Disease Profiles Flashcards
1
Q
Otitis Externa
A
Inflammation of the outer ear canal
2
Q
Otitis Externa: Bacterial Causes (3)
A
Staphylococcus aureus
Proteus species
Pseudomonas aeruginosa
3
Q
Otitis Externa: Fungal causes (2)
A
Aspergillus niger
Candida albicans
4
Q
Otitis Externa: Common triggers (2)
A
Water exposure
Cotton buds
5
Q
Otitis Externa: Clinical Presentation - Ear Canal
A
Redness and swelling of the skin of the ear canal that may be itchy and painful
6
Q
Otitis Externa: Clinical Presentation - What may be produced? (2)
A
Discharge
Excess ear wax
7
Q
Otitis Externa: Management - First line
A
Topical aural toilet (ear clean)
8
Q
Otitis Externa: Management - When is microbiology and antimicrobials used?
A
In unresponsive cases
9
Q
Otitis Externa: Management - Fungal unresponsive treatment
A
Topical clotrimazole
10
Q
Otitis Externa: Management - Bacterial unresponsive treatment
A
Gentamicin ear drops
11
Q
Otitis Externa: Management - When may systemic antibiotics be required?
A
If cellulitis develops in the pinna or parotid region
12
Q
Otitis Externa: Management - In cases of eczematous otitis externa
A
Steroid without antibiotics
13
Q
Acute Otitis Media
A
Acute inflammation of the middle ear with or without an accumulation of fluid
14
Q
Acute Otitis Media: Commonly associated with what other pathophysiology?
A
Upper Respiratory Tract Infection
15
Q
Acute Otitis Media: Most common bacterial causes (3)
A
Haemophilus influenzae
Streptococcus pneumoniae
Streptococcus pyogenes
16
Q
Acute Otitis Media: Aetiologies of chronic cases (3)
A
Pseudomonas aeruginosa
Staphylococcus aureus
Fungus
17
Q
Acute Otitis Media: Pathophysiology
A
Infection extends from the throat to the ear via the Eustachian Tube
18
Q
Acute Otitis Media: Symptoms (3)
A
Ear Pain
Fever
Irritability
19
Q
Acute Otitis Media: Signs - What may present in the middle ear?
A
Effusion
20
Q
Acute Otitis Media: Signs - Tympanic membrane appearance
A
Opaque
Bulging
May have impaired mobility
21
Q
Acute Otitis Media: Diagnosis -What is required if the eardrum perforates?
A
A swab of pus
22
Q
Acute Otitis Media: Management - First line
A
Self-limiting - 80% resolve in 4 days
23
Q
Acute Otitis Media: Management - What antibiotics if indicated? (2)
A
Amoxicillin
Erythromycin
24
Q
Acute Otitis Media: Complications - How may an abscess form?
A
Spread via the mastoid causes bone breakdown behind the ear and forms an abscess
25
Acute Otitis Media: Complications (7)
Sensorineural hearing loss
Tinnitus
Acute mastoiditis
Brain abscess or meningitis
Vertigo
Facial palsy
Venous sinus thrombosis
26
Acute Mastoiditis
Complication of acute otitis media involving infection of mastoid air cells
27
Acute Mastoiditis: Most common bacterial aetiologies
Streptococcus pneumoniae
Haemophilus influenzae
28
Acute Mastoiditis: Why are mastoid air cells suitable for infection?
Porous nature makes them suitable for pathogenic replication
29
Acute Mastoiditis: Clinical Presentation (3)
Pain, Tenderness and Swelling behind the ear
30
Acute Mastoiditis: Management
IV antibiotics
Surgical drainage for severe cases
31
Acute Mastoiditis: Main complication
Meningitis - by spreading to the middle cranial fossa and thus the brain
32
Referred Otalgia: Auriculo-temporal Branch of the Trigeminal Nerve - Aetiologies associated with the lower mandibular (3)
Dental abscess
Dental caries
Impacted molar teeth
33
Referred Otalgia: Auriculo-temporal Branch of the Trigeminal Nerve - Aetiologies of Salivary Gland Disease (3)
Infection e.g. mumps
Stones
Neoplasm
34
Referred Otalgia: Auriculo-temporal Branch of the Trigeminal Nerve - Aetiologies associated with stress
Tooth grinding
35
Referred Otalgia: Auriculo-temporal Branch of the Trigeminal Nerve - Aetiologies associated with Temporomandibular Joint Lesions
Costen's Syndrome
36
Referred Otalgia: Sensory Branch of the Facial Nerve - Aetiologies (4)
Geniculate herpes
Ramsay Hunt Syndrome
Sphenoid or Ethmoidal Sinus Pathology
Nasal Pathology
37
Referred Otalgia: Tympanic Branch of the Glossopharyngeal Nerve - Aetiologies (4)
Tonsillitis or Quinsy
Post-tonsillectomy
Carcinoma of the posterior third of the tongue or tonsil
Neuralgia of the glossopharyngeal nerve
38
Referred Otalgia: Vagus Nerve - Aetiologies (5)
Foreign body in the piriform fossa
Carcinoma of the piriform fossa
Carcinoma of the larynx
Post-cricoid carcinoma
Sepsis - piriform abscess
39
Referred Otalgia: Greater auricular nerve (C2/3) - Aetiologies (2)
Cervical neuritis
Herpes zoster
40
Referred Otalgia: Lesser occipital nerve (C3) - Aetiologies (3)
Cervical spondylitis
Cervical neuritis
Herpes zoster
41
Cholesteatoma
Growth consisting of keratinising squamous epithelium in the middle ear and or mastoid process
42
Cholesteatoma: Acquired Aetiologies (2)
Chronic otitis media
Perforated tympanic membrane
43
Cholesteatoma: Congenital Aetiology
Proliferation of the embryonic crest
44
Cholesteatoma: What is a key risk factor?
Frequent ear surgery in history
45
Cholesteatoma: Pathophysiology
Keratin becomes trapped and builds up within the ear that expands to erode surrounding bone
46
Cholesteatoma: Histology
Squamous epithelium with abundant keratin production and associated with inflammation
47
Cholesteatoma: Common Clinical Presentation
Unilateral discharge that is persistent or recurrent that is often foul-smelling
48
Cholesteatoma: Symptoms may progress to what? (4)
Vertigo
Sensorineural hearing loss
Facial nerve palsy
Intracranial abscess or Meningitis
49
Cholesteatoma: What diagnostic test is used?
Otoscopy
50
Cholesteatoma: Description of Otoscopy findings (2)
Retraction of the tympanic membrane
Defect in the tympanic membrane full of white material
51
Cholesteatoma: Management
Mastoid surgery to remove the sac of debris with reconstruction
52
Cholesteatoma: Complications - Medial (5)
Sensorineural Hearing Loss
Tinnitus
Vertigo
Facial Palsy
53
Cholesteatoma: Complications - Superior (2)
Brain Abscess
Meningitis
54
Cholesteatoma: Complications - Posterior
Venous Sinus Thrombosis
55
Alternate Name for Otitis Media with Effusion
Glue Ear
56
Otitis Media with Effusion
Inflammation of the middle ear accompanied by accumulation of fluid without the signs of acute inflammation
57
Otitis Media with Effusion: Most common in what patient group?
