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MBBS Y5 > Surgery - ENT > Flashcards

Surgery - ENT Flashcards

1
Q

what is the role of semicircular canals in the ear? what are they filled with?

A
  • to sense head movement| - endolymph
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2
Q

what is the eustachian tube? what are its 2 roles?

A

NAME?

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3
Q

role of the cochlea?

A

converts sound vibration into nerve signal

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4
Q

when is hearing loss classed as “sudden onset”?

A

when it occurs in less than 72 hours

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5
Q

what might hearing loss with associated pain / discharge indicate?

A

outer / middle ear infection

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6
Q

how is weber’s test performed?

A
  • get tuning fork vibrating - place in middle of pt’s forehead - ask if they can hear the sound and which ear it is louder in
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7
Q

what is the result for weber’s test in sensorineural hearing loss?

A

sound is louder in the normal (unaffected) ear

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8
Q

what is the result for weber’s test in conductive hearing loss?

A
  • sound is louder in the affected ear| - deaf ear feels the need to “turn up the volume”
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9
Q

how is rinne’s test performed?

A
  • get tuning fork vibrating - put it on the mastoid process and ask if they can hear it (bone conduction)- when they can no longer hear it, move the tuning fork 1cm from their ear and ask again (air conduction)- repeat for opp ear
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10
Q

what is a normal rinne’s test result?

A

NAME?

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11
Q

what is the finding of an abnormal (negative) rinne’s test? what might this indicate

A
  • sound NOT heard again once tuning fork moved off of bone (bone > air)- conductive hearing loss
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12
Q

causes of adult onset sensorineural hearing loss?

A
  • presbycusis- noise exposure- meniere’s disease- labyrinthitis- acoustic neuroma- neuro conditions - infection (e.g. meningitis)- drugs
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13
Q

neurological causes of sensorineural hearing loss?

A

NAME?

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14
Q

drug causes of sensorineural hearing loss?

A

NAME?

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15
Q

causes of adult-onset conductive hearing loss? hint: blockage

A
  • ear wax - foreign body in ear canal- infection (otitis media / externa) - middle ear effusion- eustachian tube dysfunction- perforated tympanic membrane- osteosclerosis- cholesteatoma- exostoses- tumours
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16
Q

what are exostoses?

A

benign bone growths in the ear

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17
Q

what is presbycusis?

A

age-related sensorineural hearing loss

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18
Q

pathophysiology of presbycusis?

A

loss of hair cells and neurones in cochlea

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19
Q

risk factors for presbycusis?

A

NAME?

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20
Q

presentation of presbycusis?

A

NAME?

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21
Q

how is presbycusis diagnosed?

A

audiometry

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22
Q

management of presbycusis?

A
  • optimise environment (reduce ambient noise)- hearing aids- cochlear implants (2nd line)
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23
Q

what is sudden sensorineural hearing loss (SSNHL)? commonest cause?

A
  • hearing loss over less than 72 hours unexplained by other causes - emergency!!!- 90% cases are idiopathic
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24
Q

conductive causes of sudden-onset hearing loss?

A

NAME?

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25
Q

causes of SSNHL?

A
  • idiopathic- infection - meniere’s disease- drugs- MS- migraine- stroke- acoustic neuroma - cogan’s syndrome
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26
Q

diagnostic criteria on audiometry in SSNHL?

A

at least 30 dL in 3 consecutive frequencies

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27
Q

investigations in SSNHL?

A
  • audiometry| - MRI / CT head to rule out stroke / acoustic neuroma
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28
Q

management of SSNHL?

A
  • immediate referral to ENT - treat underlying cause (e.g. ABx for infection) - steroids if idiopathic (PO, intra-tympanic injection)
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29
Q

which other conditions might eustachian tube dysfunction be related to?

A

NAME?

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30
Q

presentation of eustachian tube dysfunction?

A

NAME?

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31
Q

when does eustachian tube dysfunction worsen? give some examples

A

NAME?

