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year 3 revision > ENT revision > Flashcards

ENT revision Flashcards

1
Q

what are the 2 otolith organs?

A

utricle

saccule

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2
Q

what is smooth pursuit used for?

A

tracking moving objects

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3
Q

what is the vestibular-ocular reflex?

A

stabilised the eye on an object when the head moves

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4
Q

where are the main gravity receptors located?

A

major blood vessels

abdominal viscera

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5
Q

what is the onset of being paroxysmal positional vertigo?

A

sudden, last only seconds

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6
Q

does hearing loss accompany BPPV?

A

no

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7
Q

what manoeuvre/test might you perform to diagnose BPPV?

A

dix-hallpike

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8
Q

what manoeuvre night you perform to treat BPPV?

A

epley’s manœuvre

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9
Q

what is the onset of meniere’s disease?

A

lasts hours

episodi

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10
Q

what hearing problem accompanies meniere’s?

A

tinnitus

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11
Q

what is vestibular neuronitis?

A

vertigo that lasts hours after a URTI

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12
Q

is there any hearing loss or neurological signs with vestibular neuronitis?

A

no

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13
Q

what is treatment for vestibular neuronitis?

A

supportive

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14
Q

what is presbystasis and what causes it?

A

balance disorder

related to ageing

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15
Q

what is saccades?

A

normal eye jerk between current and new stimuli

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16
Q

why might you test calorics when testing vestibular function?

A

vestibular-ocular reflex is based on calorics (hot/cold sense)

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17
Q

give 3 simple local causes of epistaxis

A

trauma e.g. nose picking
mucosal irritation
anatomical abnormalities

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18
Q

give a tumour cause of epistaxis

A

nasopharyngeal angiofibroma (benign tumour that bleeds)

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19
Q

give 3 associated symptoms of nasopharyngeal angiofibroma - who does it affect?

A

headache
rhinorrhoea
anosmia
affects young males

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20
Q

give 4 pathological systemic causes of epistaxis

A

bleeding disorders
neoplasms
inflammatory disorders
hypertension

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21
Q

give 3 medications that may increase the risk of epistaxis

A

aspirin
clopidogrel
warfarin

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22
Q

what type of facial pain is characterised by severe stabbing, nasal obstruction and nausea?

A

trigeminal neuralgia

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23
Q

name 2 other types of facial pain

A

sinogenic

migraine

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24
Q

is there pain in chronic sinus obstruction?

A

no

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25
Q

what does acute sinus obstruction often precede?

A

URTI

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26
Q

what type of migraine make up 25% of cases?

A

classical

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27
Q

name 2 accompanying features of migraine

A

aura

visual disturbances

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28
Q

which gender is paroxysmal hemicrania more common in?

A

women

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29
Q

is pain unilateral or bilateral with paroxysmal hemicranial?

A

unilateral

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30
Q

how long does the pain last for paroxysmal hemicrania?

a) seconds
b) less than an hour
c) over 12 hours
d) days

A

b) less than an hour

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31
Q

give 2 associated symptoms of paroxysmal hemicrania

A

lacrimation
nasal congestion
rhinorrhoea

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32
Q

which gender is more commonly affected by cluster headaches?

A

men (middle aged)

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33
Q

how can cluster headaches impinge on the trigeminal nerve?

A

dilate blood vessels

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34
Q

give a neurological symptom of cluster headaches

A

horner’s

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35
Q

what is horner’s characterised by?

A

myosis
anhydrous
ptosis

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36
Q

what type of pain is mid facial segment pain and where does it occur?

A

tightness/pressure over nasal bridge or orbit

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37
Q

is mid facial segment pain symmetrical or not?

A

symmetrical

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38
Q

describe the changes to sensation that occur with mid facial segment pain

A

hyperaesthesia

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39
Q

what might a patient with mid facial segment pain complain of in regards to their nose? (although it would appear normal upon examination)

A

nasal congestion

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40
Q

what is firstline treatment for trigeminal neuralgia

A

carbamazepine

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41
Q

name 3 other drugs that may be used to treat trigeminal neuralgia

A

gabapentin
pregabalin
lidocaine
amitryptilline

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42
Q

what type of patient is more likely to get atypical facial pain that has no dermasomal associations?

A

pessimistic or with negative life events/stressed

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43
Q

which branches of the trigeminal nerve are affected in 1/3 of trigeminal neuralgia cases?

A

V2 and V3

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44
Q

what is the definition for rhinosinusitis?

A

inflammation of the nose and paranasal sinuses

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45
Q

give 2 examples of endoscopic signs you might see in rhinosinusitis

A

polyps

mucopurulent discharge

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46
Q

what is the difference between acute and chronic rhinosinusitis?

