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ENT > Week 2 > Flashcards

Week 2 Flashcards

1
Q

What are the pharyngeal tonsils also known as?

A

Adenoids

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2
Q

How does the basic histological structure of the adenoids differ from the palatine tonsils?

A

Adenoids- ciliated pseudostratified columnar epithelium

tonsils- specialised squamous

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3
Q 
Define the following:
Rhinoplasty
Otoplasty
Mentoplasty
blephroplasty
A

Rhinoplasty- plastic surgery to the nose
Otoplasty- plastic surgery to the ear (pinning back)
Mentoplasty- plastic surgery to the chin
plastic surgery to the eyelids

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4
Q

Define vertigo

A

A sensation of movement, usually spinning, or falling, being pushed

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5
Q

How might you distinguish between cardiac, neurological and vestibular system as the cause of dizziness?

A

Cardiac- lightheadedness, syncope, palpitations
Neurological- blackouts, parasthesia, visual disturbance, speech and swallow problems, weakness
Vestibular- Vertigo

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6
Q

What is nystagmus?

A

Where someone suffers from involuntary uncontrollable eye movements

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7
Q

What are the three types of hearing loss

A

Conductive
Sensorineural
Mixed

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8
Q

What is presbycusis?

A

Gradual hearing loss with old age

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9
Q

What scoring system is used to check if tonsillitis is a strep infection. What does it stand for?

A 
FeverPAIN score
Fever
Purulence on tonsils
attend rapidly
Very Inflamed tonsils
no Cough/Coryza
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10
Q

What are the possible signs of tonsillitis?

A

Erythematous, inflamed tonsils
Purulence on tonsils
Erythema and oedema of palate

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11
Q

What is Quinsy?

A

A peritonsillar abscess

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12
Q

What are the two types of obstructive hyperplasia and give some possible symptoms of each

A

Enlarged tonsils- snoring, sleep apnoea, muffled voice

Enlarged adenoids- snoring, sleep apnoea, obligate mouth breathing

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13
Q

Give two other possible names of glue ear

A

Otitis media with effusion (OME), serous otitis media (SOM)

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14
Q

How does acute otitis media differ from OME/SOM?

A

Both present with middle ear inflammation, fluid accumulation. Only AOM has acute signs/symptoms of inflammation

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15
Q

How does presbycusis often present?

A

Mainly high-frequency hearing loss with low frequencies preserved, often worse in one ear than the other.

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16
Q

Identify 4 possible treatments of tinnitus

A

CBT
Relaxation therapy
Use of environmental sound
Hearing aids in case of associated hearing loss

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17
Q

What antibiotic should be used to treat bacterial tonsillitis? What is the alternative if not tolerated?

A

Penicillin

Clarithromycin

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18
Q

How does the tympanic membrane present of a patient with AOM? What about in OME?

A

Bulging, erythematous tympanic membrane

Opaque/dull tympanic membrane with bubbles

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19
Q

Identify some of the possible symptoms of otitis media

A 
Otalgia
Fever
Discharge
Hearing loss
Upset behaviour/school performance
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20
Q

How would you approach the management of Otitis media?

A

1st watch and wait/ Oral antibiotics if bacterial and acute
2nd Review after 3 months- referral
3rd Grommet insertion

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21
Q

Identify four investigations other than history for Otitis media.

A

Otoscopy
Tympanometry
audiometry
tuning fork tests

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22
Q

How does the classical presentation of otitis externa differ from otitis media?

A

OE- discharge followed by otalgia

OM- otalgia followed by discharge

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23
Q

Identify some of the signs and symptoms of herpes simplex infection

A 
Cold sores (perioral lesions)
Mucous membrane/skin lesions
Genital lesions
Ocular infections
encephalitis
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24
Q

What causes Primary Gingivostomatitis? How does it present? How is it treated?

A

Initial infection of Herpes simplex virus.
Swelling and lesions of the gingiva (gums) and perioral lesions. Also fever, lymphadenopathy.
Aciclovir

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25
Q

What is herpetic Whitlow?

