MSRA > Ent > Flashcards

Ent Flashcards

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1
Q

Sudden sensorineural hearing loss tx

A

Arjun referral to ENT high dose steroids if high dose oral steroids not tolerated then intra-tympanic steroids

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2
Q

Samters triad

A

Asthma Aspirin sensitivity nasal polyps

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3
Q

Ototoxic drugs

A

Aspirin nsaids aminoglycosides Loop diuretics quinine

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4
Q

Treatment vestibular neuronitis

A

Short coaurse of oral prochlorperazine or antihistamine
Buccal or im
Vestibular rehab exercise

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5
Q

Bilateral parotid swelling

A

Sarcoidosis
Sjogrens
Mumps
Lymphoma
Alcoholic liver disease

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6
Q

Positive rhombergs

A

Minieres

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7
Q

Driving minieres

A

Inform dvla
Cease until satisfactory control of symptoms

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8
Q

Treatment meniere’s disease

A

Acute attacks buckle or intramuscular proclord person
Prevention beta histine and vestibular rehabilitation

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9
Q

Flamingo tinge

A

Otosclerosis

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10
Q

Recurrent otitis externa resistance to antibiotics

A

?candida

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11
Q

Initial mx of otitis externa

A

Acetic acid spary 2%
Topical antibiotics or a combined topical antibiotics with steroids

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12
Q

Gingival hyperplasia

A

Phenytoin
Cyclosporine
Ccb esp nifidipine
Aml

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13
Q

Air bone gap

A

10db

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14
Q

Naseptin contains

A

Chlorhexidine neomycin

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15
Q

Otitis externa in diabetes

A

Iv Ciprofloxacin to cover pseudomonas

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16
Q

Most common prganisms acute sinusitis

A

Strep pneu
H influenza
Rhinovirus

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17
Q

Acute sinusitis tx

A

Uncomplicated>10days intranasal steroids
Complicated phenoxymethyl
Systemic coamoxclav

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18
Q

Common cause of otitis media

A

Strep pneumo
H influenza
Moraxella catarrhalis

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19
Q

Acute otitis media causatives

A

Viral urti f/b
Strep pneumonia, h influenza, moraxella catarrhalis

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20
Q

Antibiotics in acute otitis media

A

More than 4days
Systematic unwell
Immunocompromised
Younger than 2 with bilateral om
Om with perforation or discharge

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21
Q

Antibiotics for aom

A

Amox 5-7d
Ery or clari

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22
Q

Csom define

A

Perforation with otorrhea >6wks

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23
Q

Acute sinusitis causatives

A

Strep pneumonia
H influenza
Rhinovirus

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24
Q

Antibiotics in acute sinusitis

A

Not indicated in uncomplicated cases
Phenoxymethypenicillin
Coamox if systemically unwell

