recent viral infection
  2. Recurrent vertigo attacks lasting hours or days
  3. No hearing loss
  4. Horizontal nystagmus usually present
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20
Q

What are features of BPPV?

A
  1. Gradual onset
  2. Triggered by change in head position
  3. Each episode lasts 10-20s
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21
Q

How does an acoustic neuroma present?

A
  1. Hearing loss
  2. Vertigo
  3. Tinnitus
  4. Absent corneal reflex is an important sign
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22
Q

What condition are acoustic neuromas associated with?

A

NF2

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23
Q

Is air conduction (AC) usually better than bone conduction (BC)?

A

Yes

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24
Q

What does BC > AC on Rinne’s test imply?

A

Conductive deafness

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25
Q

In Weber’s test, to which side is unilateral sensorineural deafness localised to?

A

To the unaffected side

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26
Q

In Weber’s test, to which is is unilateral conducive deafness localised to?

A

To the affected side

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27
Q

Is hearing normal or abnormal in vestibular neuronitis?

A

Normal

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28
Q

What exam can be used to distinguish vestibular neuronitis from a posterior circulation stroke?

A

The HiNTs exam

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29
Q

What is the management of vestibular neuronitis?

A
  1. Vestibular rehab exercises if chronic
  2. Buccal/IM prochlorperazine for rapid relief in severe cases
  3. Short oral course of prochlorperazine to alleviate less severe cases
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30
Q

Why should pts with hoarseness being referred down the cancer pathway have a CXR?

A

To exclude an apical lung lesion

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31
Q

What are some causes of hoarseness?

A
  1. Voice overuse
  2. Smoking
  3. Infection = viral
  4. Inflammation = GORD
  5. Malignancy = laryngeal, lung
  6. Hypothyroidism
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32
Q

What is otitis externa with worsening unrelenting pain suggestive of?

A

Malignant (necrotising) otitis externa

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33
Q

What is the most common cause of malignant otitis externa?

A

P. aeruginosa

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34
Q

What can malignant otitis externa progress to?

A

Temporal bone osteomyelitis

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35
Q

How is malignant otitis externa usually diagnosed?

A

CT

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36
Q

How is malignant otitis externa usually managed?

A

IV Abx that cover pseudomonas

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37
Q

What percentage of otitis media is viral?

A

50%

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38
Q

What percentage of otitis media improve without Abx?

A

60%

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39
Q

When should you usually treat otitis media with Abx?

A
  1. Sx > 4d or not improving
  2. Systematically unwell but not requiring admission
  3. Immunocompromise or high risk of complications secondary to other disease
  4. Younger than 2 y/o with bilateral otitis media
  5. Otitis media w/ perforation and/or discharge in the canal
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40
Q

What is the first line Abx for treatment of tonsillitis?

A

Penicillin V/Phenoxymethylpenicillin for 10 days

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41
Q

What is the first line Abx for treatment of otitis media?

A

Amoxicillin 500mg TDs for 7 days

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42
Q

What is the most common cause of neck swellings?

A

Reactive lymphadenopathy

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43
Q

What is a characteristic of a thyroid swelling?

A

Moves upward on swallowing

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44
Q

In what age group are thyroglossal cysts more common?

A

<20 y/o

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45
Q

What are some features of a thyroglossal cyst?

A
  1. Usually midline, between isthmus of thyroid and the hyoid bone
  2. Moves upward on protrusion of the tonge
  3. May be painful if infected
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46
Q

In what pt group are pharyngeal pouches more common?

A

Older men

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47
Q

What is a pharyngeal pouch?

A

A posteromedial herniation between the thyropharyngeus and cricopharyngeus muscle

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48
Q

What are some features of a pharyngeal pouch?

A
  1. Usually not seen, but if large then a midline neck lump that gurgles on palpation
  2. Dysphagia
  3. Regurgitation
  4. Aspiration
  5. Chronic cough
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49
Q

What is a cystic hygroma?

A

A congenital lymphatic lesion (lymphangioma) typically found in the neck, classically on the left side

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50
Q

In what pt group are cystic hygromas more common?

A

Most evident at birth, 90% present before 2 y/o

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51
Q

What is a branchial cyst?

A

An oval, mobile mass that develops between the SCM and the pharynx

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52
Q

How does a branchial cyst form?

A

Develops due to failure of obliteration of the second branchial cleft in embryonic development i.e. failure of fusion of the second and third branchial arches

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53
Q

In what pt group do branchial cysts usually appear?

