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Some Important MCQ > ENT And Opthalmology > Flashcards

ENT And Opthalmology Flashcards

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1
Q

Rinne’s test positive and webers lateralizes to right. Meaning?

A

Rinne’s test positive : AC >BC
Weber’s lateralize to right: better hearing in right.
Therefore : sensorineural hearing loss in left ear

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2
Q

If rinne’s postive and weber latrralizes fo right. What test to do next?

A

Schwabach test
Compare patient’s hearing to examiner hearing.
If hearing is normal= test normal
If hearing low= test prolonged.

This helps to confirm sensorineural hearing loss.

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3
Q

Sago grain appearance seen in …..

A

Healed myringitis bullosa

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4
Q

Define myrinitis bullosa

A

Otitis externa hemorrhagica
Where blisters develop on tympanic membrane. When healed, forms small round bumps that resembles sago grain.

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5
Q

Cause of bullous myringitis (5)

A
  1. Strept pneumoniae
  2. H.Influenza
  3. Beta hemolytic streptococci
  4. Moraxella catarhalis
    5: Respiratory virus:
    rhinovirus,influenza A,parainfluenza virus,RSV, enterovirus.
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6
Q

Dx of bullous myringitis
Sms

A

Clinical
Sms: sudden onset severe one sided ear pain + URTI.
Conductive deafness and discharge of affected ear.

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7
Q

Define cholesteatoma. Where is it found ?
Cholesteatoma arise from …..
Associated with …..

A

Keratinizing squamous epithelial growth in middle ear or mastoid process.
Found in attic region aka epitympanum/upper part of middle ear.

Pars flaccida or superior part of TM

Retraction pockets or perforation in pars tensa- central thicker portion of TM

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8
Q

Antral Holler Miller sign seen in …..
There is anterior bowing of …..

A

Juvenile nasopharyngeal fibroma

Anterior bowing of maxillary antrum

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9
Q

What is glomus tumor ?

What is septal hematoma?

A

Arise from glomus body-nail of finger or toes.

Accumulation of blood within nasal septum due to trauma of nose.

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10
Q

Complication of septal hematoma
Rx

A

Septal perforation and infection
Surgical drainage of blood.

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11
Q

Approach to managing nasal bone fractures?

A
  1. Without septal involvement:
    Lower the edema—> closed reduction after 7 days
  2. Septal deviation:
    Septo- rhinoplasty
  3. Septal deviation with multiple fragments: open reduction
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12
Q
  1. Mc cause of epistaxis in elderly:
  2. Mgt in active bleeding :
A
  1. HTN
  2. a. Anterior /posterior packing
    b. Not controlled: arterial ligation
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13
Q
  1. Mx cause of epistaxis in children and adults
  2. Mx site of epistaxis
  3. Mc cause of epistaxis in 15 yr female
A
  1. Finger nail trauma
  2. Little’s area
  3. Hematopoetic d/o
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14
Q

U/l purulent nasal d/c with occasional blood is …..

A

Foreign body

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15
Q

Antrochoanal polyp seen in ….
Sms

A

Children and young adults
1. Benign polypoid lesion with nasal obstruction and nasal drainage
2. Always unilateral

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16
Q

Most common sms. of foreign body in children (3)

A
  1. Nasal obstruction
  2. Rhinorrhoea
  3. Post nasal drainage
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17
Q

Chronic granulomatous disease presenting with rhinorrhoea , epistaxis and nasal obstruction in third or fourth decade of life

A

Rhinosporidiosis

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18
Q

Antrochoanal polyp distribution

A

Arise from maxillary sinus( Antrum)
Extend through maxillary sinus ostium into nasal cavity into the choana( opening at back of nasal cavity).

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19
Q

Parotid duct is also known as …..
It is ….
Function

A

Stenson’s duct.
Major duct of parotid gland.
Drains saliva from parotid into oral cavity

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20
Q

If pus is present in parotid duct, it indicates ….

A

Infection of stensons duct-infection of parotid gland.

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21
Q

Describe trotter’s triad
Associated with ….

