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UL Final Year OSCE's & Short Cases > RCSI: ENT > Flashcards

RCSI: ENT Flashcards

1
Q

What is a common issue when attempting to remove a foreign body from a child’s ear?

A

Attempts by an adult may compound the problem.

This is particularly true if the child is non-compliant.

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2
Q

What are potential presentations of a foreign body in the ear?

A

Otitis externa or perichondritis.

These conditions can arise from the presence of the foreign body.

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3
Q

How should insects in the ear be treated?

A

First killed with an oil-based solution and then removed.

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4
Q

What is a common presentation of a foreign body in the nose?

A

Unilateral rhinorrhoea.

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5
Q

What imaging should be done for unwitnessed foreign body insertion in the nose?

A

Lateral nasal, inspiratory and expiratory chest X-ray (CXR).

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6
Q

What is the urgency of removing nasal foreign bodies?

A

All nasal foreign bodies should be removed on an urgent basis to prevent aspiration.

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7
Q

What should be done if initial attempts to remove a nasal foreign body fail?

A

Removal under general anaesthetic is indicated.

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8
Q

What are potential complications of button batteries in the nose?

A

Burns and septal perforation.

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9
Q

What are the four constricted sites where a foreign body can obstruct the oesophagus?

A
  • Level of the cricoid cartilage
  • Arch of aorta
  • Left main bronchus
  • Diaphragm
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10
Q

What is the definition of acute tonsillitis?

A

Tonsils are paired lymphatic organs that form part of Waldeyer’s ring and are thought to have a protective/immunological role.

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11
Q

What is the blood supply to the tonsils?

A

Branches of the external carotid artery: * Ascending pharyngeal artery
* Lesser palatine artery
* Facial artery branches
* Dorsal lingual artery
* Ascending palatine artery

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12
Q

What are the predominant pathogens causing acute tonsillitis?

A
  • Viral (influenza, parainfluenza, adenovirus, enterovirus)
  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Anaerobes
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13
Q

List symptoms of acute tonsillitis.

A
  • Sore throat
  • Odynodysphagia
  • Otalgia (referred pain)
  • Dysphonia
  • Trismus
  • Painful cervical lymphadenopathy
  • Pyrexia
  • Malaise
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14
Q

What is the Centor Score used for?

A

To indicate the likelihood of bacterial infection as a cause of tonsillitis.

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15
Q

What does a Centor Score of 0-2 indicate regarding antibiotic treatment?

A

Do not treat with antibiotics.

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16
Q

What complications can arise from acute tonsillitis?

A
  • Quinsy
  • Parapharyngeal abscess
  • Retropharyngeal abscess
  • Chronic tonsillitis
  • Acute otitis media
  • Rheumatic fever
  • Post-streptococcal glomerulonephritis (PSGN)
  • Scarlet fever
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17
Q

What is the management for most cases of acute tonsillitis?

A

Managed in the community with analgesia, bed rest, and continued oral intake.

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18
Q

What is peritonsillar abscess also known as?

A

Quinsy.

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19
Q

What are the symptoms of a parapharyngeal abscess?

A
  • Sore throat
  • Odynodysphagia
  • Lateral neck mass
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20
Q

What is the clinical presentation of a retropharyngeal abscess?

A
  • Sore throat
  • Neck stiffness
  • Odynodysphagia
  • Stridor
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21
Q

What is the immediate management for a pinna (auricular) hematoma?

A

Urgent incision and drainage under local anaesthetic.

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22
Q

What causes otitis externa?

A

Infective inflammation of the external auditory canal.

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23
Q

What are the key risk factors for acute otitis media (AOM)?

A
  • Water exposure (swimmers)
  • Immunosuppression
  • Retained foreign body
  • Auditory canal stenosis
  • Dermatological conditions (eczema, psoriasis, dermatitis)
  • Canal trauma (cotton bud)
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24
Q

What are common pathogens associated with acute otitis media?