A

acute 12 weeks

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47
Q

how are nasal polyps normally managed?

A

topical steroid drops e.g. luticason or beclomethasone

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48
Q

what is FESS?

A

functional endoscopic sinus surgery

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49
Q

give 3 examples of viruses that can cause rhinosinusitis

A

rhinovirus
influenza
respiratory syncytial virus

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50
Q

give 3 examples of bacteria that can cause rhinosinusitis

A

pneumococcus
streptococcus
h influenzae

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51
Q

give 3 abnormalities of the osteomeatal complex that can cause rhinosinusitis

A

too small
increase secretion
impaired ciliary function

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52
Q

what are kartagener’s syndrome and primary ciliary dyskinesia both examples of?

A

mucociliary disorders

53
Q

what is Samter’s triad?

A

aspirin hypersensitivity
nasal polyps
asthma

54
Q

what complication of rhino sinusitis is characterised by diplopia, proptosis and visual abnormalities?

A

peri-orbital celluliitis

55
Q

give a vascular complication of rhinosinusitis

A

cavernous sinus thrombosis

56
Q

give an infective complication of rhinosinusitis

A

meningitis

abscess

57
Q

what nerve supplies the parotid gland?

A

glossopharyngeal

58
Q

what is the name of the duct which flows from parotid and where does it open?

A

stepson’s duct

opens next to 2nd molar

59
Q

what type of fluid does the parotid gland produce?

A

watery, serous

60
Q

what 2 senses does the parotid help to stimulate?

A

gustatory

olfactory

61
Q

what nerve does it lie very close to?

A

facial

62
Q

what type of secretion does the submandibular gland produce?

A

thick mucoid

63
Q

what type of tumours constitute 80% of salivary gland tumours?

A

pleomorphic adenomas

64
Q

where do 80% of salivary gland tumours lie?

A

parotid

65
Q

give 5 functions of saliva

A 
moisten mucosa
taste
transport
buffer
digestion
antibacterial
mineralisation
pellicle (layer of proteins)
66
Q

what causes acute viral parotitis?

A

paramyxovirus

67
Q

what 2 supportive management options are used to treat acute viral parotitis?

A

rehydration

analgesia

68
Q

give 3 complications of acute viral parotitis

A 
meningitis
encephalitis
pancreatitis
orchiditis
deafness
69
Q

give 5 causes of hypo function of the salivary glands

A 
candidiasis
lichen planes
pathos ulcers
xerostomia
poor dentition
burnt mouth
70
Q

what are the symptoms of acute bacterial parotitis similar to?

A

acute viral parotitis

71
Q

why is acute bacterial parotitis more serious that acute viral parotitis?

A

mortality 80% if not treated

72
Q

what is the most common causative organism for acute bacterial parotitis?

A

staph aureus

73
Q

what are the 4 parts of treatment for acute bacterial parotitis?

A

antibiotics
rehydration
analgesia
drainage

74
Q

describe the swelling characteristic of HIV parotitis

A

firm, non-tender

75
Q

is HIV parotitis often bilateral or unilateral?

A

bilateral

76
Q

benign lymphopithemial cysts are types of what parotitis? what causes them?

A

HIV parotitis

hyperplasia of follicles in lymph nodes

77
Q

what immune cells infiltrate lymph glands in HIV parotitis/benign lymphopithemial cysts?

A

CD8 t cells (cytotoxic)

78
Q

give 2 symptoms of sjoren’s syndrome and their implications

A 
keratoconjuctivitis sicca (dry eyes)
xerostomia (dry mouth)
79
Q

what occurs to the lymph glands in sjoren’s syndrome?

A

infiltration and atrophy of acini

80
Q

how is sjoren’s treated?

A

antinuclear antibodies

81
Q

give a complication of sjoren’s syndrome

A

non-hodgkin’s lymphoma

82
Q

what is a ranula?

A

painless salivary gland mass of constant size

83
Q

what type of agent is used to treat a ranula?

A

sclerosing agent

84
Q

what is sialolithiasis?

A

deposition of crystals in gland

85
Q

when is the pain of sialolithiasis worst?

A

around eating

86
Q

what does sialodentesis have that sialolithiasis doesn’t?

A

erythema and pus

87
Q

give 3 symptoms of mastoiditis

A

swelling over mastoid process
non-draining
ear pushed forwards and downwards

88
Q

give 2 bacterial causative organisms of otitis externa

A

pseudomonas
s aureus
proteus

89
Q

if a patient with otitis external was complaining of deep pain and had cranial nerve palsies, what would you be concerned about?

A

malignancy

90
Q

give 2 fungal causative organisms of otitis externa. what predisposes to fungal ear infections?

