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EENT Emergencies Flashcards

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1
Q

What is glaucoma?

A

-Increase in intraocular pressure
-Primarily regulated by the aqueous humour
-The aqueous humour is continually getting replenished and reabsorbed so pressure in
the eye remains constant
-Glaucoma usually results from an imbalance between secretion, flow to the iris and reabsorption

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2
Q

What is aqueous humour?

A

Transparent fluid that fills the anterior cavity of the eye and nourishes the lens and cornea

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3
Q

What are the risk factors for glaucoma?

A

-advancing age
-Myopia
-HTN
-Type II DM

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4
Q

What are the clinical manifestations of glaucoma?

A

-ocular pain
-blurred vision
-enlarged/fixed pupils
-red eyes
-corneal edema (hazy appearance)
-significant headache with associated nausea/vomiting

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5
Q

What complications can occur due to glaucoma?

A

-Leading cause of irreversible blindness, caused by degenerative damage to the retina and optic nerve
-Retinal detachment

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6
Q

What is retinal detachment?

A

-Separation of the retina from the epithelium
-Occurs when a tear allows fluid (usually vitreous) accumulates between the two layers (retina and epithelium)

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7
Q

What are the risk factors for retinal detachment?

A

-advancing age
-HTN
-myopia
-intraocular tumours
-diabetes
-previous eye surgeries
-family hx of retinal detachment, congenital eye disease (glaucoma, cataracts), abnormal vitreous body

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8
Q

What are the clinical manifestations of retinal detachment?

A

-Usually a gradual progression
-Painless changes in vision (flashing lights/sparks followed by floaters or spots in the field of vision)
-Progresses to the perception of a shadow or “dark curtain” across the field of vision
-Usually begins in the periphery and spreads circumferentially
-If left untreated, can result in permanent vision loss or blindness

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9
Q

What is cataracts?

A

lens opacity that interferes a with the transmission of light to the retina

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10
Q

What is conjunctivitis?

A

inflammation of the conjunctiva (pink eye)

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11
Q

What is macular degeneration?

A

degenerative changes in the central portion of the retina (the macula)

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12
Q

What is myopia (nearsightedness)?

A

when the eyeball is too long (relative to the cornea and lens)

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13
Q

What is hyperopia (farsightedness)?

A

when the eyeball is too short

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14
Q

What is corneal trauma?

A

-Hydration of the cornea is important and must be kept within a limited range
-Damage to surrounding epithelium can cause corneal edema and loss of transparency
-Wearing contact lenses for too long can cause corneal edema, physical trauma causing minor abrasions to the cornea can be extremely painful but typically heals on its own
-Significant damage to the cornea can produce scar tissue post recovery leading to potentially permanent visual impairment

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15
Q

What is hyphema?

A

-A collection of blood in the anterior chamber of the eye
-Usually caused by blunt trauma to the eye but may also occur spontaneously in patients with decreased coagulability

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16
Q

What is otitis externa (swimmer’s ear)?

A

-Inflammation of the external ear caused by infectious agents, irritation or allergic reaction
-Bacterial infections are the most common cause
-External Ear - pinna, external auditory canal, tympanic membrane

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17
Q

What are the clinical manifestations of otitis externa?

A

-Pain
-Itchiness
-Redness
-Tenderness
-Discharge
-Impaired hearing
-Narrowing of the external auditory canal

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18
Q

What is otitis media?

A

-Inflammation of the middle ear usually caused by infectious process
-Middle Ear - auditory ossicles (malleus, incus, stapes), and eustachian tube
-Typically caused by a disorder of the Eustachian tube that allows reflux of fluid and bacteria into the middle ear

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19
Q

What are the clinical manifestations of otitis media?

A

-Otalgia (earache)
-Fever
-Otorrhea (ear discharge)
-Hearing loss
-Middle ear inflammation (pain, etc.)
-Perforation of the tympanic membrane

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20
Q

What is vertigo?

A

A disorder of vestibular function causing an “illusion of motion” described as a sensation
of spinning or falling

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21
Q

What is the vestibule?

A

part of the inner ear responsible for equilibrium

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22
Q

What is objective vertigo?

A

sensation of the person being stationary with the environment in motion

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23
Q

What is subjective vertigo?