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32
Q

investigations for eustachian tube dysfunction?

A
  • not needed if obvious- tympanometry - audiometry- nasopharyngoscopy - otoscopy (r/o otitis media) - CT
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33
Q

management of eustachian tube dysfunction?

A

NAME?

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34
Q

surgical options for eustachian tube dysfunction?

A

NAME?

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35
Q

what is otosclerosis? what does it result in?

A
  • remodelling of small bones in middle ear| - conductive hearing loss
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36
Q

risk factors for otosclerosis?

A

NAME?

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37
Q

presentation of otosclerosis?

A
  • bilateral hearing loss (low-pitched lost first)- bilateral tinnitus- reports own voice sounding louder, so speaks quietly
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38
Q

findings O/E in otosclerosis?

A
  • normal otoscopy- normal weber’s (if bilateral)- negative rinne’s (bone > air)
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39
Q

investigation of choice (and findings) in otosclerosis?

A

audiometry shows hearing loss at lower frequencies

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40
Q

management of otosclerosis?

A
  • hearing aids| - stapedectomy / stapedotomy
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41
Q

what is otitis media often preceded by?

A

URTI

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42
Q

commonest causative organism(s) of otitis media? hint: think pneumonia

A
  • streptococcus pneumoniae (pneumococcus)| - then: H. influenzae
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43
Q

presentation of otitis media in adults?

A

NAME?

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44
Q

otoscopy findings in otitis media?

A
  • bulging, red tympanic membrane| - discharge in ear canal if membrane has burst
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45
Q

management of otitis media?

A
  • most resolve spontaneously over 3 days - paracetamol / ibuprofen for pain / fever- consider ABx (immediate or delayed)
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46
Q

when should you consider immediate ABx in otitis media?

A

NAME?

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47
Q

when should you consider delayed ABx in otitis media? when can these be claimed?

A
  • 3d after prescribing| - when you suspect they’ll worsen soon
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48
Q

ABx of choice for otitis media? hint: remember allergies!

A
  • 5-7d course of amoxicillin| - clarithromycin if penicillin allergic
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49
Q

give a common and a rare example of a complication in otitis media?

A
  • otitis media with effusion| - mastoiditis (palpate mastoid process for this)
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50
Q

describe the pathophysiology of otitis externa

A

inflammation of the skin of the external ear canal

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51
Q

causes of otitis externa?

A

NAME?

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52
Q

give 2 bacterial causes of otitis externa?

A
  • pseudomonas aeruginosa| - staph aureus
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53
Q

presentation of otitis externa?

A

NAME?

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54
Q

signs O/E of otitis externa?

A

NAME?

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55
Q

when might pus in the external ear canal be due to otitis media rather than otitis externa?

A

when the tympanic membrane has been perforated

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56
Q

investigations for otitis externa?

A
  • otoscopy| - ear swab (not used often)
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57
Q

management of mild otitis externa?

A

acetic acid 2%

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58
Q

treatment for moderate otitis externa?

A
  • add topical ABx + steroid| - e.g. neomycin + betamethasone + acetic acid 2% (called “otomize”)
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59
Q

what must you exclude before treating moderate otitis externa? hint: ABx SEs

A
  • must check the tympanic membrane is not perforated| - because it needs macrolides which can be ototoxic
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60
Q

treatment of severe otitis externa?

A

NAME?

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61
Q

management of fungal otitis externa?

A

clotrimazole ear drops

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62
Q

what is malignant otitis externa? main complication of this?

A
  • infection which has spreads to bones outside of ear canal| - osteomyelitis of temporal bone
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63
Q

risk factors for malignant otitis externa? hint: immunocompromise

A

NAME?

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64
Q

presentation of malignant otitis externa?

A

NAME?

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65
Q

key finding of malignant otitis externa?

A

granulation tissue at junction between bone and cartilage

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66
Q

management of malignant otitis externa?

A

NAME?

