History- Snoring
- Trouble breathing at night
- Sleep apnoea
- Effects
- Daytime somnolence
- Morning headache
- Seasonality
- Triggers
- Occupation
- Able to eat with mouth closed?
- Able to breathe with mouth closed?
- Hearing change
- Number of infections/ Abx in last year
Indications for tonsilectomy
- Absolute
- Obstructive sleep apnoea
- Suspected malignancy
- Relative: Episodes of tonsilitis:
- 7 or more in last year
- 5 or more per year for last 2 years
- 3 or more per year for last 3 years
- 2 or more episodes of quinsy in the last year
- Tonsilitis is defined as sore throat plus one of:
- Temp >38.5
- Cervical adenopathy
- Tonsillar exudate
- Evidence of group B haemolytic Strep.
Drugs- Betnesol drops
- Betamethasone
- Can't use for too long (2 months)
- Mometasone furoate spray
- Mupirocin ointment
- Monoxycarbolic acid antibiotic
- Good vs Gram +ves incl. MRSA
Management of Ménière's disease- Low salt diet
- Diuretics
- Hydrochlorothiazide/triamterene or acetazolamide
- Vestibular suppressants, anti-emetics, or corticosteroids
- Used for symptomatic treatment of vertigo and its associated nausea or vomiting during acute attacks
- Act centrally on the vestibular nucleus
- Meclozine, dimenhydrinate, promethazine, diazepam, prochlorperazine, prednisolone, betahistine
- Intratympanic corticosteroids
- Meniett device
- Handheld device that delivers intermittent pressure
pulses through the ear canal and is self-administered 3 times per day
- Vestibular and balance rehabilitation therapy
- Tinnitus maskers (white noise generators)
- Neuromonics
- Uses a customised neural stimulus combined with specific
music, delivered through a coordinated program to interact with,
interrupt, and desensitise tinnitus disturbance for long-term benefit
- Antidepressants or benzodiazepines
- Endolymphatic sac surgery
- Vestibular nerve section
- Prevents the vestibular afferent stimuli from reaching the brain
- Labyrinthectomy
Cholesteatoma
- Destructive and expanding growth consisting of keratinizing squamous epithelium in the middle ear and/or mastoid process
Alzheimer's diagnosis- Presence of cognitive impairment, and a suspected dementia syndrome, confirmed by neuropsychological testing for a clinical diagnosis of possible or probable AD
- Memory
- Language
- Perceptual skills
- Attention
- Constructive abilities
- Orientation
- Problem solving
- Functional abilities
- Histopathologic confirmation including a microscopic examination of brain tissue is required for a definitive diagnosis
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