Summary ENT MLA MAPPING - for Medical Exams and Finals
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Course
Medicine (MLA)
Institution
The University Of Manchester (UOM)
One page summaries for topics listed in the MLA Topic Map associated with ENT (audiology, rhinology and laryngology)
Contents include: Epistaxis; Otalgia; Acoustic Neuroma; Audiograms; Dysphagia; etc.
All MLA topics are covered within my shop - see other documents for more
Each topic covers appr...
Anatomy & Risks
IgE-mediated response to environmental allergens
- Pollen/dust mites
Can be seasonal, year-round or occupational
Symptoms & Complications
- Nasal pruritus
- Sneezing
- Rhinorrhoea
- Nasal congestion/bilateral obstruction
- Post-nasal drip
- Associated with allergic conjunctivitis
o Eye redness/puffiness
o Watery eye discharge
Investigations
- Skin prick tests to identify allergen if unknown
Treatment/Management & Side effects
- Avoid triggers
- Nasal irrigation with saline
- Short course of nasal decongestants e.g., oxymetazoline
o Do not use for long periods
o Increasing doses required to achieve same effect
o Rebound nasal mucosal hypertrophy may occur on withdrawal
- Intra-nasal / PO antihistamines
- Regular intranasal steroids if initial measures ineffective
- Oral steroids if severe and affecting QoL
- ENT referral if:
o Red flags
o Refractory cases
o Allergen testing
, Rhinosinusitis
Definition & DDx Anatomy & Risks
Inflammation of nose and paranasal Diagnosis requires ≥2 symptoms, with one
sinuses of:
- Commonly caused post-infective - Blockage/obstruction/congestion
Predisposing factors - Discharge (ant/post-nasal drip)
- Nasal obstruction Most common infectious agents
- Recent local infection e.g., rhinitis, - Strep. Pneumoniae
dental extraction - H. influenzae
- Swimming/diving - Rhinoviruses
- Smoking
Symptoms & Complications
- Nasal blockage/obstruction/congestion
o Obstruction in chronic sinusitis
o Due to mucosal hypertrophy and discharge
- Nasal discharge
o Purulent discharge in sinusitis
- Facial pain/heaviness
o Worse when sitting forward
- Reduced olfaction
- Headache
- Ear pain
- Sore throat
- Cough
Complications
- ‘Double-sickening’ = initial viral cause worsens due to 2º bacterial infection
Investigations
- Cultures if bacterial sinusitis suspected
- CT for evidence of sinus inflammation/obstruction
- Nasal endoscopy
Treatment/Management & Side effects
- Nasal saline irrigation
- Analgesia
- Intranasal corticosteroids
o High dose 14/7 if Sx ≥10 days
- Abx guided by culture results
o PenV = 1st line
o Co-amoxiclav if systemic upset
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