ENT SC1 > Throat-ENT > Flashcards

Throat-ENT Flashcards

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1
Q

tx acute tonsilitis

A
  • co-amox
  • analgesia +/- steroid bolus
  • rehydration/ bed rest
  • antipyretics
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2
Q

tx acute tonsilitis

A
  • co-amox
  • analgesia +/- steroid bolus
  • rehydration/ bed rest
  • antipyretics
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3
Q

viral vs. bacterial sore throat

A 
viral= milder, low grade adenopathy, 
bacterial= SEVERE> 48hrs
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4
Q

dx acute tonsilitis

A
  • fbc
  • MONOSPOT= Paul Bunnell
  • LFT
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5
Q

refer acute tonsilitis

A
  • severe sore throat
  • trsimus
  • hot potato
  • referred pain
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6
Q

causes of quinsy

A

S.aureus
S.pneumo
Bacteroides

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7
Q

Epiglottis in adults- location

A

SUPRAGLOTTIC

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8
Q

Tx epiglottitis

A

REFERRAL- ENT/anaesthesia/paeds

  • Oxygen
  • adnrealine neb
  • heliox
  • steroids
  • antibiotics– third gen cephalosporin
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9
Q

nasal facture– important to exclude

A

another max-fax fracture

CSF rhinorrhea

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10
Q

when to refer nasal fracture

A

obvious deformity- 5-7days; rhinoplasty

URGENTLY– septal haematoma

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11
Q

mgmt septal haematoma

A

incise
drain
tamponade

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12
Q

tx of orbital cellulitis

A

IB antibiotics
decongestants
analgesia
optic nerve damage= SURGICAL DECOMPRESSION

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13
Q

dx of orbital cellulitis

A

CT sinuses- exclude orbital abscess

urgent referral ENT/ OPTHO

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14
Q

epistaxis causes in kids

A
  • URTI

- digital trauma

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15
Q

epistaxis causes in adults

A
  • trauma
  • anterior bleed
  • posterior bleed
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16
Q

anterior bleed epistaxis in adults

A
  • little’s area

- recurrent self-limiting

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17
Q

posterior bleed epistaxis in adults

A
  • elderly
  • medical co-morbidities– anticoag, aspirin

MORE SEVERE–> ADMIT

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18
Q

bloody otorrhea tx– BASE OF SKULL FRACTURE

A

BATTLE SIGN: bruising over mastoid process, by extravasation of blood along path of posterior auricular artery

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19
Q

bloody otorrhea tx– BASE OF SKULL FRACTURE

A

BATTLE SIGN

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20
Q

viral vs. bacterial sore throat

A 
viral= milder, low grade adenopathy, 
bacterial= SEVERE> 48hrs
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21
Q

dx acute tonsilitis

A
  • fbc
  • MONOSPOT= Paul Bunnell
  • LFT
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22
Q

refer acute tonsilitis

A
  • severe sore throat
  • trsimus
  • hot potato
  • referred pain
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23
Q