A
  • Pseudomonas aeruginosa
  • Staphylococcus aureus
  • Fungal (aspergillus, candida)
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25
Q

What is the definition of otitis media with effusion (OME)?

A

Chronic accumulation of non-purulent effusion within the middle ear and mastoid air cell system.

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26
Q

What is the most common cause of conductive hearing loss in children?

A

Chronic suppurative otitis media.

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27
Q

What are common symptoms of cholesteatoma?

A
  • Painless foul-smelling discharge
  • Hearing loss
  • Vertigo
  • Tinnitus
  • Facial nerve palsy
  • Meningitis–intracranial extension
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28
Q

What are the two classifications of cholesteatoma?

A
  • Congenital
  • Acquired
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29
Q

What is an acoustic neuroma?

A

Common benign tumour of the cerebellopontine angle.

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30
Q

What is a key characteristic of cholesteatoma?

A

Locally destructive and has a tendency to recur after surgical management.

31
Q

What is a mastoidectomy?

A

A surgical procedure to remove disease from the mastoid bone.

32
Q

What is acute otitis media?

A

An infection of the middle ear characterized by inflammation and fluid buildup.

33
Q

What indicates urgent mastoid exploration?

A

Intracranial complications caused by cholesteatoma, such as meningitis or cerebral abscess.

34
Q

Define acoustic neuroma.

A

A common benign tumour of the cerebellopontine angle arising from schwann cells.

35
Q

What is the typical clinical presentation of acoustic neuroma?

A

Unilateral sensorineural hearing loss, tinnitus, vertigo, facial nerve palsy, headaches, ataxia.

36
Q

What investigations are used for acoustic neuroma?

A
  • Audiology for unilateral SNHL
  • MRI of the internal auditory meatus.
37
Q

What are local causes of epistaxis?

A
  • Idiopathic
  • Traumatic
  • Inflammatory
  • Neoplastic
  • Iatrogenic.
38
Q

What are systemic causes of epistaxis?

A
  • Anticoagulation drugs
  • Inherited bleeding disorders
  • Acquired coagulopathy
  • Hypertension.
39
Q

What is the most common area from which epistaxis originates?

A

Little’s area (Kiesselbach’s plexus).

40
Q

What is allergic rhinitis?

A

An IgE mediated type 1 hypersensitivity reaction in the nasal mucous membranes.

41
Q

List typical allergens that cause allergic rhinitis.

A
  • Pollens
  • Mould
  • House dust mite
  • Animals.
42
Q

What are the symptoms of nasal polyps?

A
  • Rhinorrhoea
  • Sneezing
  • Nasal itch
  • Epiphora
  • Nasal obstruction
  • Postnasal drip.
43
Q

What is the management for nasal polyps?

A
  • Avoid allergen
  • Oral antihistamines
  • Topical steroid nasal sprays
  • Oral steroids if severe.
  • Surgical intervention if necessary.
44
Q

What defines chronic rhinosinusitis?

A

An inflammatory condition of the paranasal sinuses and nasal passage lasting three months or longer.

45
Q

What are common symptoms of chronic rhinosinusitis?

A
  • Rhinorrhea
  • Nasal congestion
  • Facial pain/pressure/fullness
  • Hyposmia
  • Mucopurulent drainage.
46
Q

What are complications of sinusitis?

A
  • Orbital complications
  • Pott’s puffy tumour
  • Intracranial complications
  • Mucocele.
47
Q

What is the role of the larynx?

A
  • Phonation
  • Prevent aspiration during deglutition.
48
Q

What are the histological subtypes of laryngeal cancer?

A
  • Squamous cell carcinoma (SCC)
  • Neuroendocrine tumours
  • Lymphoma
  • Metastasis.
49
Q

What is the TNM system used for?

A

Staging cancer based on Tumor size, Node involvement, and Metastasis.

50
Q

What are the risk factors for head and neck cancer?

A
  • Tobacco use
  • Excessive alcohol intake
  • HPV infection
  • Radiation exposure.
51
Q

What is the Gardasil vaccine used for?

A

Prevention against HPV types 6, 11, 16, and 18.

