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Year 3 Conditions MEGADECK > ENT > Flashcards

ENT Flashcards

1
Q

<p>Define Bell’s palsy.</p>

A

<p>Bell's palsy is an acute unilateral peripheral facial nerve palsy in patients for whom physical examination and history are otherwise unremarkable, consisting of deficits affecting all facial zones equally that fully evolve within 72 hours.</p>

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2
Q

<p>Explain the aetiology/risk factors of Bell’s palsy.</p>

A

<p>Intranasal influenza infection</p>

<p>Pregnancy</p>

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3
Q

<p>Summarise the epidemiology of Bell’s palsy.</p>

A

<p>Bell's palsy is the most common aetiology of unilateral facial palsy among those 2 years of age or older. It is most prevalent in people between 15 and 45 years of age. The reported incidence is 23 to 32 cases per 100,000 per year.</p>

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4
Q

<p>Recognise the presenting symptoms of Bell’s palsy. Recognise the signs of Bell’s palsy on physical examination.</p>

A

<p>Facial drooping on one side<br></br>Absence of constitutional symptoms<br></br>Involvement of all nerve branches<br></br>Keratoconjunctivitis sicca<br></br>Pain<br></br>Synkinesis</p>

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5
Q

<p>What is keratoconjuctivitis sicca?</p>

A

<p>Keratoconjunctivitis sicca (dry eye) is common in Bell's palsy and occurs acutely due to loss of adequate blink function, with parasympathetic dysfunction to the lacrimal gland a contributing factor. It may lead to ulcerative keratitis (corneal ulcer) and subsequent blindness.</p>

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6
Q

<p>Identify appropriate investigations for Bell’s palsy and interpret the results.</p>

A

<p>Diagnosis can usually be made by examination. However, EMG may be used in order to test the tone of the facial muscles.</p>

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7
Q

<p>Generate a management plan for Bell’s palsy.</p>

A

<p>Prednisolone<br></br>Valaciclovir</p>

<p>Surgical intervention may be required in severe cases. Eye drops may also be given in order to stop the eyes from drying out.</p>

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8
Q

<p>Define BPPV.</p>

A

<p>Benign paroxysmal positional vertigo (BPPV) is a peripheral vestibular disorder that manifests as sudden, short-lived episodes of vertigo elicited by specific head movements. BPPV is one of the most common causes of vertigo. It is often self-limiting, but can become chronic and relapsing with considerable effects on a patient's quality of life.</p>

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9
Q

<p>Explain the aetiology/risk factors of BPPV.</p>

A

<p>Increasing age<br></br>Female sex<br></br>Head trauma<br></br>Vestibular neuronitis<br></br>Labyrinthitis<br></br>Migraines<br></br>Inner ear surgery<br></br>Meniere's disease</p>

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10
Q

<p>Summarise the epidemiology of BPPV.</p>

A

<p>Primary (idiopathic) BPPV has a peak incidence between 50 and 70 years of age, but can occur in any age group. Migraine and head trauma are more common in younger patients with secondary BPPV compared with older patients with secondary disease.</p>

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11
Q

<p>Recognise the presenting symptoms of BPPV. Recognise the signs of BPPV on physical examination.</p>

A

<p>Vertigo<br></br>Nausea, imbalance, and lightheadedness<br></br>Absence of associated neurological or otological symptoms<br></br>Normal neurological and otological exam<br></br>Positive Dix-Hallpike manoeuvre</p>

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12
Q

<p>Identify appropriate investigations for BPPV and interpret the results.</p>

A

<p>Dix-Hallpike manoeuvre</p>

<p>Supine lateral head turns</p>

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13
Q

<p>How do you perform Dix-Hallpike manoeuvre?</p>

A

<p>The patient is seated and positioned on an examination table such that the patient's shoulders will come to rest on the top edge of the table when supine, with the head and neck extending over the edge. The patient's head is turned 45° towards the ear being tested. The head is supported, and then the patient is quickly lowered into the supine position with the head extending about 30° below the horizontal while remaining turned 45° towards the ear being tested.</p>

<p>The head is held in this position and the physician checks for nystagmus. To complete the manoeuvre, the patient is returned to a seated position and the eyes are again observed for reversal nystagmus.</p>

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14
Q

<p>Define infectious mononucleosis.</p>

A

<p>Infectious mononucleosis (IM), also known as glandular fever, is a clinical syndrome most commonly caused by Epstein Barr virus (EBV) infection.</p>

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15
Q

<p>Explain the aetiology/risk factors of infectious mononucleosis.</p>

A

<p>Kissing<br></br>Sexual behaviour</p>

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16
Q

<p>Summarise the epidemiology of infectious mononucleosis.</p>

A

<p>Historical data suggest that the incidence of IM ranges from 50 to 100 cases per 100,000 population, and peaks between 15 and 19 years of age.</p>

17
Q

<p>Recognise the presenting symptoms of infectious mononucleosis. Recognise the signs of infectious mononucleosis on physical examination.</p>

A

<p>Cervical or generalised lymphadenopathy<br></br>Pharyngitis<br></br>Malaise<br></br>Fever<br></br>Splenomegaly</p>

18
Q

<p>Identify appropriate investigations for infectious mononucleosis and interpret the results.</p>

