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ENT Flashcards

1
Q

what Hz do humans perceive

A

20-20000

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2
Q

what is the tympanic membrane ratio to the oval window ratio

A

18:1

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3
Q

what is the resting state of the eustachian tube and what muscles are involved

A

closed

opened by tensor veli palatini and levator palatini

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4
Q

how many turns are around the modiolus in the inner ear

A

two and a half

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5
Q

how are the hair cells arranged

A

in height order

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6
Q

how are the hair cells polarised and depolarised

A

deflected towards longest - depolarisation

deflected away from the longest - hyper polarisation

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7
Q

what is otoconia

A

calcium carbonate crystals

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8
Q

what kind of receptors are the taste and smell ones

A

chemoreceptors

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9
Q

what types of cells do taste buds consist off

A

receptor cells and support cells

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10
Q

where are taste buds found

A

tongue in the papillae, palate, epiglottis, pharynx

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11
Q

how long is the half life for receptor cells and what do they synapse with

A

10 days

synapse with afferent nerve fibres

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12
Q

what are the papillae

A

finger like

give rough appearance to surface of tongue

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13
Q

types of papillae

A

filiform - most common has no taste buds
fungiform
vallate
foliate

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14
Q

how is the signal reached from receptor cells to control gustatory areas

A

signal by CN 7(chorda tympani branch), 9 and 10 via brainstem and thalamus

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15
Q

what are the 5 primary tastes

A 
salty - NaCl
sour - acids with free H+
sweet - glucose
bitter - lots of stuff
umami (meaty or savoury) - amino acids esp glutamate
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16
Q

what is ageusia and what is it caused by
hypoguesia
dysgeusia

A

loss of taste - nerve damage, inflame
decrease in taste function - chemo, meds
distortion of taste - glossitis, reflux, URTI

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17
Q

what three types of cells does the olfactory mucosa consist of

A

olfactory receptor cells
supporting cells
basal cells

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18
Q

what is the olfactory rod

A

ending of each neurone has a thick short dendrite and an expanded end - rod

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19
Q

what do odrants bind to

A

cilia

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20
Q

what is the life span of olfactory receptors and what happens when they die

A

2 months

basal calls act as precursors for new olfactory cells

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21
Q

how is smell smelt during quiet breathing

A

diffusion

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22
Q

what two things does a substance need to be in order to be smelt

A

volatile and water soluble

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23
Q

what is anosmia and what are the causes
hypsmia
dysosmia

A

can’t smell - nasal polyps, allergy
decrease smell - paskinsons
distortion of smell

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24
Q

transmission of waves into lymph causing basilar membrane to vibrate

A

oval window

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25
Q

what does the round window do

A

acts as a pressure reliever to dampen vibrations after they have had an effect

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26
Q

Na and K conc of perilymph and endolymph and what do they both do

A

power sensory cells
peri high Na low K
endo low Na high K

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27
Q

what do you do if the eardrum is perforated?

A

check for infection
if infection present - antibiotics
if no infection then wait
if within a few months the eardrum hasn’t repaired then repair via myringoplasty

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28
Q

what is the treatment plan when a patient comes in with SNHL

A

confirm SNHL
steroids
then MRI

29
Q

inflamed bilateral tonsils with grey/white exudates on tonsils

A

acute tonsillitis

30
Q

unilateral

uvula pushed to one side

A

quinsy

31
Q

grey/white membrane across pharynx

A

diphtheria

32
Q

what is a pleomorphic adenoma
who does it occur in
what is its growing track like

A

benign
common
long history. asymp. slow growing

33
Q

warthins tumour - what is it associated with - how does it present

A 
benign 
parotid
smoking
slow growing
painless
may be cystic/bilateral
34
Q

adenoid cystic carcinoma
who
symptoms

A 
malignant 
parotid
frequent perineurial invasions - facial nerve 
painless
slow growing
35
Q

what rheumatology condition can lead to salivary glad swelling

A

Sjorgens

36
Q

how is webners done

A

centre of head

37
Q

how is rinnes done

A

air and bone conduction
each ear
negative means can’t hear anything on that side

38
Q

what is balls palsy
when does it occur
how does it occur

A

commonest cause of facial nerve palsy
following URTI
sudden onset

39
Q

if many nosebleeds and in littles area then what may be the treatment

A

cauterise - silver

40
Q

what does a sebaceous cyst look like/produce

A

superficial

may produce white thick foul smelling fluid

41
Q

describe a carotid aneurysm

A

fluctuant

bruit

42
Q

what is otosclerosis
what are the symptoms
treatment

A

overgrowth of bony tissue of otic capsule
progressive CHL and tinnitus
if cochlear involved then mixed SNHL and CHL
surgery