A

Early adulthood

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54
Q

What is a complication of a cervical rib?

A

10% develop thoracic outlet syndrome

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55
Q

In what pt population are cervical ribs more common?

A

Adult females

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56
Q

What does a carotid aneurysm look like clinically?

A

Pulsatile lateral neck mass which doesnt move on swallowing

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57
Q

What are some ototoxic medications?

A
  1. Gentamicin
  2. Quinine
  3. Furosemide
  4. Aspirin
  5. Chemo
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58
Q

What are 2 uses for quinine?

A
  1. Antimalarials

2. Nocturnal leg cramps

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59
Q

What is presbyacusis?

A

Age-related sensorineural hearing loss

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60
Q

What does one see on audiometry of presbyacusis?

A

Bilateral high frequency hearing loss

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61
Q

What is the hearing loss seen with noise damage from e.g. heavy industry?

A

Bilateral and worse at frequencies of 3000-6000 Hz

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62
Q

How can you classify how acoustic neuromas present?

A
  1. CN V = absent corneal reflex
  2. CN VII = facial palsy
  3. CN VIII = hearing loss, vertigo, tinnitus
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63
Q

What is the most common cause of a perforated tympanic membrane?

A

Infection

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64
Q

What are 2 other causes of a perforated tympanic membrane?

A
  1. Direct trauma

2. Barotrauma

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65
Q

What is the management of a perforated tympanic membrane?

A
  1. Usually no tx as will heal in 6-8wks, avoid getting water in ear in this time
  2. Abx for perforations that occur following a case of acute otitis media
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66
Q

What surgery can be performed if a tympanic membrane does not heal by itself?

A

Myringoplasty

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67
Q

What is Meniere’s disease?

A

A disorder of the inner ear of unknown cause, characterised by excessive pressure and progressive dilatation of the endolymphatic system

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68
Q

How long do attacks in Meniere’s disease typically last?

A

Mins to hours

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69
Q

What is the natural history of Menieres disease?

A
  1. Symptoms resolve in the majority of pts after 5-10 yrs
  2. Most will be left with a degree of hearing loss
  3. Psychological distress is common
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70
Q

What is the management of Menieres disease?

A
  1. Acute = buccal/IM prochlorperazine

2. Prevention = Betahistine and vestibular rehab exercises

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71
Q

What special ting needs to be done with Menieres in terms of management?

A

DVLA should be informed, cease driving until satisfactory control of sx is achieved

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72
Q

What would cause facial pain that is worse on leaning forwards?

A

Sinusitis

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73
Q

What is acute sinusitis?

A

Inflammation of the mucous membranes of the paranasal sinuses

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74
Q

What are the most common infectious agents seen in acute sinusitis?

A
  1. S. pneumoniae
  2. H. influenzae
  3. Rhinoviruses
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75
Q

What are some predisposing factors for acute sinusitis?

A
  1. Nasal obstruction e.g. septal deviation/nasal polyps
  2. Recent local infection e.g. rhinitis/dental extraction
  3. Swimming/diving
  4. Smoking
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76
Q

What are some features of acute sinusitis?

A
  1. Facial pain (frontal, worse on bending down)
  2. Nasal discharge (thick and purulent)
  3. Nasal obstruction
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77
Q

What is the management of acute sinusitis?

A
  1. Analgesia
  2. Intranasal
    decongestants
  3. Intranasal corticosteroids
  4. Oral phenoxymethylpenicillin if severe
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78
Q

What can be given for tx of acute sinusitis if symptoms have not resolved after 10 days?

A

Intranasal corticosteroids

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79
Q

What is the most common cause of acute tonsillitis?

A

S. pyogenes

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80
Q

What is unilateral swelling and fever most likely to represent with acute tonsillitis?

A

Quinsy

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81
Q

What is quinsy?

A

Local abscess formation around the tonsil

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82
Q

What are 4 investigations for presbyacusis?

A
  1. Otoscopy = normal
  2. Tympanometry = normal
  3. Audiometry = bilateral sensorineural
  4. Bloods = normal
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83
Q

How many neural pathways lead to referred otalgia?

A

5

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84
Q

What are the 5 neural pathways that can lead to referred otalgia?

A
  1. CNs 5, 7, 9, 10

2. C2 & C3

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85
Q

What is otalgia in the absence of any ear signs a red flag for?

