Block 5; Week 1 ENT Quiz

Question 1

What are some things that a pt might present to a clinic for…in the ENT range?

Answer 1

Vertigo
Ear Pain
Hearing Loss
Nasal discharge

Question 2

What do you want to ask in terms of description of sensation w/ vertigo?

Answer 2

boat motion or rotating motion

any position that it feels better in

Question 3

Which associated symptoms do you want to ask about w/ a pt that is experiencing vertigo?

Answer 3

nausea
vomiting
---------
tinnitus-->ringing in ears
hearing changes
----------
headaches
double vision
-------
ear fullness
-----
unsteadiness
loss of balance
falling

Question 4

Which meds do you want to ask a person if they are taking when they present complaining of vertigo?

Answer 4

ototoxic meds

salt-retaining meds (like corticosteroids)

Question 5

Which meds are considered ototoxic?

Answer 5

ASA
aminoglycosides
gentamicin
streptomycin
furosemide
quinine
cisplatin

Question 6

What do you want to ask a person who presents w/ ear pain? Ma’am, do you also have……

Answer 6

an upper resp infection
frequent swimming
trauma to head
pain in head & neck
TMJ

Question 7

Ear pain associated symptoms?

Answer 7

fever
reduced hearing
tinnitus
vertigo
discharge from ear
itchiness of ear

Question 8

What might cause ear pain or hearing loss?

Answer 8

impaction of cerurum, depending on method of ear canal cleaning

Question 9

Which meds do you want to ask a person if they have taken when they have ear pain?

Answer 9

antibiotics

ear drops

Question 10

Instant hearing loss may indicate what? Gradual hearing loss?

Answer 10

Instant–vascular disruption, autoimmune process

Gradual-viral infection

Question 11

What are some things you want to ask a person who is experiencing hearing loss?

Answer 11

how do you hear best
observe their speech
ototoxic meds
tinnitus, ear pain, foreign body, cerumen impaction

Question 12

If you see a TM bulging w/ no mobility think what?

Answer 12

middle ear effusion due to pus or fluid

Question 13

If you see a TM retracted w/o mobility think what?

Answer 13

obstruction of tube maybe w/ middle ear effusion

Question 14

If you see TM w/ mobility only w/ negative pressure think what?

Answer 14

obstruction of tube maybe w/ middle ear effusion

Question 15

If you see a TM w/ excess mobility in small areas think what?

Answer 15

healed perforation

atrophic TM

Question 16

If you see an amber or yellow TM think?

Answer 16

serous fluid in middle ear

Question 17

If you see a blue or deep red TM think?

Answer 17

blood in middle ear

Question 18

If you see chalky white TM think?

Answer 18

infection in middle ear

Question 19

If you see redness in TM think?

Answer 19

infection in middle ear

prolonged crying

Question 20

If you see a dull TM think?

Answer 20

fibrosis

Question 21

If you see white flecks & dense white plaques in TM think?

Answer 21

healed inflammation

Question 22

If you see air bubbles in TM think?

Answer 22

serous fluid in middle ear

Question 23

Describe the Weber test.

Answer 23

tuning fork on midline of head
which ear is it louder?
occlude one ear–which ear is it louder?
**test unilateral hearing loss

Question 24

If you have normal ears, what results would you expect from the Weber test?

Answer 24

sounds the same in both ears initially

sounds louder in the occluded ear

Question 25

If you have conductive hearing loss what results would you expect from the Weber test?

Answer 25

it would sound louder (lateralize) to the bad ear.

Question 26

If you have sensorineural hearing loss what results would you expect from the Weber test?

Answer 26

it would sound louder (lateralize) to the good ear.

Question 27

What does the Rinne test check for? Describe it.

Answer 27

tests for whether hearing is better by air or bone conduction. tuning fork at mastoid bone & then in the air. should hear air conduction 2 times longer than bone conduction

Question 28

If you have conductive hearing loss what results would you expect from the Rinne test?

Answer 28

Bone conduction hear longer than air in affected ear. Rinne negative test. Normal is Rinne +.

Question 29

If you have sensorineural hearing loss what results would you expect from the Rinne test?

Answer 29

air conduction longer but less than 2:1 ratio.

Question 30

Is it normal to see perforations, bleeding, crusting of nasal cavity?

Answer 30

No.

Question 31

What would be a normal nasal mucosa?

Answer 31

deep pink & glistening. some discharge on nasal septum. hairs, firm turbinates that are deep pink too. Anterior septum thicker than posterior.

Question 32

Crusting over the anterior portion of the nasal septum may indicate what?

Answer 32

if it is in the location of the Kiesselbach plexus, may be nosebleed (epistaxis)

Question 33

What might this be: rounded elongated mass projecting into nasal cavity w/ a swollen boggy turbinate?

Answer 33

polyp

Question 34

What might this be: bluish gray or pale pink turbinates w/ swollen boggy consistency?

Answer 34

allergies

Question 35

Increased redness of nasal mucosa?

Answer 35

infection

Question 36

Localized redness & swelling of vestibule of nose?

Answer 36

furuncle

Question 37

Purulent discharge in nasal cavity?

Answer 37

upper respiratory infection or sinusitis or foreign body

Question 38

What should you describe about a discharge of the nose?

Answer 38

character (watery, mucoid, purulent, crusty, blood) amount color unilateral/bilateral

Question 39

What might indicate CSF fluid leakage?

Answer 39

unilateral watery discharge after head trauma

Question 40

What might indicate a foreign body in the nose?

Answer 40

``` unilateral purulent thick greenish malodorous discharge ```

Question 41

Is a geographic tongue normal?

Answer 41

Yes

Question 42

A smooth red tongue w/ a slick appearance may indicate what?

Answer 42

Vit B12 déficiencey

Question 43

What might your tongue look like after antibiotic therapy?

Answer 43

hairy yellow-brown-->black elongated papillae

Question 44

If the tongue deviates to one side what might that indicate?

Answer 44

tongue atrophy | hypoglossal nerve impairment

Question 45

How does a normal tongue appear?

Answer 45

``` dull red moist glistening anterior: rough posterior: rugae & thinner mucosa ```

Question 46

What should the normal ventral tongue look like?

Answer 46

pink, smooth, large veins b/w frenulum & fimbriated folds | wharton ducts

Question 47

If the duct of sublingual gland is obstructed what might you see?

Answer 47

ranula (mucocele) on the floor of the mouth

Question 48

What does a normal palate look like?

Answer 48

whitish hard palate that is dome-shaped w/ transverse rugae | pinker soft palate contiguous w/ hard palate

Question 49

Is it normal to have a bony protuberance--torus palatinus on the palate?

Answer 49

Yes.

Question 50

Is it normal to have a nodule that isn't on the midline of the palate?

Answer 50

No.

Question 51

When is a bifid uvula normal? When is it abnormal?

Answer 51

Normal: Native Americans Abnormal: submucous cleft palate

Question 52

When might you see deviation of the uvula to one side or the other?

Answer 52

vagus nerve paralysis or peritonsilar abscess | uvula will swing to normal side.