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25
Steroids in acute sinusitis
If more than 10days
26
Mild to mod allergic rhinitis
Oral or intranasal antihistamines
27
Mod to severe allergic rhinitis
Intranasal corticosteroid
28
Brand daroff
Vestibular rehabilitation
29
Defective Desquamation of filiform papillae
Black hairy tongue
30
Risk factors for black hairy tpngue
Poor oral hygiene Antibiotics Head n neck radiation Hiv Iv drug use
31
Risk factor for cholesteatoma
Cleft palate
32
Cholesteatoma inv and mx
Otoscopy attic crust Refer
33
Chronic rhinosinusitis duration
12wks
34
Red flags in chronic rhinosinusitis
Unilateral Persistent despite 3m of treatment Epistaxis
35
Treatment chronuc rhinosinusitis
Intranasal corticosteroid Nasal irrigation with saline
36
Flamingo tinge
Otosclerosis
37
Otosclerosis genetics nd onset
Ad 20-40yrs
38
Most common cause of conductive hearing loss in childhood
Glue ear
39
Positive rhombergs
Minere diseases
40
Ototoxic drugs
Aminoglycosides furosemide ๐—ฎ๐˜€๐—ฝ๐—ถ๐—ฟ๐—ถ๐—ป cytotoxic agrnts
41
Nosise damage hearing loss worse at
3,k-6k hz
42
Bilateral acoustic neuromas
Nf2
43
Topical antiseptic in epistaxis
Naseptin or mupirocin To reduce crusting and risk of vestibulitis
44
Admit for epistaxis
If less than 2yrs Comorbity After packing
45
Epistaxis that has failed all emergency
Sphenopalatine ligation
46
Geographic tongue premalignant?
Benign
47
Drugs causing gingival hyperplasia
Phenytoin ciclosporin ccb esp nifedipine
48
Non pharmacological causes of gingival hyperplasia
Aml (mylomonocytic or monocytic
49
Risk factor for glue ear
Male sex siblings with glue ear Bottlefeeding daycare Parental smoking Winter spring
50
Glue ear peaks at
2 years
51
Treatment glue ear
3.months observation Grommet Adenoidectomy
52
Laryngeal ca 2ww if
>= 45 Persistant unexplained hoarseness Or unexplained lump
53
Oral ca 2ww if
Suspected ca Unexplained ulcer more than 3weeks Unexplained lump Urgent Lump on lip or oral Erythroplakia or erythroleukoplakia
54
Which thyroid abnormality can cause hoarsenesa
Hypothyroidism
55
Malignant om commonly caused by
Pseudomonas aeroginosa Dm or immunocompromised
56
Malignant om complications
Temporal bone om
57
Diagnosis for malignant om
Ct
58
Non resolving om with worsening pain
Refer urgently
59
Otitis externa in dm
Ciproflox to cover pseudomonas
60
Mastoiditis treatment
Iv antibiotics
61
Mastoiditis med emergency
Due to potential risk of meningitis
62
Excessive pressure and progressive dilatation of endolymphatic system
Mineieres
63
Hl in mimieres
Sensorineural
64
Mx of minieres
Symptoms resolve in majority after5-10years but hl Ent assessment to confirm dx INFORM DVLA cease driving till symptom control
65
Drugs for mineres
Acute- buccal or im prochlorperazine Prevent - betahistine vest rehabilitation
66
In which cases should a **2 week wait referral** to oral surgery be done?
* Unexplained oral ulceration or mass persisting for greater than 3 weeks * Unexplained red, or red and white patches that are painful, swollen or bleeding * Unexplained one-sided pain in the head and neck area for greater than 4 weeks, associated with ear ache, but no abnormal findings on otoscopy * Unexplained recent neck lump, or a previously undiagnosed lump that has changed over a period * Unexplained persistent sore or painful throat * Signs and symptoms in the oral cavity persisting for more than 6 weeks, that cannot be definitively diagnosed as a benign lesion ## Footnote The level of suspicion should be higher in patients who are over 40, smokers, heavy drinkers, and those who chew tobacco or betel nut (areca nut).
67
In which cases should a **2 week wait referral** to oral surgery be done?
* Unexplained oral ulceration or mass persisting for greater than 3 weeks * Unexplained red, or red and white patches that are painful, swollen or bleeding * Unexplained one-sided pain in the head and neck area for greater than 4 weeks, associated with ear ache, but no abnormal findings on otoscopy * Unexplained recent neck lump, or a previously undiagnosed lump that has changed over a period * Unexplained persistent sore or painful throat * Signs and symptoms in the oral cavity persisting for more than 6 weeks, that cannot be definitively diagnosed as a benign lesion ## Footnote The level of suspicion should be higher in patients who are over 40, smokers, heavy drinkers, and those who chew tobacco or betel nut (areca nut).
68
Nasal polyps shrinked by
Topical steroid
69
Nasal poly association
Asthma aspirin sensitivity sinusitis Cf kartageners churg strauss
70
Red flag symptoms in nasal polyps
Unilateral Bleeding
71
Untreated nasal septal hematoma
Necrosis saddle nose
72
Nasal septal hematoma mc symptoms
Nasal obstruction
73
Nasal septal hematoma tx
Drain Iv antibiotics
74
Mcc neck lumps
Reactive lymphadenopathy
75
Pain while drinking alcohol