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67
Q

presentation of impacted ear wax?

A

NAME?

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68
Q

how is impacted ear wax diagnosed?

A

seen on otoscope covering tympanic membrane

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69
Q

management of impacted ear wax?

A

NAME?

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70
Q

what is primary tinnitus associated with?

A

sensorineural hearing loss

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71
Q

causes of secondary tinnitus? hint: there’s a LOT

A
  • impacted ear wax- ear infection- meniere’s disease- noise exposure- drugs- acoustic neuroma- MS- trauma - depression
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72
Q

drug causes of tinnitus?

A

NAME?

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73
Q

systemic signs associated with tinnitus?

A

NAME?

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74
Q

what is objective tinnitus?

A

sound is demonstrable O/E (it is actually there)

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75
Q

examples of causes of objective tinnitus?

A
  • carotid artery stenosis (causing a bruit)- aortic stenosis- AVM- eustachian tube dysfunction (popping / clicking sounds)
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76
Q

red flag features of tinnitus?

A

NAME?

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77
Q

prognosis of tinnitus?

A

tends to improve alone without any intervention

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78
Q

management of tinnitus?

A

NAME?

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79
Q

what is vertigo?

A

the sensation that either the patient or their environment is moving

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80
Q

vestibular causes of vertigo?

A
  • BPPV- meniere’s disease- vestibular neuronitis- labyrinthitis
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81
Q

pathophysiology of benign paroxysmal positional vertigo (BPPV)?

A

NAME?

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82
Q

course of disease in BPPV?

A

NAME?

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83
Q

diagnostic test for BPPV?

A

dix-hallpike manoeuvre

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84
Q

treatment of BPPV?

A
  • epley manoeuvre| - brandt-daroff exercises
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85
Q

presentation of meniere’s disease?

A
  • hearing loss- tinnitus - vertigo - fullness in ear feeling- “drop attacks” (unexplained falls)- unidirectional nystagmus
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86
Q

pathophysiology of acute vestibular neuritis?

A

viral infection (usually URTI) causing inflammation of the vestibular nerve

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87
Q

what is ramsay-hunt syndrome? how does it present?

A

NAME?

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88
Q

central causes of vertigo?

A

anything affecting cerebellum or brainstem:- posterior stroke- tumour- MS - vestibular migraine

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89
Q

how does vertigo from a central cause present?

A

it will be sustained and non-positional

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90
Q

presentation of vestibular migraine?

A

NAME?

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91
Q

give an example of a trigger for BPPV

A

turning over in bed

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92
Q

presentation of meniere’s disease? hint: triad

A

NAME?

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93
Q

pathophysiology of meniere’s disease?

A

excessive buildup of endolymph in the labyrinth of the inner ear

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94
Q

typical patient history in meniere’s disease?

A
  • 40-50 year old| - unilateral episodes of vertigo, hearing loss and tinnitus
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95
Q

how does the vertigo in meniere’s disease present?

A
  • episodic- lasts 20 mins - few hours- not triggered by movement or posture
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96
Q

what type of hearing loss is seen in meniere’s disease?

A

NAME?

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97
Q

how is meniere’s disease diagnosed?

A
  • clinically| - followed up by audiology assessment
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98
Q

management of acute attacks of meniere’s disease?

A
  • prochlorperazine| - antihistamines (e.g. cyclizine)
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99
Q

prophylaxis in meniere’s disease?

A

betahistine

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100
Q

what is an acoustic neuroma?

A

benign tumour of schwann cells surrounding the vestibulocochlear nerve

101
Q

in which condition are bilateral acoustic neuromas seen?

A

neurofibromatosis type II

102
Q

where do acoustic neuromas grow?

A

cerebellopontine angle

103
Q

typical history of acoustic neuroma?

A

NAME?

104
Q

which palsy might be associated with acoustic neuroma?

A

facial nerve palsy

105
Q

how is acoustic neuroma diagnosed?

