Flashcards in ENT Deck (162)
what body system mediates balance?
what system regulates gravity, linear and angular acceleration and regulates muscle tone?
what are the 2 otolith organs?
how many semicircular canals are there?
what is smooth pursuit used for?
tracking moving objects
what is optokinetic nystagmus?
reflex when tracking objects that lie outside the fovea
what is the vestibular-ocular reflex?
stabilised the eye on an object when the head moves
where are the main gravity receptors located?
major blood vessels
what balance disease is characterised by the illusion of movement when there is none?
what is the onset of being paroxysmal positional vertigo?
sudden, last only seconds
does hearing loss accompany BPPV?
what manoeuvre/test might you perform to diagnose BPPV?
what manoeuvre night you perform to treat BPPV?
what eye problem is characterised by involuntary rhythmic oscillation of the eyes?
what is the onset of meniere's disease?
what hearing problem accompanies meniere's?
what is vestibular neuronitis?
vertigo that lasts hours after a URTI
is there any hearing loss or neurological signs with vestibular neuronitis?
what is treatment for vestibular neuronitis?
what is presbystasis and what causes it?
related to ageing
what is saccades?
normal eye jerk between current and new stimuli
what is head shaking nystagmus?
nystagmus following head shaking
why might you test calorics when testing vestibular function?
vestibular-ocular reflex is based on calorics (hot/cold sense)
who is most commonly affected by epistaxis?
what causes 85% of all cases of epistaxis?
give 3 simple local causes of epistaxis
trauma e.g. nose picking
give a tumour cause of epistaxis
nasopharyngeal angiofibroma (benign tumour that bleeds)
give 3 associated symptoms of nasopharyngeal angiofibroma - who does it affect?
affects young males
give 4 pathological systemic causes of epistaxis
give 3 medications that may increase the risk of epistaxis
the blood supply of the nose is
a) very rich
c) absent in some
a) very rich
how do you distinguish between an anterior and a posterior nosebleed?
pooling in front of nose or running down back of throat
what type of facial pain is characterised by throbbing?
what type of facial pain is characterised by severe stabbing, nasal obstruction and nausea?
name 2 other types of facial pain
is there pain in chronic sinus obstruction?
what does acute sinus obstruction often precede?
describe how sinusitis affects one's sense of smell
what might you expect on a painful tooth when you percuss it?
is dental pain well or poorly localised?
what type of migraine make up 25% of cases?
name 2 accompanying features of migraine
which gender is paroxysmal hemicrania more common in?
is pain unilateral or bilateral with paroxysmal hemicranial?
how long does the pain last for paroxysmal hemicrania?
b) less than an hour
c) over 12 hours
b) less than an hour
give 2 associated symptoms of paroxysmal hemicrania
describe the onset of cluster headaches
which gender is more commonly affected by cluster headaches?
men (middle aged)
how can cluster headaches impinge on the trigeminal nerve?
dilate blood vessels
give a neurological symptom of cluster headaches
what is horner's characterised by?
what type of pain is mid facial segment pain and where does it occur?
tightness/pressure over nasal bridge or orbit
is mid facial segment pain symmetrical or not?
describe the changes to sensation that occur with mid facial segment pain
what might a patient with mid facial segment pain complain of in regards to their nose? (although it would appear normal upon examination)
give an example of a specific trigger for trigeminal neuralgia
what is firstline treatment for trigeminal neuralgia
name 3 other drugs that may be used to treat trigeminal neuralgia
what type of patient is more likely to get atypical facial pain that has no dermasomal associations?
pessimistic or with negative life events/stressed
which branches of the trigeminal nerve are affected in 1/3 of trigeminal neuralgia cases?
V2 and V3
name the 4 sinuses from top to bottom
what is the definition for rhinosinusitis?
inflammation of the nose and paranasal sinuses
give 2 examples of endoscopic signs you might see in rhinosinusitis
what is the difference between acute and chronic rhinosinusitis?
acute 12 weeks
how are nasal polyps normally managed?
topical steroid drops e.g. luticason or beclomethasone
what is FESS?
functional endoscopic sinus surgery
give 3 examples of viruses that can cause rhinosinusitis
respiratory syncytial virus
give 3 examples of bacteria that can cause rhinosinusitis
give 3 abnormalities of the osteomeatal complex that can cause rhinosinusitis
impaired ciliary function
what are kartagener's syndrome and primary ciliary dyskinesia both examples of?
what is Samter's triad?
what complication of rhino sinusitis is characterised by diplopia, proptosis and visual abnormalities?
give a vascular complication of rhinosinusitis
cavernous sinus thrombosis
give an infective complication of rhinosinusitis
what are the 3 major salivary glands?
what nerve supplies the parotid gland?
what is the name of the duct which flows from parotid and where does it open?
opens next to 2nd molar
what type of fluid does the parotid gland produce?
what 2 senses does the parotid help to stimulate?
what nerve does it lie very close to?
what type of secretion does the submandibular gland produce?
what type of tumours constitute 80% of salivary gland tumours?
are 80% of salivary gland tumours benign or malignant?
where do 80% of salivary gland tumours lie?
give 5 functions of saliva
pellicle (layer of proteins)
describe the swelling characteristic of acute viral parotitis
bilateral with mild pain
give a systemic symptom of acute viral parotitis
what causes acute viral parotitis?
