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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
Tx retropharyngeal abscess (3)
airway protection IV ABx Drainage/aspirate
26
Complications retropharyngeal abscess (5)
``` obstruction rupture mediastintis Lemierres syndrome carotid aa erosion ```
27
Most common cause epiglottitis
Hib
28
PS epiglottits 6)
``` unwell toxic lethargy febrile young child drools rapid stridor ```
29
Tx epiglottitis (5)
``` Fibreoptics Endotracheal intubation 3-4days Bloods Heliox IV Ceftriaxone ```
30
What extra thing must you do w/ epiglottitis
= notifiable disease
31
What are the 4D's of epiglottitis
Drooling Dysphonia Dyspnoea Dysphagia
32
What is lymphadenitis
Inflammation of the LN
33
Causes of lymphadenitis (6)
``` Infection - staph,strep,TB,cellulitis Salmonella Viral - HIV/HPV/CMV JIA Serum sickness Leukaemia Hodgkins ```
34
Ix lymphadenitis (7)
``` Gram stain CUlutre aspirate Biopsy Serology Bloods - ESR/WCC/FBC/LFT CXR USS ```
35
Croup - age
6m-3y
36
PS Croup (5)
``` Preceding URTI Low grade fever Barking cough Insp stridor Hoarseness ```
37
Causes Croup (3)
Parainfluenza virus ** RSV Rhinovirus
38
Tx Croup (3)
Neb adrenaline PO dexamethasone Severe - intubate + ventilate
39
What is angiodema
Abnormal vascular permeability beneath dermis
40
Main cause angiodema
Allergic
41
Other causes angiodema
Complement mediated Dx induced Idiopathic
42
Drugs inducing angiodema (3)
ACEi B lactam Other Abx
43
Mx angiodema (2)
Epinephrine | Anti histamine
44
Mx - emergency UAO
``` 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
What % of tonsillitis are viral
70%
46
Bacterial tonsillitis - PS (5)
``` White pus Painful Fever Unwell Ear ache Bilateral cervical lymphadenopathy ```
47
Med mx tonsillitis
Analgesia PO ABx - 500mg Pen V QDS 10 days Drink plenty If severe IV ABx
48
What are the 4 indications for tonsillectomy
OSA Malig Febrile convulsions Infections 1y 7eps. 2y 5eps. 3y 3eps
49
How is size of tonsillectomy determined
Brodsky's criteria
50
Post tonsillectomy bleed - <24hrs
Poor haematemesis hence --> theatre
51
Post tonsillectomy - 2-10days
Infection --> ABx
52
Complications tonsillectomy (3)
Bleed Teeth dislodge Infection
53
Cause of glandular fever
EBV
54
Triad Sx glandular fever
Sore throat Lymphadenopathy Pyrexia (Also abdo pain/HSmegaly)
55
Ix glandular fever (3)
FBC LFT Monospot glandular fever test
56
Mx glandular fever (4)
PO rehydration Analgesia LFT monitoring Avoid contact sport/alcohol 8W
57
What does sore throat encompass? (3)
Pharyngitis Tonsillitis Laryngitis
58
Mx sore throat (2)
P + I
59
NICE indications for ABx for sore throat (5)
``` Marked systemic upset Unilateral peritonsilitis Hx RF Immunocomp/DM 3+ centor criteria ```
60
Centor criteria (4)
Tonsillar exudate Tender ant cervical LN Fever No cough
61
Indications - tracheostomy (3)
Bypass UOA (infection/cancer/FB/anaphylaxis) Prov pulmonary toilet Access during H+N surgery
62
Process of tracheostomy
Horizontal incision 2cm above suprasternal notch Separate strap mm Isthmus ligated + cut Vertical incision made
63
Early risks of tracheostomy (6)
``` Displacement Blocked Pneumothorax Bleeding + local infection Dysphagia Surgical emphysema ```
64
Late risks tracheostomy (2)
Fistula | Stenosis
65
3 types of tracheostomy (3)
Disposable cannula CUffed w/ reusable inner cannula Disposable cannula

CP2 - ENT (13 decks)

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