Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ENT Year 2 > Pathology Part 1 > Flashcards

Pathology Part 1 Flashcards

1
Q

Acute otitis media

A

A painful type of ear infection. Middle ear becomes inflamed and infected.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Common organisms that cause Acute otitis media

A

Most infections are secondary to bacteria, particularly Streptococcus pneumonaie, Haemophilus influenzae and Moraxella catarrhalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Features of Acute otitis media

A

> Otalgia
May tug or rub their ear
Fever 50% of cases
Hearing loss
Recent viral URTI symptoms (e.g. coryza)
Ear discharge if tympanic.m perforates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Possible otoscopy findings in Acute otitis media

A

> Bulging tympanic.m → loss of light reflex
Opacification or erythema of tympanic.m
Perforation with purulent otorrhoea
Decreased mobility using pneumatic otoscope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Otorrhoea

A

Drainage of liquid from the ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Acute otitis media management

A
  1. Usually self-limiting
  2. Antibiotics in some cases (criteria)
  3. Analgesia
  4. Seek medical help if symptoms worsen or do not improve after 3 days.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When are antibiotics indicated in Acute otitis media?

A

> Symptoms lasting more than 4 days or not improving
Systemically unwell but not requiring admission
Immunocompromise or high risk of complications
Younger than 2 years with bilateral otitis media
Otitis media with perforation and/or discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

If antibiotics are given in Acute otitis media, what is the antibiotic of choice?

A

A 5-7 day course of amoxicillin is first-line

Penicillin allergy ; erythromycin or clarithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Chronic suppurative otitis media (CSOM)

A

Defined as perforation of the tympanic membrane with otorrhoea for > 6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Common sequelae after Acute otitis media

A

> Perforation tympanic mem. → otorrhoea
Unresolved acute otitis media with perforation may develop into CSOM
Hearing loss
Labyrinthitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Complications of Acute otitis media

A
  1. mastoiditis
  2. meningitis
  3. brain abscess
  4. facial nerve paralysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Sinusitis

A

Describes inflammation of the mucous membranes of the paranasal sinuses. The sinuses are usually sterile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Most common organisms to cause Sinusitis

A

Streptococcus pneumoniae
Haemophilus influenzae
Rhinoviruses.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Predisposing factors that lead to Sinusitis

A
  1. Nasal obstruction e.g. septal deviation or nasal polyps
  2. Recent local infection e.g. rhinitis or dental extraction
  3. Swimming/diving
  4. Smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Features of Sinusitis

A

Facial pain - pressure pain worse on bending forward

Nasal discharge: usually thick and purulent

Nasal obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Management of Sinusitis

A
  1. Analgesia
  2. Intranasal decongestants
  3. Intranasal corticosteroids may be considered if the symptoms have been present for more than 10 days
  4. Oral antibiotics given for severe presentations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Antibiotics which may be given in Sinusitis

A

Phenoxymethylpenicillin first-line, co-amoxiclav if ‘systemically very unwell, signs and symptoms of a more serious illness, or at high-risk of complications’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When are antibiotics indicated in sinusitis?

A

Given for severe presentations - ‘systemically very unwell, signs and symptoms of a more serious illness, or at high-risk of complications’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When are intranasal corticosteriods indicated in sinusitis?

A

May be considered if the symptoms have been present for more than 10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Most common organism to cause Acute tonsillitis

A

Streptococcus pyogenes the most common organism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Characteristics of Acute tonsillitis

A

Pharyngitis, fever, malaise and lymphadenopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

One condition that mimics Acute tonsillitis

A

Infectious mononucleosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Treatment for Acute tonsillitis

A

Penicillin type antibiotics is indicated for bacterial tonsillitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Complication of Acute tonsillitis

A

May result in local abscess formation (quinsy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Allergic rhinitis

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

The three classifications of Allergic rhinitis

A
  1. seasonal:
  2. perennial
  3. occupational
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Seasonal Allergic rhinitis

A

Symptoms occur around the same time every year. Seasonal rhinitis which occurs secondary to pollens is known as hay fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Perennial Allergic rhinitis

A

Symptoms occur throughout the year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Occupational Allergic rhinitis

A

Symptoms follow exposure to particular allergens within the work place

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Features of Allergic rhinitis

A 
>   sneezing
>   bilateral nasal obstruction
>   clear nasal discharge
>   post-nasal drip
>   nasal pruritus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Management for Allergic rhinitis