what 2 supportive management options are used to treat acute viral parotitis?
give 3 complications of acute viral parotitis
give 5 causes of hypo function of the salivary glands
what are the symptoms of acute bacterial parotitis similar to?
acute viral parotitis
why is acute bacterial parotitis more serious that acute viral parotitis?
mortality 80% if not treated
what is the most common causative organism for acute bacterial parotitis?
what are the 4 parts of treatment for acute bacterial parotitis?
describe the swelling characteristic of HIV parotitis
is HIV parotitis often bilateral or unilateral?
benign lymphopithemial cysts are types of what parotitis? what causes them?
hyperplasia of follicles in lymph nodes
what immune cells infiltrate lymph glands in HIV parotitis/benign lymphopithemial cysts?
CD8 t cells (cytotoxic)
what is sjoren's syndrome?
autoimmune connective tissue disorder
give 2 symptoms of sjoren's syndrome and their implications
keratoconjuctivitis sicca (dry eyes)
xerostomia (dry mouth)
what occurs to the lymph glands in sjoren's syndrome?
infiltration and atrophy of acini
how is sjoren's treated?
give a complication of sjoren's syndrome
what is a ranula?
painless salivary gland mass of constant size
what is a ranula made of?
what type of agent is used to treat a ranula?
what is sialolithiasis?
deposition of crystals in gland
when is the pain of sialolithiasis worst?
what does sialodentesis have that sialolithiasis doesn't?
erythema and pus
what is the word for ear discharge?
what is an inflamed ear canal called?
give 3 symptoms of mastoiditis
swelling over mastoid process
ear pushed forwards and downwards
give 2 bacterial causative organisms of otitis externa
if a patient with otitis external was complaining of deep pain and had cranial nerve palsies, what would you be concerned about?
give 2 fungal causative organisms of otitis externa. what predisposes to fungal ear infections?
predisposed by prolonged antibiotic use
give the 3 most common causative organisms for acute otitis media
what abnormal growth can cause chronic suppurative otitis media?
give 2 causes of chronic suppurative otitis media
perforated tympanic membrane
abnormality of tympanic membrane
what systemic complication can occur with acute mastoiditis?
give 4 causes of non infective ear discharge
what is the difference between antibiotic treatment of bacterial otitis externa, malignant otitis externa and fungal otitis externa?
bacterial = topical abx
malignant = IV abx
fungal = topical antifungals + stop abx
what type of otitis externa has the highest mortality?
what is the difference between treatment in AOM and CSOM?
AOM only give abx if it fails to improve
CSOM topic abx
what surgical treatment would you recommend for
a) mucosal CSOM
b) squamous CSOM
give 3 viral causes of acute sore throat
aden, EBV, HSV, paramyxo
give 3 bacterial causes of acute sore throat
group a strep (pyogenes)
scarlet fever (s pyogenes)
what causes glandular fever?
EBV infectious mononucleosis
give 3 symptoms of glandular fever
give 2 signs of glandular fever
how is glandular fever treated?
suppurative w steroids
what is laymen's terms for pharyngitis?
what would the throat look like upon inspection of a patient with pharyngitis?
maybe tonsil swelling
give 4 signs/symptoms of pharyngitis
how can you distinguish a peritonsilar abscess from peritonsillar cellulitis?
uvula is central in peritonsilar cellulitis
place unilateral and bilateral into this sentence:
peritonsilar abscess is characterised by severe ___ pain and _____ earache, with pyrexia
severe unilateral pain
how is the voice of someone with a peritonsilar abscess described?
describe these two symptoms of peritonsilar abscesses
a) pain when swallowing
b) inability to open jaw fully
name a breath symptom of peritonsilar abscesses
give the 2 main causative organisms of peritonsilar abscesses
how are peritonsilar abscesses managed?
broad spectrum abx and drainage
when is the pain worse in pharyngotonsillitis?
name 3 bacterial causative organisms for pharyngotonsillitis
give 2 symptoms for laryngitis
give 3 causes for laryngitis
how is laryngitis treated?
voice rest + humidity
give 4 symptoms of epiglottis, supraglottitis
which of epiglottitis and supraglottitis is more common in children?
supraglottitis more common in children
what are 2 bacterial causative organisms for epiglottis and supraglottitis?
what is immediate emergency treatment for epiglottitis and supraglottitis?
what drugs might you give to treat epiglottitis and supraglottitis?
broad spectrum abx
complete this pneumonic for the branches of the facial nerve
Two zebras bit Miley Cyrus
if a facial nerve is damaged above the spinal cord, which parts of the face will be affected?
lower contralateral quadrant (as upper quadrants are supplied doubly by nerves from both sides)
if a facial nerve is damaged below the spinal cord, which parts of the face will be affected?
ipsilateral half of face
what is neuropraxia?
reversible blockage of transmission of nerve impulses
what causes neuropraxia?
pressure on nerve fibres
what is axonotmesis?
blockage of axon flow causing neuronal degeneration
what is neurotmesis?
total nerve transection
bell's palsy is dysfunction of which cranial nerve?
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
c) widespread erythema
what is the pathophysiology of lambert eaton disease?
autoantibodies block presynaptic calcium channels