Trauma

Question 1

local cause of epistaxis

Answer 1

idiopathic 
truamatic 
inflammatory 
foreign body 
tumour

Question 2

systemic cause epistaxis

Answer 2

anticoagulants 
clotting issues 
liver disease 
haemophilia 
HHT
leukaemia 
thrombocytopaenia 
arteriosclerosis 
wegners granulomatosis 
HTN

Question 3

management local epistaxis

Answer 3

external pressure 
ice 
cautery 
packing 
remove clots with suction 
lignocaine, adrenaline

Question 4

management of distant epistaxis

Answer 4

sphenopalatine artery ligation
ant ethmoidal artery ligation
external carotid/maxillary ligation

Question 5

systemivc management of epistaxis

Answer 5

reverse anticoagulants 
correct clotting 
tranexamic acid 
platelet transfusion 
treat cause 
treat HTN

Question 6

questions to ask about ENT trauma

Answer 6

mechanism 
when 
LOC 
epistaxis 
breatihng 
bruising/swelling 
tenderness
deviation 
infraorbital sensation 
cranial nerves?

Question 7

what is a septal haematoma

Answer 7

result of inflammation to mucosa supplying nasal cartilage leading to nasal collapse
can also become infected and spread to the danger traingle

Question 8

what factors are setting the nose based off

Answer 8

breathing, cosmesis and deviation

Question 9

when would you consider resetting the nose

Answer 9

either immediately after or within 7-14 days

Question 10

complications of nasal fracture

Answer 10

epistaxis
CSF leak
meningitis
anosmia with crib plate fracture

Question 11

blood tests during admission for epistaxis

Answer 11

FBC, G&S, XM

Question 12

most common site for CSF leak and management

Answer 12

cribiform plate
usually settles but may need repair within 7 days
do not give abx as can mask a meningitis

Question 13

what is a pinna haematoma and how would you manage it

Answer 13

avascular cartilage cannot receive nutrient from mucosa due to trauma
aspirate, incision and drainage
pressure dressing

Question 14

management of lacteration to ear

Answer 14

debride
local anaesthetic
Abx
primary or reconstructive tissue repair

Question 15

key questions in temporal bone fracture

Answer 15

facial palsy 
CSF leak 
hearing loss 
vertigo 
mechanism

Question 16

features of temporal bone fracture on examination

Answer 16

battles sign
look at TM and canal
test CN VII and assess palsy
hearing test

Question 17

what is worse, progressive facial nerve palsy or immediate

Answer 17

immediate, indicates severe damage to the facial nerve

Question 18

complications of a longitudinal temporal bone fracturr

Answer 18

most common
facial nerve palsy
haemotympanum
ossicular chain dysruption

Question 19

mechanism and complications of a transverse temporal bone fracture

Answer 19

frontal blow
cross IAM to damage auditory/facial nerve
facial nerve palsy/vertigo

Question 20

management of sudden sensorineural hearing loss?

Answer 20

1mg/kg steroid and intratympanic treatment

Question 21

what foreign body MUST be removed with immediate effect

Answer 21

button batteries, organ threatening

Question 22

managing live animals in the ear?

Answer 22

drown them in oil and remove in urgent clinic

Question 23

demographic for penetrating neck trauma

Answer 23

GSW, knife
Males
younger

Question 24

aerodigestive features of penetrating neck trauma

Answer 24

SOB
hoarse
dysphonia
dysphagia

Question 25

Zone I area of penetrating neck trauma

Answer 25

cricoid to sternum and clavicle | trachea, oesophagus, thoracic duct, thyroid, great vessels, cord

Question 26

Zone II area of penetrating neck trauma

Answer 26

cricoid to hyoid larynx hyopharynx CN X, IX, XII

Question 27

Zone III area of penetrating neck trauma

Answer 27

cricoid to skull base pharynx, cranial nerves, carotids IJV, vetebral arteries cord

Question 28

management of penetrating neck trauma

Answer 28

``` ABCDE inspect and classify manage bleed aerodigestive issues neuro issues FBC, G&S, XM AP/lat neck CXR, CT angio or MRI endoscopy may be considered ```

Question 29

when is urgent surgical exploration indicated in penetrating neck trauma

Answer 29

expanding haematoma, shock, obstruction, blood in the aerodigestive tract

Question 30

cause of deep neck space infection?

Answer 30

tonsil or oropharynx infection

Question 31

symptoms of deep neck space infection

Answer 31

``` sore throat febrile limited neck movement red and tender neck trismus ```

Question 32

management of deep neck space infection

Answer 32

``` admit IV access with bloods fluids coamoxiclav and clindamycin theatre to drain manage any airway compromise by securing ```

Question 33

management of airway obstruction

Answer 33

``` ABCDE High flow O2 heliox neb budesonide and adrenaline fibre optic endoscope secure with ET, tracheostomy cricothyroidectomy in emergency cases ```

Question 34

features of orbital blowout

Answer 34

``` pain decreased visual acuity diplopia hypoaesthesia periorbital ecchymosis oedema enophthalmos restricted movemennt bony step ```

Question 35

investigation of orbital blowout

Answer 35

CT sinus | surgical if there is eye defect or entrapment

Question 36

le fort I?

Answer 36

maxilla and upper dentition

Question 37

le fort II?

Answer 37

maxilla and nose

Question 38

le fort III?

Answer 38

maxilla, orbit involved