A

Head and neck malignancy

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86
Q

What virus is nasopharyngeal carcinoma associated with?

A

EBV

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87
Q

How can you classify how nasopharyngeal carcinomas present?

A

Local and Systemic

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88
Q

How are some local ways nasopharyngeal carcinomas can present?

A
  1. Otalgia
    2, Unilateral serious otitis media
  2. Nasal obstruction/discharge/epistaxis
  3. CN palsies III-VI
89
Q

In what part of the world is nasopharyngeal carcinoma most common?

A

Southern China

90
Q

What is the 1st line treatment for nasopharyngeal carcinoma?

A

Radiotherapy

91
Q

What can extended use of topical decongestants cause?

A

Rhinitis medicamentosa

92
Q

What is rhinitis medicamentosa?

A

A condition of rebound nasal congestion brought about by extended use of topical decongestants

93
Q

What is allergic rhinitis?

A

An inflammatory disorder of the nose where the nose becomes sensitised to allergens such as house dust mites and grass, tree and weed pollens

94
Q

How can one classify allergic rhinitis?

A
  1. Seasonal
  2. Perennial
  3. Occupational
95
Q

What are some features of allergic rhinitis?

A
  1. Sneezing
  2. Bilateral nasal obstruction
  3. Clear nasal discharge
  4. Post-nasal drip
  5. Nasal pruritis
96
Q

What is the management of allergic rhinitis?

A
  1. Allergen avoidance
  2. Oral/intranasal antihistamines
  3. Intranasal corticosteroids
  4. Oral steroids to cover important life events
  5. Short course of topical nasal decongestants
97
Q

What is an example of a topical nasal decongestant?

A

Oxymetazoline

98
Q

What do you call the phenomenon where increasing doses of a drug are required to achieve the same effect?

A

Tachyphylaxis

99
Q

What must be done if there is primary haemorrhage after tonsillectomy and why?

A

Immediate return to theatre, due to risk of further more extensive bleeding

100
Q

What are the 2 main post-operative complications of tonsillectomy?

A

Pain and Haemorrhage

101
Q

What manoeuvre is diagnostic for BPPV?

A

Dix-Hallpike

102
Q

What manoeuvre is curative for BPPV?

A

Epley

103
Q

What are some features of BPPV?

A
  1. Vertigo triggered by change in head position
  2. Nausea
  3. 10-20s
  4. Positive Dix-Hallpike
104
Q

In what % of pts with BPPV is the Epley manoeuvre successful?

A

80%

105
Q

What is the eponym for the vestibular rehabilitation exercises that can be done at home for BPPV?

A

Brandt-Daroff Exercises

106
Q

What medication can be prescribed for BPPV, but is of limited value?

A

Betahistine

107
Q

What is the prognosis of BPPV?

A
  1. Good, usually resolves spontaneously after a few weeks to months
  2. 50% will have recurrence of symptoms 3-5 years after diagnosis
108
Q

What is Ramsay Hunt Syndrome?

A

Facial nerve palsy caused by VZV reactivatoin in the geniculate ganglion of CN VII

109
Q

What are some features of Ramsay Hunt Syndrome?

A
  1. Auricular pain often first
  2. Facial nerve palsy
  3. Vesicular rash (around ear commonly)
  4. Vertigo
  5. Tinnitus
110
Q

What is the management of Ramsay Hunt syndrome?

A

Oral aciclovir and corticosteroids

111
Q

What is halitosis, mouth pain, poor dental hygiene with bleeding gums and widespread gingival ulceration suggestive of?

A

Acute necrotizing ulcerative ginigivitis

112
Q

What is the management of acute necrotizing ulcerative gingivitis?

A
  1. Refer to dentist, meanwhile:
  2. Oral metronidazole for 3 days
  3. Chlorhexidine
  4. Analgesia
113
Q

What abx should be given to treat malignant otitis externa in diabetics and why?

A

Ciprofloxacin to cover pseudomonas

114
Q

How can thyroid surgery lead to hypocalcaemia?

A

Damage to parathyroid glands

115
Q

What is an ECG feature of hypocalcaemia?

A

Prolonged QT interval

116
Q

What are some complications of thyroid surgery?

A
  1. Anatomical = recurrent laryngeal nerve damage
  2. Bleeding = respiratory compromise
  3. PTH glands = hypocalcaemia
117
Q

What is the classical pathological finding in a branchial cyst?

