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Flashcards in Throat Deck (112):
1

What is taste known as

gustation

2

What is the lifespan of the sensory receptors (taste nephrons) in the taste buds

10 days

3

What are the sensory receptors of the taste buds replaced by once they've expired

basal cells

4

What are the 4 different types of papillae

vallate
foliate
fungiform
filiform

5

What is the papillae that senses temperature etc

filiform

6

What supplies the anterior two-thirds of the tongue

CNVII - chorda tympani

7

What supplies the posterior third of the tongue

CNIX

8

What supplies everything else (epiglottis, pharynx etc)

CNX

9

What is ageusia

loss os taste function

10

What are the causes of aguesia

nerve damage
local inflammation (epiglottitis, radiation, tobacco)
some endocrine disorders

11

What is hypogeusia

decreased taste function

12

What are the causes of hypogeusia

chemo
medications

13

What is dysgeusia

distortion of taste function

14

What are the causes of dysgeusia

glottitis
gum infection
tooth decay
reflux
URTI
meds
neoplasms
chemo
zinc deficiency

15

What is the oral cavity

from lips to tonsils

16

What is the nasopharynx

from posterior nasal opening to soft palate

17

What is oropharynx

from soft palate to tip of epiglottis

18

What is layngopharynx/hypopharynx

from tip of epiglottis to just below the cricoid cartilage

19

What is the nerve supply to the vocal cords

recurrent laryngeal nerve (CNX)

20

What are the 5 primary tastes

salty
sweet
sour
bitter
unami (savoury/meaty)

21

What are the 3 salivary glands

parotid (CNIX)
submandibular (CNVII - chorda tympani)
sublingual (CNVII - chorda tympani)

22

Which nerve supplies the muscles of the tongue (genioglossus, hyoglossus, palatoglossus, styloglossus)

CNXII
if damaged, tongue will deviate TO the damaged side

23

What supples the skeletal muscles of the soft palate

CNV3 and CNX
If damaged, the uvula will deviate AWAY from the damaged side

24

Acute pharyngitis =

acute inflammation of the oropharynx

25

Tonsilitis =

acute inflammation of the tonsils

26

Acute follicular tonsillitis =

bacterial tonsillitis

27

What is acute follicular tonsillitis usually caused by

strep pyogenes

28

What is the treatment for acute follicular tonsillitis

penicillin

29

What is a complication of acute follicular tonsillitis 3 weeks post infection

rheumatic fever

30

what would rheumatic fever present with

fever
arthritis
pancarditis

31

What is a complication of acute follicular tonsillitis that would occur 1-3 weeks post infection

glomerulonephritis

32

What would glomerulonephritis present with

haematuria
albuminuria
oedema

33

What is the organism that causes diptheria

corynebacterium diptheriae

34

What would someone present with if they had diptheria

grey white membrane on back of throat

35

The exotoxin that is released from diptheria is

cardiotoxic and neurotoxic

36

What is the treatment for diptheria

anti-toxin and supportive Abx - penicillin/erythromycin

37

What prevents diptheria

vaccination

38

Someone with candida albicans will present with

white patches on red, raw mucous membranes

39

What is the cause of candida albicans

endogenous

40

what is the treatment for candida albicans

nystatin

41

glandular fever is also known as

infectious mononucleosis

42

What triad of symptoms is most common in glandular fever

fever
lymphadenopathy (cervical most prominent)
pharyngitis

43

What other symptoms/sings may occur with glandular fever

sore throat
tonsillitis
malaise/lethargy
jaundice/hepatitis
rash
leukocytosis
atypical lymphocytes
splenomegaly (50%)
palatal petechiae

44

What is the cause of infectious mononucleosis

EBV

45

What is the investigation for glandular fever

EBV IgM
Paul-bunnel test
Monospot test
FBC
LFTs

46

What is the treatment for infectious mononucleosis

bed rest
paracetamol
avoid sport and alcohol for 6 weeks

47

What should not be given in infectious mononucleosis

amoxicillin - causes a macular rash

48

What are the complications of glandular fever

anaemia
thrombocytopenia
splenic rupture
upper airway obstruction
increased risk of lymphoma - especially if immunosuppressed

49

Which type of HSV causes oral ulcers

type 1
type 2 rarely

50

Which type of HSV causes genital ulcers

50% type 1
50% type 2

51

When does type 1 HSV usually first present

childhood (transferred by saliva contact)

52

What does type 1 HSV cause in childhood

primary gingivostomatitis

53

What does primary gingivostomatitis present as

disease of pre-school
systemic upset
lips, buccal mucousa and hard palate affected
vesicles 1-2mm
ulcers
fever
local lymphadenopathy

54

What is the investigation for primary gingivostomatitis

viral swab for PCR

55

What is the treatment for primary gingivostomatitis

aciclovir

56

What is a cold sore

reactivation of HSV

57

What is the treatment for a cold sore

aciclovir/suppression
not all reactivations are symptomatic
NOTE - aciclovir doesnt prevent latency

