18. Sense Organs - Pathologies Flashcards

1
Q

Otitis Externa (Swimmer’s Ear): definition

A

Inflammation of the outer ear

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2
Q

Otitis Externa (Swimmer’s Ear): epidemiology

A

5x more common in swimmers

Also prevalent in humid cultures, diabetes mellitus, HIV and people with narrow auditory canal

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3
Q

Otitis Externa (Swimmer’s Ear): pathophysiology

A
Ear wax (cerumen) contains lysozymes and oil that create an acidic, lubricating coat
This coat inhibits bacterial and fungal growth so insufficient wax can predispose to infection
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4
Q

Otitis Externa (Swimmer’s Ear): aetiology

A

90% associated with bacterial infection
Remaining fungal or allergic
Excess wax (obstruction)
Water in the ear
Frequent use of earplugs/headphones/hearing aids
Acne, eczema, fungal infections following antibiotic use

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5
Q

Otitis Externa (Swimmer’s Ear): signs and symptoms

A
Pain (especially with movement of pinna)
Discharge - often purulent
Swelling
Itching
Red, swollen auditory canal
Hearing deficit
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6
Q

Otitis Externa (Swimmer’s Ear): allopathic treatment

A

Hygiene
Avoid water in ears
Syringe ears with saline solution (by GP)
Topical antibiotics

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7
Q

Otitis Media: definition

A

Inflammation of the middle ear

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8
Q

Otitis Media: epidemiology

A

Most common cause of earache in children due to horizontal eustachian tube
75% <10 yrs old
Many have food or inhaled allergies

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9
Q

Otitis Media: pathophysiology

A

Fluid puts pressure on tympanic membrane

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10
Q

Otitis Media: aetiology

A

Infectious organisms - bacterial/viral

Allergies

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11
Q

Otitis Media: signs and symptoms

A

Earache/pain
Malaise, fever, nausea
Mild earing loss
Can get bulging of tympanic membrane

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12
Q

Otitis Media: complications

A

Scar tissue on eardrum (with rupture of tympanic membrane)

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13
Q

Otitis Media: allopathic treatment

A

Rupture of tympanic membrane

Antibiotics

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14
Q

Secretory Otitis Media: definition

A

Effusion of the middle ear resulting from incomplete resolution of acute otitis media

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15
Q

What is secretory otitis media also known as?

A

Glue ear

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16
Q

Secretory Otitis Media: pathophysiology

A

Gluey fluid dampens the tympanic membrane and ossicle vibrations which leads to hearing impairment

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17
Q

Secretory Otitis Media: signs and symptoms

A

Hearing loss
Pressure in ear
Mild intermittent ear pain

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18
Q

Secretory Otitis Media: allopathic treatment

A
Tympanostomy tube (grommet) inserted into eardrum to drain fluid
Tonsils may be removed
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19
Q

Labyrinthitis (Otitis Interna): definition

A

Balance disorder associated with inflammation of the membranous labyrinth

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20
Q

Labyrinthitis (Otitis Interna): aetiology

A

Often follows upper respiratory infection

Following head injury, allergy or reaction to medication

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21
Q

Labyrinthitis (Otitis Interna): signs and symptoms

A

Sudden, severe vertigo
Sudden, unilateral hearing loss
Tinnitus
Nausea, vomiting

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22
Q

Labyrinthitis (Otitis Interna): allopathic treatment

A

Anti-emetic drugs (anti-sickness)