A
  • MRI or CT| - MRI is more detailed so preferred
106
Q

management of acoustic neuroma?

A

NAME?

107
Q

complications of treating meniere’s disease?

A
  • CN8 damage (permanent HL, dizziness)| - CN7 injury (facial weakness)
108
Q

what is a cholesteatoma?

A

abnormal collection of squamous epithelial cells in the middle ear

109
Q

is a cholesteatoma worrying?

A
  • not malignant| - can erode middle ear bones, predisposing to infection
110
Q

early presentation of cholesteatoma?

A
  • foul ear discharge| - unilateral conductive hearing loss
111
Q

later features of cholesteatoma?

A

all caused by expansion:- infection- pain- vertigo- CN7 palsy

112
Q

investigations and findings for cholesteatoma?

A

NAME?

113
Q

management of cholesteatoma?

A

surgical removal

114
Q

presentation of facial nerve palsy?

A

unilateral facial weakness

115
Q

important differential for facial nerve palsy?

A

stroke!

116
Q

is there forehead sparing in CN7 palsy? why / why not?

A
  • it is an LMN lesion| - therefore no, the forehead is not spared
117
Q

is there forehead sparing in stroke? why / why not?

A
  • it is an UMN lesion| - therefore, yes the forehead is spared
118
Q

what is bell’s palsy?

A

idiopathic unilateral LMN CN7 palsy

119
Q

prognosis for bell’s palsy?

A
  • most patients recover in weeks| - some have residual weakness
120
Q

management of bell’s palsy?

A
  • if presented within 72h of symptom onset, then prednisolone - lubricating eye drops
121
Q

eye complication from bell’s palsy? how is it prevented?

A

NAME?

122
Q

which organism causes ramsay-hunt syndrome?

A

herpes zoster

123
Q

presentation of ramsay-hunt syndrome?

A

NAME?

124
Q

treatment for ramsay-hunt syndrome?

A

ideally within 72h:- prednisolone- acicloviralso lubricating eyedrops

125
Q

which systemic diseases can give a CN7 palsy?

A

NAME?

126
Q

what is the most likely site of bleed in epistaxis?

A

little’s area

127
Q

causes of nosebleeds?

A

NAME?

128
Q

management of nosebleeds?

A
  • sit up, tilt head forwards - squeeze soft part of nostrils together for 15 mins - spit out any blood in mouth- after 10-15 mins: nasal packing (tampons) or nasal cautery (with silver nitrate)
129
Q

what can be prescribed after a nosebleed? why is this useful?

A
  • naseptin cream (chlorhexidine and neomycin)| - stops crusting and infection
130
Q

when is sinusitis classed as chronic?

A

when it lasts >12 weeks

131
Q

what are the 4 types of paranasal sinus?

A

NAME?

132
Q

causes of sinusitis?

A
  • infection (typically post-viral URTI)- allergies (allergic rhinitis)- obstruction of drainage- smoking- asthma = RF
133
Q

what could cause obstruction of drainage from the paranasal sinuses?

A

NAME?

134
Q

presentation of acute sinusitis?

A

NAME?

135
Q

findings O/E in sinusitis?

A

NAME?

136
Q

key condition associated with chronic sinusitis?

A

nasal polyps

137
Q

investigations in sinusitis?

A

NAME?

138
Q

management of acute sinusitis?

A
  • if systemic infection / septic then hosp admission- no Tx for first 10 days - after this:- mometasone nasal spray 200mcg BD for 14d- delayed ABx prescription if no improvement in 7d after steroid
139
Q

prognosis for most cases of acute sinusitis?

A
  • good| - self-resolving in 2-3 weeks
140
Q

management of chronic sinusitis?

A

NAME?

141
Q

describe correct administration of a nasal spray

A

NAME?

142
Q

what is a nasal polyp? where is it found?

A
  • growth of nasal mucosa| - nasal cavity or sinuses
143
Q

are nasal polyps typically uni or bilateral? do they grow fast or slow?