43
Q 
list the investigations for the following 
CHL
SNHL
Nerves affected
blood in ear
salivary glands
facial fracture
sinuses and nose
orbital blowout fracture
A 
CT
MRI (looking for acoustic neuromas etc)
MRI
CT
US with FNA
CT first line for facial fracture
CT
CT
44
Q

what drug dries out mouth

A

amitriptalline

45
Q

scala media scala tympani scala vestiboli where

A

endolymph scala media

perilymph tympani vestibuli

46
Q

difference between endolymph and perilymph

A

endolymph inside like intracellular (high K low Na)

perilymph outside like extracellular (low K high Na)

47
Q

what is the otolith

A

article and saccule of inner ear which has otoconia

48
Q

list some causes of ototoxicity

A

gent

carboplantin drugs

49
Q

what can an orbital blowout fracture lead to

A

entrapment of muscles - diplopia

facial palsy

50
Q

treatment for allergic rhinitis

if pregnant or breast feeding?

A

first line oral antihistamine esp if allergic conjucitivits
nasal polyps/nasal blockage - intranasal corticosteroid (2nd line)

preg - intranasal corticosteroid. oral antihistamine 2nd line or an add on

51
Q

step up ladder of allergic rhinitis

A

anti histamine add corticosteroid
if on corticosteroid increase to max dose
if on max dose of corticosteroid then add oral antihistamine
is still symptoms then ipratropium bromide
if still symptoms them oral steroids

52
Q

histology of tonsils

histology of adenoids

A

specialised squamous, deep crypts, lymphoid follicles

ciliated pseudo stratified columnar, stratified squamous, deep folds

53
Q

acute complications of bacterial sore throat

late complications of bacterial sore throat

A

scarlet fever, quinsy , sinusitis/OM

GN 1-3 weeks after, rheumatic fever 3 weeks after

54
Q

What kind of toxin does diphtheria release

A

neurotoxin

cardiotoxin

55
Q

where are laryngeal nodules in women

A

bilateral on middle 1/3 to posterior 1/3 of vocal cords

56
Q

what do laryngeal polyps look like

A

unilateral and pedunculated

57
Q

give 80-90% of cerebellopentine angle tumours

A

vestibular schwonnoma

58
Q

what is pinna haematoma and how is it treated

A

collection of blood between the cartilage of the pinna and the overlying skin
aspiration. incision and drainage. pressure dressing

59
Q

what is an orbital fracture
what is the weakest point
what are the symptoms

A

impact injury to the globe
infraorbital groove
diplopia, ocular movement affected, bruising, decreased vision, oedema

60
Q

CHL
SNHL
which kind of temporal bone fracture

A

longitudinal

transverse

61
Q

Causes of chronic tonsillitis

A

strep pyrogens, HI, SA, strep pneumonia

30% beta lactamase producing

62
Q

give symptoms of adenoidal hyperplasia

A

obligate mouth breathing
hypo nasal voice
AOM/OME
snoring

63
Q

give symptoms of tonsillar hyperplasia

A

snoring
muffled voice
dysphagia

64
Q

symptoms of otitis external

A 
redness over out ear
pain
inflam 
red
increase in ear wax can lead to CHL
65
Q

mild discomfort over head or under cheeks assoc w URTI

severe pain, tenderness and purulent discharge

A

sinusitis - uncx - don’t give AB - will heal within 14 days

secondary bacterial infection - penicillin (doxycycline)

66
Q

reasons for giving AB in OME

A

persistent >3/12
CHL >25db
speech/language issues

67
Q

investigations for dizziness

A 
otoscope
neurological exam
BP
balance 
audiometer
68
Q

treatment for meniers

A

betahistine

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