A
  1. Allergen avoidance
  2. Mild-to-moderate intermittent, or mild persistent symptoms: oral or intranasal antihistamines
  3. Moderate-to-severe persistent symptoms, or initial drug treatment is ineffective - intranasal corticosteroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Management of mild-to-moderate intermittent, or mild persistent symptoms of Allergic rhinitis

A

Oral or intranasal antihistamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Management of moderate-severe and persistant symptoms of Allergic rhinitis

A

Intranasal corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Oxymetazoline

A

Nasal decongestant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Complications of prolonged use of nasal decongestants

A

As increasing doses are required to achieve the same effect

Rebound hypertrophy of the nasal mucosa may occur upon withdrawal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Rhinitis medicamentosa

A

Rebound hypertrophy of the nasal mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Audiogram findings in sensorineural hearing loss

A

Both air and bone conduction are impaired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Audiogram findings in conductive hearing loss

A

Only air conduction is impaired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Audiogram findings in mixed hearing loss

A

Both air and bone conduction are impaired, with air conduction often being ‘worse’ than bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Normal Audiogram findings

A

Anything above the 20dB line is essentially normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Sensorineural hearing loss (SNHL)

A

Caused by damage to the structures in your inner ear or your auditory nerve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Conductive hearing Loss

A

When the natural movement of sound through the external ear or middle ear is blocked, and the full sound does not reach the inner ear.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Auricular haematomas

A

Describes a collection of blood within the cartilaginous auricle (outer ear) which typically results from blunt trauma - common in rugby players and wrestlers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Management of Auricular haematomas

A
  1. Need same-day assessment by ENT

2. Incision and drainage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Benign paroxysmal positional vertigo

A

Characterised by the sudden onset of dizziness and vertigo triggered by changes in head position. The average age of onset is 55 years and it is less common in younger patients.

Benign paroxysmal positional vertigo Tiny calcium “stones” inside your inner ear canals help you keep your balance. Sometimes these stones move into an area of your inner ear - the semicircular canal. When you move your head in certain ways, the stones in the semicircular canal move. Sensors in the semicircular canal are triggered by the stones, which causes a feeling of dizziness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Features of Benign paroxysmal positional vertigo (BPPV)

A

Vertigo triggered by change in head position (e.g. rolling over in bed)

May be associated with nausea

Each episode typically lasts 10-20 seconds

Positive Dix-Hallpike manoeuvre, indicated by: patient experiences vertigo & rotatory nystagmus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Diagnosis of BPPV

A

Dix-Hallpike manoeuvre

Positive result indicated by indicated by vertigo & rotatory nystagmus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Management of BPPV

A

Epley manoeuvre

Exercises they can do themselves at home, termed vestibular rehabilitation, for example Brandt-Daroff exercises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Prognosis for BPPV

A

Good prognosis and usually resolves spontaneously after a few weeks to months

Around half of people with BPPV will have a recurrence of symptoms 3–5 years after their diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Black hairy tongue

A

Common condition which results from defective desquamation of the filiform papillae. Despite the name the tongue may be brown, green, pink or another colour.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Predisposing factors that lead to Black hairy tongue

A 
>   poor oral hygiene
>   antibiotics
>   head and neck radiation
>   HIV
>   intravenous drug use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Management of Black hairy tongue

A
  1. Tongue scraping

2. Topical antifungals if Candida

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Branchial cleft cyst

A

A lump that develops in the neck or just below the collarbone. May have a fistula and are therefore prone to infection. They may enlarge following a respiratory tract infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Cholesteatoma

A

A non-cancerous growth of squamous epithelium that is ‘trapped’ within the skull base causing local destruction. Most common in patients aged 10-20 years.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What congenital abnormality increases the risk of Cholesteatoma by 100 fold

A

Being born with a cleft palate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Features of Cholesteatoma

A 
>   foul-smelling, non-resolving discharge
>   hearing loss
>   vertigo
>   facial nerve palsy
>   cerebellopontine angle syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Otoscopy findings in cholesteatoma

A

‘attic crust’ - seen in the uppermost part of the ear drum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Management of cholesteatoma

A

Referred to ENT for consideration of surgical removal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Chronic rhinosinusitis

A

An inflammatory disorder of the paranasal sinuses and linings of the nasal passages that lasts 12 weeks or longer.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Predisposing factors for Chronic rhinosinusitis

A
  1. atopy: hay fever, asthma
  2. nasal obstruction e.g. Septal deviation or nasal polyps
  3. recent local infection e.g. Rhinitis or dental extraction
  4. swimming/diving
  5. smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Features of Chronic rhinosinusitis

