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Head and Neck > Conditions/Diseases > Flashcards

Conditions/Diseases Flashcards

1
Q

Acute Otitis Media

A

Common; 3-18months

Pain, fever, discharge

Microbiology - H. Influenza, Strep. Pneumonia, Moraxella Catarrhalis

Treatment - ABs i.e. co-amoxiclav, grommets, adenoidectomy if recurrent

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2
Q

Acute Suppurative Otitis Media

A

Pus in middle ear

Otalgia, otorrhea

Observation, amoxicillin

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3
Q

Allergic rhinitis

A

inflammation nose due to allergen

Antihistamines, corticosteroid possible if chronic

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4
Q

Auricular Haematoma

A

blood collection in ear due to bursting of perichondrial vessels

blunt trauma to external ear structures, leads to “cauliflower ear”

Bleeding

Incision and drainage, pressure dressing, ABs

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5
Q

Benign positional vertigo

A

Otoconia in semicircular canals

vertigo precipitated bu specific changes in head position, lasts seconds, no associated symptoms

Dix-Hallpike test

epley manoeuvre

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6
Q

Branchial Cyst

A

birth defect, remnant of embyrological development

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7
Q

Carotid Stenosis

A

narrowing of carotid arteries due to atherosclerosis in artery wall

sudden numbness or weakness of face/limbs, trouble speaking, trouble seeing, dizziness, severe headache

Duplex US, CTA/MRA head, neck and chest

Antiplatelet therapy, cardiovascular risk deduction, symptomatic = carotid endarcterectomy/stenting

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8
Q

Cervical Lymphadenopathy

A

enlargement of cervical lymph nodes

infection, thyroid problems, cancer

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9
Q

Choanal Atresia

A

congenital disorder where back of nasal passage is blocked

chest retraction unless mouth breathing or crying, inability to nurse and breath simultaneously, inability to pass catheter, cyanosis

Imaging possible

Bilateral is EMERGENCY so insertion of oral airway to break seal prior to surgery

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10
Q

Cholesteatoma

A

abnormal benign collection of squamous epithelial cells in middle ear

possibly repeated middle ear infections

discharge, hearing loss, vertigo, tinnitus

Pure tone audiogram, CT scan of petrous temporal bones

Surgery, preoperative ABs and aural care

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11
Q

Chronic Suppurative Otitis Media

A

perforated tympanic membrane/cholesteatoma

complications = dead ear, facial palsy, meningitis, brain abscesses

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12
Q

Perforated tympanic membrane

A

Infection, trauma, grommet

recurrent infection, hearing loss

water precautions, myringoplasty

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13
Q

Cleft palate

A

roof of mouth contain opening into nose

feeding problems, speech problems, hearing problems, frequent ear infections

surgery, speech therapy

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14
Q

Colloid goitre

A

Due to gland hyperplasia, iodine deficiency, puberty, pregnancy, lactation

RARELY; breathing difficulty, dysphagia, neck vein distension and dizziness when arms raised above head (large goitre)

hormone test, US neck, biopsy

medication, hormone therapy, surgery

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15
Q

Cystic hygroma

A

fluid filled sac in neck resulting from blockage in lymphatics system

soft spongy lump

can normally be seen on scan during pregnancy

Surgical removal, sclerotherapy

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16
Q

Epistaxis

A

Common, M>F

digital trauma, consider coagulapathy, haematological abnormality

Appropriate first aid, AB ointments i.e. naseptin, bactroban, cautery i..e silver nitrate under LA, nasal packing

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17
Q

Facial Nerve Palsy

A

lower motor neuron facial palsy

Differentials;
intratemp - cholesteatoma
extratemp - parotid tumour
idiopathic - Bell’s palsy

treat underlying cause, steroids, eye care

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18
Q

Foreign body in the ear

A

EMERGENCY

removal; urgency would be

Button battery > organic > inorganic

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19
Q

Grave’s Disease

A

aka Toxic Diffuse Goitre, autoimmune disease affecting thyroid causig overproduction of thyroid hormone

F>M

anxiety, irritability, weight loss but no appetite loss, thyroid goitre, bulging eyes, fatigue, tachycardia, irregular heart beat

fine tremor, thyroid eye disease, clubbing, pre-tibial myxoedema

TSH; suppressed, serum T3 and T4

radioiodine therapy, anti-thyroids, beta blockers, thyroid surgery

20
Q

Laryngeal Carcinoma

A

mostly squamous cell carcinomas

hoarseness of voice, odynophagia

nasendoscopy, laryngoscopy, biopsy, CT, PET-CT, MRI, US

radiotherapy, surgery, chemotherapy

21
Q

laryngomalacia

A

congenital softening of tissues of the larynx

stridor/wheeze, high pitched sound, difficulty feeding, poor weight gain, choking while feeding, apnoea

flexible laryngoscopy

observation, GORD therapy including smaller meals/thickened feed, surgical therapy

22
Q

Lipoma

A

benign tumour made of fat tissue

soft lump, moves with light finger pressure, generally small, may be painful

surgical removal

23
Q

Malignant Otitis Externa

A

osteomyelitis of temporal bone

severe pain in elderly diabetic, granulations in external auditory meatus, possible cranial nerve palsies