2-8 year old children
58
Otitis Media with Effusion: Associated with what pathology?
Eustachian tube dysfunction or obstruction
59
Otitis Media with Effusion: More common in what sex?
Males
60
Otitis Media with Effusion: Most common aetiologies (3)
Streptococcus pneumoniae
Haemophilus influenza
Moraxella catarrhalis
61
Otitis Media with Effusion: Aetiologies in Adults (3)
Rhinosinusitis
Nasopharyngeal carcinoma
Nasopharyngeal lymphoma
62
Otitis Media with Effusion: Clinical Presentation (2)
Deafness
Problems associated with hearing loss - poor performance or behavioural problems or speech delay
63
Otitis Media with Effusion: Clinical Presentation -Main sign
Middle ear effusion - showing fluid or bubbles
64
Otitis Media with Effusion: Clinical Presentation -Signs of Tympanic Membrane (3)
Altered colour
Retracted
Impaired mobility
65
Otitis Media with Effusion: Diagnosis - 3 possible assessments
Otoscopy
Tuning fork tests
Age-appropriate hearing assessment - Audiometry or Tympanometry
66
Otitis Media with Effusion: Diagnosis - Tuning fork tests show what?
Conductive hearing loss
67
Otitis Media with Effusion: Diagnosis - Audiometry shows what?
Conductive hearing loss
68
Otitis Media with Effusion: Diagnosis - Tympanometry shows what?
Flat tracing
69
Otitis Media with Effusion: Management - First Line
Watch and wait - 90% resolve in 3 months
70
Otitis Media with Effusion: Management - When is the case reviewed if watchful waiting?
3 months
71
Otitis Media with Effusion: Management - When to refer to surgery (4)
Persistent (>3 months) bilateral Otitis Media with effusion
Conductive Hearing Loss >25 dB
Speech or language problems
Developmental or behavioural problems
72
Otitis Media with Effusion: Management - <3 years surgical approach
Grommets - vent the eardrum to allow for fluid drainage
73
Otitis Media with Effusion: Management - >3 years first line surgical approach
Grommets
74
Otitis Media with Effusion: Management - >3 years if grommet doesn't work?
Adenoidectomy
75
Otitis Media with Effusion: Management - When may adenoidectomy be considered early?
If nasal symptoms are present
76
Otitis Media with Effusion: Complications of Grommets (4)
Infection or discharge
Early extrusion
Retention
Persistent perforation
77
Perforated Tympanic Membrane: Mainly associated with what?
Acute Otitis Media in young individuals
78
Perforated Tympanic Membrane: Possible aetiologies (2)
Sudden negative pressure
Objects within the ear
79
Perforated Tympanic Membrane: Clinical Presentation (4)
Sudden severe pain
Possible - bleeding, hearing loss and tinnitus
80
Perforated Tympanic Membrane: Diagnostic tests of choice (2)
Otoscopy
Audiometry
81
Perforated Tympanic Membrane: Audiometry shows what?
Conductive Hearing Loss
82
Perforated Tympanic Membrane: Management -First line
Normally heals spontaneously
83
Perforated Tympanic Membrane: Management - When is surgical repair indicated?
If the patient is symptomatic with recurrent discharge
84
Otosclerosis
Hereditary disorder in which new bony deposits occur within the stapes footplate and cochlear resulting in gradual hearing loss
85
Otosclerosis: Most common age
20-30 years old
86
Otosclerosis: More common in what sex?
Women
87
Otosclerosis: Why is it more common in women?
High oestrogen is linked to otosclerosis
88
Otosclerosis: Clinical Presentation
Gradual onset hearing loss
89
Otosclerosis: Diagnostic Test
Audiometry
90
Otosclerosis: Audiometry shows what?
Conductive or mixed hearing loss
91
Otosclerosis: Classic feature on audiometry
Carhart's Notch at 2KHz
92
Otosclerosis: Management (2)
Hearing Aids
Stapedectomy
93
Prebycusis
Degenerative disorder of the cochlear resulting in hearing loss
94
Prebycusis: Pathophysiology (3)
Can be due to:
- Loss of outer hair cells - environmental noise toxicity over time
- Loss of ganglion cells
- Strial atrophy
95
Prebycusis: Clinical Presentation
Gradual onset hearing loss
96
Prebycusis: Diagnostic Test of Choice
Audiometry
97
Prebycusis: Audiometry - Which frequencies are affected most?
Higher frequencies
98
Prebycusis: Audiometry - Usually shows what type of hearing loss?
Sensorineural
99
Prebycusis: Management
High-frequency specific hearing aid
100
Noise-Induced Hearing Loss: Pathophysiology
Cochlear Damage - due to e.g. shooting or industrial noise
101
Noise-Induced Hearing Loss: Test of choice
Audiometry
102
Noise-Induced Hearing Loss: Audiometry - What type of hearing loss is there?
Sensorineural
103
Noise-Induced Hearing Loss: Audiometry - Characteristic dip where?
4kHz
104
Drug-Induced Hearing Loss: What drugs can cause hearing loss? (5)
Gentamicin - an other aminoglycosides
Cisplatin
Vincristine
Aspirin
NSAID overdose
105
Vestibular Schwannoma
Benign tumour of the CN VIII nerve sheath that arises in the internal auditory meatus
106
Vestibular Schwannoma: May be associated with what risk factor?
Extensive exposure to excessive loud noise
107
Vestibular Schwannoma: If it is bilateral and in a young patient what must be considered?
Neurofibromatosis Type 2
108
Vestibular Schwannoma: Location
Temporal bone - 80-90% are cerebellopontine angle tumours
109
Vestibular Schwannoma: Gross appearance
Circumscribed tan/white/yellow mass
110
Vestibular Schwannoma: Histology
Encapsulated mass with two possible growth patterns - Antoni A or B
111
Vestibular Schwannoma: Clinical Presentation - (3)
Progressive sensorineural unilateral hearing loss
Tinnitus
Facial Numbness
112
Vestibular Schwannoma: Clinical Presentation - Common presentation in larger tumours
Imbalance
113
Vestibular Schwannoma: Clinical Presentation - Pathophysiology of Facial Numbness
Compression of the trigeminal nerve as the tumour enlarges
114
Vestibular Schwannoma: Diagnostic Test
MRI
115
Vestibular Schwannoma: Gold standard management
Surgical excision
116
Vestibular Schwannoma: Management - Small lesions require what management?