causes of quinsy

A

S.aureus
S.pneumo
Bacteroides

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24
Q

Epiglottis in adults- location

A

SUPRAGLOTTIC

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25
Tx epiglottitis
REFERRAL- ENT/anaesthesia/paeds - Oxygen - adnrealine neb - heliox - steroids - antibiotics-- third gen cephalosporin
26
nasal facture-- important to exclude
another max-fax fracture | CSF rhinorrhea
27
when to refer nasal fracture
obvious deformity- 5-7days; rhinoplasty | URGENTLY-- septal haematoma
28
mgmt septal haematoma
incise drain tamponade
29
anterior ethmoidal artery
ophthalmic-ica-common carotid
30
sphenopalatine artery
terminal IMAX-ECA
31
greater palatine
IMAX-ECA
32
septal branch
superior labial-facial-IMAX-ECA
33
grade 1 chandlers
preseptal/ periorbital cellulitis
34
grade 2 chandlers
postseptal/ orbital cellulitis
35
grade 3 chandlers
subperiosteal abscess
36
grade 4 chandlers
intra-orbital abscess
37
grade 5 chandlers
cavernous sinus thrombosis
38
tx of orbital cellulitis
IB antibiotics decongestants analgesia optic nerve damage= SURGICAL DECOMPRESSION
39
dx of orbital cellulitis
CT sinuses- exclude orbital abscess | urgent referral ENT/ OPTHO
40
epistaxis causes in kids
- URTI | - digital trauma
41
epistaxis causes in adults
- trauma - anterior bleed - posterior bleed
42
anterior bleed epistaxis in adults
- little's area | - recurrent self-limiting
43
posterior bleed epistaxis in adults
- elderly - medical co-morbidities-- anticoag, aspirin MORE SEVERE--> ADMIT
44
perichondral haematoma tx
- IV abx - analgesia - refer--> incise and drain
45
bloody otorrhea tx-- BASE OF SKULL FRACTURE
BATTLE SIGN
46
causes of bloody otorrhea
- otitis-- media/ externa - focal trauma - head injury - post-op
47
mgmt bloody otorrhea
RADIOLOGY, PRIMARY/SECONDARY SURVEILLANCE | HEAD INJURY TEAM
48
epistaxis tx
1. Tilt head forward and apply nasal compression for 15 minutes 2. Try againIf fails to resolve consider hospital admission 3. Perform ABCD and correct any underlying pathology (HTN, bleeding disorder) 4. Establish IV Line access 5. Offer Nasal Decongestant (Oxymetazoline) 6. Visualize and Cauterize the wound with silver nitrate 7. Pack nose and give oral antibiotics Ribbon Gauze w/ BIPP, merocel (tampon), rapid rhino (balloon) 8. Antibiotics to prevent: sinusitis, otitis media, cavernous sinus thrombosis 9. if bleeding persists, consider surgical intervention Arterial ligation Radiological Embolization
49
RR newborn
30-50
50
RR toddler
20-40
51
RR school
15-25
52
RR adult
12-15
53
indications for tracheostomy
``` PELAPS Prophylaxis Edema- infective/trauma/burn Long term ventilation Airway obstruction Pulmonar toilet-- aspiration Sleep apnea ```
54
do an open one, when there are contraindications to ventilation, such as...
OBESE COAGULOPATHIC PREVIOUS- Rtx/ Sx
55
stridor neonate
- laryngomalacia - congenital tumor - subglottic stenosis - vocal cord paralysis
56
stridor children
- croup - FB - epiglottitis - acute laryngitis - respiratory papillomatosis
57
stridor adults
- laryngeal cancer - laryngeal trauma - acute laryngitis - epiglottitis
58
complications of tracheostomy
1. death 2. obstruction-- from secretion since FB 3. bleeding 4. displacement 5. subcutaneous emphysema 6. pneumothorax 7. fistula-- TEF, tracheoinnominate 8. RLN
59
cuffed tube
can talk; seal for ventilation | change: ulcerates or RLN or aspiration or dysphasia
60
double lumen tube
change: clean
61
fenestrated tube
can talk; | change: granulations go through
62
inflammatory causes of neck mass
- cervical adenitis | - chronic sialadenitis
63
infectious causes of neck mass
- staph - strep - TB - HIV - Cat scratch - Toxo - EBV - Actinomycosis
64
congenital causes of neck mass
``` LATERAL= branchial cleft cyst DIFFUSE= lymph/haemangioma MIDLINE= - thyroglossal duct cyst - dermoid cyst ```
65
benign neoplastic causes of neck mass
benign: - lipoma - fibroma - neuroma - haemangioma
66
malignant neoplastic causes of neck mass
malignant: - lymphoma - SCC - PTC - RCC or breast mets
67
traumatic causes of neck mass
pseudoaneurysm | AV fistula
68
idiopathic causes of neck mass
Sarcoidosis Cattleman's disease Kimuras disease
69
Kimuras disease=
chronic inflammation
70
Castlemans disease=
benign lymphoproliferative
71
side effects of gradualism vaccine
pain/ red at injection site faint-- 15 minutes after v.rare= anaphylaxis
72
presentation of SCC
= LATE, stages 3-4
73
causes of leukoplakia
- irritation-- dentures, rough teeth, fillings, crowns - smoking - lip sun exposure - oral cancer - HIV
74
PC HPV head and neck cancer
- SOB - hoarseness - difficulty swallowing - painful swallowing - persistent pain - bleeding - ulceration-- oral, skin - lump/ mass lesion
75
other name for rodent ulcer
JACOBI ULCER
76
two new names of aggressive BCC's
cicatricial (morpheaform) | infiltrative
77
superficial multicentric BCC
trunk/ erythematous patch
78
merkel cell skin cancer a/w
POLYOMA VIRUS
79
T size for SCC
2cm
80
high risk features of SCC
- ear or hair bearing lip - greater than 2cm - clark four-- reticular dermal invasion - perineural invasion - poorly differentiated - chronic inflammation/ ulcer/ burn
81
melanoma of extremities
FEMALES
82
melanoma of trunk
MALES
83
amelanotic melanoma
trunk, head and neck presents in NORMAL SKIN RAPID growth
84
desmoplastic melanoma
HIGHLY AGGRESSIVE NEURAL INVASION SUNLIGHT EXPOSED areas
85
in situ clarks
dermis
86
stage 2 clarks
papillary dermis
87
stage 3 clarks
papillary-reticular dermis
88
stage 4 clarks
reticular dermis
89
stage 5 clarks
subcutaneous fat
90
GAMES for thyroid cancer
``` G-grade A-age-45yo M-m stage- M0, M1 Extrathyroid extension Size-4cm ```
ENT SC1
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