ENT Flashcards
(162 cards)
1
Q
what body system mediates balance?
A
vestibular
2
Q
what system regulates gravity, linear and angular acceleration and regulates muscle tone?
A
vestibular
3
Q
what are the 2 otolith organs?
A
utricle
saccule
4
Q
how many semicircular canals are there?
A
3
5
Q
what is smooth pursuit used for?
A
tracking moving objects
6
Q
what is optokinetic nystagmus?
A
reflex when tracking objects that lie outside the fovea
7
Q
what is the vestibular-ocular reflex?
A
stabilised the eye on an object when the head moves
8
Q
where are the main gravity receptors located?
A
major blood vessels
abdominal viscera
9
Q
what balance disease is characterised by the illusion of movement when there is none?
A
vertigo
10
Q
what is the onset of being paroxysmal positional vertigo?
A
sudden, last only seconds
11
Q
does hearing loss accompany BPPV?
A
no
12
Q
what manoeuvre/test might you perform to diagnose BPPV?
A
dix-hallpike
13
Q
what manoeuvre night you perform to treat BPPV?
A
epley’s manœuvre
14
Q
what eye problem is characterised by involuntary rhythmic oscillation of the eyes?
A
nystagmus
15
Q
what is the onset of meniere’s disease?
A
lasts hours
episodi
16
Q
what hearing problem accompanies meniere’s?
A
tinnitus
17
Q
what is vestibular neuronitis?
A
vertigo that lasts hours after a URTI
18
Q
is there any hearing loss or neurological signs with vestibular neuronitis?
A
no
19
Q
what is treatment for vestibular neuronitis?
A
supportive
20
Q
what is presbystasis and what causes it?
A
balance disorder
related to ageing
21
Q
what is saccades?
A
normal eye jerk between current and new stimuli
22
Q
what is head shaking nystagmus?
A
nystagmus following head shaking
23
Q
why might you test calorics when testing vestibular function?
A
vestibular-ocular reflex is based on calorics (hot/cold sense)
24
Q
who is most commonly affected by epistaxis?
A
children
25
what causes 85% of all cases of epistaxis?
idiopathic
26
give 3 simple local causes of epistaxis
trauma e.g. nose picking
mucosal irritation
anatomical abnormalities
27
give a tumour cause of epistaxis
nasopharyngeal angiofibroma (benign tumour that bleeds)
28
give 3 associated symptoms of nasopharyngeal angiofibroma - who does it affect?
headache
rhinorrhoea
anosmia
affects young males
29
give 4 pathological systemic causes of epistaxis
bleeding disorders
neoplasms
inflammatory disorders
hypertension
30
give 3 medications that may increase the risk of epistaxis
aspirin
clopidogrel
warfarin
31
the blood supply of the nose is
a) very rich
b) poor
c) absent in some
a) very rich
32
how do you distinguish between an anterior and a posterior nosebleed?
pooling in front of nose or running down back of throat
33
what type of facial pain is characterised by throbbing?
vascular
34
what type of facial pain is characterised by severe stabbing, nasal obstruction and nausea?
trigeminal neuralgia
35
name 2 other types of facial pain
sinogenic
| migraine
36
is there pain in chronic sinus obstruction?
no
37
what does acute sinus obstruction often precede?
URTI
38
describe how sinusitis affects one's sense of smell
hyposmia
39
what might you expect on a painful tooth when you percuss it?
more pain
40
is dental pain well or poorly localised?
poorly
41
what type of migraine make up 25% of cases?
classical
42
name 2 accompanying features of migraine
aura
| visual disturbances
43
which gender is paroxysmal hemicrania more common in?
women
44
is pain unilateral or bilateral with paroxysmal hemicranial?
unilateral
45
how long does the pain last for paroxysmal hemicrania?
a) seconds
b) less than an hour
c) over 12 hours
d) days
b) less than an hour
46
give 2 associated symptoms of paroxysmal hemicrania
lacrimation
nasal congestion
rhinorrhoea
47
describe the onset of cluster headaches
sudden
48
which gender is more commonly affected by cluster headaches?
men (middle aged)
49
how can cluster headaches impinge on the trigeminal nerve?
dilate blood vessels
50
give a neurological symptom of cluster headaches
horner's
51
what is horner's characterised by?
myosis
anhydrous
ptosis
52
what type of pain is mid facial segment pain and where does it occur?
tightness/pressure over nasal bridge or orbit
53
is mid facial segment pain symmetrical or not?
symmetrical
54
describe the changes to sensation that occur with mid facial segment pain
hyperaesthesia
55
what might a patient with mid facial segment pain complain of in regards to their nose? (although it would appear normal upon examination)
nasal congestion
56
give an example of a specific trigger for trigeminal neuralgia
washing face
| brushing teeth
57
what is firstline treatment for trigeminal neuralgia
carbamazepine
58
name 3 other drugs that may be used to treat trigeminal neuralgia
gabapentin
pregabalin
lidocaine
amitryptilline
59
what type of patient is more likely to get atypical facial pain that has no dermasomal associations?
pessimistic or with negative life events/stressed
60
which branches of the trigeminal nerve are affected in 1/3 of trigeminal neuralgia cases?
