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ENT SB > Embryology and Microbiology > Flashcards

Embryology and Microbiology Flashcards

1
Q

what are the pharyngeal arches and when do they develop

A

Arch 1 → Day 22
Arches 2 and 3 → Day 24
Arches 4 and 6 → Day 29

i.e. week 4 and 5

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2
Q

what does each arch consist of

A

Core of mesenchyme
Neural crest cells
CN component
Artery

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3
Q

what CN are associated with what arch

A

Arch 1 - CN V2 and V3
Arch 2 - CN VII
Arch 3 - CN IX
Arch 4 - CN X - Superior laryngeal branch
Arch 6 - CN X - Recurrent laryngeal branch

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4
Q

what does 1st Arch form

A

Maxillary process - maxilla, zygomatic and part of temporal bone
Mandibular process - Meckel’s cartilage, incus, malleus, mandible

Muscles of mastication
Mylohyoid

Sensory skin supply to face

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5
Q

what does 2nd arch form

A

Stapes, styloid process of temporal bone + stylohyoid ligament
Hyoid

Muscles of facial expression
Stapedius

CN VII

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6
Q

what does 3rd arch form

A

Greater horn and lower part of body of hyoid

Glossopharyngeal (IX) nerve

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7
Q

what does 4th and 6th arches form

A

Laryngeal cartilages

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8
Q

what does 1st pouch form

A

middle ear
eustachian tube
tympanic membrane

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9
Q

what does 2nd pouch form

A

palatine tonsil

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10
Q

what does 3rd pouch form

A

inferior parathyroid gland

thymus

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11
Q

what does 4th pouch form

A

superior parathyroid gland

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12
Q

what does 1st pharyngeal cleft form

A

external auditory meatus

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13
Q

what give rise to the otic vesicles/inner ear

A

otic placodes

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14
Q

what contributes to the auricle

A

Arch 1 and Arch 2

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15
Q

what 5 swellings of the face are present from week 4

A

Frontonasal prominence (with nasal placodes)

Maxillary prominence (x2)

Mandibular prominence (x2)

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16
Q

what additional facial swellings are seen in Week 5

A

Medial nasal swellings

Lateral nasal swellings

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17
Q

what do facial clefts result from

A

failure of some of the facial processes to fuse correctly

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18
Q

in what week should palatine shelves fuse

A

Week 7

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19
Q

what is the most common bacterial cause of a sore throat

A

Strep. pyogenes (Grp A Strep)

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20
Q

Tx of Strep throat

A

Oral Penicillin

Clarithromycin if allergic

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21
Q

Early Complications of Strep throat

A

Peritonsillar abscess (quinsy)
Sinusitis/ otitis media
Scarlet fever

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22
Q

Late complications of Strep throat

A

Rheumatic fever

Glomerulonephritis

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23
Q

what does Diphtheria present with

A

Severe sore throat with a grey white membrane across the pharynx

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24
Q

Tx of Diphtheria

A

Antitoxin and Supportive

Penicillin/erythromycin

25
Q

White patches on red, raw mucous membranes in throat/ mouth - diagnosis and what organism

A

Candida/Thrush

Candida albicans

26
Q

Tx of candida/thrush

A

Nystatin suspension topically

27
Q

what is acute otitis media

A

infection of middle ear
typically URI extending up the eustachian tube
presents with earache

28
Q

what are bacterial causes of AOM

A

Haemophilus influenzae, Streptococcus pneumoniae

Streptococcus pyogenes

29
Q

when is antibiotics considered for AOM

A

bilateral AOM in

30
Q

what is the antibiotic Tx for AOM

A

Amoxicillin - 5 days

if allergic Clarithromycin

31
Q

Tx for acute sinusitis

A

if uncomplicated avoid antibiotics

where indicated
1st line Penicillin
2nd line Doxycyline

32
Q

what is otitis externa

A

inflammation of outer ear canal

33
Q

presentation of otitis externa

A

Redness and swelling of the skin of the ear canal.
Itchy
Sore and painful.
Discharge, or increased amounts of ear wax.
Hearing can be affected.

34
Q

bacterial causes of otitis externa

A

Staphylococcus aureus
Proteus spp
Pseudomonas aeruginosa

35
Q

fungal causes of otitis externa

A

Aspergillus niger

Candida albicans

36
Q

Mx of otitis externa

A

Topical aural toilet

Swab unresponsive causes

  • Topical Gentamicin for Pseudomonas
  • Topical Clotrimazole for the rest
37
Q

what is infectious mononucleosis also known as

A

glandular fever

38
Q

Sx of glandular fever

A

Fever
Enlarged lymph nodes
Sore throat, pharyngitis, tonsillitis
Malaise, lethargy

Jaundice/Hepatitis
Rash
Splenomegaly

39
Q

complications of glandular fever

A

anaemia, thrombocytopenia
splenic rupture
upper airway obstruction
increased risk of lymphoma

40
Q

what causes glandular fever

A

Epstein-Barr Virus (EBV)

41
Q

Tx for glandular fever

A

Bed rest
Paracetamol
Avoid sport
Corticosteroids in complicated cases

42
Q

Ix of lab confirmation of glandular fever

A

1st - Epstein-Barr virus IgM
2nd - Heterophile antibody
- Paul-Bunnell test
- Monospot test

Blood count and film
Liver function tests

43
Q

what can present similar to glandular fever

A

cytomegalovirus

44
Q

what can HSV type 1 cause and when is it acquired

A

Oral lesions/Primary gingivostomatitis

Childhood

45
Q

how does Primary gingivostomatitis present

A 
fever
local lymphadenopathy
lips, buccal mucosa, hard palate
vesicles 1-2mm
ulcers
46
Q

Tx for primary gingivostomatitis

A

Aciclovir treatment

47
Q

can HSV 1 have a latency period ?

A

yes

48
Q

what does reactivation of HSV 1 cause and what can be used to treat it

A

cold sore

Aciclovir

49
Q

what is herpetic whitlow and who tend to get it

A

lesion on finger or thumb caused by HSV

occupational hazard of dentistry and anaesthetics

50
Q

how is HSV confirmed

A

Viral DNA by PCR

51
Q

what is herpangina and what causes it

A

Vesicles/ulcers on soft palate

caused by coxsackie viruses

52
Q

how is herpangina diagnosed

A

clinically
OR
PCR test of swab

53
Q

what else can coxsackie virus cause

A

Hand, foot and mouth disease

54
Q

what is common in hand, foot and mouth disease

A

family outbreaks

55
Q

what are apthous ulcers

A 
Non viral, self limiting 
Recurring painful ulcers of the mouth 
- confined to mouth
- absence of systemic disease
- ulcer last less than 3 weeks
56
Q

what are non viral causes of recurrent ulcers

A 
Behcet's disease
IBD
Reiter's disease
Drug reactions
Lichen planus, pemphigus, pemphigoid
57
Q

what is a chancre

A

Painless indurated ulcer at site of entry of bacterium Treponema pallidum
i.e. Primary syphilis

58
Q

where are chancre commonly found and what happens if they are left untreated

A

most common site - genital but oral lesions can happen

can progress to secondary and tertiary syphilis

ENT SB (9 decks)

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