52
Q

What is the typical management approach for laryngeal cancer?

A
  • Multidisciplinary meeting discussion
  • Surgical resection
  • Radiotherapy
  • Chemotherapy.
53
Q

Fill in the blank: 90% of HPV 16 targeting reticulated tissue of the _______.

A

tonsils.

54
Q

What is the significance of the HPV oncogenes E6 and E7?

A

E6 binds to p53 and E7 binds to Rb, disrupting tumor suppression.

55
Q

What is the most common histological subtype of head and neck cancer?

A

SCC (Squamous Cell Carcinoma)

SCC accounts for approximately 90% of cases.

56
Q

What percentage of Laryngeal Squamous Cell Carcinoma (LSSC) arises in the glottic or supraglottic region?

A

Approximately 98%

Glottic LSSC is more common than subglottic LSSC, which makes up only 2% of cases.

57
Q

List the variants of Squamous Cell Carcinoma (SCC).

A
  • Spindle cell carcinoma
  • Verrucous carcinoma
  • Basaloid carcinoma
  • Adenosquamous carcinoma
58
Q

What are the primary treatment options for stages I and II head and neck cancer?

A

Single modality therapy

Options include surgery or radiotherapy.

59
Q

What treatment is often required for stages III and IV head and neck cancer?

A

Combined therapy

This may include surgery with adjuvant radiotherapy or chemotherapy.

60
Q

What are the surgical options for treating laryngeal cancer?

A
  • Transoral laser microsurgery
  • Hemilaryngectomy with voice preservation
  • Supraglottic or supracricoid laryngectomy
  • Total laryngectomy
61
Q

What is the preferred treatment for oral cavity cancer?

A

Surgery with or without radiotherapy

Adjuvant radiotherapy is considered for positive margins or perineural invasion.

62
Q

What are the key risk factors for oropharyngeal cancer?

A
  • Alcohol
  • Smoking
  • HPV infection
63
Q

What is the mainstay of treatment for nasopharyngeal carcinoma (NPC)?

A

Radiotherapy

Concurrent chemotherapy is used for advanced stages.

64
Q

What are the common clinical presentations of nasopharyngeal carcinoma?

A
  • Epistaxis
  • Nasal obstruction
  • Neck mass
  • Cranial nerve dysfunction
  • Unilateral middle ear effusion
65
Q

What are the indications for tonsillectomy?

A
  • 7 episodes of tonsillitis in 1 year
  • 5–6 episodes per year over 2 years
  • 3 episodes per year over 3 years
  • 2 or more episodes of peritonsillar abscess
66
Q

What is the definition of ventilation (tympanostomy) tubes?

A

Small tube inserted into the tympanic membrane to keep the middle ear aerated for a prolonged period of time.

67
Q

What are the indications for tympanostomy tubes?

A
  • Otitis media with effusion
  • Recurrent acute otitis media
  • Persistent Eustachian tube dysfunction
  • Barotrauma
  • Acute otitis media with bulging tympanic membrane or facial paralysis
68
Q

What is the definition of mastoidectomy?

A

Operative procedure to gain access to mastoid air cells, middle and inner ear structures.

69
Q

List the types of mastoidectomy.

A
  • Cortical mastoidectomy
  • Radical mastoidectomy
70
Q

What are the complications associated with parotidectomy?

A
  • Facial nerve dysfunction
  • Hearing loss
  • Tinnitus
  • Vertigo
  • Intracranial complications
  • Sigmoid sinus thrombosis
71
Q

What is the definition of neck dissection?

A

Surgical excision of the cervical lymph nodes.

72
Q

What are the types of neck dissection?

A
  • Radical neck dissection
  • Modified radical neck dissection
  • Selective neck dissection
73
Q

What are common complications of neck dissection?

A
  • Wound infection
  • Flap necrosis
  • Frozen shoulder syndrome
  • Vagus nerve injury
  • Hematoma
  • Thoracic duct injury

UL Final Year OSCE's & Short Cases (107 decks)

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