A

Hearing loss u/l
Facial pain
Palatal palsy

Malignant tumors of lateral wall of nasopharynx

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22
Q

Define Gradenigo syndrome

A

Triad:
otitis media, facial pain,abducens palsy

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23
Q

Samter’s triad aka…..
Characteristics (3)

A

Aspirin associated respiratory disease
Asthma
Recurrent nasal polyp
Sinus congestion

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24
Q

Features of adenoid facies (5)

A
  1. Open mouth
  2. High arched palate
  3. Protrusion of upper incisors
  4. Enlongation of facial structure
  5. Flattened mid face

—-Dennis Morgan lines, allergic shiner,nasal crease

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25
Structures in the eye derieved from neural crest cells (4)
1. Uveal melanocytes 2. Trabecular mesh work 3. Ciliary muscle 4. Cornea
26
What is hyaloid artery?
Transient embryonic blood vessel that nourishes the developing lens during early stages of eye development. As eye matures; it regress and remain as hyaloid canal or cloquet canal
27
Features of direct opthalmoscopy
Direct opthalmoscopy: 1. Condensing lens: not required 2. Examination distance: as close to patient’s eye as possible 3. Image: virtual, erect 4. Magnification: 15 times 5. Illumination: not bright,not useful in hazy media 6. Area of field in focus: 2D 7. Stereopsis: absent 8. Accessible fundus view: Slightly Beyond the equator 9. Examination through hazy media: Not possible 10. Patient sitting position: Easy, sitting position , can visualize posterior pole of retina.
28
Features of indirect Opthalmoscopy (10)
1. Condensed lens: convex lens 2. Examination distance: at arms length 3. Image: real inverted 4. Magnification: 4-5 times 5. Illumination: bright,useful for hazy media 6. Area of field in focus : 8D 7. Stereopsis: present 8. Accessible fundus view: Upto orra serrata-peripheral pole of retina 9. Exam through hazy media: possible 10. Patient position ease: Supine, difficult, require training.
29
Trauma to the eye with vegetable matter can cause…..
Fungal ulcer
30
Clinical features of mycotic corneal ulcer:
Red FISH Rolled out dry elevated margins Feathery finger like projections Immune ring Satellite lesions Hypopyon
31
Define geographical ulcer Associated with ….(2)
Non infectious Irregular borders and epithelial defects Associated with Neurotrophic keratitis Exposure keratopathy
32
Feature of acanthameoba keratitis (3)
Severe Pain Photophobia Corneal ring infiltrates aka radial keratoneuritis
33
Chronic irritation of both eyes in young female with papillary conjunctivitis and corneal filaments s/o… Most important test to consider is…
Autoimmune conditions / dry eye syndrome Thyroid function test- Graves’ disease Schirmer test
34
Signs of heterochromic iridocyclitis of Fuch(6) Most important sign seen…..
1. Gradual blurring of vision in one eye 2. Diffuse iris atrophy 3. Small white stellate keratic ppt (deposits in inner surface of cornea) 4. Cells in anterior chamber and anterior vitreous. 5. Acqueous flare 6. posterior subcapsular cataract and glaucoma Most important sign: amsler sign- when cut anterior chamber, there is hyphema in anterior chamber due to bv present.
35
Intermediate uveitis is also known as …. Define
Pars planitis I.f of middle layer of eye -lens, ciliary body
36
Sms of intermediate uveitis (7)
1. Blurred vision 2. Dark floaters in vision field interfering with vision 3. Swelling inside the eye 4. Glaucoma 5. Vision loss. 6. Cataract-as d/s progress 7. Retinal detachment-as d/s progress
37
What is heerfordt’s disease? Sms (5)
Variant of sarcoidosis 1. Parotid gland enlargement 2. Generalized fever 3. facial nerve palsy 4. Anterior uveitis 5. Ocular involvement
38
Sms of subacute iridocyclitis (5)
Painful red eye - around iris Blurred vision Miosis Headaches Photophobia
39
Painful red eye, florid rubiosis s/o Rx
Central retinal vein occlusion Panretinal photocoagulation
40
Describe pan retinal photocoagulation
Laser used to burn certain areas of retina, decrease oxygen demand to that area—> decrease in neovascularization. Also used in DR
41
What is seton implantation
Glaucoma resistant to surgery Place a drainage tube to control IOP
42
What is diode photocoagulation?
Laser to target and reduce size of ciliary body which produces acqueous humor to decrease IOP. Used in refractory glaucoma
