ENT Flashcards

Question

What is tonsillitis?

Answer 1

Inflammation ot palatine tonsilis. It can be caused virus influneza/EBV or bacteria Group A strep

Answer 2

Fever >38°C * Tonsillar exudate * Absence of cough * Tender anterior cervical lymphadenopathy

Answer 3

Fever >38°C * Purulence (tonsillar exudate) * Attend rapidly (3 days or less) * Severely Inflamed tonsils * No cough or coryza ▫ 0 or 1: 13 to 18% likelihood of GAS ▫ 2 or 3: 34 to 40% likelihood ▫ 4 or 5: 62 to 65% likelihood

Answer 4

Supportive care ▫ Paracetamol, NSAIDs ▫ Fluids ▫ Topical lidocaine ▫ Throat lozenges * Antibiotics? ▫ Use Centor or FeverPAIN scoring ▫ 1st line phenoxymethylpenicillin ▫ 2nd line clarithromycin ▫ Erythromycin if pregnant

Answer 5

Scarlet fever Rheumatic fever

Answer 6

Symptoms Unilateral pain drooling pain when swallowing dysphagia Unilateral otolglia Signs Fever Unilateral swelling of the tonsial Deviated uvla redness Fever trismus muffeld voice" hot potatoe voice" Cervical lymphadepathy

Answer 7

Admit to hosptial drainage IV ABX IV fluids

Answer 8

It is an EBV that is characterised by swelling of the tonsils bilaterally. It tend to be tranmitted by kissing and sharing thing like straws or spoons etc. Some signs include erythema, petichiae, hoarse voice, absensce of cough, hoarse voice, cervical lymphadenopathy Fever hypertrophy of the tonsilis exduate on the tonsils spelenomegaly hepetomegly macopalpular rash Symptoms sore throat mylaia fatigue

Answer 9

1) Monospot test(hetrophile antibodies) 2) FBC- lymphotosis 3)LFTs - elevated ALT/AST

Answer 10

Conservative treatment - Fluids - Anaglesia - Symptoms expected for 2-4 weeks with fatigue lasting longer * Avoid kissing, sharing eating/drinking utensils * Avoid heavy lifting and contact/collision sports for 1st month of illness

Answer 11

Crohns Coelic disease Emotional stress Lack of vitamin - B12 Injury HIV food senstivies

Answer 12

Supportive ▫ Saline mouth rinsing ▫ Topical corticosteroid  If started immediately upon symptoms ▫ Milk of Magnesia * Ulceration >21 days ▫ 2WW referral ? cancer If recurrent consisder doing HIV, crohns or coelic disease, vitamin deficiency testing

Answer 13

Immunosuprressed Diabetic older or young child Asthamtic- ICS user smoker vitamin deficiency Broad specturm antibiotis Poor dental health

Answer 14

Symptoms Local burning, soreness or itching * Odynophagia or chest pain ▫ Oesophageal Signs * Dependent upon thrush subtype ▫ Oral thrush  Patches of curd-like yellow/white plaques on tongue, palate or pharynx  Easily scraped off revealing erythematous base ▫ Acute erythematous/atrophic  Erythematous palate or dorsal tongue ▫ Angular cheilitis  Erythema, fissuring angle of mouth

Answer 15

Treat underlying condition Mincozole or nystain suspension If severe: Oral fluconazole * Advise patients taking inhaled steroids to rinse mouth after each use to prevent thrush

Answer 16

Infection of the major salivary glands by retrograde transmission of bacteria from oral cavity via the salivary duct

Answer 17

Signs & Symptoms: ▫ Enlarged painful salivary gland, purulent drainage from duct orifice, red/painful duct, fever , decreased salivary secretion

Answer 18

Heat/cold compresses with massage ▫ Aggressive hydration ▫ Lemon drops or citrus juice to promote salivary flow ▫ Analgesia medication

Answer 19

Patchy white coating that doesnt rub off usually under the tongue Risk factors include: Alcohol ▫ Tobacco ▫ Immunosuppression ▫ Chronic candidiasis

Answer 20

Refer to ENT for biospy

Answer 21

Oral herpes is a viral infection of HSV1 - it usually transmitted via kissing, sharing utensils etc Prodrome x6-48h ▫ Pain, burning, tingling, pruritus, paraesthesia * Painful blisters * Fever, malaise, sore throat ▫ Primary infection * Fever, cervical lymphadenopathy ▫ Primary infection * Clustered erythematous vesicles of mouth, nose or chin ▫ Ulcers eventually crust over and heal

Answer 22

Oral antiviral -acycloir Avoid kissing or oral sex until healed ▫ Do not share items that come in contact with lesions (e.g. lipstick) ▫ Avoid touching lesions ▫ Wash hands with soap and water

Answer 23

Calaculus in any salivary gland * It causesPain and swelling associated with eating Management * May be removed intra-orally ▫ Lemon drops or citrus juice to promote salivary flow

Answer 24

Conductive - refer to ENT Sensiuriel - Refer to audiology - need hearing aids

Answer 25

Smoking exposure GORD Atopy nusrey Bottle feeding 2months- 6 years recurrent URI absesnce of pnemococcal vaccine

Answer 26

mishearing popping ear fullness balance problems changes in behavoiur growth and speech delay signs Potentially normal TM  Amber/yellow TM colour  Loss of light reflex  Opacification  Air bubbles or air/fluid level  Retracted TM  Prominent malleus and incus

Answer 27

Diagnosis  Audiogram  Asymmetrical sensorineural hearing loss  MRI of internal auditory meatus  Confirms diagnosis Management – Refer ENT  Dependent upon size & growth  Watchful waiting  Radiation  Surgical resection

Answer 28

Pneumatic otoscopy Reduced mobility TM Audiometry -Determine presence and level of hearing loss Refer to ENT  Watchful waiting for 3 months  Often resolves spontaneously

ENT Flashcards

(52 cards)