A

sensation of the person in motion and the environment stationary

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24
Q

What is epistaxis?

A

-A nosebleed
-Non-traumatic epistaxis is spontaneous in origin and very rarely fatal
-Caused by a ruptured blood vessel within the nasal mucosa
-Can be a symptom of a more severe underlying medical condition: Altered coagulopathy (pharmacological/malignant), hypertension
-Accidentally swallowed blood/blood clots can cause irritation to the gastric mucosa resulting in GI discomfort, nausea, vomiting

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25
What is rhinosinusitis?
-Inflammation of the nasal sinuses -Paranasal sinuses are cavities within the facial bones that are lined with ciliated respiratory epithelium -Connect to the nasal cavity through narrow openings called ostia -Sinuses are labeled after the bone in which they are located: frontal, ethmoid, maxillary, and sphenoidal -Commonly develops during an URTI that causes mucosal swelling, obstructs the ostia, and impairs mucociliary clearing
26
What are the clinical manifestations of rhinosinusitis?
-Facial pain -Headache -Purulent nasal discharge -Decreased sense of smell -Fever
27
What is an abscess?
a collection of pus that is restricted to a specific area in tissues, organs or confined spaces
28
What is a dental abscess?
-A dental abscess can form inside the teeth, in the gums or in the bone that holds the teeth -Usually caused by a bacterial infection caused by tooth decay or an impacted tooth (not grown out of your mouth properly) Clinical Manifestations: -Pain -Redness -Swelling -Cold/heat sensitivity -Head/jaw ache -Fever
29
What is a dental fracture?
-A fractured, cracked or chipped tooth as a result of trauma -Can cause pain, inflammation, and may progress to abscess formation if left untreated -May present a choking hazard or cause oropharyngeal/gastrointestinal trauma if a piece is swallowed
30
What is trismus?
-A spasm of the jaw muscles causing the mouth to remain tightly closed -Can be caused by: Tetanus, dental disorder/ illness/injury, head trauma, seizures -Tetanic spasm of the jaw muscles mediated by the trigeminal (V) nerve -May present a significant airway concern if activated
31
What is epiglottitis?
-An acute inflammation of the epiglottis, typically caused by a bacterial infection -Characterized by inflammatory edema of the supraglottic area (epiglottis and pharynx) -Symptoms arise suddenly and can cause fatal airway obstruction and asphyxia if not treated immediately (within hours)
32
What are the clinical manifestations of epiglottitis?
-Pale, lethargic and distinct position (sitting up, mouth open, chin thrust forward) -Difficulty swallowing causes drooling and muffled voice -Moderate to severe dyspnea -Stridor, nasal flaring, sternal retractions (accessory muscle use) -Febrile
33
What is tonsilitis?
-An inflammation of the tonsils caused by an infectious process -A common occurrence in children, teenagers and young adults -Causes sore throat, dysphagia and fever
34
What is a peritonsillar abscess?
-An abscess behind the tonsil -Typically a complication of tonsillitis and most commonly caused by an infectious process -Not a very common problem provided that antibiotics are used to treat tonsillitis -If left untreated, swelling and inflammation can cause airway obstruction
35
What is a retropharyngeal abscess?
-An abscess in the back of the throat caused by an infectious process -Can produce: Dysphagia, stiff neck, muffled voice, drooling, fever -If swelling becomes significant may produce airway compromise and stridor -More common in children
36
What is a tracheostomy?
-A surgical, semi-permanent or permanent opening in the anterior neck through to the trachea -A tracheostomy tube is placed in the stoma (whole/opening in the body) to provide a pathway for breathing -Surgical procedure – tracheotomy -There may be many reasons for the insertion of a tracheostomy including: Throat cancers, trauma, neurological compromise, anatomical abnormalities
37
What is anemia?
-An abnormally low number of circulating red blood cells OR level of hemoglobin OR both -Results in a diminished capacity for oxygen transport -Blood loss Anemia, destruction of RBCs, defective RBCs, inadequate RBC production
38
What is blood loss anemia?
-Loss of RBCs due to hemorrhage produces a decrease in the total quantity of hemoglobin and decrease in the ability to transport O2 -Symptoms and progression depend on whether the hemorrhage is acute or chronic -Acute - decreased vascular volume results in hypovolemic shock and decreased circulating O2 -Chronic - doesn’t typically affect volume (RBCs lost are rapidly replaced) -Rapid replacement RBCs quickly deplete iron levels, so they have little to no hemoglobin