A

Acellular fluid with cholesterol crystals

118
Q

Why are branchial cysts prone to infection?

A

They may have a fistula

119
Q

What is the DDx for a neck lump in a child?

A
  1. Congenital
  2. Inflammatory
  3. Neoplastic
120
Q

What are the congenital causes of a neck lump in a child?

A
  1. Branchial cyst
  2. Thyroglossal cyst
  3. Dermoid cyst
  4. Vascular malformation
121
Q

What are the inflammatory causes of a neck lump in children?

A
  1. Reactive lymphadenopathy

2. Lymphadenitis

122
Q

What are the neoplastic causes of a neck lump in children?

A
  1. Lymphoma
  2. Thyroid tumour
  3. Salivary gland tumour
123
Q

What are some causes of vertigo?

A
  1. Viral labyrinthitis
  2. Vestibular neuronitis
  3. BPPV
  4. Menieres disease
  5. Vertebrobasilar ischaemia
  6. Acoustic neuroma
124
Q

On an audiogram, values above which line is normal?

A

20dB lin

125
Q

On an audiogram, which forms of conduction are impaired in sensorineural hearing loss?

A

Both air and bone conduction

126
Q

On an audiogram, which forms of conduction in conductive hearing loss?

A

Only air conduction is impaired

127
Q

On an audiogram, which forms are conduction in in mixed hearing loss?

A

Both air and bone conduction, with air being worse than bone

128
Q

What are the Centor criteria?

A

Abx for 3+/4 of:

  1. Tonsillar exudate
  2. Tender cervical lymphadenopathy/lymphadenitis
  3. Fever
  4. Absence of cough
129
Q

What phenomenon is seen after using nasal decongestants for a long period of time?

A

Tachyphylaxis

130
Q

What is a cholesteatoma?

A

A benign growth of squamous epithelium that is forms a cyst within the middle ear or mastoid, causing local destruction

131
Q

What increases the risk of a cholesteatoma?

A

Being born with a cleft palate

132
Q

What are the main features of a cholesteatoma?

A
  1. Foul-smelling, non-resolving discharge

2. Hearing loss

133
Q

What do you see on otoscopy of a cholesteatoma?

A

‘Attic crust’ seen in the uppermost part of the eardrum

134
Q

What is the management of a cholesteatoma?

A

ENT referral for surgical removal

135
Q

What is the main cause of sudden sensorineural hearing loss?

A

Idiopathic

136
Q

What is the management for sudden sensorineural hearing loss?

A

High dose steroids (60mg/day) for 7 days and refer urgently to ENT

137
Q

What are some complications of tonsillitis?

A
  1. Otitis media
  2. Quinsy (peritonsillar abscess)
  3. Rheumatic fever
  4. Glomerulonephritis
138
Q

What are the criteria for tonsillectomy?

A

All of:

  1. Sore throats are due to tonsillitis
  2. 5 or more episodes per year
  3. Symptoms for at least a year
  4. Disabling and preventing normal functioning
139
Q

Why is mastoiditis a clinical emergency?

A

Due to the risk of meningitis

140
Q

What are some complications of mastoiditis?

A
  1. Meningitis
  2. CN palsies
  3. Hearing loss
  4. Osteomyelitis
  5. Carotid artery spasm
141
Q

What are some features of mastoiditis?

A
  1. Otalgia
  2. Fever
  3. Systemic upset
  4. Swelling, tenderness and erythema over mastoid process
  5. External ear protrudes forwards
  6. Hx of recurrent otitis media
142
Q

What is the management of haemorrhage 5-10 days after a tonsillectomy and why?

A

Admission and Abx, as it is associated with wound infection

143
Q

What is a key differentiating feature between viral labyrinthitis and vestibular neuronitis?

A

Hearing can be affected in viral labyrinthitis, is spared in vestibular neuronitis

144
Q

What medication is useful for helping to prevent attacks of Menieres disease?

A

Betahistine

145
Q

What is labyrinthitis?

A

Inflammatory disorder of the membranous labyrinth, affecting both the vestibular and cochlear end organs

146
Q

How can you classify the causes of labyrinthitis?

A
  1. Viral
  2. Bacterial
  3. Systemic disease
147
Q

What is the most common cause of labyrinthitis?

A

Viral

148
Q

In tonsillitis, what may uvular deviation be suggestive of?

A

A peritonsillar abscess (quinsy)

149
Q

What are some features of peritonsillar abscess (quinsy)?