A

Herpes simplex infection of the finger

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26
Q

What is the classic triad of symptoms for Infectious Mononucleosis?

A

Fever
Pharyngitis
Lymphadenopathy

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27
Q

Give two differentials of tonsillitis

A

Glandular fever

Quinsy

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28
Q

Apart from Fever, pharyngitis and lymphadenopathy give some other symptoms of Glandular fever

A 
Jaundice
Macular rash (from ampicillin for sore throat)
Splenomegaly
palatal petechiae
tonsillar exudate
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29
Q

Give three investigations for glandular fever

A

EBV IgM test
Heterophile antibody test
Bloods show Atypical lymphocytes (lymphocytosis)

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30
Q

Name three topical treatments you may use to treat otitis externa

A

Earcalm
Otomize
sofradex

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31
Q

What investigations would you consider for a patient presenting with dizziness/vertigo

A 
Otoscopy
Neurological exam
Blood Pressure (including lying and standing to rule out orthostatic hypotension)
Balance system manoeuvres
Audiometry
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32
Q

What is the most common cause of vertigo?

A

Benign Positional Paroxysmal Vertigo (BPPV)

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33
Q

Identify three causes of BPPV

A

idiopathic
head trauma
ear surgery

34
Q

Describe the pathophysiology of BPPV

A

The aetiology causes the otoconia crystals to be displaced into the Semi-circular canals from the utricle.

35
Q

What are the distinguishing symptoms of BPPV?

A 
Vertigo upon:
Looking up
Getting up
Bending over
Turning in bed
Lasts under 30seconds
Nystagmus
36
Q

What is the main test for BPPV?

A

Dix-Hallpike test

37
Q

What is the mainstay of treatment for BPPV?

A

Epley Manoeuvre

38
Q

Name a cause of prolonged vertigo that is often also causes nausea and vomiting. How is it treated?

A

Vestibular neuronitis

Vestibular sedatives

39
Q

What is the known pathophysiology associated with Meniere’s disease? How does it present?

A

Endolymphatic hydrops

Vertigo, Low frequency sensorineural hearing loss, tinnitus

40
Q

Name a complication of otitis media

A

Mastoiditis- if untreated possible meningitis

41
Q

Define Cholesteatoma.

What is the appropriate treatment of this condition?

A

Keratinizing squamous epithelium within the middle ear cleft

Mastoidectomy

42
Q

Name the two tuning fork tests

A

Rinne’s test

Weber’s test

43
Q

What is otosclerosis?

A

Gradual onset conductive hearing loss due to fixation of the stapes bone

44
Q

What is septal haematoma and why is it a medical emergency?

A

It is the accumulation of blood in the nasal septum resulting in swelling.
It is an emergency because it can lead to ischaemic necrosis of the septal cartilage

45
Q

Identify four possible complications of nasal bone fracture

A

epistaxis
CSF leak
Meningitis
Anosmia- cribriform plate fracture

46
Q

Describe the typical first aid advice for epistaxis

A

Digital compression of nostrils
ice packs
leaning forward

47
Q

Following first aid, if necessary what are the other treatments of epistaxis?

A

Intranasal cautery- diathermy/silver nitrate
Intranasal packing- Rapid-rhino packs
Sphenopalatine artery ligation last resort

48
Q

Recurrent ______ __________ results in Cauliflower ears. It is treated by…

A

Pinna Haematoma

aspiration or incision and drainage

49
Q

What type of fracture is caused by 1.lateral blows and 2. frontal blows to the head?

A
  1. longitudinal

2. transverse

50
Q

What causes conductive hearing loss in Longitudinal fractures and what causes sensorineural hearing loss in transverse fractures

A

conductive- haemotympanum, ossicle bone damage

sensorineural- vestibulocochlear disruption

51
Q

How do you treat facial nerve palsy?

A

Facial nerve decompression

52
Q

Enophthalamus and teardrop sign on CT are suggestive of what?