Monitoring by MRI within a 6 month interval
117
Allergic Rhinitis: Pathophysiology
IgE-mediated allergic reaction - Type I Hypersensitivity - that causes the generation of histamine and leukotrienes
118
Allergic Rhinitis: Definition of Intermittent
Symptoms <4 days per week or symptoms for <4 weeks
119
Allergic Rhinitis: Definition of Persistent
Symptoms >4 days per week AND >4 weeks of duration
120
Allergic Rhinitis: What classification system is used?
ARIA Classification
121
Allergic Rhinitis: ARIA Classification - Mild definition
Normal sleep with symptoms that do not affect the patients day to day life
122
Allergic Rhinitis: ARIA Classification - Moderate-Severe definition
Involves >1 - abnormal sleep, impaired activities and missed school or work
123
Allergic Rhinitis: ARIA Classification - Clinical presentation (4)
Sneezing
Nasal itching
Nasal discharge and congestion
Allergic crease indicates repeated itching of the nose
124
Allergic Rhinitis: Management - First Line
Allergen Avoidance
125
Allergic Rhinitis: Management - Second Line Options (3)
Anti-histamines e.g. Cetrizine
Topical Corticosteroids e.g. Beclomethasone
Anti-histamines + Corticosteroids
126
Allergic Rhinitis: Management - Third Line
Immunotherapy e.g. Montelukast
127
Allergic Rhinitis: Management - Option for mucosal hypertrophy
Diathermy
128
Non-Allergic Rhinitis
Inflammation of the inside of the nose that is not due to allergy
129
Non-Allergic Rhinitis: Aetiologies (5)
Infection
Vasomotor rhinitis
Occupational rhinitis
Hormonal rhinitis
Drug-induced rhinitis
130
Non-Allergic Rhinitis: Pathophysiology - Vasomotor Rhinitis
Parasympathetic overdrive within the nose
131
Non-Allergic Rhinitis: Pathophysiology - Aetiologies of Vasomotor Rhinitis (5)
Chemical irritants
Changes in weather
Excess humidity
Dry atmosphere
Stress
132
Non-Allergic Rhinitis: Pathophysiology - Associations with Hormonal Rhinitis (2)
Pregnancy
Hormonal medication - HRT or Contraceptive Pill
133
Non-Allergic Rhinitis: Pathophysiology - Examples of Drug-induced Rhinitis (4)
ACE Inhibitors
Beta Blockers
NSAIDs
Cocaine
134
Non-Allergic Rhinitis: Pathophysiology
Lining of the nose becomes swollen and inflamed due to vasodilated blood vessels and build up of fluid in the nose causing blockage of nasal passages
135
Non-Allergic Rhinitis: Clinical Presentation (4)
Rhinorrhoea
Sneezing
Itchy nose
Nasal congestion
136
Non-Allergic Rhinitis: Management for vasomotor rhinitis
Ipratropium (anti-cholinergic)
137
Non-Allergic Rhinitis: Complications (2)
Sinusitis
Nasal polyps
138
Acute Sinusitis
Symptomatic inflammation of the paranasal sinuses with symptoms that last for less than 12 weeks
139
Acute Sinusitis: Usually followed by what?
Viral respiratory tract infection
140
Acute Sinusitis: Most commonly preceded by what?
Rhinitis
141
Acute Sinusitis: Preceding rhinitis can spread from what?
Dentition
142
Acute Sinusitis: Most common organisms (3)
Streptococcus pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
143
Acute Sinusitis: In adults it is diagnosed by what?
Presence of nasal blockage or discharge with facial pain/pressure/headache and/or reduction of the sense of smell
144
Acute Sinusitis: What indicates secondary bacterial infection?
Severe pain and tenderness with purulent nasal discharge
145
Acute Sinusitis: Management - First Line
Analgesics and Nasal Decongestants
146
Acute Sinusitis: Management - Consider prescribing what if symptoms are around for 10 days with no improvement?
High dose nasal corticosteroid
147
Acute Sinusitis: Management - Consider what management for severe cases of >10 days duration?
First line - Phenocymethylpenicillin
Second Line - Doxycycline (not in children)
148
Acute Sinusitis: Main Complications (2)
Spread of infection from sinuses to the orbit - cellulitis, periosteal abscess or orbital abscesses
Thrombosis of retinal vein or cavernous sinus - spread into the superior sagittal sinus
149
Nasal Polyps
Soft painless non-cancerous growths on the lining of nasal passages
150
Nasal Polyps: Aetiologies - Often associated with what pathology?
Non-allergic asthma
151
Nasal Polyps: Aetiologies (4)
Allergy
Infection
Aspirin sensitivity
Nickel exposure
152
Nasal Polyps: Aetiologies - If they are young what may be the cause?
Cystic Fibrosis
153
Nasal Polyps: Pathophysiology
Inflammation and oedema of the sinus nasal mucosa that prolapses into the nasal cavity to cause significant obstruction
154
Nasal Polyps: Histology
Lined by respiratory or squamous epithelium and oedematous stroma containing mixed inflammatory cells +/- eosinophils
155
Nasal Polyps: Clinical Presentation (3)
Blocked nose
Runny nose
Reduced sense of taste or smell
156
Nasal Polyps: What investigation is done?
Nasoendoscopy
157
Nasal Polyps: Management
Oral then topical steroids
158
Nasal Polyps: Management if polyps are large
Surgical removal
159
Granulomatosis with Polyangiitis
Inflammation of small and medium-sized blood vessels that results in damage to organ systems within the body
160
Granulomatosis with Polyangiitis: Normal age
>40 years old
161
Granulomatosis with Polyangiitis: Pathophysiology
Autoimmune disorder characterised by small vessel vasculitis and necrosis limited to the respiratory system and kidneys
162
Granulomatosis with Polyangiitis: Clinical Presentation (6)
Sinusitis
Nasal crushing - saddle nose
Epistaxis
Oral ulcers
Sensorineural deafness
Otitis media
163
Granulomatosis with Polyangiitis: Why does saddle nose occur?
Cartilage damage from ischaemia
164
Granulomatosis with Polyangiitis: Diagnosis
Characterised by high frequency ANCA antibodies
- cANCA - GPA
- pANCA - microscopic polyangiitis
165
Granulomatosis with Polyangiitis: Management
IV steroids and Cyclophosphamide
166
Tumours of the Nose: Benign Lesions - Most common
Squamous Cell Papillomas
167
Tumours of the Nose: Benign Lesions - Examples (3)
Sinonasal Papillomas
Recurrent Respiratory Papillomatosis
Angiofibromas
168
Sinonasal Papillomas: Aetiology (2)
HPV
Organic Solvents
169
Sinonasal Papillomas: More common age
>50 years old
170
Sinonasal Papillomas: More common in what sex?