39
What is hemolytic anemia?
-Caused by the premature destruction of RBCs, usually due to an irregularity in the RBC or Hgb -The ineffective RBCs get phagocytized -Hemolytic anemia may be inherited or acquired -Sickle Cell Disease is an inherited disease that results in malformed and ineffective RBCs -Some acquired forms of hemolytic anemia include autoimmune disorders
40
What is deficiency anemia?
-Results from the decreased production of erythrocytes by the bone marrow -May be a direct result of the failure of the bone marrow or a deficiency in the requirements for erythropoiesis (ie. low iron)
41
What is aplastic anemia?
decreased functional bone marrow causes a decrease in the production of all formed elements
42
What is iron deficiency?
usually a result of nutritional deficit or blood loss but may result in an increased demand for iron elsewhere in the body (pregnancy)
43
What are the clinical manifestations of anemia?
-Fatigue -Weakness -Dyspnea (severe on exertion) -Pallor -Confusion/altered LOA -Compensatory symptoms (tachycardia, tachypnea, palpitations) -Decreased SpO2 (significant on exertion) -All symptoms may be significantly amplified with minimal physical exertion
44
What are bleeding disorders?
-Bleeding disorders result when the blood lacks, or has impaired function of, certain clotting factors -They are almost always inherited but may be acquired -Most common forms include: Hemophilia (A and B) and Von Willebrand Disease
45
What are clotting factors?
Plasma proteins that are crucial in the clotting process
46
What is Disseminate Intravascular Coagulation (DIC)?
-Not a primary disease, but a complication of a wide variety of conditions: burns, trauma, acidosis, shock, infections, hypotension, etc. -Results in massive, systemic, activation of the coagulation sequence -The systemic coagulation produces significant quantities of microthrombi that cause vessel occlusion and tissue hypoxia -This also uses up all available coagulation proteins and platelets, causing potential severe hemorrhage
47
What is Acquired Immune Deficiency Syndrome (AIDS)?
-The disease caused by infection with Human Immunodeficiency Virus (HIV) -A chronic illness characterized by profound immunosuppression with associated infections, malignancies and CNS degeneration
48
What causes AIDS?
-HIV is a retrovirus that attacks the T helper cells responsible for coordinating immune responses -Progressive deterioration of the immune system leaves the patient susceptible to severe infections from normally harmless pathogens -Body manages to fight off the HIV virus quite well but, due to its persistence, the virus remains and eventually, over years, the amount of T-helper cells begins to decline and eventually the virus prevails -An HIV infection becomes AIDS when the CD4+ count becomes very low (10-15 years from onset of infection) -Virus itself does little to cause symptoms/harm to the patient; it is the secondary infections that produce symptoms and mortality
49
How is AIDS transmitted?
-HIV is transmitted through sexual contact, blood-to-blood contact or perinatally -Infected semen and vaginal fluids that may come in contact with any vascular mucous membranes -t’s blood-borne nature makes it imperative to always be vigilant and wear appropriate PPE -Patient is infectious regardless of symptoms
50
What is tuberculosis (TB)?
-An infectious bacteria that can infect any organ but most often involves the lungs -thrives in an oxygen rich environment -Transmitted by respiratory droplets (minute particles in water) from contaminated people: talking, sneezing, coughing -After recovery, the pathogen can remain dormant in the patient for years and can reinfect or transmit if the patient becomes immunocompromised
51
What are the clinical manifestations of TB?
-Initial onset can be insidious (fever, weight loss, fatigue, night sweats) -Can progress to: high fever, pleuritis and lymphadenitis -Initially dry cough but can become productive with purulent or blood-tinged sputum -Dyspnea and orthopnea with rales (fine crackles) on auscultation
52
What is influenza?
-Viral upper respiratory tract infection (Type A, B and C) -Infection rates are highest in children and older adults -Very contagious - transmission occurs via droplet contamination -Virus targets and kills cilia and epithelial cells in the upper respiratory tract -Can progress to the lower tract causing damage to bronchi and alveoli -Inhibiting the innate immunity of the respiratory tract leaves the patient open to secondary infections