A

Facial pain: frontal pressure pain which is worse on bending forward

Nasal discharge: usually clear if allergic or vasomotor. Thicker, purulent discharge suggests secondary infection

Nasal obstruction: e.g. ‘mouth breathing’

Post-nasal drip: may produce chronic cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Management of Chronic rhinosinusitis

A
  1. avoid allergen
  2. intranasal corticosteroids
  3. nasal irrigation with saline solution

Defined by the presence of at least two out of four cardinal symptoms (i.e., facial pain/pressure, hyposmia/anosmia, nasal drainage, and nasal obstruction) for at least 12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Red flag symptoms for Chronic rhinosinusitis

A
  1. unilateral symptoms
  2. persistent symptoms despite compliance with 3 months of treatment
  3. epistaxis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Cochlear implant

A

An electronic device that may be offered to patients with severe-to-profound hearing loss.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Criteria for getting a cochlear implant

A

In children, audiological assessment and/or difficulty developing basic auditory skills.

In adults, patients should have completed a trial of appropriate hearing aids for at least 3 months which they have been objectively demonstrated to receive limited or no benefit from.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Contraindications for receiving cochlear implant

A

Lesions of cranial nerve VIII or in brain stem causing deafness

Chronic infective otitis media, mastoid cavity or tympanic membrane perforation

Cochlear aplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Acoustic neuroma features

A

Features predicted by affected cranial nerves
> cranial nerve VIII: hearing loss, vertigo, tinnitus
> cranial nerve V: absent corneal reflex
> cranial nerve VII: facial palsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Another name for acoustic neuroma

A

Vestibular schwannomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Bilateral acoustic neuromas

A

Seen in neurofibromatosis type 2

70
Q

Acoustic neuroma

A

A benign tumor that develops on the balance (vestibular) and hearing, or auditory (cochlear) nerves leading from your inner ear to the brain

71
Q

Noise damage frequency

A

Workers in heavy industry are particularly at risk

Hearing loss is bilateral and typically is worse at frequencies of 3000-6000 Hz

72
Q

Drug ototoxicity

A

Examples include aminoglycosides (e.g. Gentamicin), furosemide, aspirin and a number of cytotoxic agents

73
Q

Another name for glue ear

A

Otitis media with effusion

74
Q

Glue ear

A

Glue ear, known as adhesive otitis, is a condition that occurs when the middle part of your ear fills with fluid.

75
Q

Complications that arise with Glue ear

A

Speech and language delay, behavioural or balance problems may also be seen

76
Q

What kind of hearing loss does ear wax cause?

A

Conductive hearing loss

77
Q

Ear wax treatment

A

Ear drops or irrigation
The following drops may be used:
olive oil, sodium bicarbonate 5% & almond oil

78
Q

When should ear wax not be treated?

A

Treatment should not be given if a perforation is suspected or the patient has grommets.

79
Q

Epistaxis classification

A

Anterior and posterior bleeds

80
Q

Anterior epistaxis cause

A

Often has a visible source of bleeding and usually occurs due to an insult to the network of capillaries that form Kiesselbach’s plexus.

81
Q

Posterior epistaxis cause

A

More profuse and originate from deeper structures unlike anterior. They occur more frequently in older patients and confer a higher risk of aspiration and airway compromise.

82
Q

Epistaxis that has failed all emergency management

A

May require sphenopalatine ligation in theatre

83
Q

Epistaxis which has failed to resolve after 10-15 minutes of continuous pressure on the nose

A

Cautery should be used initially if the source of the bleed is visible and cautery is tolerated

Packing may be used if cautery is not viable or the bleeding point cannot be visualised

84
Q

Initial management of epistaxis

A

> Sit with their torso forward &mouth open
Avoid lying down unless they feel faint
Pinch the cartilaginous area of the nose firmly for at least 20 minutes

85
Q

Trigeminal neuralgia type facial pain

A

Unilateral facial pain characterised by brief electric shock-like pains, abrupt in onset and termination
May be triggered by light touch, emotion

86
Q

Temporal arteritis type facial pain

A

Tender around temples

Raised ESR

87
Q

Drug causes of gingival hyperplasia

A

> phenytoin
ciclosporin
calcium channel blockers (especially nifedipine)

88
Q

Head and neck cancer

A

An umbrella term. It typically includes:
> Oral cavity cancers
> Cancers of the pharynx
> Cancers of the larynx