Lymphoma Uncommon
76
Pharyngeal pouch anatomy
Posteromedial herniation btw thyropharyngeus and cricopharyngeus
77
Gurgles on palpation
Pharyngeal pouch
78
Left side swelling in infant
Cystic hugroma
79
Brachial cyst anatomy
Btw scm and pharynx Failure of obliteration of second brachial cleft
80
Brachial cyst presents in age
Early adulthood
81
More coomon in males
Nasal polyps
82
More common in females
Cervical rib
83
Thoracic outlet syndrome associated with
Cervical rib
84
Otitus externa causes
Staph pseudo fungal Seborrheic derm contact derm Swimming
85
First line otitis externa
Topical antibiotics with or without steroids
86
Second line otitis externa
Oral flucloxacillin Swab
87
Recurrant otitis externa
Empirical antifungal
88
Deafness in otosclerosis
Conductive Fixation of stapes at the oval window
89
Otosclerosis genetics
Ad
90
Mx of otosclerosis
Hearing aid Stapedectomy
91
Bilateral parotid swelling
Mumps Sarcoidosis sjogrens Lymphome ALd
92
Unilateral parotid swelling
Pleomorphic adenoma Stones Infection
93
Perforation tx
Heal 6-8wks Otherwise myringoplasty If aom antibiotics
94
Halitosis
Pharyngeal pouch Pnd
95
Bleeding 6-8hrs aftr tonsillectomy
Primary or reactionary Return to ot
96
Secondary hmmge
5-10days after Infection Admission nd antibiotics
97
Drug exposure that might contribute to presbycusis
Salicylates chemo
98
Gradual loss of directionality of sound in elderly
? Presbyacus
99
Tympanometry and otoscopy in presbycusis
Normal
100
Herpea zosree reactivation in
Geniculate ganglion of seventh cranial nerve
101
Treatment of ramsay hunt
Oral acyclovir
102
Sore throat + history of rheumatic fever
Antibiotics
103
Unilateral peritonsillitis
Antibiotics
104
Centor
Tonsillar exudate Tender ant cervical lymphadenopathy Fever No cough 3 or 4 antibiotics
105
Feverpain
Fever 38* Purulence Attend rapidly 3days Inflammed tonsils No cough coryza
106
Sudden onset sensorineural hl
Urgebt referral Mri HIGH DOSE ORAL STEROIDS
107
Treatment ssnhl
High dose oral STEROIDS
108
Absent corneal reflex
Acoustic neuroma
109
Imaging for tinnitus
IF requured Mri IAM
110
Pulsatile tinnitus
MRA Glomus jugulare tumour Paranganglionic neuroendicrine
111
Recent viral + vertigo + no hl or tinnus
Vestibular neuronitis
112
Dizziness on extending head
Vbi
113
Vertigo in vestibular neuronitis
May last hours or days Recurrent No hl or tinnitus
114
Mx vestibular neuronitis
Buccal or im prochlorperazine rapud relief Short oral course of prochlorperazine or antihistamines for less severe cases Vestibular rehabilitation
115
Mc form of labyrinthitis
Viral
116
Nystagmus in labyrinthitis
Spont unidirectional horizontal towards healthy side
117
Hl in labyrinthitis
Sensorineural
118
Treatment of viral labyrinthitis
Self limiting Prochlorperazine or antihistamines
119
Persistent smelly discharge + hearing loss
Cholesteatoma until proven otherwise?
120
Mild to mod allergic rhinitis
Prn intranasal antihistamines (azelastine Or prn oral antihistamines
121
Mid to severe allergic rhinitis
Regular intranasal steroid (mometasonr or fluticasone
122
Persistent watery rhinorrea
Intranasal anticholinergic
123
Nasal itching or sneezibg
Po antihistamines Or intranasal steroid + antihistamines spray
124
Littles area
Anterior
125
Posterior bleed usually from
Sphenopalatine
126
Red or blue mass behind tm
Glomus jugulare
127
Frst line for imlacted wax
Olive oil qds or sod bicarb 5% 3-5d
128
Bulging erythematous tm
Aom
129
Rdtrated yellow tm absent light reflex
? Glue ear
130
Watchful waiting for glue ear unless
Downs, cleft palate
131
Bimodal incidence
Glue ear 2, 5 yrs old
132
Watchful waiting involves
2 audiometry tests 3 months apart
133
Brand daroff
Bppv
134
Roaring tinnitus
Mineres
135
Red flags in vertigo
>24h Headache deafness Ataxia Neurological signs
136
Cervical lymphadenopathy + whitewash tonsillar exudate+ splenomegaly + ruq tenderness
Ebv
137
Inv for glandular fever
<12 or immunocompromised -ebv serology Otherwise monospot test Fbc atypical or reactive lymphocytes Lft ast alt elevated
138
Muffled hot potato voice + trismus+ halitosis
Quinsy
139
Rash after amoxicillin
Glandular fever
140
Mx of glandular fever
Rest analgesia AVOUD CONTACT SPORTS OR WT LIFTING FOR 4WKS
141
Triad of meniers
Recurrent episodic vertigo Tinnitus Fluctuating hearing loss
142
Discharge in glue ear
No discharge? Difference from csom?
143
Csom mx
Ent referral Usually topic quinolones +/- steroids
144
Bells palsy treatment
Prednisolone 50-60mg od 10d Eye care
145
Ramsay hunt treatment
Acyclovir + pred 60mg 5d
146
Granulation tissue
Malignant otitis externa
147
Risk factors for nasopharyngeal ca
Southeast cantonese Salty diet Ebv
148
Frst line for acute rhinosinusitis
Phenoxymethypenicillin Coamoxclav if very unwell
149
Hl mosf marjed at high frequencies
Presbycusis
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