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3D week 4 - nasal and throat disorders > secondary care > Flashcards

secondary care Flashcards

1
Q

what tuning for is used for ear examination and why must it be that frequency

A

512 Hz -> if it is a lower frequency then the vibration will be felt more easily and hear less easily

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2
Q

what are the 5 cardinal symptoms of otology

A
  1. pain
  2. discharge
  3. tinnitus
  4. vertigo
  5. hearing loss
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3
Q

mgx for simple otitis externa

A
  1. abx drops - ciprofloxacin/gentamicin
  2. keep ears dry e.g. cover in vaseline if going in water
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4
Q

what causative organism does otitis externa with yellow discharge indicate

A

pseudamonas areugosia

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5
Q

what causative organism does otitis externa with white creamy discharge indicate

A

s. Aureus

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6
Q

what causative organism does otitis externa with white discharge indicate

A

candida

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7
Q

what causative organism does otitis externa with black spores in discharge indicate

A

apergillus

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8
Q

how long should anti-fungals be given for in otitis externa

A

2 weeks and then a further 2 weeks after resolving

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9
Q

what is “swimmer’s ear”

A

otitis externa

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10
Q

what are the ENT lymphnode categories

A

1a - submental
1b - submandibular
2 - upper jugular (base of skull -> hyloid)
3 - hyloid -> cricoid
4 - lower jugular
5 -posterior triangle (posterior SCM, boarder of trapezius, middle 1/3 of clavical)
6 - anterior triangle (including thyroid)
7 - superior mediastinum

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11
Q

why does the thyroid move when swallowing

A

it is connected to the trachea via barry’s ligament

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12
Q

why do thyroglossal cyst move on tongue protrusion

A

embryologically, the thyroid develops from the base of the tongue -> cyst arises from cluster of cells left during formation and so they are attached to the tongue

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13
Q

why can throat pain be referred to the ear

A

the ear is supplied by the glossopharengeal and vagus nerves (jacob’s plexus) which can refer pain there from the ear

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14
Q

examples of drugs that can cause salivary drying (3)

A
  1. amytriptiline
  2. opiates
  3. lithium
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15
Q

how can a lipoma be distinguished from other cystic swellings

A

edges are not distinct

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16
Q

what are the 3 major salivary glands

A
  1. parotid
  2. sublingual
  3. submandibular
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17
Q

what is stenson’s duct

A

the main excretory duct of the parotid gland

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18
Q

what is the rule of 80s (salivary tumours)

A

80% of all salivary tumors are in the parotid, 80% of parotid tumors are benign, and 80% of the benign tumors that arise in the parotid are pleomorphic adenomas

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19
Q

what is a pleomorphic adenoma

A

benign salivary gland tumors, which predominantly affect the superficial lobe of the parotid gland

20
Q

what is wharton’s duct

A

the submandibular gland’s primary excretory duct

21
Q

what nerves run near to the submandibular gland

A

CN VII (marginal mandibular); CN XII; lingual nerve (CN V3)

22
Q

what is pemberton’s sign

A

used to evaluate venous obstruction in patients with goiters -> The sign is positive when bilateral arm elevation causes facial plethora

23
Q

why does pemberton’s sign arise

A

It has been attributed to a “cork effect” resulting from the thyroid obstructing the thoracic inlet (due to goitre), thereby increasing pressure on the venous system

24
Q

what other symptom is associated w glandular fever (other than swollen tonsils)

A

hepato/splenomegaly

25
Q

what are the tonsil grades

A

grade 1 - This is the normal size of the tonsils, Tonsils occupy less than 25 percent of the oropharynx. The tonsils are not visible properly.
grade 2 - This size is also considered as normal size and the tonsils extend to the pillars. Tonsils occupy 26 to 50 percent of the oropharyngeal airway.
grade 3 - The tonsils can get infected leading to its inflammation. Due to this inflammation, these take up 75% of the oropharyngeal airway. Also, tonsils extend beyond pillars but stop beyond the midline.
grade 4 - The tonsils reach each other and extend to the midline. This is the most enlarged size of tonsils as these take more than 75% of the airways.

26
Q

3 key features of quinsy

A
  1. trismus
  2. unilateral deviation/uvula deviation
  3. voice change (hot potato)
27
Q

abx for quinsy

A

IV - benzyl penicillin (+fluids + steroids)
oral - Pen V (Phenoxymethylpenicillin)

28
Q

where is the aspiration performed in quinsy

A

at the base of the uvula and tonsillar pharyngeal wall

29
Q

indications for tonsillectomy

A
  1. tonsillitis 7 times in 1 year
  2. peritonsilar abscess
  3. asymetrical abscess
  4. suspicion of malignancy
  5. OSA/ snoring
  6. speech abnormalities
  7. dysphagia
30
Q

risks of neck abscess draining (3)

A
  1. incomplete drainage
  2. recurrence
  3. risk of injury to important structures e.g. carotid sheath
31
Q

what is the centor criteria

A

determines the likelihood of there being a bacterial tonsillitis
1. fever ≥ 38 °C
2. absence of cough
3. swollen anterior cervical lymph nodes
4. tonsillar exudates or swelling

32
Q

complications of tonsillectomy

A
  1. Odynophagia (pain on swallowing)
  2. bleeding (primary within 24hrs due to surgical reasons or secondary due to infection)
  3. pulmonary complications
  4. infection
33
Q

what should be done in epistaxis to prevent vomiting

A

sit pt forwards and spit blood out so as to not aspirate of swallow -> swallowing blood can induce vomiting

34
Q

why does CPAP machine usage increase the risk of epistaxis

A

it dries out the nasal mucosa

35
Q

what is an ear wick

A

a device used to put abx drops into the ear when the ear canal is very swollen/narrow -> otitis externa

36
Q

how long is the antifungal treatment of otomycosis usually for

A

1 month

37
Q

otitis externa mimic

A

furunculosis in ear - an infected hair follicle at the entrance to the ear canal;
Symptoms may include: sudden onset, extreme pain and a red swelling in the outer canal

38
Q

what is the sinonasal outcome test (SNOT)

A

a validated patient-reported outcome measure for chronic rhinosinusitis

39
Q

dislocation of what leads to deviated frontal septum

A

Columella: The tissue that links the nasal tip to the nasal base, and separates the nares

40
Q

what simple test can be used to assess nasal airwaypatency

A

condensation test

41
Q

what is a nasal polyp

A

oedema of mucous lining of the nose causing herniation through the basement membrane

42
Q

if nasal polyps are present in children what other underlying condition might this indicate

A

Cystic fibrosis

43
Q

nasal polyps mgx

A
  1. systemic sterois
  2. steroid spray
  3. antohisthamine
  4. monteluekast
  5. abx
44
Q

what is nasal vestibulitis

A

an infection in your nostrils, near the opening of your nose

45
Q

nasal vestibulitis mgx

A
  1. nasceptin
  2. bactroban
  3. vaseline
46
Q

hoe does septal perforation lead to being unable to breath properly

A

results in turbulent disrupted airflow through the airways

47
Q

what is an inverted papilloma

A

a benign but locally aggressive tumor that arises in the nasal cavity and paranasal sinuses - may present as a polyp

3D week 4 - nasal and throat disorders (9 decks)

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