A
  • bilateral and slow growing| - unilateral polyps are a red flag for Ca!!!
144
Q

which other conditions are associated with nasal polyps?

A
  • chronic sinusitis- asthma- samter’s triad- CF- eosinophilic granulomatosis with polyangiitis (churg-strauss)
145
Q

what is samter’s triad?

A
  1. nasal polyps2. asthma 3. aspirin intolerance / allergy
146
Q

presentation of nasal polyps?

A

NAME?

147
Q

which types of examination are useful in nasal polyps?

A
  • nasal speculum| - nasal endoscopy (done by specialist)
148
Q

management of nasal polyps?

A
  • unilateral polyps always need specialist referral to r/o Ca- intranasal steroid drops / spray- intranasal polypectomy- endoscopic nasal polypectomy (if further up nose / in sinuses)
149
Q

pathophysiology of obstructive sleep apnoea (OSA)?

A

collapse of pharyngeal airway during sleep

150
Q

typical history in OSA?

A
  • pt’s partner reports that the pt stops breathing for up to a few mins at night - pt unaware of this
151
Q

risk factors for OSA?

A

NAME?

152
Q

features of OSA?

A

NAME?

153
Q

complications of severe OSA?

A

NAME?

154
Q

what is the epworth sleepiness scale used for?

A

to assess symptoms of sleepiness in OSA

155
Q

what should you check in anyone with OSA?

A
  • occupation| - sleepiness could make them dangerous at work, e.g. lorry driver
156
Q

management of OSA?

A

NAME?

157
Q

most common causative organism in bacterial tonsillitis? second most common one?

A
  • group A strep (strep pyogenes)| - pneumococcus
158
Q

commonest cause of tonsillitis?

A

viral infection

159
Q

which tonsils are most likely to be affected in tonsillitis?

A

palatine tonsils

160
Q

presentation of acute tonsillitis?

A
  • sore throat- fever >38C- pain on swallowing
161
Q

(potential) findings O/E of tonsillitis?

A

NAME?

162
Q

which 2 scoring systems can be used to work out whether tonsillitis is viral or bacterial?

A
  • centor criteria| - feverPAIN score
163
Q

criteria in the feverPAIN score?

A
  • fever in last 24h- purulent tonsils - attended within 3d of symptom onset- inflammation, severe- no cough / coryza
164
Q

when should you consider admitting a patient with tonsillitis?

A

for any of the following:- immunocompromised- systemically unwell- dehydrated- stridor- resp distress- evidence of quinsy / cellulitis

165
Q

when should ABx be considered in tonsillitis?

A
  • centor score: 3 or more- feverPAIN score: 4 or more- immunocompromised - Hx of rheumatic fever- significant comorbidities
166
Q

first line antibiotic in bacterial tonsillitis?

A
  • penicillin V (phenoxymethylpenicillin)| - if penicillin allergic: clarithromycin
167
Q

safety netting advice in viral tonsillitis?

A

return if:- pain has not settled in 3d- fever >38.3C after 3d

168
Q

complications of tonsillitis?

A

NAME?

169
Q

what is a quinsy? how could it occur?

A

NAME?

170
Q

demographic most commonly affected by tonsillitis?

A

children

171
Q

presentation of quinsy?

A

NAME?

172
Q

most common causative organism of quinsy?

A

group A strep (strep pyogenes)

173
Q

management of quinsy?

A

NAME?

174
Q

indications for tonsillectomy?

A

based on no. of cases of tonsillitis:- 7+ in 1y- 5+ per year for 2y- 3+ per year for 3yother indications- 2 episodes of quinsy- enlarged tonsils causing difficulty breathing, swallowing or snoring

175
Q

complications of tonsillectomy?

A
  • post-tonsillectomy bleeding- sore throat for up to 2w- damage to teeth- infection - risks with GA
176
Q

how could a post-tonsillectomy bleed be life-threatening?

A

if blood is aspirated

177
Q

management of post-tonsillectomy bleeding?

A

NAME?

178
Q

differentials for a neck lump in an adult? hint: there’s a LOT

A

NAME?

179
Q

additional differentials for neck lump in a young child?

A

NAME?

180
Q

what are the 2WW criteria for referral of a neck lump?

A
  • unexplained neck lump in anyone aged >45| - persistent, unexplained neck lump at any age
181
Q

when should an urgent USS be performed on a neck lump? timeframes for this scan?

A
  • when it is growing in size - within 2w if over 25- within 48h if under 25- referral to 2WW depending on USS findings
182
Q

which blood tests may be requested for a neck lump? why?

A
  • FBC, blood film (leukaemia, infection)- HIV test- monospot test (EBV antibodies) - TFTs- ANA (SLE)- LDH (hodgkin’s lymphoma, very non-specific)
183
Q

investigations for a neck lump?

A
  • bloods- USS (1st line imaging)- nuclear medicine scan- biopsy
184
Q

causes of lymphadenopathy? give examples of each

A

NAME?

185
Q

features of lymphadenopathy suggestive of Ca?

A
  • unexplained- persistently enlarged >3cm in size- abnormal shape- hard / “rubbery”- non-tender- tethered to skin / underlying tissue- any associated B symptoms
186
Q

causative organism in infectious mononucleosis?

A

epstein barr virus (EBV)

187
Q

how does EBV spread?

A

through saliva (kissing, sharing cups, toothbrushes)

188
Q

presentation of infectious mononucleosis?

A

NAME?

189
Q

first line investigation of infectious mononucleosis?

A

monospot test

190
Q

which immunoglobuin indicates acute infection with infectious mononucleosis? which indicates immunity?

A
  • IgM = acute infection| - IgG = immunity
191
Q

management of infectious mononucleosis?

A

NAME?

192
Q

typical demographics affected by hodgkin’s lymphoma?

A
  • bimodal age distribution- one peak around age 20 - another around age 75
193
Q

key presenting feature of lymphoma? where might this be found?

A
  • lymphadenopathy- “rubbery” nodes- pain in the nodes upon drinking alcohol- neck- axillary nodes- inguinal nodes
194
Q

features of lymphoma?

A

quite non-specific:- fatigue- lymphadenopathy- pallor (anaemia)- petechiae / abnormal bruising (thrombocytopenia) - abnormal bleeding- hepatosplenomegaly - B symptoms

195
Q

finding on lymph node biopsy in hodgkin’s lymphoma?

A

reed-sternberg cells

196
Q

how is lymphoma staged?

A

ann arbor staging system

197
Q

list the 3 B symptoms

A

NAME?

198
Q

causes of goitre?

A
  • graves disease (hyper)- toxic multinodular goitre (hyper)- hashimoto’s thyroiditis (hypo)- iodine deficiency (rare)- lithium
199
Q

what is a goitre?

A

generalised swelling of the thyroid

200
Q

differentials for individual lumps in the thyroid?

A

NAME?

201
Q

causes of enlarged salivary glands?

A

NAME?

202
Q

describe the lump found in a carotid body tumour

A

NAME?

203
Q

how might a carotid body tumour give horner’s syndrome?

A

by compressing on the vagus nerve (CN10)

204
Q

finding on imaging of carotid body tumour?

A
  • “splaying” of internal and external carotids| - called lyre’s sign
205
Q

what is a lipoma?

A

benign fat tumour

206
Q

findings O/E of a lipoma?

A

NAME?

207
Q

management of carotid body tumours?

A

surgical removal

208
Q

management of lipomas?

A
  • reassurance| - may be surgically removed
209
Q

pathophysiology of thyroglossal cyst?

A

NAME?

210
Q

key differential of a thyroglossal cyst?

A

ectopic thyroid tissue

211
Q

findings O/E of a thyroglossal cyst?

A

NAME?

212
Q

management of thyroglossal cysts?

A

surgical removal

213
Q

main complication of thyroglossal cysts?

A
  • infection| - lump becomes hot, tender and painful
214
Q

presentation of a branchial cyst?

A

NAME?

215
Q

typical demographic affected by branchial cysts?

A

NAME?

216
Q

management of branchial cysts?

A
  • conservative| - surgical excision if problematic
217
Q

where could a head and neck Ca grow?

A

NAME?

218
Q

risk factors for head and neck Ca?

A
  • smoking - chewing tobacco- paan!- alcohol- HPV (esp strain 16)- EBV infection
219
Q

red flag features suggestive of head and neck Ca?

A
  • lump in mouth / on lip- unexplained mouth ulcers lasting >3m- erythroplakia (unexplained red lesion)- persistent neck lump- unexplained hoarse voice- unexplained thyroid lump
220
Q

management of head and neck Ca?

A

NAME?

221
Q

what cell type are most head and neck cancers?

A

squamous cell carcinoma

222
Q

causes of glossitis?

A

NAME?

223
Q

3 key causes of angioedema?

A

NAME?

224
Q

risk factors for oral candiaisis?

A

NAME?

225
Q

management of oral candidiasis?

A
  • miconazole gel- nystatin suspension - fluconazole tablets (if severe / recurrent)
226
Q

describe geographic tongue

A

irregularly shaped patches form on tongue from loss of papillae

227
Q

causes of geographic tongue?

A

NAME?

228
Q

2 key causes of strawberry tongue?

A
  • scarlet fever| - kawasaki disease
229
Q

causes of black hairy tongue?

A

NAME?

230
Q

what is leukoplakia?

A
  • precancerous condition| - gives white patches on tongue / inside cheeks
231
Q

describe the patches found in leukoplakia

A
  • asymptomatic- irregular - slightly raised - fixed in place (can’t be scraped off)
232
Q

investigation for leukoplakia?

A

biopsy to look for dysplasia / Ca

233
Q

management of leukoplakia?

A

NAME?

234
Q

describe the lesions seen in lichen planus

A
  • shiny- purplish- flat-topped raised areas- white lines across surface (wickham’s striae)
235
Q

which demographics are more likely to be affected by lichen planus?

A
  • those >45| - women
236
Q

management of oral lichen planus?

A

NAME?

237
Q

presentation of gingivitis?

A

NAME?

238
Q

what is periodontitis? what is its main complication?

A
  • chronic and severe inflammation of gums around teeth| - tooth loss!
239
Q

RFs for gingivitis?

A

NAME?

240
Q

management of gingivitis?

A
  • good oral hygiene- stop smoking- “scale and polish” to remove tartar - chlorhexidine mouthwash- metronidazole / dental surgery if needed
241
Q

causes of gingival hyperplasia?

A
  • gingivitis- pregnancy- vit C def (scurvy)- acute myeloid leukaemia (AML)- drugs
242
Q

drug causes of gingival hyperplasia?

A

NAME?

243
Q

which conditions can give rise to aphthous ulcers?

A
  • IBD - coeliac disease- behcet’s disease- vitamin / mineral deficiency- HIV
244
Q

which vitamin / mineral deficiencies could cause aphthous ulcers?

A

NAME?

245
Q

management of simple aphthous ulcers?

A
  • most self-resolve in 2w- bonjela- difflam spray- lidocaine
246
Q

management of severe aphthous ulcers?

A
  • hydrocortisone buccal tablets| - betamethasone tablets / inhaler
247
Q

what is the 2WW criteria with regard to aphthous ulcers?

A

pts with unexplained ulceration lasting >3w need a referral

248
Q

when should you consider giving ABx in tonsillitis?

A
  • centor score >3| - feverPAIN score >4
249
Q

pathophysiology of meniere’s disease?

A

build-up of excessive endolymph in semicircular canals

MBBS Y5 (27 decks)

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