Males
171
Sinonasal Papillomas: Histology - Three types
Inverted
Exophytic
Oncocytic
172
Sinonasal Papillomas: Histology - Location of inverted types
Lateral walls and paranasal sinuses
173
Sinonasal Papillomas: Histology - Location of oncocytic types
Lateral walls and paranasal sinuses
174
Sinonasal Papillomas: Histology - Locatio of exophytic types
Nasal Septum
175
Sinonasal Papillomas: Recurrent Respiratory Papillomatosis
Rare condition in which papillomas form along the aerodigestive tract
176
Sinonasal Papillomas: Recurrent Respiratory Papillomatosis - Associated with what?
HPV
177
Sinonasal Papillomas: Recurrent Respiratory Papillomatosis - Clinical presentation in children
Hoarse voice and progressive SOB
178
Tumours of the Nose: Malignant Lesion Examples (5)
Squamous Cell Carcinoma
Nasopharyngeal Carcinoma
Primary Adenocarcinoma
Neuroblastoma
Lymphoma
179
Most common malignant lesion of the nose
Squamous Cell Carcinoma
180
Nasopharyngeal Carcinoma: High incidence where?
Far east
181
Nasopharyngeal Carcinoma: More common in what sex?
Males
182
Nasopharyngeal Carcinoma: Associated with what? (2)
EBV
Volatile Nitrosamines in food
183
Nasopharyngeal Carcinoma: Histology
Keratinising SCC + Non-keratinising SCC + Baseloid SCC
184
Sub-glottic Stenosis
Narrowing of the airway below the vocal cords and above the trachea
185
Sub-glottic Stenosis: In adults it is seen in association with what?
Vasculitis
186
Sub-glottic Stenosis: Clinical Presentation
Progressive breathing difficulty that is exacerbated by exertion
187
Hand, Foot and Mouth Disease
Clinical syndrome characterised by an oral enanthem and a macular, maculopapular or vesicular rash of the hands and feet
188
Hand, Foot and Mouth Disease: Aetiology
Coxsackie Viruses
189
Hand, Foot and Mouth Disease: Diagnostic Test
Clinical or PCR test of swab
190
Oral Ulcers: Primary Syphillis - How is this acquired?
Direct sexual contact with infectious lesions of another person
191
Oral Ulcers: Primary Syphillis - Clinical presentation
Genital, Oral and Pharyngeal lesions that are painless and indurated
192
Oral Ulcers: Primary Syphillis - Bacteria
Treponema pallidum
193
Oral Ulcers: Mucosal Leishmaniasis - Pathophysiology
Involvement of mucosal tissue of the nose, oral cavity and pharynx by Leishmania species
194
Oral Ulcers: Mucosal Leishmaniasis - Common in what locations? (2)
Africa
America
195
Oral Ulcers: Behcet's Disease - Most common clinical presentation
Recurrent oral ulcers - can develop genital ulcers and uveitis too
196
Oral Ulcers: Behcet's Disease - Most common where? (2)
Middle East
Asia
197
Oral presentation of Coeliac Disease or IBD
Recurrent apthous ulcers
198
What drug reactions can cause oral ulcers? (3)
NSAIDs
Beta Blockers
Sulfonamides
199
Oral Ulcers: What skin diseases can also present with oral ulcers? (3)
Lichen planus
Pemphigus
Pemphigoid
200
Squamous Cell Papilloma: Arises from what epithelium?
Stratified squamous epithelium
201
Squamous Cell Papilloma: Two peaks of incidence
<5 years old
20-40 years old
202
Squamous Cell Papilloma: Related to what types of HPV?
-6 and -11
203
Squamous Cell Papilloma: Clinical Presentation
Painless lesion of the mucosa of the hard and soft palate - can also occur at the tongue, lips, tonsils, skin, oesophagus or cervix
204
Squamous Cell Papilloma: Histology - Macroscopic appearance
Exophytic, Sessile or Pedunculated Mass
205
Squamous Cell Papilloma: Histology - Microscopic appearance
Finger-like projection with a fibrovascular core that is covered by stratified squamous epithelium
206
Squamous Cell Papilloma: Management Options (3)
Cryotherapy
Topical Salicyclic Acid
Surgical excision
207
Salivary Gland Tumours: Two Examples of Benign Tumours
Pleomorphic Adenoma
Warthin's Tumour
208
Salivary Gland Tumours: Two Examples of Malignant Lesions
Mucoepidermoid Carcinoma
Adenoid Cystic Carcioma
209
Most common benign tumour of the salivary glands
Pleomorphic Adenoma
210
Pleomorphic Adenoma: More common in what sex?
Females
211
Pleomorphic Adenoma: Most common age for parotid tumour
30-60 years old
212
Pleomorphic Adenoma: Known link to what?
Radiation
213
Pleomorphic Adenoma: Macroscopic appearance
Well-circumscribed light tan to grey mass
214
Pleomorphic Adenoma: Microscopic Appearance
Highly variable epithelial and myoeptihelial cells in chondromyxoid stroma
215
Warthin's Tumour: More common in what sex?
Males
216
Warthin's Tumour: Most common age
>50 years old
217
Warthin's Tumour: Strongly associated with what?
Smoking
218
Warthin's Tumour: Macroscopic appearance
Well-circumscribed light grey cystic mass
219
Warthin's Tumour: Microscopic appearance
Bilayered oncocytic epithelium with lymphoid stroma
220
Most common malignant salivary tumour worldwide
Mucoepidermoid Carcinoma
221
Most common malignant salivary gland tumour in the UK
Adenoid Cystic Carcinoma
222
Mucoepidermoid Carcinoma: Low grade
>90% 5 years survival
223
Mucoepidermoid Carcinoma: High grade
<60% 5 year survival
224
Mucoepidermoid Carcinoma: Associated with what genetic mutation?
MECT1-MAML2 Fusion
225
Mucoepidermoid Carcinoma: Microscopic Appearance
Variable mix of squamous, mucous and intermediate cells with solid and cystic components
226
Adenoid Cystic Carcinoma: Most common age
>40 years old
227
Adenoid Cystic Carcinoma: Most common malignant tumour of what structure?
Palate
228
Adenoid Cystic Carcinoma: Where does this commonly present in the salivary glands?
Parotids
229
Adenoid Cystic Carcinoma: Why may there be associated pain or loss of function symptoms?
Due to frequent perineural invasion
230
Adenoid Cystic Carcinoma: Macroscopic appearance
Grey or white infiltrative mass
231
Adenoid Cystic Carcinoma: Microscopic appearance
Small uniform cells with little cytoplasm within a solid, tubular or cribriform plate
232
Facial nerve palsy suggests what?
CN VII damage - common in parotid tumours
233
Salivary Gland Tumours: Management
Superficial or total paroidectomy
234
Salivary Gland Tumours: If not removed what is there a risk of?
