Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
42 Cards in this Set
- Front
- Back
Most common causative agents of otitis externa
|
Pseudomonas and staph aureus
|
|
Management of otitis externa
|
Non infective? - Betamethasone
Infective? - Betamethasone + neomycin. Also consider oral flucloxacillin. |
|
Most common cause of neck swelling
|
Reactive lymphadenopathy (i.e. illness)
|
|
Key feature of thyroid swelling
|
Moves upwards on swallowing
|
|
Features of thyroglossal cyst
|
Most common in patients <20, moves upwards on protrusion of the tongue
|
|
Features of cystic hygroma
|
Typically presents before age 2 (mostly present at birth). Swelling is classically on left side.
|
|
Common causative agents of otitis media
|
pneumococcus, haemophilus
|
|
Treatment of otitis media
|
Oral amoxicillin
|
|
Hearing tests in children
|
At birth - otoacoustic emissions and/or audiological brainstem responses
6-18 months - distraction testing 2-5 years - conditioned response audiometry and speech discrimination 5 years - pure tone audiogram |
|
Tinnitus differentials
|
Ringing, hissing or buzzing = inner ear
Popping or clicking = external or middle ear Pulsatile sounds = anxiety, inflammatory causes, vascular causes (including cardiac stenosis), carotid body tumours |
|
Drug causes of tinnitus
|
Aspirin, loop diuretics, aminoglycosides, quinines, alcohol excess
|
|
Reasons for referral in nasal obstruction
|
Numbness, tooth loss, bleeding, unilateral mass, a tumour may be present.
|
|
Pathogenesis of sinusitis
|
Typically viral infection leading to mucosal oedema and decreased ciliary action, therefore stasis.
Or, outflow obstruction. |
|
Symptoms of sinusitis
|
Pain, worse on leaning forward. Post nasal drip leading to foul taste in mouth. Nasal congestion. Anosmia.
|
|
Sinusitis imaging
|
Rigid endoscopy + CT
|
|
Common causative agents of sinusitis
|
Strep pneumoniae, haemophilus influenzae
|
|
Sinusitis management
|
Conservative. If no improvement after 5 days, nasal douching and topical steroids can be tried. Antibiotic therapy is typically via co-amoxiclav.
|
|
Typical patient with nasal polyps
|
Adult male (>40)
|
|
Most common sites of polyps
|
Middle turbinates, middle meatus, ethmoids
|
|
Nasal polyps S&S
|
Watery rhinorrhoea, postnasal drip, obstruction, changes in voice, sinusitis, anosmia, mouth breathing
|
|
Nasal polyps are associated with...
|
Rhinitis, asthma (esp adult onset), CF, aspirin hypersensitivity
|
|
Nasal polyps management
|
Betamethasone sodium phosphate drops. Maintenance with beclometasone spray. Prednisolone tablets may provide short term relief.
|
|
Management of anterior epistaxis
|
Tilt head downwards, pressure on cartilage for 15 mins.
Ribbon gauze soaked in vasoconstrictor +/- local anaesthetic e.g. xylometazaline (otrivine) with 2% lidocaine Cauterize with silver nitrate sticks |
|
Management of posterior epistaxis
|
Typically more complicated. Endoscopy and cautery. Packing for 48 hours.
|
|
Most common causative agent of sore throat
|
Group A strep
|
|
Antibiotic management of sore throat
|
Penicillin V (phenoxymethylpenicillin). Erythromycin if allergic
|
|
What is a quinsy?
|
A peritonsillar abscess, typically following tonsillitis. Look out for patient unable to swallow saliva who talks with a 'hot potato' voice
|
|
Sore throat + rash...
|
Think scarlet fever. Rash will typically be on chest, axillae, or behind ears. Normally 12-48 hrs after infection. Also look out for 'strawberry tongue'
Treat with penicillin |
|
Severity grading of croup
|
1. Inspiratory stridor +/- barking cough
2. Grade 1 + expiratory stridor 3. Grade 2 + pulsus paradoxus 4. Grade 3 + cyanosis or decreased cognition |
|
Main cause of stridor
|
Croup
|
|
Causative agent of croup
|
Parainfluenza virus
|
|
Cardinal signs of epiglottitis
|
Drooling, head forward, tongue out.
Sore throat, fever, dyspenoea, dysphagia, cellulitis, tenderness, hoarseness, pharyngitis, anterior neck nodes. |
|
Managing epiglottitis
|
Take to ITU, give O2 by mask. Give nebulised adrenaline, IV dexamethasone. Cultures. Find cricothirotomy kit.
IV penicillin G (benzylpenicillin) + ceftriaxone |
|
Antiobiotic therapy for laryngitis
|
Penicillin V (phenoxymethylpenicillin)
|
|
Common causes of layngeal nerve palsy
|
Cancers, iatrogenic.
Otherwise, CNS disease (polio, syringomyelia), aortic aneurysm. Neurotropic virus. |
|
Symptoms of nasopharyngeal cancer
|
Epistaxis, diplopia, conductive deafness, referred pain, cranial nerve palsy, nasal obstruction, neck lumps.
|
|
Diagnosis of nasopharyngeal cancer
|
Endoscopy + Biopsy. Stage with MRI.
|
|
Management of nasopharyngeal cancer
|
Radiotherapy +/- chemo +/- surgery
|
|
Symptoms of acoustic neuroma (vestibular schwannoma)
|
Tinnitus +/- deafness, signs of raised ICP, dizziness.
Most commonly affected cranial nerves are V, VI and VII. |
|
Malignant causes of dysphagia
|
Oesophageal cancer, pharyngeal cancer, gastric cancer, lung cancer.
|
|
Neuro causes of dysphagia
|
Bulbar palsy, myaesthenia gravis, syringomyelia
|
|
Non neuro or malignant causes of dysphagia
|
Strictures, pharyngeal pouch, achalasia, systemic sclerosis, oesophagitis, iron deficient anaemia
|