Derm/ENT/Eyes Flashcards
How can you differentiate between labyrinthitis and vestibular neuronitis?
VN DOES NOT have tinnitus or deafness.
Vertigo, N&V, tinnitus, deafness and nystagmus secondary to viral or bacterial infection
Treatment for labyrinthitis
Anti-emetics- prochlorperazine, promethazine, cyclizine
Vestibular sedative- calcium channel and histamine antagonist- cinnarizine
Histamine analgoue- betahistine
What is Meniere’s Disease?
Endolymphatic hydrops, presents with vertigo, N&V, tinnitus, sensorineural hearing loss and nystagmus away from the affected ear.
MRI and bloods for Ix.
Same treatment as labyrinthitis
What is Acute Otitis Media and how do you treat it?
AOM is infection of the middle ear, usually presents with otalgia, decreased hearing, irritability, fever, vomiting and loss of appetite.
Most common bacteria- H. Influenzae and S. pneumoniae
Most common cause of erysipelas?
S. pyogenes
Features of Age related macular degeneration
Commonest cause of impaired vision in UK
Choroidal neovascularisation (Wet AMD)
Blurring of vision
Scotoma- black patch in central vision
Metamorphosia- straight lines appear curved
What is SCC and its most affected demographic
Malignant tumour of the epidermal keratocytes and mainly affects sun-exposed skin of middle-aged and elderly individuals
Rapidly expanding painless, ulcerated lesions
Can arise from precancerous lesions known as actinic keratoses
What is acoustic neuroma?
Acoustic neuroma is Schwann cell sheath tumour of the vestibulocochlear nerve.
Usually presents as unilateral sensorineural hearing loss which CAN FLUCTUATE.
Headaches, N&V, tinnitus, vertigo and facial numbness and weakness.
Which is the common dermatophyte in onychomycosis and what is the treatment?
Tricophyton rubrum
General lifestyle advice such as good hygiene
Topical nail lacquer
Oral terbinafine and/or itraconazole
What is the triad of Osler-Weber-Rendu syndrome?
Telangiectasia
Recurrent epistaxis
Positive family history
Common sites of scabies and treatment
Greyish-white linear burrows seen on finger webs, fingers, elbows and wrists.
Permethrin cream is first line treatment
What is the difference between pinna cellulitis and pinna perichondritis and what are the causative organisms for each?
PC involves ear lobe redness whereas PP spares the earlobes and only infects the cartilaginous pinna.
PC- S. aureus
PP- P.aeruginosa
Hallmark symptom of cholesteotoma?
Painless and frequent recurrence of otorrhoea.
Conductive hearing loss
Dizziness
Triad of optic neuritis
Pain on eye movement, impaired colour vision (especially red) and subacute unilateral visual loss.
Most commonly associated with MS
Uhthoff’s and Pulfrich’s phenomenon may be present
What is BPPV and what are the two eponymous tests involved?
Benign paroxysmal positional vertigo is due to the displacement of otoliths from maculae into semicircular canals
Dix-Hallpike is the diagnostic test and Epley manoeuvre is the corrective manoeuvre along with self guided positioning and guidance.
What is seborrhoeic dermatitis?
Seborrhoeic dermatitis is a scaly rash usually affecting areas rich in sebaceous glands, such as. the nasolabial folds and hair follicles.
What is acne rosacea?
Common rash affecting the face and is commonly associated with flushing.
Central facial erythema +/- papules and pustules
Avoid aggravating factors and topical agents such as metronidazole gel.
What is vitreous haemorrhage?
Vitreous haemorrhage is extravasated blood in the vitreous as a result of trauma, aneurysms, retinal tear/detachment.
VERY COMMON IN DIABETICS
What are the F’s of retinal detachment?
Floaters
Flashes
Fall in acuity
Field loss
Describe the lesions in Molluscum contagiosum
Clusters of small shiny papules with an umbilicated centre caused by the Poxvirus.
Treatment-
Advise and reassurance
Potassium hydroxide
Cryotherapy
Curettage
Explain acute angle closure glaucoma and its treatment
Increased intra-ocular pressure due to impaired aqueous secretion
IV acetazolamide
Topical pilocarpine
Surgical iridectomy once acute episode managed
Common presentation of acute angle closure glaucoma
Periorbital pain, N&V and visual deficits with blurry vision and halos
Common presentation of nasal polyps
Headaches, nasal congestion, hyposmia to anosmia, changes in sense of taste and persistent postnasal drip
How to investigate and treat for nasal polyps?
Coronal Sinus CT
Medical- topical or systemic steroids
Surigcal- polypectomy or ethmoidectomy
What is Bell’s Palsy?
Lower motor neurone facial nerve palsy usually from latent herpes zoster virus.
Facial distortion, loss of taste, hyperacusis and watery eye- usually unilateral
Now recommended to treat with oral pred.
What is Ramsay Hunt syndrome?
Varicella zoster virus is reactivated in the geniculate ganglion of the 12th nerve.
Sensorineural deafness, vertigo and facial paralysis.
Treated with acyclovir or steroids.
What is guttate psoriasis?
Usually preceded by strep infection.
Tear drop lesions on trunk and limbs.
Most cases resolve spontaneously, topical treatments as per psoriasis and UVB phototherapy
What is pityriasis rosea?
Herald patch followed 1-2 weeks later by multiple erythematous slightly raised oval lesions. Fir tree appearance.
Potentially caused by HHV-7
Self limiting in 6 weeks.
Common causes of hirsutism
PCOS
Cushings syndrome
Congenital adrenal hyperplasia
Androgen therapy
Obesity
