Week 2 Flashcards by Jonny McClung

What are the pharyngeal tonsils also known as?

Adenoids

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How does the basic histological structure of the adenoids differ from the palatine tonsils?

Adenoids- ciliated pseudostratified columnar epithelium

tonsils- specialised squamous

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Define the following:
Rhinoplasty
Otoplasty
Mentoplasty
blephroplasty

Rhinoplasty- plastic surgery to the nose
Otoplasty- plastic surgery to the ear (pinning back)
Mentoplasty- plastic surgery to the chin
plastic surgery to the eyelids

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Define vertigo

A sensation of movement, usually spinning, or falling, being pushed

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How might you distinguish between cardiac, neurological and vestibular system as the cause of dizziness?

Cardiac- lightheadedness, syncope, palpitations
Neurological- blackouts, parasthesia, visual disturbance, speech and swallow problems, weakness
Vestibular- Vertigo

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What is nystagmus?

Where someone suffers from involuntary uncontrollable eye movements

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What are the three types of hearing loss

Conductive
Sensorineural
Mixed

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What is presbycusis?

Gradual hearing loss with old age

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What scoring system is used to check if tonsillitis is a strep infection. What does it stand for?

FeverPAIN score
Fever
Purulence on tonsils
attend rapidly
Very Inflamed tonsils
no Cough/Coryza

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What are the possible signs of tonsillitis?

Erythematous, inflamed tonsils
Purulence on tonsils
Erythema and oedema of palate

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What is Quinsy?

A peritonsillar abscess

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What are the two types of obstructive hyperplasia and give some possible symptoms of each

Enlarged tonsils- snoring, sleep apnoea, muffled voice

Enlarged adenoids- snoring, sleep apnoea, obligate mouth breathing

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Give two other possible names of glue ear

Otitis media with effusion (OME), serous otitis media (SOM)

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How does acute otitis media differ from OME/SOM?

Both present with middle ear inflammation, fluid accumulation. Only AOM has acute signs/symptoms of inflammation

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How does presbycusis often present?

Mainly high-frequency hearing loss with low frequencies preserved, often worse in one ear than the other.

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Identify 4 possible treatments of tinnitus

CBT
Relaxation therapy
Use of environmental sound
Hearing aids in case of associated hearing loss

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What antibiotic should be used to treat bacterial tonsillitis? What is the alternative if not tolerated?

Penicillin

Clarithromycin

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How does the tympanic membrane present of a patient with AOM? What about in OME?

Bulging, erythematous tympanic membrane

Opaque/dull tympanic membrane with bubbles

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Identify some of the possible symptoms of otitis media

Otalgia
Fever
Discharge
Hearing loss
Upset behaviour/school performance

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How would you approach the management of Otitis media?

1st watch and wait/ Oral antibiotics if bacterial and acute
2nd Review after 3 months- referral
3rd Grommet insertion

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Identify four investigations other than history for Otitis media.

Otoscopy
Tympanometry
audiometry
tuning fork tests

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How does the classical presentation of otitis externa differ from otitis media?

OE- discharge followed by otalgia

OM- otalgia followed by discharge

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Identify some of the signs and symptoms of herpes simplex infection

Cold sores (perioral lesions)
Mucous membrane/skin lesions
Genital lesions
Ocular infections
encephalitis

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What causes Primary Gingivostomatitis? How does it present? How is it treated?

Initial infection of Herpes simplex virus.
Swelling and lesions of the gingiva (gums) and perioral lesions. Also fever, lymphadenopathy.
Aciclovir

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What is herpetic Whitlow?

Herpes simplex infection of the finger

What is the classic triad of symptoms for Infectious Mononucleosis?

Fever Pharyngitis Lymphadenopathy

Give two differentials of tonsillitis

Glandular fever | Quinsy

Apart from Fever, pharyngitis and lymphadenopathy give some other symptoms of Glandular fever

``` Jaundice Macular rash (from ampicillin for sore throat) Splenomegaly palatal petechiae tonsillar exudate ```

Give three investigations for glandular fever

EBV IgM test Heterophile antibody test Bloods show Atypical lymphocytes (lymphocytosis)

Name three topical treatments you may use to treat otitis externa

Earcalm Otomize sofradex

What investigations would you consider for a patient presenting with dizziness/vertigo

``` Otoscopy Neurological exam Blood Pressure (including lying and standing to rule out orthostatic hypotension) Balance system manoeuvres Audiometry ```

What is the most common cause of vertigo?

Benign Positional Paroxysmal Vertigo (BPPV)

Identify three causes of BPPV

idiopathic head trauma ear surgery

Describe the pathophysiology of BPPV

The aetiology causes the otoconia crystals to be displaced into the Semi-circular canals from the utricle.