Malignant transformation into an adenoma
235
Salivary Gland Tumours: What is at risk during a parotidectomy? (3)
Facial nerve
Retromandibular vein
External carotid artery
236
Sialadenitis
Salivary gland infection
237
Sialolithiasis
Salivary gland stones
238
Acute Tonsillitis: Main cause
Viral
239
Acute Tonsillitis: Viral causes (6)
EBV
Rhinovirus
Influenza Virus
Parainfluenza
Enterovirus
Adenovirus
240
Acute Tonsillitis: Most common bacterial cause
Streptococcus pyogenes
241
Acute Tonsillitis: Bacterial causes other than Streptococcus pyogenes (2)
Haemophilus influenzae
Staphylococcus aureus
242
Acute Tonsillitis: 40% of cases have bacteria that produce what?
Beta-lactamase
243
Acute Tonsillitis: Viral Tonsillitis - Time period
3-4 days
244
Acute Tonsillitis: Viral Tonsillitis - Clinical Presentation (5)
Malaise
Sore throat
Temperature
Able to undertake normal activity
Possible lymphadenopathy
245
Acute Tonsillitis: Bacterial Tonsillitis - Time period
1 week
246
Acute Tonsillitis: Bacterial Tonsillitis - Clinical Presentation (6)
Systemic upset
Fever
Odynophagia
Halitosis
Unable to work
Lymphadenopathy
247
Acute Tonsillitis: Bacterial Tonsillitis - How is this assessed?
FeverPAIN to determine if antibiotics are required for Streptococcus pyogenes
248
Acute Tonsillitis: Bacterial Tonsillitis - FeverPAIN factors
Fever
Purulence
Attend rapidly - within 3 days
Very inflamed tonsils
No cough
249
Acute Tonsillitis: When should mononucleosis be suspected?
If a sore throat and lethargy persists into the second week and aged 15-25
250
Acute Tonsillitis: Management - What is the first line antibiotic?
Penicillin
251
Acute Tonsillitis: Management - What is the first line antibiotic if penicillin allergic?
Clarithromycin
252
Acute Tonsillitis: Management - When to refer (6)
Stridor
Breathing difficulty
Clinical dehydration
Sore throat for 3-4 weeks
Dysphagia for 3+ weeks
Red/White Patches or Ulceration that persists for 3+ weeks
253
Acute Tonsillitis: Management - When are investigations for throat cancer required?
Persistent sore throat with a neck mass
254
Acute Tonsillitis: Management - Infection control for acute Streptococcus pyrogenes infection
Isolation for the first 48 hours of treatment
Standard infection control with risk assessment for droplet precaution
255
Acute Tonsillitis: Complications (4)
Otitis media
Peritonsillar abscess
Parapharyngeal abscess
Lemierre Syndrome
256
Lemierre Syndrome
Suppurative thrombophlebitis of the jugular vein
257
Acute Tonsillitis: Complications - Late complications of Streptococcus pyogenes (2)
Rheumatic fever - 3 weeks post throat has fever, arthritis and pericarditis
Glomerulonephritis - haematuria, albuminuria and oedema 1-3 weeks post throat
258
Alternate name for a Peritonsillar Abscess
Quinsy
259
Peritonsillar Abscess: Main aetiology
Main complication of acute tonsillitis
260
Peritonsillar Abscess: Pathophysiology
Bacteria between the muscle and tonsils produce pus
261
Peritonsillar Abscess: Clinical Presentation - Preceded by what?
3-7 days of acute tonsillitis
262
Peritonsillar Abscess: Clinical Presentation - Symptoms (4)
Unilateral throat pain
Odynophagia
Trismus - muscles spasms into the TMJ
Altered speech
263
Peritonsillar Abscess: Clinical Presentation - Signs (2)
Medial displacement of the tonsil and uvula
Concavity of the palate is lost
264
Peritonsillar Abscess: Management
Aspiration and IV antibiotics
265
Chronic Tonsillitis
Persistent infection of the tonsils with symptoms that persist beyond two weeks
266
Chronic Tonsillitis: Clinical Presentation - Symptom
Chronic sore throat
267
Chronic Tonsillitis: Clinical Presentation - Signs (4)
Malodourous breath
Presence of tonsilliths
Peritonsillar erythema
Persistent cervical lymphadenopathy
268
Diptheria
Contagious bacterial infection that mainly affects the nose and throat
269
Diptheria: Pathophysiology
Corynebacterium diptheria produces a potent exotoxin that is cardiotoxic and neurotoxic
270
Diptheria: Clinical Presentation
Severe sore throat with a grey-white membrane across the pharynx
271
Diptheria: Management - Severe Cases
Antibiotics with Diptheria Anti-toxin
272
Diptheria: First line management
Antibiotics - Penicillin or Erythromycin
273
Diptheria: Prevention
Toxoid vaccine made from a cell-free purified toxin extracted from a strain of C. diptheriae
274
Infectious Mononucleosis: Alternate Name
Glandular Fever
275
Infectious Mononucleosis: Causative Organism
Ebstein-Barr Virus
276
Infectious Mononucleosis: Pathophysiology
EBV establishes a persistent infection in epithelial cells - particularly the pharynx
277
Infectious Mononucleosis: Clinical Presentation Triad
Fever
Pharyngitis
Lymphadenopathy
278
Infectious Mononucleosis: Symptoms (3)
Fever
Malaise
Sore throat - tonsillitis and pharyngitis
279
Infectious Mononucleosis: Signs (6)
Gross tonsillar enlargement with membranous exudates
Marked cervical and generalised lymphadenopathy
Palatal petchial haemorrhages
Hepatosplenomegaly
Rash
280
Infectious Mononucleosis: What must these patients avoid and why?
Avoid contact sports - prevent rupture
281
Infectious Mononucleosis: Diagnosis - Blood results (3)
Atypical lymphocytes and lymphocytosis
Low CRP
Deranged liver function tests
282
Infectious Mononucleosis: Diagnosis - What may blood results mimic?
Sepsis
283
Infectious Mononucleosis: Diagnosis - Most accurate test
EBV serology test
284
Infectious Mononucleosis: Management - First line
Self-limiting - rest and paracetamol
285
Infectious Mononucleosis: Management - When and what antibiotics used?
To prevent secondary infection - Penicillin
286
Infectious Mononucleosis: Management - Do not prescribe what and why?
Ampicillin or Amoxicillin - can cause a generalised macular rash
287
Infectious Mononucleosis: Management - What if it does not improve?
Systemic steroids
288
Laryngeal Nodules and Polyps
Non-inflammatory response to laryngeal injury caused by vocal cord abuse and irritation
289
Laryngeal Nodules and Polyps: Aetiologies (3)
Vocal abuse
Infection
Smoking
290
Laryngeal Nodules and Polyps: May be associated to what disorder?
Hypothyroidism
291
Laryngeal Nodules and Polyps: Pathophysiology - Most common Nodule location
Bilaterally on the middle 1/3 to posterior 1/3 of the vocal cord
292
Laryngeal Nodules and Polyps: Pathophysiology - Nodules most common in what sex?