89
Q

Head and neck cancer features

A

neck lump
hoarseness
persistent sore throat
persistent mouth ulcer

90
Q

Laryngeal cancer referral criteria

A

Referral (for an appointment within 2 weeks) in people aged 45 and over with:
persistent unexplained hoarseness or
an unexplained lump in the neck

91
Q

Thyroid cancer referral criteria

A

Referral (for an appointment within 2 weeks) for thyroid cancer in people with an unexplained thyroid lump

92
Q

Oral cancer referral criteria

A

Referral (for an appointment within 2 weeks) in people with either:
unexplained ulceration in the oral cavity lasting for more than 3 weeks or
a persistent and unexplained lump in the neck.

93
Q

Causes of hoarseness

A 
>   voice overuse
>   smoking
>   viral illness
>   hypothyroidism
>   gastro-oesophageal reflux
>   laryngeal cancer
>   lung cancer
94
Q

Laryngopharyngeal reflux (LPR)

A

Caused by gastro-oesophageal reflux resulting in inflammatory changes to the larynx/hypopharynx mucosa.

95
Q

Laryngopharyngeal reflux features

A 
A lump in the throat - 'globus'
Typically worse when swallowing saliva rather than eating or drinking
hoarseness 
chronic cough 
dysphagia 
heartburn 
sore throat
96
Q

Management of Laryngopharyngeal reflux

A

> lifestyle measures & avoid triggers
proton pump inhibitor
sodium alginate liquids (e.g. Gaviscon)

97
Q

Ludwig’s angina

A

Type of progressive cellulitis that invades floor of mouth & soft tissues of neck. Most cases result from odontogenic infections which spread into the submandibular space.

98
Q

Features of Ludwig’s angina

A

neck swelling
dysphagia
fever

99
Q

Management of Ludwig’s angina

A
  1. airway management

2. intravenous antibiotics

100
Q

Malignant otitis externa

A

Uncommon type of otitis externa that is found in immunocompromised individuals (90% cases found in diabetics)

101
Q

Common cause of Malignant otitis externa

A

Pseudomonas aeruginosa

102
Q

Infection spread in Malignant otitis externa

A

Infection commences in the soft tissues of the external auditory meatus, then progresses to involve the soft tissues and into the bony ear canal

Progresses to temporal bone osteomyelitis

103
Q

Features of Malignant otitis externa

A 
Diabetes (90%) or immunosuppression 
Severe, unrelenting, deep-seated otalgia
Temporal headaches
Purulent otorrhea
Possibly dysphagia, hoarseness, and/or facial nerve dysfunction
104
Q

Diagnosis of Malignant otitis externa

A

A CT scan is typically done

105
Q

Management of Malignant otitis externa

A

Non-resolving otitis externa with worsening pain should be referred urgently to ENT

Intravenous antibiotics that cover pseudomonal infections

106
Q

Mastoiditis features

A

> Severe otalgia classically behind the ear
History of recurrent otitis media
Fever
Very unwell
The external ear may protrude forward
Swelling, erythema & tenderness over mastoid process

107
Q

Meniere’s disease

A

A disorder of the inner ear that can lead to vertigo and hearing loss. In most cases, Meniere’s disease affects only one ear. Can occur at any age, but it usually starts between young and middle-aged adulthood.

108
Q

Meniere’s disease features

A
  1. recurrent episodes of vertigo, tinnitus and hearing loss (sensorineural).
  2. Aural fullness or pressure
  3. nystagmus and a positive Romberg test
  4. episodes last minutes to hours
109
Q

Management of acute attacks of Meniere’s disease

A

Buccal or intramuscular prochlorperazine. Admission is sometimes required

110
Q

Samter’s triad

A

The association of asthma, aspirin sensitivity and nasal polyposis is known as Samter’s triad.

111
Q

Associations that lead to nasal polyps

A 
asthma
aspirin sensitivity
infective sinusitis
cystic fibrosis
Kartagener's syndrome
Churg-Strauss syndrome
112
Q

Features of nasal polyps

A

nasal obstruction
rhinorrhoea, sneezing
poor sense of taste and smell

113
Q

Management of nasal polyps

A

All patients should be referred to ENT

Topical corticosteroids shrink polyp size

114
Q

Medication to shrink nasal polyps

A

Topical corticosteroids

115
Q

Nasal septal haematoma

A

Important complication of nasal trauma which should always be looked for. Describes the development of a haematoma between the septal cartilage and the overlying perichondrium.