53
What are the clinical manifestations of influenza?
-Fever and chills -Malaise -Muscle aches -Headache -Watery nasal discharge -Non-productive cough (dry) -Sore throat -Rhinotracheitis
54
What are antibiotic resistant infections?
-Antibiotic resistance occurs when bacteria change in response to antibiotic medications -These mutated bacteria become increasingly more difficult to fight -There is a rising culture of over prescribing antibiotics and not allowing our own innate and adaptive immunity do their jobs -This problem can lead to the development of “superbugs” (MRSA, VRE, CRE, certain E.coli strains, C. diff)
55
What is Meningococcemia?
-Meningococcal Septicemia/Sepsis -Infection with meningococcus (one of the main bacteria that causes meningitis) that spreads to the blood stream -Bacteria multiply in the blood stream and causes systemic damage to blood vessel walls and target tissues/organs -Presents same as meningitis but with associated signs of sepsis
56
What is sepsis?
a medical emergency that describes the body’s systemic immunological response to an infectious process that can lead to end stage organ dysfunction and death
57
What is septicemia?
a bacterial infection in the blood stream that can cause sepsis
58
What is SIRS (Systemic Inflammatory Response Syndrome)?
a systemic inflammatory response to a variety of illnesses or injuries
59
What is SIRS criteria?
(2 or more of the following): -HR > 90bpm -RR > 20bpm -Temp >38oC/<36oC -Elevated WBCs -Prehospital: low ETCO2 correlates to high risk of sepsis
60
What is tetanus?
-A bacterial infection that produces painful muscle contractions and trismus -The bacteria release a neurotoxin that travels to the central nervous system and interferes with neurotransmitters involved in muscle contraction -Transmitted from contaminated soil, dust and feces making direct contact with an open wound
61
What are the clinical manifestations of tetanus?
-Muscle spasms (painful) -Dysphagia -Opisthotonos (muscle spasms causing backward arching of the head, neck and spine)
62
What is varicella/chicken pox?
-A common communicable childhood disease caused by the varicella-zoster virus (same virus that causes “shingles”) -Causes characteristic skin lesions that develop rapidly
63
What are the clinical manifestations of chicken pox?
-Lesions -Pruritis -Cough -Runny nose -Febrile -Photosensitivity (rare)
64
What is varicella/shingles?
-When a primary infection of chickenpox is “defeated”, the varicella virus remains dormant in the nervous system -Later in life, and especially in immunocompromised people, it is possible for the virus to become reactivated
65
What are the clinical manifestations of shingles?
-Produces fever -Malaise -Headache -Periorbital pruritis -Development of a progressive rash that usually isolates to “patches” that may or may not develop crusty skin lesions -May or may not affect the eyes
66
What is rubella?
-A mild disease similar to measles that produces a rash and other mild cold symptoms -Rash typically starts in the trunk and spreads to the limbs -Spreads via close contact
67
What is West Nile virus?
A viral infection transmitted mostly via bites from infected mosquitos and then subsequent human to human contact
68
What are the clinical manifestations of West Nile Virus?
-Fever -Headache -Malaise -Body aches -Nausea -Vomiting -Occasional skin rash -Severe disease may develop meningitis, encephalitis and paralysis
69
What is toxic shock syndrome?
-Similar to septic shock, the development of TSS occurs when bacteria release toxins that cause direct harm to vasculature and target organs/tissues -Septic Shock - result of inflammatory/immune response -Toxic Shock - direct result of exo/endotoxin damage -Toxin - substances that alter the normal function of the host’s cells
70
What are the clinical manifestations of TSS?
-Fever -Chills -Malaise -Headache -Fatigue -+/- rash -N/V/D
71
What is a neoplasm?
an abnormal mass of tissue in which the growth exceeds, and is uncoordinated with, that of normal tissues
72
What does the suffix -oma mean?
the suffix added to the parenchymal tissue from which the growth originated (ie. osteoma, neuroblastoma)
73
What is a benign neoplasm?
usually do not cause death unless their location or size interferes with vital functions. Expand and grow but does not spread.
74
What is a malignant neoplasm?
invade and destroy tissues and spread to other parts of the body

Patho (9 decks)

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