V2 and V3
61
name the 4 sinuses from top to bottom
frontal
ethmoidal
sphenoidal
maxilliary
62
what is the definition for rhinosinusitis?
inflammation of the nose and paranasal sinuses
63
give 2 examples of endoscopic signs you might see in rhinosinusitis
polyps
| mucopurulent discharge
64
what is the difference between acute and chronic rhinosinusitis?
acute 12 weeks
65
how are nasal polyps normally managed?
topical steroid drops e.g. luticason or beclomethasone
66
what is FESS?
functional endoscopic sinus surgery
67
give 3 examples of viruses that can cause rhinosinusitis
rhinovirus
influenza
respiratory syncytial virus
68
give 3 examples of bacteria that can cause rhinosinusitis
pneumococcus
streptococcus
h influenzae
69
give 3 abnormalities of the osteomeatal complex that can cause rhinosinusitis
too small
increase secretion
impaired ciliary function
70
what are kartagener's syndrome and primary ciliary dyskinesia both examples of?
mucociliary disorders
71
what is Samter's triad?
aspirin hypersensitivity
nasal polyps
asthma
72
what complication of rhino sinusitis is characterised by diplopia, proptosis and visual abnormalities?
peri-orbital celluliitis
73
give a vascular complication of rhinosinusitis
cavernous sinus thrombosis
74
give an infective complication of rhinosinusitis
meningitis
| abscess
75
what are the 3 major salivary glands?
parotid
submandibular
sublingual
76
what nerve supplies the parotid gland?
glossopharyngeal
77
what is the name of the duct which flows from parotid and where does it open?
stepson's duct
| opens next to 2nd molar
78
what type of fluid does the parotid gland produce?
watery, serous
79
what 2 senses does the parotid help to stimulate?
gustatory
| olfactory
80
what nerve does it lie very close to?
facial
81
what type of secretion does the submandibular gland produce?
thick mucoid
82
what type of tumours constitute 80% of salivary gland tumours?
pleomorphic adenomas
83
are 80% of salivary gland tumours benign or malignant?
benign
84
where do 80% of salivary gland tumours lie?
parotid
85
give 5 functions of saliva
```
moisten mucosa
taste
transport
buffer
digestion
antibacterial
mineralisation
pellicle (layer of proteins)
```
86
describe the swelling characteristic of acute viral parotitis
bilateral with mild pain
87
give a systemic symptom of acute viral parotitis
pyrexia
88
what causes acute viral parotitis?
paramyxovirus
89
what 2 supportive management options are used to treat acute viral parotitis?
rehydration
| analgesia
90
give 3 complications of acute viral parotitis
```
meningitis
encephalitis
pancreatitis
orchiditis
deafness
```
91
give 5 causes of hypo function of the salivary glands
```
candidiasis
lichen planes
pathos ulcers
xerostomia
poor dentition
burnt mouth
```
92
what are the symptoms of acute bacterial parotitis similar to?
acute viral parotitis
93
why is acute bacterial parotitis more serious that acute viral parotitis?
mortality 80% if not treated
94
what is the most common causative organism for acute bacterial parotitis?
staph aureus
95
what are the 4 parts of treatment for acute bacterial parotitis?
antibiotics
rehydration
analgesia
drainage
96
describe the swelling characteristic of HIV parotitis
firm, non-tender
97
is HIV parotitis often bilateral or unilateral?
bilateral
98
benign lymphopithemial cysts are types of what parotitis? what causes them?
HIV parotitis
| hyperplasia of follicles in lymph nodes
99
what immune cells infiltrate lymph glands in HIV parotitis/benign lymphopithemial cysts?
CD8 t cells (cytotoxic)
100
what is sjoren's syndrome?
autoimmune connective tissue disorder
101
give 2 symptoms of sjoren's syndrome and their implications
```
keratoconjuctivitis sicca (dry eyes)
xerostomia (dry mouth)
```
102
what occurs to the lymph glands in sjoren's syndrome?
infiltration and atrophy of acini
103
how is sjoren's treated?
antinuclear antibodies
104
give a complication of sjoren's syndrome
non-hodgkin's lymphoma
105
what is a ranula?
painless salivary gland mass of constant size
106
what is a ranula made of?
mucocoele
107
what type of agent is used to treat a ranula?
sclerosing agent
108
what is sialolithiasis?
deposition of crystals in gland
109
when is the pain of sialolithiasis worst?
around eating
110
what does sialodentesis have that sialolithiasis doesn't?
erythema and pus
111
what is the word for ear discharge?