Women
293
Laryngeal Nodules and Polyps: Pathophysiology - Appearance of Polyps
Unilateral and Pedunculated
294
Laryngeal Nodules and Polyps: Clinical Presentation (3)
Voice changes - hoarse or raspy voice
Pain
Frequent coughing or throat clearing
295
Laryngeal Nodules and Polyps: Investigation of choice
Biopsy
296
Laryngeal Nodules and Polyps: Biopsy appearance
Stratified squamous epithelium with oedematous, fibrous or myxoid stroma
297
Contact Ulcer
Raw sores on the mucous membrane covering the cartilage to which the vocal cords are attached
298
Contact Ulcer: Aetiologies (4)
Chronic throat clearing
Voice abuse
GORD
Intubation
299
Contact Ulcer: Pathophysiology
Benign response to injury to the posterior vocal cord
300
Contact Ulcer: Clinical Presentation (2)
Mild pain - during speaking or swallowing
Degrees of hoarsness
301
Epiglottitis
Inflammation of the epiglottis
302
Epiglottitis: Most common causes (4)
Streptococcus pneumoniae
Streptococcus pyogenus
Staphylococcus aureus
Haemophilus influenza Type B
303
Epiglottitis: Symptoms (3)
Severe sore throat
Drooling saliva
Pyrexia
304
Epiglottitis: Signs (2)
Normal oral cavity
May have stridor
305
Epiglottitis: Management in mild cases (3)
Antibiotics
Nebulisers - Adrenaline or Saline
Corticosteroids
306
Epiglottitis: Management in severe cases options (3)
Antibiotics
Intubation and ventilation OR Tracheostomy
307
Reinke's Oedema
Swelling of the vocal cords due to fluid collected within the Reinke's space
308
Reinke's Oedema: Most common cause
Smoking
309
Reinke's Oedema: Clinical Presentation (3)
Hoarse Voice
Dysphonia
Throat Discomfort
310
Reinke's Oedema: Main Investigation
Otoscopy
311
Obstructive Hyperplasia of the Tonsils and Adenoids: Most common cause of what?
Obstructive Sleep Apnoea in Children
312
Obstructive Hyperplasia of the Tonsils and Adenoids: Tonsils and Adenoids have greatest increase in size when?
Aged 2 to 8 years
313
Obstructive Hyperplasia of the Tonsils and Adenoids: Pathophysiology
The disproportionate growth of the adenoids and tonsils compared to the skeletal boundaries results in a narrower airway
314
Obstructive Hyperplasia of the Tonsils and Adenoids: Clinical Presentation for Adenoids (4)
Obligate mouth breathing
Hyponasal voice
Snoring and signs of sleep disturbance
Obstructive Sleep Apnoea
315
Obstructive Hyperplasia of the Tonsils and Adenoids: Clinical Presentation for tonsils (3)
Snoring and signs of sleep disturbance
Muffled voice
Visibly enlarged tonsils without symptoms
316
Obstructive Hyperplasia of the Tonsils and Adenoids: Management and when it is required?
If there is recurrent or persistent obstructive or infectious symptoms related to adenoid hypertrophy - Removal of tonsils and adenoids
317
Nasopharyngeal Carcinoma: Linked to what?
EBV
318
Laryngeal Carcinoma: Most common aetiologies (2)
Cigarettes
Alcohol
319
Oropharyngeal Carcinoma: Commonly associated with what?
HPV
320
Oral Cavity Carcinoma: Associated with what?
Chewing tobacco
321
Head and Neck Cancer: When is a laryngoscope referral indicated?
Dysphonia lasting 3 weeks
322
Head and Neck Cancer: Nasopharyngeal Cancer - Ear Symptoms
Unilateral Conductive Hearing Loss
323
Head and Neck Cancer: Nasopharyngeal Cancer - Nasal Symptoms (3)
Unilateral epistaxis
Nasal blockage
Mass within the nasopharynx
324
Head and Neck Cancer: Nasopharyngeal Cancer - Involves what nerves? (5)
III
IV
V2
V3
VI
325
Head and Neck Cancer: Pathophysiology of Neck Lumps - Midline Swelling Differentials (3)
Thyroid
Thyroglossal Cyst
Dermoid Cyst
326
Head and Neck Cancer: Pathophysiology of Neck Lumps - Thyroglossal Cysts arise where?
Any part of the thyroglossal tract
327
Head and Neck Cancer: Pathophysiology of Neck Lumps - Thyroglossal Cysts clinical presentation
Moves with the tongue
328
Head and Neck Cancer: Pathophysiology of Neck Lumps - Thyroglossal Cysts Presents in what patients?
Teenage years
329
Head and Neck Cancer: Pathophysiology of Neck Lumps - Differential for Anterior Triangle Swellings (5)
Lymph nodes
Branchial Cyst
Saliary glands
Carotid Body Tumour
Cystic Hydroma
330
Head and Neck Cancer: Pathophysiology of Neck Lumps - Clinical Presentation of Branchial Cyst
Benign lump persisting on the second brachial arch that arises in the upper part of the anterior triangle
331
Head and Neck Cancer: Pathophysiology of Neck Lumps - Most common age of presentation for Branchial Cyst
Teenagers
332
Head and Neck Cancer: Metastasis - Supra-glottic Tumours drain into where?
Superior deep cervical nodes
333
Head and Neck Cancer: Metastasis - Glottic Tumours present where?
On the cords
334
Head and Neck Cancer: Metastasis - Glottic Tumours Presentation
Voice change and Airway Obstruction
335
Head and Neck Cancer: Metastasis - Sub-Glottic Tumours metastatises to where?
Paratracheal Nodes
336
Head and Neck Cancer: Metastasis - Sub-Glottic Tumours Clinical Presentation (2)
Voice Change
Airways Obstruction
337
Head and Neck Cancer: How to confirm it is a tumour?
Panendoscopy and Biopsy from primary site and suspected metastases
338
Head and Neck Cancer: Staging Techniques
CT Neck and Chest
339
Head and Neck Cancer: Imaging - US Detects what?
Lymph Nodes and Thyroid
340
Head and Neck Cancer: Imaging - CT Detects
Detection of Lymph Nodes and Larynx
341
Head and Neck Cancer: Imaging - MRI Detects
Deep lobe of the parotid
Base of the tongue
Nasopharynx
342
Head and Neck Cancer: Imaging - PET Detects
Metastatic Nodes
343
Head and Neck Cancer: Management - Early T1/T2 Laryngeal Cancer
Transoral Laser Surgery and Radiotherapy
344
Head and Neck Cancer: Management - Advanced T3/T4 Laryngeal Cancer
Partial or Total Laryngectomy + Chemotherapy + Radiotherapy
345
Head and Neck Cancer: Management - Early T1/T2 Oropharyngeal Cancer
Chemotherapy + Transoral Robotic Surgery
346
Head and Neck Cancer: Management - Advanced T3/T4 Oropharyngeal Cancer
Chemoradiotherapy
347
Head and Neck Cancer: Management - Nasopharyngeal Cancer
Chemoradiotherapy
348
Head and Neck Cancer: Management - Parotid Gland Cancer
Superficial or Total Parotidectomy
349
Paraganglioma
Tumours arising in clusters of neuroendocrine cells dispersed throughout the body
350
Paraganglioma: Aetiology - Most common age
>50 years old
351
Paraganglioma: Aetiology - Associated with what genetic syndromes (3)
MEN2
Von Hippel-Lindau Syndrome
NF-1
352
Paraganglioma: Aetiology - Most common genetic mutation
Mutations in succinate dehydrogenase subunit
353
Paraganglioma: Pathophysiology - Sympathetic arise from where?