A

<p>FBC<br></br>Heterophile antibodies<br></br>EBV-specific antibodies<br></br>Real-time PCR<br></br>CT abdomen</p>

19
Q

<p>Generate a management plan for infectious mononucleosis.</p>

A

<p><strong>1st line:</strong> Paracetamol/ibuprofen</p>

<p><u>Plus:</u><br></br>Corticosteroid or intravenous immunoglobulin</p>

20
Q

<p>Identify the possible complications of infectious mononucleosis and its management.</p>

A

<p>Splenic rupture<br></br>Neurological complications<br></br>Chronic active EBV infection<br></br>Autoimmune diseases, non-haematological<br></br>Malignancy<br></br>Fatigue<br></br>Renal complications</p>

21
Q

<p>Summarise the prognosis for patients with infectious mononucleosis.</p>

A

<p>The prognosis for healthy people with IM is very good. Death occurs rarely, and is usually caused by airway obstruction, splenic rupture, neurological complications, haemorrhage, or secondary infection.</p>

22
Q

<p>Define Meniere’s disease.</p>

A

<p>Meniere's disease (MD) or Meniere syndrome is an auditory disease characterised by an episodic sudden onset of vertigo, low-frequency hearing loss (in the early stages of the disorder), low-frequency roaring tinnitus, and the sensation of fullness in the affected ear.</p>

23
Q

<p>Explain the aetiology/risk factors of Meniere’s disease.</p>

A

<p>Recent viral infection<br></br>Genetic predisposition<br></br>Autoimmune disease</p>

24
Q

<p>Summarise the epidemiology of Meniere’s disease.</p>

A

<p>MD is primarily a disease of adulthood, although several cases have been reported in children. Onset usually occurs in the fourth decade. No racial differences have been clearly reported, and around 50% of patients with this diagnosis present with a family history of MD. It is slightly more common in females, with a 1.1:1 female-to-male ratio.</p>

25
Q

<p>Recognise the presenting symptoms of Meniere’s disease.</p>

A

<p>Vertigo<br></br>Hearing loss<br></br>Tinnitus<br></br>Aural fullness</p>

26
Q

<p>Recognise the signs of Meniere’s disease on physical examination.</p>

A

<p>Positive Romberg's test</p>

<p>Fukuda's stepping test: Turns towards the affected side when asked to march in place.</p>

27
Q

<p>Identify appropriate investigations for Meniere’s disease and interpret the results.</p>

A

<p>Pure-tone air and bone conduction with masking</p>

<p>Speech audiometry</p>

<p>Tympanometry/immittance/stapedial reflex levels<br></br>Oto-acoustic emissions (OAE)</p>

28
Q

<p>Define thyroglossal cysts.</p>

A

<p>A thyroglossal cyst is a fibrous cyst that forms from a persistent thyroglossal duct. Thyroglossal cysts can be defined as an irregular neck mass or a lump which develops from cells and tissues left over after the formation of the thyroid gland during developmental stages.</p>

29
Q

<p>Explain the aetiology/risk factors of thyroglossal cysts.</p>

A

<p>Thyroglossal cysts develop in the embryonic stage and can cause complications if they become infected.</p>

30
Q

<p>Summarise the epidemiology of thyroglossal cysts.</p>

A

<p>Thyroglossal cysts are the most common cause of midline neck masses and are generally located caudal to (below) the hyoid bone.</p>

31
Q

<p>Recognise the presenting symptoms of thyroglossal cysts. Recognise the signs of thyroglossal cysts on physical examination.</p>

A

<p>Midline mass in the neck</p>

<p>Dysphagia</p>

<p>Dyspepsia</p>

32
Q

<p>Identify appropriate investigations for thyroglossal cysts and interpret the results.</p>

A

<p>Blood Test</p>

<p>Ultrasound</p>

<p>Thyroid Scan</p>

<p>Fine Needle Aspiration</p>

33
Q

<p>Define tonsillitis.</p>

A

<p>Acute tonsillitis is an acute infection of the parenchyma of the palatine tonsils.</p>

34
Q

<p>Explain the aetiology/risk factors of tonsillitis.</p>

A

<p>Age between 5 and 15 years</p>

<p>Contact with infected people in enclosed spaces</p>

35
Q

<p>Summarise the epidemiology of tonsillitis.</p>

A

<p>In UK general practice, recurrent sore throat has an annual incidence of 100 in 1000 population. In the US, sore throat accounts for 1% of ambulatory visits. Acute tonsillitis is more common in children between the ages of 5-15 years.</p>

36
Q

<p>Recognise the presenting symptoms of tonsillitis. Recognise the signs of tonsillitis on physical examination.</p>

A

<p>Pain on swallowing<br></br>Fever (>38°C)<br></br>Tonsillar exudate<br></br>Sudden onset of sore throat<br></br>Headache<br></br>Abdominal pain<br></br>Nausea and vomiting<br></br>Presence of cough or runny nose<br></br>Tonsillar erythema<br></br>Tonsillar enlargement<br></br>Enlarged anterior cervical lymph nodes</p>

37
Q

<p>Identify appropriate investigations for tonsillitis and interpret the results.</p>

A

<p>Throat culture</p>

<p>Rapid streptococcal antigen test</p>

Year 3 Conditions MEGADECK (15 decks)

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