ottorhoea
112
what is an inflamed ear canal called?
otitis externa
113
give 3 symptoms of mastoiditis
swelling over mastoid process
non-draining
ear pushed forwards and downwards
114
give 2 bacterial causative organisms of otitis externa
pseudomonas
s aureus
proteus
115
if a patient with otitis external was complaining of deep pain and had cranial nerve palsies, what would you be concerned about?
malignancy
116
give 2 fungal causative organisms of otitis externa. what predisposes to fungal ear infections?
aspergillus
candida
fumigatis
predisposed by prolonged antibiotic use
117
give the 3 most common causative organisms for acute otitis media
s pneumonia
h influenza
moraxella
118
what abnormal growth can cause chronic suppurative otitis media?
cholesteatoma
119
give 2 causes of chronic suppurative otitis media
perforated tympanic membrane
trauma/grommets
bacteria
abnormality of tympanic membrane
120
what systemic complication can occur with acute mastoiditis?
septicaemia
121
give 4 causes of non infective ear discharge
```
atopic dermatitis
eczema
psoriasis
trauma
CSF
blood
```
122
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
```
123
what type of otitis externa has the highest mortality?
malignant
124
what is the difference between treatment in AOM and CSOM?
AOM only give abx if it fails to improve
| CSOM topic abx
125
what surgical treatment would you recommend for
a) mucosal CSOM
b) squamous CSOM
a) tympanoplasty
| b) mastoidectomy
126
give 3 viral causes of acute sore throat
```
rhinovirus
coronavirus
syncytial virus
parainfluenza
aden, EBV, HSV, paramyxo
```
127
give 3 bacterial causes of acute sore throat
group a strep (pyogenes)
scarlet fever (s pyogenes)
c diphtheriae
128
what causes glandular fever?
EBV infectious mononucleosis
129
give 3 symptoms of glandular fever
```
sore throat
pyrexia
malaise
anorexia
rash
```
130
give 2 signs of glandular fever
lymphadenopathy
| splenomegaly
131
how is glandular fever treated?
suppurative w steroids
132
what is laymen's terms for pharyngitis?
sore throat
133
what would the throat look like upon inspection of a patient with pharyngitis?
erythematous
| maybe tonsil swelling
134
give 4 signs/symptoms of pharyngitis
temperature
lymphadenopathy
cough
rhinorrhoea
135
how can you distinguish a peritonsilar abscess from peritonsillar cellulitis?
uvula is central in peritonsilar cellulitis
136
place unilateral and bilateral into this sentence:
| peritonsilar abscess is characterised by severe ___ pain and _____ earache, with pyrexia
severe unilateral pain
| bilateral earache
137
how is the voice of someone with a peritonsilar abscess described?
hot potato
138
describe these two symptoms of peritonsilar abscesses
a) odynophagia
b) trismus
a) pain when swallowing
| b) inability to open jaw fully
139
name a breath symptom of peritonsilar abscesses
oris halitosis
140
give the 2 main causative organisms of peritonsilar abscesses
strep progenies
| staph aureus
141
how are peritonsilar abscesses managed?
broad spectrum abx and drainage
142
when is the pain worse in pharyngotonsillitis?
swallowing
143
name 3 bacterial causative organisms for pharyngotonsillitis
strep progenies
staph aureus
haem influenza
144
give 2 symptoms for laryngitis
fever
| dysphonia
145
give 3 causes for laryngitis
chemical trauma
physical trauma
viral infection
146
how is laryngitis treated?
voice rest + humidity
| steroids
147
give 4 symptoms of epiglottis, supraglottitis
```
sore throat
dysphagia
dysarthria
tachycardia
difficulty breathing
```
148
which of epiglottitis and supraglottitis is more common in children?
supraglottitis more common in children
149
what are 2 bacterial causative organisms for epiglottis and supraglottitis?
s pneumoniae
| h parainfluenzae
150
what is immediate emergency treatment for epiglottitis and supraglottitis?
secure airway
151
what drugs might you give to treat epiglottitis and supraglottitis?
broad spectrum abx
| steroids
152
complete this pneumonic for the branches of the facial nerve
| Two zebras bit Miley Cyrus
```
temporal
zygomatic
buccal
mandibular
cervical
```
153
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)
154
if a facial nerve is damaged below the spinal cord, which parts of the face will be affected?
ipsilateral half of face
155
what is neuropraxia?
reversible blockage of transmission of nerve impulses
156
what causes neuropraxia?
pressure on nerve fibres
157
what is axonotmesis?
blockage of axon flow causing neuronal degeneration
158
what is neurotmesis?
total nerve transection
159
bell's palsy is dysfunction of which cranial nerve?
7
160
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
161
what is the pathophysiology of lambert eaton disease?
autoantibodies block presynaptic calcium channels
162
what causes lambert eaton disease?
underlying malignancy