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23
Q

Meniere’s Disease: definition

A

Disorder of inner ear, caused by change in fluid volume in labyrinth

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24
Q

Meniere’s Disease: pathophysiology

A

Progressive distention of the membranous labyrinth

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25
Meniere's Disease: aetiology
Genetics Viral Autoimmune links - RA, SLE Food allergy links
26
Meniere's Disease: signs and symptoms
``` Vertigo Tinnitus Hearing loss Nausea, vomiting Ear pressure Characterised by fluctuating patterns of symptoms ```
27
Meniere's Disease: allopathic treatment
No cure - only symptom minimisation
28
Tinnitus: definition
Perception of sound originating from within the head rather than outside
29
Tinnitus: aetiology
Objective - pulsatile (carotid stenosis, valve disease), muscular (spasm of tympanic muscles) Subjective - ear origin (Meniere's, ear infection, wax), neurological (head injury, MS, tumour), infections (meningitis), drug related (NSAIDs, loop diuretics), TMJ (jaw) dysfunction
30
Hearing Impairment: definition (conductive)
Ear canal obstructions, ossicle abnormalities, ruptured tympanic membrane
31
Hearing Impairment: definition (sensory)
Poor hair cell function due to congenital condition, infection or noise trauma
32
Mild hearing loss: definition
25-40dB
33
Moderate hearing loss: definition
41-70 dB
34
Severe hearing loss: definition
71-90 dB
35
Profound hearing loss: definition
90 dB+
36
Hearing Impairment: aetiology
Diseases - measles, meningitis, mumps, rubella, chlamydia, syphilis Premature birth Head injuries Shaken baby syndrome
37
Hearing Impairment: allopathic treatment
Hearing aid | Cochlear implant
38
Blepharitis: definition
Inflammation of eyelid margin | Can be acute or chronic
39
Blepharitis: epidemiology
Most common in adults
40
Blepharitis: pathophysiology
Often associated with Staphylococcus aureus infection | Dermatitis
41
Blepharitis: signs and symptoms
Often bilateral Red eyelid margins Sore, gritty eyes, scales, flakes Eyelids may stick together, worse in morning Itching and burning Loss of eyelashes Can block sebaceous glands and cause recurrent styes
42
Blepharitis: allopathic treatment
Eyelid hygiene - clean with cotton bud Warm compress Topical antibiotics Avoid contact lens use
43
Stye: definition
Inflammation of sebaceous glands of eyelid
44
Where is usually affected by a stye?
Usually affects upper lid
45
Stye: aetiology
Usually a bacterial infection - Staphylococcus | Risks - diabetes mellitus, chronic blepharitis
46
Stye: signs and symptoms
Red, swollen and/or painful infection of sebaceous glands of eyelid
47
Stye: complications
Cyst formation can damage the cornea
48
Stye: allopathic treatment
Usually none necessary Hot compress 3/4 times a day once burst Antibiotic ointment if stye doesn't resolve
49
Conjunctivitis: definition
Highly contagious inflammation of the conjunctiva
50
Conjunctivitis: aetiology
Viral Bacterial Often linked with allergies
51
Conjunctivitis: signs and symptoms
Red eye, irritated and uncomfortable Watery (viral/allergic) Purulent discharge (bacterial) Photophobia suggests corneal (deeper) involvement
52
Conjunctivitis: allopathic treatment
Eye bath with salt water or eye-cleansing solution | Antibiotic eye drops
53
Uveitis: definition
Inflammation of any part of the uvea
54
Uveitis: aetiology
Autoimmune links - HLA-B27 eg AS Trauma to eye (inc contact lenses) Viral infection, fungal or parasitic
55
Uveitis: signs and symptoms
``` Progressive unilateral red eye with pain Blurred vision Photophobia Visual acuity reduced in affected eye Watery discharge ```
56
Uveitis: allopathic treatment
Antibiotics | Cortisone depending on cause
57
Cataracts: definition
Opacity of the lens
58
Cataracts: pathophysiology
Healthy lens = transparent | Cataracts = new fibres produced and become disorganised with cytoplasm
59
Cataracts: allopathic treatment
Surgery
60
Cataracts: aetiology
``` Age-related deterioration of lens Congenital Diabetes mellitus Smoking Steroids ```
61
Cataracts: signs and symptoms
Gradual painless loss of vision | Diplopia
62
Age-Related Macular Degeneration (AMD): definition
Ageing changes that occur in the central areas of the retina (macula)
63
Age-Related Macular Degeneration (AMD): epidemiology
55 yrs+ | Leading cause of vision loss worldwide
64
Age-Related Macular Degeneration (AMD): aetiology
Advancing age Smoking CVD risk factors Family history
65
Age-Related Macular Degeneration (AMD): signs and symptoms
Reduced visual acuity Difficulty with near vision Gradual and progressive loss of central vision
66
Age-Related Macular Degeneration (AMD): diagnosis
Amsler grid | Ophthalmoscopy
67
Muscae Volitantes (Floaters): definition
Opacities floating in field of vision | Shadowy shapes that move with eye movements
68
Muscae Volitantes (Floaters): aetiology
Shrinkage of vitreous humour causing collagen to become fibrils Vitreous haemorrhage with haemorrhaging in diabetic retinopathy
69
Retinal Detachment: definition
Separation of the neurosensory layer of the retina from the pigmented epithelium
70
Retinal Detachment: pathophysiology
Accumulation of sub-retinal fluid in the potential space
71
Retinal Detachment: signs and symptoms
Floaters in vision Flashing lights Curtains descending over vision
72
Retinal Detachment: allopathic treatment
Ocular emergency - surgery
73
Retinal Detachment: complications
Visual impairment | Blindness
74
Retinal Detachment: epidemiology
Middle-aged | Elderly
75
Glaucoma: definition
Increased intraocular pressure caused by inadequate drainage
76
Glaucoma: intraocular pressure levels
IOP should be 10-21 mmHg | >40 = significant damage caused
77
Glaucoma: pathophysiology
Causes compression of the retina and optic nerve
78
Glaucoma: aetiology
Congenital Acquired - uveitis, intraocular haemorrhage Obstruction of the canal of Schlemm Smoking
79
Glaucoma: signs and symptoms (acute)
Mild - pain in eyes Haloes around lights, relieved by sleep ``` Severe - rapid deterioration of vision Intense eye pain Redness, watering of eye Sensitivity to bright light Nausea, vomiting ```
80
Glaucoma: signs and symptoms (chronic)
Often no symptoms until permanent damage has occurred Late symptoms - loss of peripheral vision Blurring of objects directly in front of person Loss of night vision
81
Glaucoma: complications
Damage to optic nerve and retina leads to permanent blindness
82
Glaucoma: allopathic treatment
Eye drops/tablets to reduce fluid retention | Laser or surgical treatment
83
Diabetic Retinopathy: definition
Progressive, potentially sight-threatening disease of the retinal microvasculature
84
Diabetic Retinopathy: pathophysiology
Microvascular damage occurs which occludes branches of the retinal artery causing neovascularisation The vessel walls become physically weak and leaky, leading to micro-aneurysms, oedema and haemorrhaging
85
Diabetic Retinopathy: aetiology
Chronic hyperglycaemia
86
Diabetic Retinopathy: prognosis
May retain normal sight or present as a decline in vision or floaters