A
  1. Severe throat pain, lateralises to one side
  2. Uvular deviation to unaffected side
  3. Trismus
  4. Reduced neck mobility
150
Q

What is trismus?

A

Difficulty opening the mouth, a.k.a. lockjaw

151
Q

How is quinsy normally managed?

A
  1. IV Abx
  2. Needle aspiration under LA
  3. Tonsillectomy considered in 6 weeks
152
Q

Are polyps usually uni or bilateral in rhinosinusitis?

A

Bilateral

153
Q

What must one be suspicious of when seeing a unilateral nasal polyp?

A

Malignancy

154
Q

What are some associations of nasal polyps?

A
  1. Asthma
  2. Aspirin sensitivity
  3. Infective sinusitis
  4. CF
  5. Kartagener’s
  6. Churg-Strauss
155
Q

How are nasal polyps usually managed?

A

Topical corticosteroids

156
Q

What is Samter’s triad?

A
  1. Asthma
  2. Nasal polyps
  3. Aspirin sensitivity
157
Q

What would cause a young adult to present with mumps and pancreatitis/orchitis/reduced hearing/meningoencephalitis?

A

Mumps

158
Q

How can you classify parotid tumours?

A

Benign and malignant

159
Q

What are some benign parotid tumours?

A
  1. Benign pleomorphic adenoma
  2. Warthin tumour (adenolymphoma)
  3. Monomorphic adenoma
  4. Haemangioma
160
Q

What are some malignant parotid tumours?

A
  1. Mucoepidermoid carcinoma
  2. Adenoid cystic carcinoma
  3. Mixed tumours
  4. Acinic cell carcinoma
  5. Adenocarcinoma
  6. Lymphoma
161
Q

What is the most common parotid neoplasm (80%)?

A

Benign pleomorphic adenoma

162
Q

What is the second most common parotid neoplasm (5%)?

A

Warthin tumour

163
Q

What is a Warthin tumour?

A

Adenolymphoma

164
Q

What is Sjogren’s syndrome?

A

Autoimmune disorder characterised by parotid enlargement, xerostomia and keratoconjunctivitis sicca

165
Q

How does Sjogren’s present in the parotid?

A

Bilateral, non-tender enlargement

166
Q

How can Sarcoidosis present in the parotid?

A

Bilateral, non-tender enlargement

167
Q

What are 3 disorders of the submandibular glands?

A
  1. Sialolithiasis
  2. Sialadenitis
  3. Submandibular tumours
168
Q

How much saliva to the submandibular glands produce per day?

A

800-1000ml

169
Q

Where are salivary stones most likely to be impacted?

A

Whartons duct

170
Q

What is colicky pain and postprandial swelling of the submandibular gland indicative of?

A

Sialolithiasis

171
Q

What is the most common cause of sialadenitis?

A

S. aureus infection

172
Q

What duct drains the parotid gland?

A

Stensens duct

173
Q

What causes an epidermoid cyst?

A

Proliferation of epidermal cells within a circumscribed space of the dermis

174
Q

What are some causes of tinnitus?

A
  1. Menieres disease
  2. Otosclerosis
  3. Acoustic neuroma
  4. Hearing loss
  5. Drugs
  6. Impacted ear wax
  7. Chronic suupurative otitis media
175
Q

What are 4 drugs that can cause tinnitus?

A
  1. Aspirin
  2. Aminoglycosides
  3. Loop diuretics
  4. Quinine
176
Q

What are some complications of a large cholesteatoma?

A
  1. Vertigo
  2. Facial nerve palsy
  3. Sensorineural hearing loss
  4. Cerebellopontine angle syndrome
177
Q

What condition causing hearing loss can be precipitated by pregnancy in those who are genetically predisposed?

A

Otosclerosis

178
Q

What is sialadenitis?

A

Inflammation of the salivary gland, likely secondary to obstruction by a stone impacted in the duct

179
Q

What are the 3 main salivary glands?

A
  1. Parotid glands
  2. Submandibular glands
  3. Sublingual glands
180
Q

How can one remember the rule of salivary gland tumours?

A

80% parotid, 80% of these are pleomorphic adenomas, 80% superficial lobe

181
Q

What is the most common site for epistaxis to originate from?

A

Little’s area (anterior bleed)

182
Q

What is Little’s area?

A

Site of Kiesselbach’s plexus, supplied by 4 arteries

183
Q

How can you classify the cause of epistaxis?

