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ECOS Spring Final Exam > Approach to ENT > Flashcards

Approach to ENT Flashcards

1
Q

How do you test for nasal obstruction?

A
  • Press on each ala nasi and ask patient to breathe in
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2
Q

What does a mouth exam involve?

A
  • Look at oral mucosa and gingiva
  • palpate oral mucosa and gingiva
  • Check ventral aspect of tongue, below, and sides
  • Look at buccal mucosa
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3
Q

Describe finger rub test.

A

Place hand near both ears and rub fingers near one ear at a time. Have patient tell you what side they hear the sound on

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4
Q

What is the whisper test?

A

Stand behind patient and ask them to cover one ear. Softly whisper different letters and numbers and ask patient to repeat.

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5
Q

How do you palpate thyroid?

A
  • Place fingers of both hands on neck with index fingers below the criocid cartilage
  • Ask patient to swallow
  • Displace trachea to the right with the fingers of the left hand, with right hand palpate laterally for right lobe of thyroid in the space btw displaced trachea and SCM
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6
Q

Lymph nodes to check?

A
  • Preauricular
  • Posterior auricular
  • Tonsilar
  • Occipital
  • Superficial cervical
  • Posterior cervical
  • Supraclavicular
  • Submental
  • Submandibular
  • Deep cervical chain
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7
Q

Allergic rhinitis?

A
  • Inflammation in nose caused by allergen characterized by sneezing rhinorrhea and nasal obstruction
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8
Q

Anterior epistaxis?

A
  • Most common nosebleed usually affects vascular watershed area of nasal septum
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9
Q

Posterior epistaxis?

A
  • Less coommon usually causes more significant bleeding and affects posterolateral branches of sphenopalatine artery
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10
Q

Tonsillitis

A

Inflammation of tonsils due to bacteria or virus

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11
Q

Infectious mononucleosis

A
  • Vasued by epstein barr virus and causes triad of fever, tonsillar pharyngitis, and lymphadenopathy
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12
Q

What is pharyngitis?

A
  • Inflammation of the pharynx resulting in sore throat
  • Most likely caused by:
    • adenovirus, rhinovirus, coronavirus, enterovirus, flu
    • Bacterial, group A beta hemolytic streptococcus
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13
Q

What are other differentials for a sore throat?

A
  • mono
  • GERD
  • postnasal drip secondary to rhinitis
  • persistent cough
  • thyroiditis
  • allergies
  • foreign body
  • smoking
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14
Q

What is streptococcal pharyngitis?

A
  • caused by group A beta hemolytic streptococcus (streptococcous pyogenes)
  • sx:
    • sore throat
    • headache
    • fatigue
    • fever
    • body aches
    • nausea
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15
Q

What symptoms are seen with highest likelihood of GABHS?

A
  • children 5-15
  • winter and early spring
  • absence of cough
  • tender anterior cervical lymphadenopathy
  • tonsillar exudate
  • fever
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16
Q

What is acute otitis media?

A
  • symptomatic inflamation of middle ear caused by bacteria or viruses
17
Q

What is acute suppurative OM?

A
  • acute OM with purulent material in middle ear
18
Q

What is OM with effusion?

A
  • Inflammation and fluid buildup in middle ear without bacterial or viral infection
  • May occur bc fluid buildup persists after an ear infection has resolved
19
Q

what is Chronic OM with effusion?

A
  • Occurs when fluid remians in middle ear and continues to return without bacterial or vifrral infection
  • Makes kids susceptible to new infection and can impact hearing
20
Q

Chronic suppurative OM?

A
  • persistent ear infection resulting intearing or perfoeation of eardrum
  • More than 6 weeks is chronic
21
Q

What is otitis externa?

A
  • Outter ear infection
  • can be caused by bactera entering a small break in skin of canal
  • Patient can report drainage from ear
  • Usually assoc with pain on touching external ear structures
22
Q

Otosclerosis?

A
  • abnormal bone growth around stapes
  • associated with progressive hearing loss beginning ages 10-30
  • Conductive loss: ossicles sclerosis into single immovable mass
  • Sensory loss: otic capsule sclerosis
23
Q

What is the weber test?

A
  • Helps determine conductive vs sensorineural hearing loss
  • place vibrating tuning fork on middle of head or forehead and ask if there is a difference btw the ears
    • normal should be same bilaterally
    • If problem sound will lateralize to one ear
  • If abnormal do Rinne test
24
Q

What is rinne test?

A
  • Place tuning fork on mastoid process testing bone conduction and once they cant hear it you place it next to ear and ask them to tell you when they cant hear it
  • Normal is to hear longer in air conduction than bone conduction
25
Q

What results will indicate conductive loss?

A
  • Weber: lateralizes
  • Rinne: BC > AC
26
Q

What test results indicate sensorineural loss?

A
  • Weber: Lateralizes to good ear
  • Rinne: AC >BC
27
Q

What causes sensorineural hearing loss?

A
  • Hereditary
  • Meniere disease
  • MS
  • Trauma
  • Ototoxic drugs
  • Barotruama
28
Q

What causes conductive hearing loss?

A
  • Cerumen impaction
  • Middle ear fluid
  • Lack of ossicle movement
  • Trauma
  • Tumors
29
Q

Rhinosinusitis?

A
  • Mucosal lining in paranasal sinuses and nasal cavity become inflammed
  • Infectious causes:
    • Viruses or bacterial
  • Dental infections and procedures, iatrogenic causes,immunodeficieny, impaired ciliary motility, mechanical obstruction
  • Sx:
    • nasal discharge, cough, sneezing, nasal congestion,fever headache, pain, and facial pressure
30
Q

Bacterial sinusitis?

A
  • Suspicion of acute bacterial sinusitis
  • Double sickening (after 2-3 weeks initally gets better but then gets worse) purulent rhinorrhea, elevated ESR
  • Pain upon tapping sinuses
  • needs antibiotics
31
Q

Croup?

A
  • Laryngotracheitis
  • Swelling of larynx trachea and bronchi causing stridor and barking cough in kids 6 months to 3 yrs
  • Caused by viruses
  • Hx: barking cough
  • Tx: oxygen, dexamethasone, breathing treatment (nebulized epinephrine) often self limited and no intervention needed
32
Q

What sign on x ray indicates croup?

A

Steeple sign, narrowing of trachea

33
Q

Epiglottitis?

A
  • Inflammation of epiglottis and adjacent structures
  • Caused by Haemophilus type B influenza and GABHS
  • Hx: rapid onset sore throat, muffled voice, drooling
  • Presents with high fever, toxic appearance, child sitting/leaning forward
  • Workup: consider lateral neck XR, elevate WBC
  • Tx: protect airway, may need to intubate, broad spectrum antibiotics
34
Q

Differnetials for (ENT) vertigo?

A
  • Eustachian tube dysfxn
  • BPPV
  • Vestibular neuritis
35
Q

What is the most common cause of vertigo?

A
  • BPPV
  • sudden sensation that your spinning
  • Triggered by specific changes in head position
36
Q

What is vestibular neuritis?

A
  • Inflammation of nerve affecting branch assoc with balance resulting in dizziness but no hearing loss
37
Q

Labyrinthitis?

A
  • Occurs when infection affects both branches of vestibulo cochlear nerve resuting in hearing chagnes and dizziness or vertigo
38
Q

Meniere’s disease?

A
  • Disorder of inner ear feeling that youre spinning and fluctuating hearing loss with progressive permanent loss of hearing, riniging and feeling of fullness or pressure in ear
  • Usually affects only one ear
  • Starts btw 20 and 50
  • Chronic condition

ECOS Spring Final Exam (7 decks)

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