Prepared by:
Soila Ansar (G12)
Compiled by:
Hafiz Muhammad Umair Noor (G12)
Reference Books:
- Dhingra ENT 8th Edition (Chapter numbers are mentioned according to this edition)
Overview:
- As it’s a clinical subject so first you need to understand the basics of preparing such subjects, like you will be focusing on the clinical workup of every disease which includes:
- Differential Diagnosis: patient’s complaints or symptoms, points to be noted in history and signs on inspection and examination.
- Confirmation of Diagnosis: examination points and investigations to rule out other DDS, investigations to confirm a certain diagnosis and investigations to monitor the response of treatment on follow up.
- Management:
- Conservative: lifestyle changes , any special advice.
- Medical : drugs etc.
- Surgical: minimal invasive to radical procedure.
- Always try to segregate emergency situations from non-emergency cases as in ER case, you will skip conservative step and provide immediate resuscitation ( almost similar steps to follow in most of the cases like, admission, IV lines for fluid and antibiotics if infective cause, oxygen therapy if spO2 indicates the need, definitive airway, monitoring) to stabilize the patient. We usually avoid surgical procedures as they further deteriorate the patient’s physiological reserve but indicated only if it’s necessary to save the life of the patient.
- One other important thing I want to mention beforehand, as in the modular system you’re provided with LOs and our books are not written according to these LOs therefore it’s not always possible to find the answer in your books. I’ll try to cover max points from the book but It’ll be better if you people take help from AI sources.
NOSE
(ENT2-Nose-001)
Chapter 23:
- External nose – bony part, cartilaginous part,
- internal nose- choana, vestibule , nasal valve, nasal valve area,
- Lateral nasal wall: inferior turbinate( opening of NLD, hasner’s valve) middle turbinate ( attachments, basal lamella, openings of sinuses,) middle meatus( uncinate , hiatus semilunaris, infundibulum, bulla ethmoidalis, atrium , agger nasi cells, concha bullosa, haller cells,) superior turbinate( onodi cells related to optic nerve, sphenoethmoídal recess), supreme turbinate.
- Medical wall: bones forming it
- Linings of vestibule, olfactory region, respiratory region and their differences
- Nerve: olfactory nerve injury–> CSF rhinorroea
- autonomic nerve: vidian nerve — > neurectomy in vasomotor
- lymphatics: communication with CSF space
- Blood : ICA + ECA
Chapter 35:
- Openings of ant and post groups of sinuses
- Maxillary sinus: shape, floor related to roots of 2nd premolar + 1st molar teeth , oroantral fistula, Roof–> infraorbital nerve+ vessles
- Frontal Sinus: locations, drainage of sinus,
- Ethmoidal Sinus: openings, lamina papyracea
- Anterior group cells and thier locationsn,
- Posterior group cels( onodi cells relation of optic nerve)
- Sphenoid sinus: relations in diagram
- mucus membrane’s difference
- Ventilation of sinuses: paradoxical
- Mucociliary clearance: all sinuses+ diagrams
- Development of sinuse: table –> status at birth and first radiological evidence
(ENT2-Nose-002)
Chapter 25:
- Cellulitis
- Fruncle / Boil : staph aureus, etiology, danger area of nose, Management, complications (CST, cellulitis, septal abscess)
- Vestibulitis: staph aureus, acute & chronic forms, management.
- Remember these points( in case)
- Saddle nose ( augmentation rhinoplasty)
- Hump nose( reduction rhinoplasty)
- Encephalocele( cough impulse)
- Rhinophyma( potato tumor, hypertrophy of sebaceous glands on nose tip)
- BCC( rodent ulcer, rolled edges, no mets,)
- SCC( rolled out edges )
Chapter 29:
- Foreign body nose (presentation, investigation: radiograph, 5 causes of unilateral nasal discharge, treatment: eustachian catheter, complications)
- Rhinolith (etiology, C/F , stony hard, irregular mass, txt)
- Nasal myiasis (Chrysomyia, underlying cases, C/ F with timeline, complications, txt, advice)
(ENT2-Nose-003)
Chapter 55:
- Definition of snoring+ its mechanism and etiology
- Definition of sleep apnoea+ types+ pathophysiology+ table of consequences of OSA
- Clinical workup: History+ physical examination+ Treatment options( conservative than surgical)
(ENT2-Nose-004)
Chapter 26 & 88:
- Entire chapters are very important.
(ENT2-Nose-005)
Chapter 27:
- Acute rhinitis types, viral rhinitis complete
- Chronic rhinitis types
- hypertrophic rhinitis
- Atrophic rhinitis is very important
- rhinitis sicca and caseosa
Chapter 30:
- Allergic rhinitis( etiology, phases, C/F , ARIA classification, investigations, complicated, treatment options , immunotherapy
Chapter 31:
- Vasomotor rhinitis
- Rhinitis medicamentosa
(ENT2-Nose-006)
Chapter 36:
- definition, classification, symptoms, Acute maxillary, frontal, ethmoidal and sphenoid sinusitis
Chapter 37:
- CRS with and w/o polyposis and their treatment options
- surgical techniques old(3) and new(FESS)
- Fungal sinusitis
Chapter 38:
- complications ( local, orbital, cranial) entire chapter
(ENT2-Nose-007)
Chapter 32:
- entire chapter is important.
(ENT2-Nose-008)
Chapter 33:
- Little’s area, retrcolumellar vein, woodruffs plexus
- Causes of epistaxis
- classification+ difference
- Management (follow this sequence of steps : First aid, general measures, cauterization, anterior packing/ posterior packing, then delayed management which includes endoscopic cauterization, elevation of SMR flap, ligation of vessels(do it in detail like which vessel is ligated in which bleeed and how), TeSpal, embolization.
- Osler Weber rendu syndrome (hereditary heamorrhagic telemgiectasia )
(ENT2-Nose-009)
Chapter 34:
- general management
- Fracture of nasal bone and septum ( most common fracture, types, C/F, diagnosis, best time of reduction, closed and open reduction)
- Fracture of zygoma (2nd most common)
- Fracture of orbital floor ( blow out fravtire, tennis ball, blunt trauma, tear drop sign)
- Fractures of maxilla( Le fort types, fracture lines, features, Dx, Mx,type ll and lll can have CSF rhinorroea)
- Fracture of mandible( common sites, features, Dx, treatment)
Chapter 29:
- CSF rhinorroea complete
(ENT2-Nose-010)
Chapter 28:
- Tuberculosis, lupus vulgaris
- Leprosy
- Aspergillosis , Mucormycosis ( also see Ch 37 )
- Wegeners granulomatosis
- Sarcoidosis
(ENT2-Nose-011)
Chapter 39:
- Inverted papilloma complete
- squamous cell CA
Chapter 40:
- etiological factors in malignant tumors ( nickel- SCC , furniture- ethmoidal adeniCA )
- Maxillary sinus CA( features and spread, diagnosis,ohngren classification, treatment, weber furgusson incision)