116
Q

Management of Nasal septal haematoma

A

surgical drainage

intravenous antibiotics

117
Q

Complication of untreated Nasal septal haematoma

A

Irreversible septal necrosis may develop within 3-4 days. Due to pressure-related ischaemia of the cartilage resulting in necrosis. This may result in a ‘saddle-nose’ deformity

118
Q

What virus is associated with development of Nasopharyngeal carcinoma?

A

Associated with Epstein Barr virus infection

119
Q

What part of the world is Nasopharyngeal carcinoma mostly found?

A

Rare in most parts of the world, apart from individuals from Southern China

120
Q

Carotid aneurysm

A

Pulsatile lateral neck mass which doesn’t move on swallowing

121
Q

Thyroglossal cyst

A

Usually midline, between the isthmus of the thyroid and the hyoid bone
Moves upwards with protrusion of the tongue

122
Q

Otitis externa

A

A condition that causes inflammation of the external ear canal

123
Q

Causes of otitis externa

A

infection: bacterial
seborrhoeic dermatitis
contact dermatitis (allergic and irritant)
recent swimming is a common trigger

124
Q

Common bacterial cause of otitis externa

A

Staphylococcus aureus

Pseudomonas aeruginosa

125
Q

Features of otitis externa

A

ear pain, itch, discharge

otoscopy: red, swollen, or eczematous canal

126
Q

Management of otitis externa

A

Topical antibiotic or a combined topical antibiotic with a steroid

If the tympanic membrane is perforated aminoglycosides are traditionally not used*

Canal debris then consider removal
Canal is extensively swollen then an ear wick is sometimes inserted

127
Q

Otosclerosis

A

Describes the replacement of normal bone by vascular spongy bone. It causes a progressive conductive deafness due to fixation of the stapes at the oval window.

128
Q

Features of Otosclerosis

A 
Onset is usually at 20-40 years
conductive deafness
tinnitus
normal tympanic membrane*
positive family history
129
Q

Otosclerosis inheritance

A

Autosomal dominant

130
Q

Management of Otosclerosis

A

hearing aid

stapedectomy

131
Q

Most common parotid neoplasm (80%)

A

Benign pleomorphic adenoma or benign mixed tumor

132
Q

Second most common benign parotid tumor (5%)

A

Warthin tumor (papillary cystadenoma lymphoma or adenolymphoma)

133
Q

Most common cause of a perforated tympanic membrane

A

Infection

134
Q

Management of perforated tympanic membrane

A

> No treatment - heal after 6-8 weeks

> Antibiotics to perforations which occur following an episode of acute otitis media.

> Myringoplasty if does not heal by itself

135
Q

A complication of bacterial tonsillitis

A

Peritonsillar abscess (quinsy)

136
Q

Features of bacterial tonsillitis

A

Severe throat pain, lateralises to one side
Deviation of uvula to unaffected side
Trismus (difficulty opening the mouth)
Reduced neck mobility

137
Q

Management of bacterial tonsillitis

A

Patients need urgent review by an ENT specialist.
Needle aspiration or incision & drainage + IV antibiotics
Tonsillectomy should be considered to prevent recurrence

138
Q

Pathophysiology of Pleomorphic adenoma

A

Proliferation of epithelial and myoepithelial cells of the ducts and an increase in stromal components

Slow-growing, lobular, and not well encapsulated

139
Q

Post-operative complications of tonsillectomy

A

Primary and secondary haemorrhages

Primary, in first 6-8 hours following surgery. It is managed by immediate return to theatre.

Secondary haemorrhage occurs between 5 and 10 days after surgery and is often associated with a wound infection.

140
Q

Presbycusis

A

Age-related hearing loss is the gradual loss of hearing in both ears. It’s a common problem linked to aging.

141
Q

What kind of hearing loss is Presbycusis?

A

Sensorineural - high-frequency hearing is affected bilaterally

142
Q

Features of Presbycusis

A

Sensorineural - high-frequency hearing is affected bilaterally

143
Q

Audiometry features of Presbycusis

A

Bilateral sensorineural pattern hearing loss

144
Q

Investigations in Presbycusis

A

Otoscopy: Normal
Tympanometry: Normal middle ear function with hearing loss (Type A)
Audiometry: Bilateral sensorineural pattern hearing loss

145
Q

Features of Ramsay Hunt syndrome

A

auricular pain is often the first feature
facial nerve palsy
vesicular rash around the ear
other features include vertigo and tinnitus

146
Q

Ramsay Hunt syndrome

A

Caused by the reactivation of the varicella zoster virus in the geniculate ganglion of the seventh cranial nerve.