ABs for weeks or months

24
Q

Meniere’s disease

A

condition of the inner ear, endolymphatic hydrops

dizziness, spinning sensations, unsteadiness, nausea, vomiting, noise inside ear, sudden drop in hearing

bendroflumethazide, untratympanic, dexamethasone, intratympanic gentamicin

25
Q

Migraine

A

?vascular ?renal

spontaneous vertigo, variable duration, headache, sensory sensitivity, precipitated by triggers

avoid migraine triggers, prophylactic medication

26
Q

Nasal Polyps

A

soft, painless, non-cancerous growths

chronic inflammation due to asthma, recurrent infection, allergies, drug sensitivity or certain immune conditions

runny nose, persistent stuffiness, postnasal drip, decreased/absent sense of smell, facial pain/headache

anterior rhinoscopy, nasendoscopy

intranasal corticosteroid, leukotriene receptor antagonist, surgical polypectomy

27
Q

Otitis Media with Effusion (glue ear)

A

80% before 10yo, 2 peaks at 2yo and 5yo

risks; day care, smoking, cleft palate, down syndrome
eustachian tube dysfunction, adenoidal hypertrophy

hearing loss, speech delay, behavioural problems, academic decline (imbalance)

dull tympanic membrane, fluid level, bubbles

most improve within 3 months, autoinflation, grommet, hearing aids

28
Q

Otosclerosis

A

fixation of stapes by extra bone

conductive hearing loss, normal tympanic membrane

hearing aid or stapendectomy

29
Q

Parotitis

A

systemic infection localises to salivary gland resulting in swelling and inflammation of the gland

stone formation or stenosis of parotid duct, HIV, mumps

swollen gland in side of face, pain whilst chewing or swallowing

treat infection causing it

30
Q

Pharyngeal pouch

A

herniation of pharyngeal mucosa between thyropharyngeus and cricopharyngeus muscles of inf. constrictor

voice hoarseness, dysphagia, aspiration pneumonia, regurgitation, weight loss

barium swallow

excision, dilate

31
Q

Pleomorphic adenoma

A

benign salivary gland neoplasm; neoplastic proliferation of parenchymatous glandular cells, myoepithelial components

32
Q

Quinsy

A

aka peritonsillar abscess

  • collection of pus forms between one of tonsils and wall of throat
  • a complication of tonsillitis

severe sore throat (usually one-sided), swelling, dysphagia, odynophagia, earache on affected side

ABs; penicillin V, clarithromycin, amoxicillin etc. corticosteroids, painkillers, surgery i.e. tonsillectomy

33
Q

Sensorineural Hearing Loss

A

hearing loss in which root cause is in the inner ear

viral infections, trauma, presbyacusis, noise exposure, ototoxic medications, acoustic neuroma

hearing aids

34
Q

Septal haematoma

A

blood collection in the septum, no blood supply to septum

post trauma, almost always bilateral, can lead to perforation

If perforation occurs then whistling noise, bleeding

Drainage ASAP

35
Q

Thyroid cancer (general)

A

4 main types

  • papillary
  • follicular
  • medullary
  • anaplastic

lump, changes in speech i.e. hoarseness, dysphagia, pain in neck and throat, tenderness, redness are all possible

cervical lymphadenopathy

TSH, fine needle biopsy, US neck, laryngoscopy, blood tests for thyroid function

36
Q

Papillary thyroid cancer

A

Most common

Usually asymptomatic; may have some symptoms

Usually high cure rate w/10yr survival ~90%

Treatment
- surgery to remove tumour +/- radioactive iodine

37
Q

Follicular thyroid cancer

A

Follicular cells

Haematogenous thyroid metastasis, women over 50

High cure rate w/10yr survival ~90%

Treatment
- surgery to remove tumour +/- radioactive iodine

38
Q

Medullary thyroid cancer

A

Familial association 10%, commonly asociated with multiple endocrine neoplasia (MEN)

Arises from parafollicular C cells; secrete calcitonin

Lymph node spread common

10 yr survival ~75%

Treatment

  • total thyroidectomy
  • removal nearby lymph nodes

*radioactive iodine won’t work as it won’t be taken up by this type of cancer

39
Q

Anaplastic thyroid cancer

A

Aggressive, local spread, very old, poor prognosis

Spread to lymph nodes and organs more likely than papillary

Median life expectancy ~4months

Radiotherapy, chemo, chemoradiation, surgery, supportive care

40
Q

Thyroglossal cyst

A

Benign; dilatation of thyroglossal duct remnant, may become infected, midline grows with age

tenderness, redness and swelling of neck mass, dysphagia, difficulty breathing

moves upward on tongue protrusion

Blood tests for thyroid function, FNA cytology, US Scan prior to removal to ensure functioning thyroid tissue elsewhere

excision but chance of recurrence

41
Q

Tympanosclerosis

A

Calcification in tympanic membrane +/- middle ear

usually asymptomatic

usually no treatment

42
Q

Tinnitus

A

any perception of sound not caused by an external source

unilateral, pulsatile

treat underlying cause, sound enrichment, stress management

43
Q

Vertigo

A

problem with the way balance works in inner ear

DIFFERENTIALS;
benign positional vertigo, meniere’s, vesitbular neuritis, migraine

44
Q

Vestibular neuritis

A

reactivation of latent HSV infection of vestibular ganglion

spontaneous vertigo, associated unilateral hearing loss, duration; days, nystagmus

Acute treatment; vestibular sedatives

Chronic treatment; vestibular rehab

45
Q

Huntington’s disease

A

Inherited disease, death of brain cells

Difficulty concentrating, memory lapses, depression, stumbling and clumsiness, involuntary jerky/fidgety movements, mood swings, personality changes, difficulty moving

Medication for depression, mood swings, involuntary movements

OT, SLT, Physio

46
Q

Spondylosis

A

Degeneration intervertebral discs

Painful

Cervical causes neck pain; exercises can help

47
Q

Horner syndrome

A

Interruption sympathetic system

Miosis, ptosis, absence facial sweating, sinking of eyeball into bony cavity

Head and Neck (3 decks)

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