ENT, Nose, and Throat: Practice Flashcards

A comprehensive set of ENT-focused flashcards covering ear, nose, throat topics, including differential diagnoses, physical exam clues, management, and when to involve ENT.

What type of hearing loss involves dysfunction of the cochlea or neural components?

Sensorineural (neural) hearing loss.

In Weber testing, where does conductive hearing loss lateralize?

To the affected (bad) ear.

In Weber testing, where does sensorineural hearing loss lateralize?

To the opposite (good) ear.

During a Rinne test, which conduction is normally better: air or bone?

Air conduction (AC) should be greater than bone conduction (BC).

What is the initial management for an auricular hematoma to prevent cauliflower ear?

Incise and drain promptly; cover with prophylactic antibiotics; refer to ENT.

How is cerumen impaction typically managed if the tympanic membrane is intact?

Ear irrigation or curettage; avoid irrigation if the TM is not intact.

Which condition presents with ear pain, tragus tenderness, and purulent discharge suggesting an infectious process?

External otitis (swimmer’s ear).

Ramsay Hunt otitis externa is usually caused by which virus?

Varicella-zoster (herpes zoster).

What are the three most common pathogens causing acute otitis media (AOM) in children?

Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis.

What is the first-line antibiotic for AOM in a child without penicillin allergy?

Amoxicillin (80 mg/kg/day, divided) for 7 days (7–10 days depending on age/severity).

If a child with AOM also has conjunctivitis, what antibiotic change is common?

Augmentin (amoxicillin-clavulanate).

What is a common treatment strategy for eustachian tube dysfunction with persistent popping?

Nasal fluticasone spray; Valsalva maneuvers; time.

What preflight strategy helps prevent barotrauma during air travel?

Decongestants (eg, oxymetazoline) before flight; swallow during ascent/descent.

What is typically seen if barotrauma causes a perforated eardrum, and how long does healing take?

Visible TM perforation; usually heals in 2–4 weeks.

Mastoiditis is a complication of which infection, and how is it typically treated?

Complication of acute otitis media; requires IV antibiotics and often admission.

Peripheral vertigo is characterized by what nystagmus feature and response to fixation?

Horizontal nystagmus; suppressed with visual fixation.

Central vertigo differs from peripheral vertigo in nystagmus how?

Nystagmus can be vertical or torsional and is not suppressed by fixation.

What is the treatment maneuver for BPPV?

Epley maneuver (particle repositioning).

What conditions are associated with vestibular neuritis and labyrinthitis, and how do they differ by hearing?

Viral inner ear infection; labyrinthitis has hearing loss; neuritis does not.

What lifestyle and medication strategies are used to manage Meniere’s disease?

Low-salt diet, avoid caffeine/alcohol/stress, diuretics, vestibular rehab.

What is presbycusis and its typical audiometric pattern?

Age-related high-frequency sensorineural hearing loss; symmetric.

What imaging study and diagnosis is typical for vestibular schwannoma?

MRI of the brain focusing on the internal auditory canal; unilateral SNHL with tinnitus.

Which virus is commonly tested for in an unmatched unilateral ear symptoms and what imaging is used if a vestibular schwannoma is suspected?

Unilateral SNHL with tinnitus; MRI brain with IAC (internal auditory canal).

What is the common etiologic agent for the common cold and its typical duration?

Rhinovirus; 10–14 days of symptoms.

What are the first-line treatments for acute bacterial rhinosinusitis (ABRS)?

Augmentin; consider 5–7 days in guidelines; alternatives if penicillin allergy include doxycycline or respiratory fluoroquinolone.

What features define chronic rhinosinusitis and how is it managed?

Symptoms >12 weeks; imaging and ENT involvement; intranasal steroids, saline rinses, possible surgery.

What is the typical pharmacologic approach to allergic rhinitis?

Intranasal corticosteroids (Flonase) plus oral non-sedating antihistamines (loratadine); consider intranasal antihistamines, cromolyn, montelukast.

What is rhinitis medicamentosa and how is it treated?

Rebound congestion from chronic decongestant use; discontinue decongestants; start nasal steroids and saline.

What finding might nasal polyps indicate in a child, and how are they treated?

Chronic rhinosinusitis; may suggest cystic fibrosis; treated with intranasal corticosteroids.

What is the initial management of epistaxis from Kiesselbach’s plexus?

Pinch the lower third of the nose for 10 minutes; nasal vasoconstrictor (oxymetolazine) if available; humidify.

When is posterior epistaxis management with balloon catheter typically required?

If anterior measures fail or source is posterior; often requires ENT admission.

What is the first-line approach to a nasal foreign body in a child if visible?

Attempt removal with appropriate instrument; if not visible or unsuccessful, call ENT/EMT.

What is the Centor criteria for strep pharyngitis and how is it used?

Tonsillar exudates, tender anterior cervical lymphadenopathy, fever, absence of cough; 3 or more suggests rapid strep testing.

What are common signs of a peritonsillar abscess and its typical management?

Muffled voice, uvular deviation, trismus, fever; CT to assess size; drain when indicated.

What are the key clinical features and management of epiglottitis?

Acute illness with tripod positioning; drooling; muffled voice; prepare for airway; IV antibiotics (3rd-gen cephalosporin).

How do leukoplakia and erythroplakia differ from thrush in the mouth, and what is the recommended management?

Leukoplakia/erythroplakia are non-wipable plaques indicating premalignancy; biopsy; thrush wipes off and is fungally treated.

What is oral hairy leukoplakia associated with and what patient population should be screened?

EBV; often seen with HIV; screen for HIV.

What are common management strategies for aphthous ulcers?

Saltwater gargles; topical corticosteroid (triamcinolone) for symptomatic relief.

What dental conditions require dental referral and what is Ludwig’s angina?

Gingivitis etc.; Ludwig’s angina is bilateral submandibular space infection that can threaten airway.

How is acute herpes simplex virus (HSV-1) typically managed on first onset?

Antivirals such as acyclovir or valacyclovir (Valtrex); confirm with PCR if needed.

What is the typical treatment for oral candidiasis (thrush) in adults and when might systemic therapy be needed?

Topical nystatin swish/swallow; systemic fluconazole if extensive or esophagitis.

What are common causes and treatments for acute sialadenitis and sialolithiasis?

Sialadenitis: infection of salivary gland (staph); warm compresses, sialogogues, antibiotics (eg, ampicillin-sulbactam); sialolithiasis: salivary gland stones; hydration and sialogogues; warm compresses.

What is acute laryngitis and when should you consider cancer?

Hoarse voice usually viral; rest and humidified air; if symptoms persist >2 weeks or with stridor, evaluate for head/neck cancer.

What is a key HPV-related cancer risk in the oropharynx and how is it changing immunization strategy?

HPV16; vaccination is expanding to reduce risk.

What are the basic steps for managing angioedema when it is not anaphylaxis and when is EpiPen indicated?

If anaphylaxis (breathing/airway involvement) use epinephrine; otherwise treat with H1/H2 steroids.

What is temporomandibular joint disorder (TMD) and its common management?

Pain with jaw movement, ear pain; physical therapy, mouth guards, and lifestyle changes.

In a three-year-old with rapid-onset fever, sore throat, drooling, tripod breathing, what is top differential and immediate action?

Epiglottitis; ensure airway readiness and have intubation equipment available before examination.