147
Q

Management of Ramsay Hunt syndrome

A

Oral aciclovir and corticosteroids

148
Q

Rinne’s and Weber’s test

A

Allows differentiation of conductive and sensorineural deafness.

149
Q

Rinne’s test

A

Tuning fork is placed over the mastoid process until the sound is no longer heard,

‘positive test’: air conduction (AC) is normally better than bone conduction (BC)

‘negative test’: if BC > AC then conductive deafness

150
Q

Weber’s test

A

Tuning fork is placed in the middle of the forehead equidistant from the patient’s ears - asked which side is loudest

In unilateral sensorineural deafness, sound is localised to the unaffected side

In unilateral conductive deafness, sound is localised to the affected side

151
Q

Conductive hearing loss

A

Rinne’s test
Bone conduction > air conduction in affected ear
Air conduction > bone conduction in unaffected ear

Weber test - Lateralises to affected ear

152
Q

Sensorineural hearing loss

A

Rinne’s - Air conduction > bone conduction bilaterally

Weber’s - Lateralises to unaffected ear

153
Q

Salivary glands

A

parotid (serous)
submandibular
sublingual

154
Q

What salivary gland do tumors usually affect?

A

Parotid glands (80%)

155
Q

Sore throat

A

encompasses pharyngitis, tonsillitis, laryngitis

156
Q

FeverPAIN criteria

A 
Fever over 38°C.
Purulence (pharyngeal/tonsillar exudate).
Attend rapidly (3 days or less)
Severely Inflamed tonsils
No cough or coryza
157
Q

Centor criteria

A

(fever >38.5°C, swollen, tender anterior cervical lymph nodes, tonsillar exudate and absence of cough) are an algorithm to assess the probability of group A β haemolytic Streptococcus (GABHS) as the origin of sore throat, developed for adults

158
Q

Majority of sensorineural hearing loss

A

Idiopathic

159
Q

Management of all cases of sensorineural hearing loss

A

Urgent referral to ENT.

High-dose oral corticosteroids

160
Q

Causes of tinnitus

A 
Idiopathic	
Meniere's disease	
Otosclerosis	
Sudden onset sensorineural hearing loss 
Acoustic neuroma	
Excessive loud noise
Presbycusis
Impacted ear wax
161
Q

Drug causes of tinnitus

A

Aspirin/NSAIDs
Aminoglycosides
Loop diuretics
Quinine

162
Q

Causes of Vertigo (dizziness)

A 
Viral labyrinthitis	
Vestibular neuronitis
Benign paroxysmal positional vertigo	
Meniere's disease	
Vertebrobasilar ischaemia	
Acoustic neuroma
163
Q

Vestibular neuronitis

A

A cause of vertigo that often develops following a viral infection. Affects the vestibular branch of 8th cranial nerve.

164
Q

Features of Vestibular neuronitis

A
  1. Recurrent vertigo lasting hours or days
  2. Nausea and vomiting may be present
  3. Horizontal nystagmus is usually present
  4. No hearing loss or tinnitus
165
Q

Management of Vestibular neuronitis

A

Vestibular rehabilitation exercises

Buccal or intramuscular prochlorperazine is often used to provide rapid relief for severe cases

Short oral course of prochlorperazine, or an antihistamine may be used to alleviate less severe cases

166
Q

Examples of oral antihistamines

A

cinnarizine, cyclizine, or promethazine

167
Q

Labyrinthitis

A

An inflammatory disorder of the membranous labyrinth, affecting both the vestibular and cochlear end organs. Labyrinthitis can be viral, bacterial or associated with systemic diseases. Viral labyrinthitis is the most common form of labyrinthitis.

168
Q

Difference between Labyrinthitis and vestibular neuritis

A

Vestibular neuritis is used to define cases in which only the vestibular nerve is involved, hence there is no hearing impairment;

Labyrinthitis is used when both the vestibular nerve and the labyrinth are involved, usually resulting in both vertigo and hearing impairment.

169
Q

Infectious mononeucleois

A

Infectious mononeucleois - aka glandular fever has petechial heamorrhages, mimics tonisilits due to enlarged tonsils and fever - may cause splenomegaloy and hepatomegaly.

170
Q

Likely association of oropharynx sqamous cell carcinoma

A

HPV

171
Q

Likely association with nasopharynx cancers

A

EBV

ENT Year 2 (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions