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CP2 - ENT > Throat - Emergency Presentations > Flashcards

Throat - Emergency Presentations Flashcards

1
Q

Sx - upper airway obstruction (6)

A 
Noisy breathing 
Increased SOB
Hoarse voice 
Pain
Dysphagia
Agitation
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2
Q

Signs UAO (5)

A 
Stridor 
SOB 
Voice change
Drooling 
Cyanosis
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3
Q

What is stridor

A

Noisy breathing due to partial obstruction below larynx

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4
Q

Inspiratory phase stridor

A

At laryngeal level

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5
Q

Expiratory phase stridor

A

Asthma/bronchi/bronchioles

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6
Q

Mixed/biphasic stridor

A

Combo trachea/larynx/lower airways

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7
Q

Congenital causes stridor (2)

A

Laryngomalacia

VC palsy

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8
Q

Acquired causes stridor (5)

A 
Epiglottitis 
Croup
Malignancy
Angiodema
VC paralysis
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9
Q

Def stertor

A

Low pitched noise at level of oropharynx

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10
Q

3 structures that can cause stertor (3)

A

Tonsils
Adenoids
Tongue

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11
Q

How does stertor PS

A

Heavy snoring

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12
Q

Causes of stertor (4)

A

Tonsilitis
nasal obstruction
choanal stenosis
FB

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13
Q

PS - DNSI (7)

A 
Pain
Trismus 
Dysphagia 
Dysphonia 
Stridor 
Drooling 
Pyrexia/malaise
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14
Q

What is a Quinsy

A

pus between the tonsil capsule and lateral pharyngeal wall

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15
Q

PS QUinsy (6)

A 
Unilateral facial pain 
Dysphagia 
Trismus 
Hot potato voice  
Odynophagia 
Rx otalgia - IX/X
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16
Q

O/E Quinsy

A

Unilateral swelling

Tonsils/uvula pushed to op side

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17
Q

Mx Quinsy

A

IV - fl + ABx

Drain

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18
Q

Where is a parapharyngeal abscess

A

Lateral to pharynx

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19
Q

What can a parapharyngeal abscess cause?

A

Venous thrombus

Mediastinitis

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20
Q

Where is a retropharyngeal abscess

A

Behind pharynx

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21
Q

Who gets retropharyngeal abscesses

A

Children < 2

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22
Q

Sx retropharyngeal abscess (6)

A 
Sore throat
Dysphagia
Trismus 
Drooling 
Fever 
Muffled voice
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23
Q

Signs retropharyngeal abscess (5)

A 
Septic 
Decr head movement 
Mass 
Airway compromise 
Tongue swelling
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24
Q

Ix retropharyngeal abscess

A

CT/USS

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25
Q

Tx retropharyngeal abscess (3)

A

airway protection
IV ABx
Drainage/aspirate

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26
Q

Complications retropharyngeal abscess (5)

A 
obstruction 
rupture
mediastintis 
Lemierres syndrome 
carotid aa erosion
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27
Q

Most common cause epiglottitis

28
Q

PS epiglottits 6)

A 
unwell 
toxic 
lethargy
febrile 
young child drools 
rapid stridor
29
Q

Tx epiglottitis (5)

A 
Fibreoptics 
Endotracheal intubation 3-4days 
Bloods
Heliox
IV Ceftriaxone
30
Q

What extra thing must you do w/ epiglottitis

A

= notifiable disease

31
Q

What are the 4D’s of epiglottitis

A

Drooling
Dysphonia
Dyspnoea
Dysphagia

32
Q

What is lymphadenitis

A

Inflammation of the LN

33
Q

Causes of lymphadenitis (6)

A 
Infection - staph,strep,TB,cellulitis 
Salmonella
Viral - HIV/HPV/CMV
JIA
Serum sickness 
Leukaemia 
Hodgkins
34
Q

Ix lymphadenitis (7)

A 
Gram stain 
CUlutre aspirate 
Biopsy
Serology 
Bloods - ESR/WCC/FBC/LFT
CXR
USS
35
Q

Croup - age

36
Q

PS Croup (5)

A 
Preceding URTI
Low grade fever
Barking cough 
Insp stridor 
Hoarseness
37
Q

Causes Croup (3)

A

Parainfluenza virus **
RSV
Rhinovirus

38
Q

Tx Croup (3)

A

Neb adrenaline
PO dexamethasone
Severe - intubate + ventilate

39
Q

What is angiodema

A

Abnormal vascular permeability beneath dermis

40
Q

Main cause angiodema

41
Q

Other causes angiodema

A

Complement mediated
Dx induced
Idiopathic

42
Q

Drugs inducing angiodema (3)

A

ACEi
B lactam
Other Abx

43
Q

Mx angiodema (2)

A

Epinephrine

Anti histamine

44
Q

Mx - emergency UAO

A 
A-E
Clear mouth 
Give HELIOX
Get ENT/anaesthetics 
IV cannulae through cricothyroid membrane 
USe PCT cricothyroidectomy kit 
Insert stillette 
Thread endotracheal tube over stillette + remove 
Attach Ambu bag + O2 supply + ventilate
45
Q

What % of tonsillitis are viral

46
Q

Bacterial tonsillitis - PS (5)

A 
White pus 
Painful 
Fever 
Unwell 
Ear ache 
Bilateral cervical lymphadenopathy
47
Q

Med mx tonsillitis

A

Analgesia
PO ABx - 500mg Pen V QDS 10 days
Drink plenty
If severe IV ABx

48
Q

What are the 4 indications for tonsillectomy

A

OSA
Malig
Febrile convulsions
Infections 1y 7eps. 2y 5eps. 3y 3eps

49
Q

How is size of tonsillectomy determined

A

Brodsky’s criteria

50
Q

Post tonsillectomy bleed - <24hrs

A

Poor haematemesis hence –> theatre

51
Q

Post tonsillectomy - 2-10days

A

Infection –> ABx

52
Q

Complications tonsillectomy (3)

A

Bleed
Teeth dislodge
Infection

53
Q

Cause of glandular fever

54
Q

Triad Sx glandular fever

A

Sore throat
Lymphadenopathy
Pyrexia
(Also abdo pain/HSmegaly)

55
Q

Ix glandular fever (3)

A

FBC
LFT
Monospot glandular fever test

56
Q

Mx glandular fever (4)

A

PO rehydration
Analgesia
LFT monitoring
Avoid contact sport/alcohol 8W

57
Q

What does sore throat encompass? (3)

A

Pharyngitis
Tonsillitis
Laryngitis

58
Q

Mx sore throat (2)

59
Q

NICE indications for ABx for sore throat (5)

A 
Marked systemic upset
Unilateral peritonsilitis 
Hx RF
Immunocomp/DM
3+ centor criteria
60
Q

Centor criteria (4)

A

Tonsillar exudate
Tender ant cervical LN
Fever
No cough

61
Q

Indications - tracheostomy (3)

A

Bypass UOA (infection/cancer/FB/anaphylaxis)
Prov pulmonary toilet
Access during H+N surgery

62
Q

Process of tracheostomy

A

Horizontal incision 2cm above suprasternal notch
Separate strap mm
Isthmus ligated + cut
Vertical incision made

63
Q

Early risks of tracheostomy (6)

A 
Displacement 
Blocked 
Pneumothorax
Bleeding + local infection 
Dysphagia 
Surgical emphysema
64
Q

Late risks tracheostomy (2)

A

Fistula

Stenosis

65
Q

3 types of tracheostomy (3)

A

Disposable cannula
CUffed w/ reusable inner cannula
Disposable cannula

CP2 - ENT (13 decks)

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