A

aspergillus
candida
fumigatis
predisposed by prolonged antibiotic use

91
Q

give the 3 most common causative organisms for acute otitis media

A

s pneumonia
h influenza
moraxella

92
Q

what abnormal growth can cause chronic suppurative otitis media?

A

cholesteatoma

93
Q

give 2 causes of chronic suppurative otitis media

A

perforated tympanic membrane
trauma/grommets
bacteria
abnormality of tympanic membrane

94
Q

give 4 causes of non infective ear discharge

A 
atopic dermatitis
eczema
psoriasis
trauma
CSF
blood
95
Q

what is the difference between antibiotic treatment of bacterial otitis externa, malignant otitis externa and fungal otitis externa?

A 
bacterial = topical abx
malignant = IV abx
fungal = topical antifungals + stop abx
96
Q

what type of otitis externa has the highest mortality?

A

malignant

97
Q

what is the difference between treatment in AOM and CSOM?

A

AOM only give abx if it fails to improve

CSOM topic abx

98
Q

what surgical treatment would you recommend for

a) mucosal CSOM
b) squamous CSOM

A

a) tympanoplasty

b) mastoidectomy

99
Q

give 3 viral causes of acute sore throat

A 
rhinovirus
coronavirus
syncytial virus
parainfluenza
aden, EBV, HSV, paramyxo
100
Q

give 3 bacterial causes of acute sore throat

A

group a strep (pyogenes)
scarlet fever (s pyogenes)
c diphtheriae

101
Q

give 2 signs of glandular fever

A

lymphadenopathy

splenomegaly

102
Q

how is glandular fever treated?

A

suppurative w steroids

103
Q

what would the throat look like upon inspection of a patient with pharyngitis?

A

erythematous

maybe tonsil swelling

104
Q

give 4 signs/symptoms of pharyngitis

A

temperature
lymphadenopathy
cough
rhinorrhoea

105
Q

how can you distinguish a peritonsilar abscess from peritonsillar cellulitis?

A

uvula is central in peritonsilar cellulitis

106
Q

place unilateral and bilateral into this sentence:

peritonsilar abscess is characterised by severe ___ pain and _____ earache, with pyrexia

A

severe unilateral pain

bilateral earache

107
Q

how is the voice of someone with a peritonsilar abscess described?

A

hot potato

108
Q

describe these two symptoms of peritonsilar abscesses

a) odynophagia
b) trismus

A

a) pain when swallowing

b) inability to open jaw fully

109
Q

give the 2 main causative organisms of peritonsilar abscesses

A

strep progenies

staph aureus

110
Q

how are peritonsilar abscesses managed?

A

broad spectrum abx and drainage

111
Q

name 3 bacterial causative organisms for pharyngotonsillitis

A

strep progenies
staph aureus
haem influenza

112
Q

give 2 symptoms for laryngitis

A

fever

dysphonia

113
Q

give 3 causes for laryngitis

A

chemical trauma
physical trauma
viral infection

114
Q

how is laryngitis treated?

A

voice rest + humidity

steroids

115
Q

give 4 symptoms of epiglottis, supraglottitis

A 
sore throat
dysphagia
dysarthria
tachycardia
difficulty breathing
116
Q

which of epiglottitis and supraglottitis is more common in children?

A

supraglottitis more common in children

117
Q

what are 2 bacterial causative organisms for epiglottis and supraglottitis?

A

s pneumoniae

h parainfluenzae

118
Q

what drugs might you give to treat epiglottitis and supraglottitis?

A

broad spectrum abx

steroids

119
Q

complete this mnemonic for the branches of the facial nerve

Two zebras bit Miley Cyrus

A 
temporal
zygomatic
buccal
mandibular
cervical
120
Q

if a facial nerve is damaged above the spinal cord, which parts of the face will be affected?

A

lower contralateral quadrant (as upper quadrants are supplied doubly by nerves from both sides)

121
Q

if a facial nerve is damaged below the spinal cord, which parts of the face will be affected?

A

ipsilateral half of face

122
Q

what is neuropraxia?

A

reversible blockage of transmission of nerve impulses

123
Q

what causes neuropraxia?

A

pressure on nerve fibres

124
Q

what is axonotmesis?

A

blockage of axon flow causing neuronal degeneration

125
Q

what is neurotmesis?

A

total nerve transection

126
Q

bell’s palsy is dysfunction of which cranial nerve?

A

7

127
Q

which of these is not a symptom of Melkersson-Rosenthal syndrome?

a) facial paralysis
b) face and lip swelling
c) widespread erythema
d) furrows/folds in tongue

A

c) widespread erythema

128
Q

what is the pathophysiology of lambert eaton disease?

A

autoantibodies block presynaptic calcium channels

129
Q

what causes lambert eaton disease?

A

underlying malignancy

year 3 revision (9 decks)

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