Paraganglia below the level of the neck - Organ of Zuckerandl or Bladder
354
Paraganglioma: Pathophysiology - Parasympathetic arise from where?
Great vessels of the head and neck
355
Paraganglioma: Histology
Nests of round or oval cells surrounded by delicate vascular septae
356
Paraganglioma: Clinical Presentation - Sympathetic Paragangliomas (4)
Features of Catacholamine Excess - Headaches, Palpitations, Diaphoresis and Hypertension
357
Paraganglioma: Clinical Presentation - Parasympathetic Paragangliomas (3)
Cranial nerve palsies
Neck mass
Tinnitus
358
Paraganglioma: Management Options (2)
Surgical resection
radiothearpy
359
Nasal Trauma: Must exclude what?
Septal Haematoma
360
Nasal Trauma: Management of Septal Haematoma
Drained to prevent nasal collapse
361
Nasal Trauma: Problem with septal haematoma
Stops blood supply getting to the cartilage
362
Nasal Trauma: Management - Unilateral Discharge
Refer urgently
- Suspected foreign body in the nose of children
- Nasal or Paranasal tumour in adults
363
Nasal Trauma: Management - Nasal Fractures
Review in the ENT clinic in 5-7 days post-injury
Then digital manipulation in <3 weeks
364
Nasal Trauma: Complications (3)
CSF leak
Meningitis
Anosmia
365
CSF Leak: Aetiology
Fracture through the cribiform plate
366
CSF Leak: Clinical Presentation (2)
Persistent clear rhinorrhoea
Headache
367
CSF Leak: Management Pathway
1. Most are self-resolving
2. Requires repair does not resolve within 10 days
368
CSF Leak: Must not give what drugs and why?
Antibiotics - can mask meningitis
369
Epistaxis
Nose bleed
370
Epistaxis: Local Aetiologies (4)
Trauma
Foreign Bodies
Inflammation
Tumour
371
Epistaxis: Systemic Aetiologies - Drugs (2)
Warfarin
Aspirin
372
Epistaxis: Systemic Aetiologies - Haematological Causes (4)
Clotting abnormalities
Haemophilia
Leukaemia
Thrombocytopenia
373
Epistaxis: Systemic Aetiologies - GI cause
Liver disease
374
Epistaxis: Systemic Aetiologies - Cardiovascular causes (3)
Arteriosclerosis
Hereditary Haemorrhagic Telangectasia
Hypertension
375
Epistaxis: Systemic Aetiologies - Inflammatory disorder
Wegner's Granulomatosis
376
Epistaxis: Pathophysiology - Most common area
Little's Area on the anterior septum
377
Epistaxis: Pathophysiology - What blood vessels are in the Little's Area? (5)
Anterior ethmoid artery
Posterior ethmoid artery
Sphenopalatine artery
Great Palatine Artery
Superior labial artery
378
Epistaxis: Management - First Line
First Aid Measures - Pinch the fleshy part of the anterior part of the nose and lean forward with ice pack compression
379
Epistaxis: Management - Secondary care management
Arrest and slow flow - via topical vasoconstrictor or ice
Anterior rhinoscopy or Nasal Endoscopy to investigate the source of bleeding
380
Epistaxis: Management - Direct therapy
Silver nitrate cautery if there is an identifiable anterior bleeding point
381
Epistaxis: Management - Indirect therapy options
Nasal packs or Foley Catheters to compress difficult to identify bleeding points or heavy bleeding points
382
Epistaxis: Management - Surgical Options
Sphenopalatine artery ligation - endoscopic
383
Pinna Haematoma: Most commonly seen in what patients? (2)
Boxers
Rugby Players
384
Pinna Haematoma: Pathophysiology
Initial trauma causes the peri-chondral blood vessels tear causing a haematoma between the auricular cartilage and overlying perichondrium
385
Pinna Haematoma: Pathophysiology - If pinna haematomas are left untreated what would happen?
Disrupted blood supply would cause avascular necrosis of the pinna
386
Pinna Haematoma: Pathophysiology - How does cauliflower ear develop?
Fibrocartilage overgrowth
387
Pinna Haematoma: Management (3)
Aspiration
Incision and Drainage
Pressure dressing
388
Temporal Bone Fracture: Two classifications
Longitudinal
Transverse
389
Temporal Bone Fracture: Aetiology - Longitudinal Fractures
Lateral blow to the head
390
Temporal Bone Fracture: Aetiology - % of cases that are longitudinal fractures
80%
391
Temporal Bone Fracture: Longitudinal Fracture description
Fracture line is parallel to the long axis of the petrous pyramid
392
Temporal Bone Fracture: Aetiology - Transverse Fractures
Fronto-occipital head trauma
393
Temporal Bone Fracture: Transverse Fracture % of cases
20%
394
Temporal Bone Fracture: Transverse Fracture Description
Fracture at right angles to the long axis of the petrous pyramid
395
Temporal Bone Fracture: Transverse Fracture likely to damage what?
Facial nerve
396
Temporal Bone Fracture: Clinical Presentation - Main Sign
Battle sign - bruising over the mastoid that indicates a base of the skull fracture
397
Temporal Bone Fracture: Diagnostic Test
CT
398
Temporal Bone Fracture: Complications - Longitudinal Fracture (5)
Bleeding from the external canal due to laceration of the skin and drum of the ear
Haemotympanum - conductive deafness
Ossicular chain disruption
Facial palsy
CSF Otorrhoea - leaking from the ear
399
Temporal Bone Fracture: Complications - Transverse Fracture (4)
Can cross the internal acoustic meatus to cause damage to the auditory and facial nerves
Sensorineural hearing loss due to CN VIII damage
Facial palsy
Vertigo
400
Hearing Loss Following Trauma: Management of Conductive Hearing Loss - Why is it often delayed?
Polytrauma
401
Hearing Loss Following Trauma: Management of Conductive Hearing Loss - May require what three things?
Facial nerve decompression
Management of CSF leak
Hearing Restoration - hearing aid or ossiculoplasty
402
Hearing Loss Following Trauma: Management of Sudden Sensorineural Hearing Loss
Weber Test - sound will heard in good ear
High dose steroids
Consider intra-tympanic treatment
403
Neck Trauma: Higher incidence in what sex?