58

How does herpangina present

vesicles/ulcers of soft palate

59

What is the cause of herpangina

coxsackie - enterovirus

60

What is the investigation for herpangina

viral swab for PCR or clinical diagnosis

61

What is the cause of hand, foot and mouth disease

coxsackie - enterovirus

62

What is the investigation for hand, foot and mouth disease

viral swab for PCR

63

Apthous ulcers are (viral/non-viral)

non-viral

64

How does apthous ulcers present

recurring painful ulcers
round/ovoid with an inflammatory halo
confined to mouth
NO systemic disease associated
begin in childhood
each ulcer lasts <3wks

65

Bechcets disease is non viral - what does this present as

recurrent oral ulcers
genital ulcers
uevitis

66

Where is bechets most common

middle and east asia

67

How does primary syphilis present

painless indurate ulcer at site of entry
(most commonly genital but can be oral)

68

What is the causative organism of primary syphilis

treponema pallidum

69

What type of epithelium is present in the palatine tonsils

specialised squamous

70

What type of epithelium is present in the adenoids

ciliated pseudostratified columnar

71

viral acute tonsillitis will present with

sore throat
temperature
able to undertake near normal activities
lasts 3-4days

72

What will bacterial acute tonsillitis present with

pyrexia
dysphagia
lymphadenopathy
severe malaise
grey exudate on tonsils

73

What is the causes of acute tonsillitis

viral - EBV
- rhinovirus
- influenza
Bacterial - strep pyogenes
H. influenza

74

What is the centor criteria for

to differentiate between viral and bacterial tonsillitis

75

What is involved in the centor criteria

Hx of fever
tonsillar exudates
tender anterior cervical lymphadenopathy
absence of cough

76

What is the modified centor criteria

+1 point for <15yrs
-1 point for >44yrs

77

What treatment is given to those with a centor criteria of 0-1

no Abx required (bacterial risk <10%)
rest
analgesia

78

What is the recommended treatment for someone with a centor criteria of 2-3

Abx if symptoms progress (2= 15% bacterial risk, 3= 32% bacterial risk)

79

A centor criteria of 4+ points should be given what treatment

Abx (bacterial risk = 56%)

80

What is the Abx for acute tonsillitis

penicillin 500mg QD
clarithromycin if penicillin allergic

81

When may a patient need hospitalised with acute tonsillitis

if can't eat/drink/take abx/ isn't coping

82

What is the treatment for acute tonsillitis in hospital

IV fluids
IV Abx
steroids

83

When is surgery indicated for tonsillitis

quinsy with Hx of recurrent tonsillitis
5+ episodes in each of the 2 preceding years
7+ documented "severe" episodes
3+ episodes in each of the 3 preceding years

84

Quinsy is also known as

peritonsillar abscess

85

What is a peritonsillar abscess

a collection of pus outside the capsule of the tonsil

86

What does quinsy present with

trismus (locked jaw)
pus pushes uvula across the midline to opposite side
unilateral throat pain
odynophagia
hot potato voice
drooling

87

What is the cause of quinsy

complication of acute tonsillitis

88

What is the treatment for quinsy

incision and drainage
+ Abx

89

what would someone with epiglottitis present with

severe sore throat
drooling
pyrexia
examination of the oral cavity is normal
possibly stridor

90

What is the cause of epiglottitis

H. influenza type B

91

What is the treatment for mild epiglottitis

supportive
Abx
nebulisers (adrenaline/saline)
corticosteroids

92

what is the treatment for severe epiglottitis

Abx
intubation and ventilation
tracheostomy

93

Cancer of the oral cavity are most likely to be where and what type

SCC
found on the lateral aspects of the tongue and floor of the mouth

94

Red flags for cancer are

>3wks of - sore throat
- hoarseness
- stridor
- dysphagia
- lump in the neck
- unilateral ear pain

95

What is the first line investigation for dysphagia

endoscopy
Barium swallow is 2nd line if nothing found on endoscopy

96

What is the 1st line investigation for a neck lump

USS
possibly with FNA

97

Vocal cord nodules usually present

bilaterally
F>M
on the free edge of the vocal cord (preventing full closure and breathy or harsh voice)

98

Who are vocal cord nodules usually found in

singers, teachers, lawyers (people who use their voice a lot of strain their voice)

99

Vocal cord nodules can be prevented with

speech therapy

100

What is Reinke's oedema

a collection of tissue fluid in sub-epithelial layer of the vocal cord

101

What causes Reinke's oedema

poor lymphatic drainage predisposes to oedema

102

What is Reinke's associated with

smoking
voice abuse
acid reflux

103

What is the treatment for Reinke's

remove irritation
surgery to thin the cords

104

What is salolithiasis

formation of stones in the salivary glands
- obstruct the salivary gland and predispose to infection

105

Which salivary land is most affected by salolithiasis

submandibular gland

106

How does salolithiasis present

M>F
40+yrs
pain and swelling after eating

107

What is the most common salivary gland tumour

pleomorphic adenoma

108

A newborn baby with stridor is most likely to have

layngomalacia

109

Croup is associated with

barking cough

110

What is the cause of croup

parainfluenza virus

111

How does a pharyngeal pouch usually present

elderly
M>F
dysphagia
hoarse voice
aspiration pneumonia
cough
hallitosis (bad breath)
regurgitation

112

What is increased in someone with an untreated pharyngeal pouch

increased risk of developing pharyngeal carcinoma