A

Maxillary bone fracture

blowout fracture

53
Q

The horizontal, pyramidal and transverse fractures of the midface are called what?

A

Le Fort I, II, and III

54
Q

How would one manage airway obstruction

A 
ABC 
Heliox
Nebulised steroid
Nebulised adrenaline
possible tracheostomy
55
Q

What effectively are hearing aids?

A

Sound amplifying devices- like miniature loudspeakers, some can reduce background noise

56
Q

Define Halitosis

A

Unpleasant breath

57
Q

What tool is used to look at the nasal cavity?

A

Oroscope

58
Q

Neonates are ______ ________ breathers

A

Obligate nasal

59
Q

Give an alternative name for snoring sounds which originate from the oropharynx

A

Stertor

60
Q

What pathogen most commonly causes acute epiglottitis?

A

Haemophilus Influenzae type b (Hib)

61
Q

How is acute epiglottitis treated?

A

Endotracheal intubation

IV antibiotics

62
Q

Identify the three steps on the WHO analgesic ladder

A

1st Adjuvant analgesics
2nd mild Opioids and adjuvant analgesics
3rd moderate Opioids and adjuvant analgesics

63
Q

What are adjuvant analgesics?

A

Painkillers who’s primary indication is for something other than pain

64
Q

Name two types of adjuvant diuretics and two examples of each

A

Anti-convulsant: gabapentin, pregabalin

Anti-depressant: Amytriptyline, duloxetine

65
Q

Name 5 types of Rhinitis

A 
Intermittent Rhinitis
Persistent Rhinitis
Nasal Polyps
Vasomotor Rhinitis
Infective rhinitis
66
Q

What triggers intermittent rhinitis and what triggers persistent rhinitis?

A

Intermittent- Tree and grass pollens, fungal spores

Persistent- Dust mite faeces, Dogs, cat

67
Q

What does the treatment of allergic rhinitis entail?

A

1st Allergen avoidance
2nd Antihistamines
3rd topical steroids
4th Antihistamines and topical steroids

68
Q

Name a virus that is a significant cause of head and neck cancer in the UK

A

HPV (Human Papilloma Virus)

69
Q

What is the main type of cancer effecting the head and neck?

A

Squamous cell carcinoma

70
Q

What are the most common three bacterial causes of otitis externa?

A

Pseudomonas
Proteus
Staph aureus

71
Q

Name four antibiotics used to treat otitis externa

A

Neomycin
Gentamicin
Polymyxin B
Framycetin

72
Q

Name two fungal causes of otitis externa

A

Aspergillus

candida

73
Q

Name three possible wax solvents (Cerumenolytics)

A

Sodium bicarbonate
Almond oil
olive oil

74
Q

Identify three possible side effects of ear drops

A

Dizziness
Local sensitivity
Ototoxicity- with aminoglycoside antibiotics when TM is perforated

75
Q

The Paul-Bunnell test and Monospot test are examples of what?

A

Heterophile tests for Infectious mononucleosis

76
Q

What does QALYs and ICER stand for?

A

ICER- Incremental Cost Effectiveness Ratio- used to determine best drug for cost
QALY- Quality Adjusted Life Years- calculation of how many quality of life years potentially shall be gained by having treatment

77
Q

All The laryngeal muscles are supplied by the _________ ________ nerve apart from the _________ muscle.

A

Recurrent laryngeal

Cricothyroid

78
Q

Name the main cause of reinke’s oedema

A

Smoking

79
Q

Name the investigation used to provide information about the vocal chords

A

Stroboscopy

80
Q

How does Ramsay-Hunt syndrome present? What virus causes this?

A

Herpetic rash, Bell’s Palsy, tinnitus, hearing loss, vertigo

Varicella zoster virus

81
Q

Name the ducts of the submandibular gland and the parotid gland

A

Submandibular- Whartons duct

Parotid- Stensons duct

ENT (2 decks)

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