What are the four types of deafness?
Conductive
Sensorineural
Mixed
Central
What are the features of otitis externa?
Acute inflammation of the skin of the external ear
What is the usual cause of otitis externa?
Found in swimmers
Pseudomonas
How do you normally treat otitis externa?
Oral toilet
What is furnuculosis
Very painfull staphylococcal abscess arising in a hair folicle
How does otitis media usually present?
Rapid pain
Fever
anorexia
vomiting
usually after upper resp infection
What is cholesteatoma?
Active squamous chronic otitis media
What is another name for glue ear?
Otitis media with effusion
What is the fudamental problem in glue ear?
dysfunction of the eustation tube
What is important to remember about otitis media with effusion?
It can occour without pain
What signs would you find in the history of a patient with otitis media?
history of poor listening
bad behaviour
inattention
poor speach
school work
What type of hearing loss would you find in glue ear?
Conductive
What is the management plan for glue ear?
Most resolve on their own in 3 months
if not then grommets can be used
How long does it take for grommets to pop out?
3-12 months
How do you treat tinnitus?
hearing aid which increases volume of back ground noise
Tinnitus retraining therapy
listen to music in the house
Define vertigo?
A sensation of movement, usually spinning
What is the vestibulo-ocular reflex?
When you turn your head you are able to keep your eyes focused on a single spot
What causes nystagmus?
Vestibular pathologies
What does BPPV stand for?
Benign positional paroxysmal vertigo
What is the pathophysiologyof BPPV
Otolith material from the urticle is displaced into the semicircular canals
What is the most common semi circular cannal affected in BPPV?
Posterior semi circular cannal
What is the classic histroy of BPPV?
Verigo upon:
Looking up
turning in bed
Bending forward
Rising from bending
What is the Hallpike’s test?
The patient should show nystagmus
What do the epley and brandt-daroff exercises do?
Move the disloged otoliths into the utricle
What are the two causes of prologned vertigo?
Vestibular neuronitis and Labyrinthitis
What is the difference between labyrinthitis and vestibular neuronitis
Labtrinthitis may be associated with tinnitus or hearing loss where as vestibular neuronitis is not
How do you treat vestibular neuronitis and labyrinthitis?
Supportive management with vestibular sedatives
generally self-limiting
What is meniere’s disease?
History of recurrent, spontaneous , rotational vertigo with at least two episodes often lasting hours
What is the main function of tonsils?
Trap bacteria and viruses on inhalation
Expose the immune system to these antigens to make antibodies
What is Waldeyer’s ring?
Ring of lymphoid tissue in the oropharynx and nasopharynx
What usually causes actue tonsillitis?
Usually viral
EBV
Rhinovirus
Influenza
Parainfluenza
Enterovirus
What is the usual bacterial cause of tonsilitis?
Streptococcus pyogenes (group A strep)
H.influenza
S. aureus
What is in the centor criteria for differentiating between bacterial and viral tonsilitis?
Fever
Tonsillar exudate
Tender anterior cervical lymphnodes
Absence of cough
How do you treat tonsilitis?
Viral wil go away in 4 days
Bacterial in a week
Supportive treatmet
Penicillin 500mg for 10 days
What is the requirement to be eligible for tonsillectomy?
7+ tonsillitis in one year
5+ each year for two years
3+ each year for three years
What is a peritonsilar abscess?
A complication of acute tonsilitis
Bacteria is trapped between the muscle and tonsil producing puss
What is the classic history of a peritonsilar abscess?
Unilateral throat pain
Painful swallowing
3-7 days of preceding acute tonsillitis
What would you see in the throat of a patient with peritonsilar absecesses?
Medial displacement of the tonsil and uvula
How do you treat peritonsilar abscess?
Aspirate and antibiotics
What is another name for glandular fever and what causes it?
Infectious mononeucleosis
ebstein-barr virus
What are the clinical signs of infectious mononeucleosis?
Gross tonsillar enlargement
marked cervical lymphadenopathy
hepatosplenomegaly
What investigaion findings would you find in glandular fever?
Atypical lymphocutes
postive monospot test fo Paul-Bunnell test
Low CRP (<100)
How do you treat glanduar fever?
Symptomaticaly
what must you not prescribe in glandular fever?
Ampicillin will result in a macular rash
What are adjuvant analgesics?
Painkillers whoes primary indications is for something other than pain
Anticonvulsants- gabapentin and pregabalin
Antidepressants - amitriptyline
What is a quinsy?
Peritonsillar abscess
How do you treat scarlet fever?
Penicillin
What happens in cholesteatoma?
Normal cuboidal epithelium changes to squamous epithelium which a high cell turnover and abundant keratin production
What is a vestibular schwannoma?
Nerve tumour of the vestibular nerve
What would you suspect in bilateral vestibular schwannoma?
Neurofibromatosus type 2
What is sialolithiasis?
Stones in the salivary gland
What is the most common salivary gland tumour?
Pleomorphic adenoma of the parotid gland
What must you remember about stridor?
In a sore throat with stridor or respiratory difficulty attempts to examine the throat should be avoided and th eatient should be admitted to hospital
What is this a buzzword for
“severe sore throat with grey/white pseudomembrane across the pharynx”
Diphtheria
How do you treat oral thrush?
Nystatin
What is the treatment for Acute sinusitis?
1st Penicillin
2nd Doxycyline but not in children