ENT/derm/ophthal Flashcards
Malignant tumour of epidermal keratinocytes
SCC
What is a +ve Rinnes test
NORMAL i.e. air conduction is better than bone conduction
Weber test - what is the result if the LEFT ear is a) SN loss b) conductive loss
a) louder in the right ear
b) louder in the left ear
Telogen vs anagen effluvium
Telogen - stress (physiological)
Anagen - chemo
Pterygium vs Pinguecula
Pterygium grow over the edge of the cornea, pinguecula don’t
Complications of peritonsillar abscess
- necrotising fasciitis of deep neck tissues
- spread to cause pericarditis, mediastinitis, pleural effusion
Chalazion vs stye
Chalazion - blocked meiobian gland, usually painless
Stye - infected eyelash follicle, painful, edge of eyelid
Clinical fx of keratoconus + management
- bilateral blurred vision + myopia
- Munsons sign
contacts/glassess –> corneal transplant
Management of fungal nail infection
- Conservative (if asymptomatic)
- if mild (<2 nails, <50% nail involved) - topical amorolfine 5%
3) if >2 nails, >50% nail involved: oral terbinafine for months
Most frequently used drugs which are ototoxic are..?
Aminoglycosides: gentamicin
Loop diuretics
Location of lesion associated with homonymous hemianopia
optic tract (posterior to optic chiasm)
Location of lesion associated with homonymous hemianopia with macular sparing
Optic radiation
Metamorphosia, grey patch in central field of vision, abnormal dark adaptation - diagnosis?
AMD
Molluscum - cause?
Conservative management advice?
Glasgow 7 of melanoma signs
size
shape
colour
diameter >7mm
inflammation
exudate/bleeding
itch/odd sensation
4 conditions associated with nasal polyps
Asthma
Hayfever
Aspirin hypersensitivity
CF
What is Horners syndrome?
- Signs?
- Causes?
Interrupted sympathetic supply to eye
- ptosis, miosis, anhydrosis
- CENTRAL cause - stroke/ MS
- PREGANGLIONIC causes: Pancoast tumour, mediastinal/thyroid mass, neck surgery/trauma
- POSTGANGLIONIC cause: carotid artery dissection, otitis media, head/neck trauma
CN3 palsy
- 3 features?
compressive vs ischemic
- down and out pupil
- ptosis
- dilated pupil in COMPRESSIVE causes (fibres are superficial of nerve)
Optic vs oculomotor nerve action
Optic nerve detects light entry to the eye
Oculomotor nerve causes pupillary constriction
Argyll Robertson vs Holmes Adie Pupil
- ARP = accomodation reflex present (brisk), sluggish light reflex. SMALL pupils
- HAP = large irregular pupils, with . also responds normally to accom and poorly to light
Pemphigoid gestationis
- distribution?
Periumbilical region, then spreads to trunk/back/buttocks/arms
Scabies
1st line treatment?
Permethrin 5%
2 topical treatments for superficial BCCs
imiquimod, 5 FU
A lesion which mimics SCC?
Keratoacanthoma
Keratitis from UV exposure
- typical presentation?
- management?
Presentation: 6 hours post UV exposure with pain and watery eye. Punctate erosions on fluoroscein staining
Management: ointment, artificial tears, analgesia, topical abx
Best imaging for suspected nasal polyps
coronal sinus CT
4 signs/symptoms of retinal detachment
4Fs
Flashes
Floaters
Fall in acuity
Field loss
Developmental defects –> neck lumps
Likely dx if lump is:
- anterior triangle
- posterior triangle
- midline
anterior triangle: branchial cyst (often in young adults)
posterior triangle: cystic hygroma (babies)
midline: thyroglossal cyst, dermoid cyst
pinna cellulitis vs perichondritis
perichondritis - redness SPARES the ear lobe
Holmes Adie vs Argyll robertson pupil
Accommodation reflex intact in both, but poor light reflex
Argyll Robertson - pupils small (like argyl in scotland) and irregular
Holmes Adie -Huge Ass pupil, v dilated
central retinal artery occlusion - appearance of the retina?
how does it present?
pale retina, cherry red spot
sudden painless loss of vision
what acne treatment can be given in pregnancy?
topical benzoyl peroxide
topical therapies for superficial BCCs?
imiquimod, 5FU
what is lichen simplex chronicus
NOT a primary process - thickening and lichenification of skin due to excess scratching
1st line treatment for scabies
permethrin 5%
Management of acne rosacea?
if flushing is predominant - topical brimonidine
if papules/pustules predominant - topical IVERMECTIN
Lump on lateral aspect of eyebrow in a child
- diagnosis? when to worry?
dermoid cyst
if in the midline –> see if it extends into CNS
Acanthosis nigricans
- two important causes to consider?
Diabetes - do HbA1c
Gastric Ca
pizza pie appearance of the retina
diagnosis?
CMV retinitis
Cellulitis near the eyes or nose
Abx of choice?
Co-amoxiclav
treatment of dermatitis herpetiformis
dapsone
gluten free diet
1st sign of diabetic retinopathy?
subsequent signs
microaneurysms
then dot and blot hamorrhages, hard exudates, cotton wool spots
Neovascularisation
rare but important adverse effect of chloramphenicol
Bone marrow suppression
Treatment of erythema ab igne
topical retinoid or laser
define chronic suppurative otitis media
otorrhoea >6 week
most commonly due to pseudomonas
stages of hypertensive retinopathy
I: silver wiring
II: AV nipping
III: haemorrhages
IV: papilloedema