43
What is laser iridotomy?
Laser to create a hole in the iris, to make acqueous humor flow from posterior to anterior chamber to relieve pupillary block. Used in angle closure glaucoma
44
Describe pigmentary retinal dystrophy Sms?
Inherited retinal disorders characterized by degeneration of photoreceptor cells in the retina. Early sms: night blindness,tunnel vision
45
Fundoscopic changes in RP? Perimetry s/o
1. Attenuation of arterioles 2. Waxy pallor of optic disc 3. Bone-spicule like pigmentation in mid- peripheral retina Perimetry: ring scotomas
46
Define Staghart’s disease Signs It has ……inheritance pattern
Inherited retinal dystrophy that leads to degeneration of macula—-> loss of central vision. B/l symmetric macular atrophy Yellow-white flecks in the macula -made of lipofuscin pigments in retinal pigment epithelium. Autosomal recessive
47
Define Best’s disease
Accumulation of lipofusin leading to egg yolk appearance on Fundoscopy. There is central vision loss and abnormal EOG finding
48
Expand ERG ,EOG
Electroretinogram Electrooculogram
49
Vision loss in retinitis pigmentosa
Peripheral vision loss—> eventual central vision loss
50
Central vision loss—> peripheral vision loss
Cone-rod dystrophy
51
Define Coat’s disease (4)
1. Affects u/l eyes of young males 2. Abnormal development of blood vessels in the retina—> retinal ischemia 3. Disease is due to aneurysm and telangiectasic vessels 4. There is subretinal yellow exudates
52
Colobamas present mainly in…..
Upper eyelid- but can also be in upper and lower eyelid
53
Coloboma in medial upper eyelid is …. Lower eyelid Rx
Isolated finding Congenital abnormalities -cleft lip/palate Rx: surgical correction, also eyelid must be lubricated well to prevent dryness of cornea and conjunctiva.
54
Define cryptophthalmos Define ankylobhlepharon
Failure of eyelid to develop and separate Ass with malformed eye Fusion of all or parts of eyelid
55
What is distichiasis ? Trichiasis?
Extra row of eyelashes arising from normal posterior row of eyelashes Misdirected eyelashes
56
Define Artl’s line
Entropion of upper and lower eyelid + linear conjunctival scars -upon eversion of upper eyelid. Due to chronic condition affecting the conjunctiva.
57
Artl’s line seen in ……. Features of trachoma (3)
Trachoma-stage 3/cicatricial stage Follicles Scarring Cicatricial entropion.
58
Pseudomembranes of conjuctiva s/o
Ligneous conjunctivitis
59
Define parinaud’s oculogranular syndrome? (2)
Granulomatous conjuctivitis Periauricular LAP —in response to infection/neoplasm
60
Features of kawasaki disease (7)
1. Acute febrile illness lasting 5days 2. B/l non exudative conjunctivitis 3. Mucosal membrane changes including redness and cracking of lip 4. Strawberry tongue 5. Skin rash- peeling of skin 6. Swelling of hands and feet 7. Cervical LAP
61
Features of HSP
Rash, joint pain,GI sms, renal sms
62
Congenital stationary night blindness is …
Oguchi disease
63
Difference between CRAO and CRVO
CRAO: sudden painless LOV, optic disc pallor,Cherry red spots, segmental loss of bv->boxcarring effect CRVO: painless u/l LOV, retinal hges, cotton wool spots, dilated tortorous veins
64
Facial nerve functions (4) Facial nerve exits via….
1. Fibers to orbicularis oculi of facial muscle( facial expression ) 2. Small area of ear 3. Parasympathetic nerves to submandibular and sublingual gland via chorda tympani. 4. Lacrimal gland via greater petrosal nerve Exits the brainstem via cerebellopontine angle
65
Wolfram syndrome aka…..
DIDMOAD Diabetes insipidus Diabetes Mellitus Optic atrophy Deafness
66
Wolfram syndrome presents in ….. Other features (3)
Childhood or adolescence 1. Neurological abnormalities 2. Urinary tract problems 3. Psychiatric disturbances
67
What is kjer syndrome? What is behr syndrome? (4)
Hereditary b/l optic atrophy 1. Progressive Spastic paresis(weakness and spasticity of legs ) 2. Optic atrophy 3. Ataxia 4. Mental retardation
68
Difference between botulinum toxin eye problem and tensilon test
Botulinum toxin: ptosis, opthalmoplegia, fixed dilated pupils Tensilon test: ptosis,,opthalmoplegia, normal pupils.
69
GQI antibody is done for …..
Miller Fischer syndrome Variant of GBS Opthalmoplegia,ataxia,areflexia,pupil problems

Some Important MCQ (1 decks)

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