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PHA223 (2023) > ENT > Flashcards

ENT Flashcards

1
Q

What are the sinuses responsible for?

A

Immune defence/air filtration through their mucus production.
- Ciliated nasal & sinal mucosae move mucus
- Nasal mucus traps bacteria and small particles

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2
Q

Describe nasal congestion.

A
  • Excess nasal secretions
  • Inflamed & swollen nasal mucosa
    Causes: allergies & URT infections
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3
Q

What do histamine receptors do?

A

Mediator of allergic/ inflammatory reaction

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4
Q

Where are H1 receptors found and what is their function?

A

Smooth muscle, respiratory epithelium, endothelial cells, bronchial smooth muscle cells
F: vasodilation, bronchoconstriction, mucus secretion

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5
Q

Where are H2 receptors found and what is their function?

A

Gastric parietal cells
F: gastric acid secretion

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6
Q

Where are H3 receptors found and what is their function?

A

CNS
F: sleep/wake, cognition, neurotransmission

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7
Q

Where are H4 receptors found and what is their function?

A

Immune cells
F: immune response modulation

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8
Q

Describe the effects of histamine on the smooth muscle.

A
  1. Bronchial SM H1-R activation induces bronchoconstriction due to increases Ca 2+.
  2. Coupled to G-protein
  3. Activation causes increased Ca2+ leading to release of mediators
  4. Vascular SM H1-R activation induces vasodilation
  5. Relaxation of vascular SM & vasodilation increase BF and leakage from vessels into surrounding tissue leading to swelling.
  6. Irritation of airways and sinuses triggers mucus production which fills the sinuses.
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9
Q

What is the MOA of decongestants?

A

alpha1-R agonists - bind to receptors in URT triggering vasoconstriction

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10
Q

What are the two types of decongestants?

A

Adrenergics - largest group of sympathomimetics
Anticholinergics - less commonly used parasympatholytics

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11
Q

Oral decongestants

A

Adrenergic
- Prolonged effects but delayed onset
- Less potent than topical
- No rebound congestion
E.g. - pseudoephedrine, phenylephrine, ephedrine

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12
Q

What are the side effects of oral decongestants?

A

headaches
insomnia
dry mouth

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13
Q

What is the MOA of oral decongestants?

A

Bind to alpha1-R in URT and alpha1-R in blood vessels and some affinity for B-R in cardiac muscle - not suitable for patients with heart conditions

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14
Q

Topical decongestants

A

Adrenergic
- Constrict small blood vessels supplying URT
- Tissues shrink to open nasal passages - nasal secretion drain
- Relieves nasal stuffiness
- Prompt onset and optent effect
- Sustained use over several days causes rebound congestion
E.g. - oxymetazoline, xylometazoline

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15
Q

What are the side effects of topical decongestants?

A

CV effects
nasal dryness
headache/nausea

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16
Q

What are nasal steroids used for and what are some examples?

A
  • Mainly used for allergies/hay fever for up to 3months
  • Turn off immune cells, having an anti inflammatory response which leads to decreased congestion which relieves nasal stuffiness.
    E.g. Beclometasone dipropionate, fluticasone
17
Q

What are the side effects of nasal decongestants?

A

Nasal dryness and irritation

18
Q

What is otitis media?

A

Middle ear inflammation between tympanic membrane & inner ear. Often follows URT symptoms e.g. cough

19
Q

How does otitis media occur?

A

The middle of the ear becomes infected, pressure builds up behind eardrum causing intense pain, fever and hearing loss

20
Q

What is suppurative otitis media?

A

Perforated tympanic membrane - otorrhoea (fluid discharge)

21
Q

What is the treatment for otitis media?

A

1st line - analgesics e.g. paracetamol, ibuprofen
2nd line - antibiotics in some cases but not preferred

22
Q

What is Glue Ear?

A

Chronic otitis media - inflammation of middle ear and accumulation of fluid blocking the eustachian tube
- hearing loss
- common in kids
- spontaneous resolution in 3months-1 year

23
Q

What is otitis externa? treatment?

A

Swimmers ear - inflammation of outer ear and ear canal
Treatment: dilute acetic acid e.g. earcalm and steroid drops and antibacterial drops (POM)

24
Q

What are the types of sore throat?

A

Pharyngitis/ acute tonsillitis
- bacterial or viral infection
- headache, muscle aches, cough, dysphagia
- Inflammation - redness & swelling

25
Q

Describe strep throat and its treatment.

A

Rapid strep test - swab throat and test
- if group a sterp treat with penicillin
Treatment: lozenges/ throat spray - menthol/local anaesthetics e.g. lidocaine.

26
Q

When should patients be. referred?

A
  • Recurrent sore throats
  • No improvement of symptoms after 2 weeks
  • Persistent high temp above 38 degree not decrease by medication.
  • Can develop into more serious infection

PHA223 (2023) (22 decks)

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