A

Anterior or Posterior

184
Q

Which location produces profuse epistaxis?

A

Posterior haemorrhage

185
Q

What position should be assumed for management of a nosebleed?

A

Sit with torso forward and mouth open, pinch soft area of nose firmly for 15mins and ask pt to breathe through mouth

186
Q

What can be used to reduce crusting and risk of vestibulitis if first aid measures are successful for epistaxis?

A

Naseptin

187
Q

What is Naseptin?

A

Chlorhexidine and neomycin

188
Q

What are some cautions to use of Naseptin?

A

Peanut/soy/neomycin allergies –> Mupirocin is a viable alternative

189
Q

What should be done to nosebleeds if bleeding doesnt stop after 10-15 mins of continuous pressure?

A
  1. Cautery if source of bleed is visible and is tolerated

2. Packing if bleeding point cannot be visualised

190
Q

What are 3 drugs that cause gingival hyperplasia?

A
  1. Phenytoin
  2. Ciclosporin
  3. CCBs
191
Q

What condition can cause gingival hyperplasia?

A

AML

192
Q

What is an important complication of nasal trauma which should always be looked for?

A

Nasal septal haematoma

193
Q

What is a nasal septum haematoma?

A

Development of a haematoma between the septal cartilage and the overlying perichondrium

194
Q

How does a nasal septal haematoma typically present?

A

Bilateral, red swelling arising from the nasal septum, that feels boggy

195
Q

What is the management of a nasal septal haematoma?

A
  1. Surgical drainage

2. IV Abx

196
Q

What is a complication of nasal septal haematoma if left untreated?

A

Irreversible septal necrosis within 3-4 days –> saddle-nose deformity

197
Q

When should mouth ulcers be sent to oral surgery as a 2 week referral?

A

Persisting for >3 weeks

198
Q

When should intranasal corticosteroids be considered for sinusitis?

A

If symptoms have persisted for 10 days or more

199
Q

What does the umbrella term head and neck cancer cover?

A
  1. Oral cavity cancer
  2. Pharynx cancer
  3. Larynx cancer
200
Q

What are 4 presentations of head and neck cancers?

A
  1. Neck lump
  2. Hoarseness
  3. Persistent sore throat
  4. Persistent mouth ulcer
201
Q

What head and neck cancer may present as a painless lymphadenopathy because of its tendency for early spread?

A

Nasophargyngeal carcinoma

202
Q

What might be the cause of otitis externa after returning from holiday?

A

Swimming pools

203
Q

What is pain on palpation of the tragus suggestive of?

A

Otitis externa

204
Q

What is the management of a perforated tympanic membrane caused by barotrauma?

A

Reassure and follow up (it is self limiting)

205
Q

What may be performed if a perforated tympanic membrane does not heal by itself?

A

Myringoplasty

206
Q

What virus is tonsillar SCC associated with?

A

HPV

207
Q

What 3 things does a ‘sore throat’ encompass?

A
  1. Pharyngitis
  2. Tonsillitis
  3. Laryngitis
208
Q

What is the commonest tumour of the parotid gland?

A

Pleomophic adenomas

209
Q

What is an example of a concern for nasal cancer?

A

Recurrent unilateral epistaxis

210
Q

In pts with chronic or recurrent ear discharge, what must you examine and why?

A

Attic of tympanic membrane to exclude a cholesteatoma

211
Q

What is Ludwig’s angina?

A

Cellulitis at the floor of the mouth

212
Q

What is a risk factor for developing Ludwig’s angina?

A

Immunocompromised pts with poor dentition

213
Q

Why is Ludwig’s angina deadly?

A

It can spread to the fascial spaces of the head and neck

214
Q

What is a pre-auricular sinus?

A

Congenital condition in which an epithelial defect forms around the external ear

215
Q

What is the management of a pre-auricular sinus?

A
  1. Small sinuses require no treatment

2. Deeper sinuses may need to be excised

216
Q

What is black hairy tongue?

A

A relatively common condition which results from defective desquamation of the filiform papillae

217
Q

What are predisposing factors for black hairy tongue?

A
  1. Poor oral hygiene
  2. Abx
  3. Head and neck radiation
  4. HIV
  5. IVDU
218
Q

What is the management of black hairy tongue?

A
  1. Tongue scraping

2. Topical antifungals if Candida

Medicine and Surgery Mushkies (52 decks)

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