What are the distinguishing symptoms of BPPV?

``` Vertigo upon: Looking up Getting up Bending over Turning in bed Lasts under 30seconds Nystagmus ```

What is the main test for BPPV?

Dix-Hallpike test

What is the mainstay of treatment for BPPV?

Epley Manoeuvre

Name a cause of prolonged vertigo that is often also causes nausea and vomiting. How is it treated?

Vestibular neuronitis | Vestibular sedatives

What is the known pathophysiology associated with Meniere's disease? How does it present?

Endolymphatic hydrops | Vertigo, Low frequency sensorineural hearing loss, tinnitus

Name a complication of otitis media

Mastoiditis- if untreated possible meningitis

Define Cholesteatoma. | What is the appropriate treatment of this condition?

Keratinizing squamous epithelium within the middle ear cleft | Mastoidectomy

Name the two tuning fork tests

Rinne's test | Weber's test

What is otosclerosis?

Gradual onset conductive hearing loss due to fixation of the stapes bone

What is septal haematoma and why is it a medical emergency?

It is the accumulation of blood in the nasal septum resulting in swelling. It is an emergency because it can lead to ischaemic necrosis of the septal cartilage

Identify four possible complications of nasal bone fracture

epistaxis CSF leak Meningitis Anosmia- cribriform plate fracture

Describe the typical first aid advice for epistaxis

Digital compression of nostrils ice packs leaning forward

Following first aid, if necessary what are the other treatments of epistaxis?

Intranasal cautery- diathermy/silver nitrate Intranasal packing- Rapid-rhino packs Sphenopalatine artery ligation last resort

Recurrent ______ __________ results in Cauliflower ears. It is treated by...

Pinna Haematoma | aspiration or incision and drainage

What type of fracture is caused by 1.lateral blows and 2. frontal blows to the head?

1. longitudinal | 2. transverse

What causes conductive hearing loss in Longitudinal fractures and what causes sensorineural hearing loss in transverse fractures

conductive- haemotympanum, ossicle bone damage | sensorineural- vestibulocochlear disruption

How do you treat facial nerve palsy?

Facial nerve decompression

Enophthalamus and teardrop sign on CT are suggestive of what?

Maxillary bone fracture | blowout fracture

The horizontal, pyramidal and transverse fractures of the midface are called what?

Le Fort I, II, and III

How would one manage airway obstruction

``` ABC Heliox Nebulised steroid Nebulised adrenaline possible tracheostomy ```

What effectively are hearing aids?

Sound amplifying devices- like miniature loudspeakers, some can reduce background noise

Define Halitosis

Unpleasant breath

What tool is used to look at the nasal cavity?

Oroscope

Neonates are ______ ________ breathers

Obligate nasal

Give an alternative name for snoring sounds which originate from the oropharynx

Stertor

What pathogen most commonly causes acute epiglottitis?

Haemophilus Influenzae type b (Hib)

How is acute epiglottitis treated?

Endotracheal intubation | IV antibiotics

Identify the three steps on the WHO analgesic ladder

1st Adjuvant analgesics 2nd mild Opioids and adjuvant analgesics 3rd moderate Opioids and adjuvant analgesics

What are adjuvant analgesics?

Painkillers who's primary indication is for something other than pain

Name two types of adjuvant diuretics and two examples of each

Anti-convulsant: gabapentin, pregabalin | Anti-depressant: Amytriptyline, duloxetine

Name 5 types of Rhinitis

``` Intermittent Rhinitis Persistent Rhinitis Nasal Polyps Vasomotor Rhinitis Infective rhinitis ```

What triggers intermittent rhinitis and what triggers persistent rhinitis?

Intermittent- Tree and grass pollens, fungal spores | Persistent- Dust mite faeces, Dogs, cat

What does the treatment of allergic rhinitis entail?

1st Allergen avoidance 2nd Antihistamines 3rd topical steroids 4th Antihistamines and topical steroids

Name a virus that is a significant cause of head and neck cancer in the UK

HPV (Human Papilloma Virus)

What is the main type of cancer effecting the head and neck?

Squamous cell carcinoma

What are the most common three bacterial causes of otitis externa?

Pseudomonas Proteus Staph aureus

Name four antibiotics used to treat otitis externa

Neomycin Gentamicin Polymyxin B Framycetin

Name two fungal causes of otitis externa

Aspergillus | candida

Name three possible wax solvents (Cerumenolytics)

Sodium bicarbonate Almond oil olive oil

Identify three possible side effects of ear drops

Dizziness Local sensitivity Ototoxicity- with aminoglycoside antibiotics when TM is perforated

The Paul-Bunnell test and Monospot test are examples of what?

Heterophile tests for Infectious mononucleosis

What does QALYs and ICER stand for?

ICER- Incremental Cost Effectiveness Ratio- used to determine best drug for cost QALY- Quality Adjusted Life Years- calculation of how many quality of life years potentially shall be gained by having treatment

All The laryngeal muscles are supplied by the _________ ________ nerve apart from the _________ muscle.

Recurrent laryngeal | Cricothyroid

Name the main cause of reinke's oedema

Smoking

Name the investigation used to provide information about the vocal chords

Stroboscopy

How does Ramsay-Hunt syndrome present? What virus causes this?

Herpetic rash, Bell's Palsy, tinnitus, hearing loss, vertigo | Varicella zoster virus

Name the ducts of the submandibular gland and the parotid gland

Submandibular- Whartons duct | Parotid- Stensons duct

Week 2 Flashcards

(81 cards)