Men
404
Neck Trauma: Pathophysiology - Zone I regions (5)
Trachea
Oesophagus
Thoracic Duct
Thyroid
Spinal Cord
405
Neck Trauma: Pathophysiology - Blood Vessels of Zone I (4)
Brachiocephalic
Subclavian
Common carotid
Thyrocervical Trunk
406
Neck Trauma: Pathophysiology - Structures of Zone II (6)
Larynx
Hypopharynx
CN X
CN XI
CN XII
Spinal Cord
407
Neck Trauma: Pathophysiology - Vessels of Zone II (2)
Carotid
Internal Jugular
408
Neck Trauma: Pathophysiology - Structures of Zone III (3)
Pharynx
Cranial Nerves
Spinal Cord
409
Neck Trauma: Pathophysiology - Vessels of Zone III (3)
Carotid
Internal Jugular Vein
Vertebral Arteries
410
Neck Trauma: Clinical Presentation - Symptoms that are important to the aerodigestive tract (5)
Dyspnoea
Hoarseness
Dysphonia
Dysphagia
Haemoptysis
411
Maxillary Fractures: Maxilla functionally forms a bridge between what?
The cranial base and dental occlusion plane
412
Maxillary Fractures: Mechanism of Injury
High-energy blunt trauma to the facial skeleton
413
Orbital Floor Fractures: Diagnostic Investigation
CT tear drop sign - indicates blow out fracture
414
Orbital Floor Fractures: Management when?
Surgical repair of the bony walls if there is entrapment, large defects or enopthalmos (eyes are sunken in)
415
Deep Neck Space Infection
Extension of infection from the tonsil or oropharynx into deeper tissue
416
Deep Neck Space Infection: Symptoms (2)
Sore throat
Limited neck movements
417
Deep Neck Space Infection: Signs (3)
Febrile
Trismus - muscle spasms in the TMJ
Red and Tender Neck
418
Deep Neck Space Infection: Management (2)
IV Access for bloods and rehydration
IV antibiotics - Co-amoxiclav or Clindamycin
419
Deep Neck Space Infection: Complications
Infection may extend to the mediastinum via the pre-vertebral space through fascial compartments - leads to infection of the heart and lungs
420
What is a major concerning foreign body in the ear or nose?
Watch batteries
421
BPPV
Benign Positional Paroxysmal Vertigo
422
Benign Positional Paroxysmal Vertigo
Vertigo caused by the presence of otoliths in the semi-circular canal instead of the utricle
423
Benign Positional Paroxysmal Vertigo: Aetiology (2)
Head trauma
Ear surgery
424
Benign Positional Paroxysmal Vertigo: Most common cause of vertigo on doing what?
Looking up
425
Benign Positional Paroxysmal Vertigo: Pathophysiology
Otoliths within the canal move on movement of the patients head causing abnormal movement of endolymph resulting in vertigo
426
Benign Positional Paroxysmal Vertigo: Other symptoms
Nausea and Vomiting
427
Benign Positional Paroxysmal Vertigo: Time period
Seconds
428
Benign Positional Paroxysmal Vertigo: Vertigo on doing what? (3)
Looking up
Turning or lying down in bed
Bending forward
429
Benign Positional Paroxysmal Vertigo: Diagnostic test
Dix-Hallpike Maoeuvre - invokes symptoms and torsional nystagmus
430
Benign Positional Paroxysmal Vertigo: Management (3)
Epley Manoeuvre
Selmont Manoeuvre
Brandt-Daroff Exercises
431
Vestibular Neuritis
Inflammation of the vestibular nerve
432
Labyrinthitis
Inflammation of the labyrinth
433
Vestibular Neuritis and Labyrinthitis: Main aetiology
Viral
434
Vestibular Neuritis and Labyrinthitis: Clinical presentation of First Attack
Vertigo with hours of Nausea and Vomiting
435
Vestibular Neuritis and Labyrinthitis: Time period
Prolonged - Days
436
Vestibular Neuritis and Labyrinthitis: May be associated with what symptoms? (3)
Viral Symptoms - Malaise, Headache and Nausea and Vomiting
437
Vestibular Neuritis and Labyrinthitis: Labyrinthitis is associated with what symptoms?
Tinnitus or Hearing loss - not seen in VN
438
Vestibular Migraine
Episode of vertigo in someone who has history of migraines
439
Vestibular Migraine: Clinical Presentation (4)
Light-sensitivity during dizzy spells
Phonophobia
Fluctuating hearing loss
Motion sensitivity with bouts of motion sickness
440
Vestibular Migraine: Management
Abortive Agents - triptans
Prophylaxis - Propanolol and Amitryptiline
441
Meniere's Disease
Idiopathic disorder causing vertigo
442
Meniere's Disease: Pathophysiology
Excess endolymph within the membranous labyrinth and increasing pressure results in symptoms due to dysfunctioning sodium channels
443
Meniere's Disease: Clinical Presentation - Triad
Severe paroxysmal vertigo
Sensorineural hearing loss
Tinnitus
444
Meniere's Disease: Clinical Presentation - Vertigo
Recurrent spontaneous rotational vertigo with at least 2 episodes >20 minutes
445
Meniere's Disease: Clinical Presentation - Time
>20 minutes - often last hours
446
Meniere's Disease: Clinical Presentation - Sensation of what?
Ear being full
447
Meniere's Disease: Audiology result
Low frequency sensorineural hearing loss
448
Meniere's Disease: Management Options (3)
Tinnitus therapy
Hearing aids
Lifestyle - Reduce salt, avoid chocolate and caffeine and avoid stress
449
Vertebrobasilar Insufficiency
Temporary set of symptoms due to ischaemia in the posterior circulation of the brain
450
Vertebrobasilar Insufficiency: Most common Aetiology
Arteriosclerosis in the posterior circulation arteries
451
Vertebrobasilar Insufficiency: Clinical Presentation - Causes vertigo when?
When looking up
452
Vertebrobasilar Insufficiency: Clinical Presentation - What other symptom is required for diagnosis?
Visual disturbance
Weakness
Numbness
453
Acute Infective Rhinosinusitis
Symptomatic inflammation of the paranasal sinuses
454
Acute Infective Rhinosinusitis: Symptom time period
Less than 12 weeks
455
Acute Infective Rhinosinusitis: Is typically followed by what?
Viral respiratory tract infection
456
Acute Infective Rhinosinusitis: Most commonly preceded by what?
Rhinitis that has spread from dentition
457
Most common causative organisms (3)
Streptococcus penumoniae
Haemophilus influenzae
Moraxella catarrhalis
458
Acute Infective Rhinosinusitis: Diagnosed in patients by what?
Presence of nasal blockage or nasal discharge with facial pain or head aches and/or a reduced sense of smell
459
Acute Infective Rhinosinusitis: What indicates secondary bacterial infection?
Severe pain and tenderness with purulent nasal discharge
