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-otitis externa = very itchy, inflammation of skin, minimal hearing loss, pain = all symptoms occur at
the same time, most common cause = pseudomonas, treat with gent drops, fungal otitis externa
requires longer treatment than bacterial cause
-necrotising otitis externa = very severe pain that keeps them up at night, RF = DM, red lump
discharge on inferior floor on otoscopy, may get facial nerve palsy or abducens palsy
-cholesteatoma aka active squamous otitis media= discharging ear that does not resolve with Abx
treatment, management is surgical – mastoidectomy, atticotomy, comps = intracranial abscess,
facial nerve palsy, meningitis, cholesteatoma can be congenital, due to grommet, or idiopathic, look
for wax in weird places on otoscopy
-discharging perforation = active mucosal COM, treatment= aural toilet (microsuction), Abx + steroid
spray/drops, myringoplasty = fixing the hole
--understand polyp vs allergic rhinitis, in polyp the colour is paler than the rest of the nasal passage,
in rhinitis the colour of the polyp-y looking thing is the same as the nasal passage
-more than 10 days = not viral cold, = sinusitis= nasal obstruction/discharge + oedema/polyps +/-
facial pain
-perforation with granulations think autoimmune, perforation with smooth shite etc. no weird shit
then think cocaine
-Hyposmia might be a very early sign of Parkinson's disease.[2] Hyposmia is also an early and almost
universal finding in Alzheimer's disease and dementia with Lewy bodies.[2] Lifelong hyposmia could
be caused by Kallmann syndrome.[3]
-causes of airway obstruction = bleeding e.g. from tonsils, trauma, masses e.g. lymph nodes, goitres,
tumours
-tracheostomy vs laryngectomy, tracheostomy = stuff above entry point is still there, laryngectomy =
take away voice box and sew it over, make a neopharynx – if they need O2 you stick O2 on the neck
not the mouth
-ludwig’s angina = raised floor of mouth + trismus, generally caused by dental infections, worry
about airway – give IV Abx and steroids
-peri-orbital cellulitis test red vision, examine for meningitis, chandler’s classification
-pars flaccida = where choleastomoma tends to be, pars tensa = where perf tends to be
-if you are looking for ear scars, must look in pre and post auricular
-hold pinna downwards for the child and upwards for an adult
-tympanosclerosis = calcium deposition on TM, benign condition, asymptomatic, occurs most likely
following trauma – will be asked in osce to draw the distribution of tympanosclerosis that you see