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Clin Med 2 > ENT/Eye Patho Review > Flashcards

ENT/Eye Patho Review Flashcards

1
Q

Oral cavity contents

A

teeth, gums, tongue

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2
Q

Pharynx

A

air passageway, muscles for swallowing, openings of ET tubes

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3
Q

Larynx

A

connects pharynx to trachea/lungs, contains vocal cords

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4
Q

Epiglottis

A

tissue overlying opening to larynx -> protects larynx from food passage (aspiration)

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5
Q

Salivary glands

A

parotid, submandibular, sublingual; add moisture to food, add carb digesting enzymes

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6
Q

Cochlea

A

snail shaped, generates neural impulses via auditory nerve to brain

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7
Q

Vestibular apparatus

A

helps with body equilibrium

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8
Q

Halitosis

A

= bad breath (bacterial breakdown of amino acids -> sulfide gas production)

**risk of acute necrotizing ulcerative gingivitis

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9
Q

Apthous Stomatitis vs HSV1

A

HSV 1 - viral oral cold sores on lips, mucosa, gums, hard palate

AS - canker sore more discrete along buccal mucosa, soft palate, tongue, gingiva

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10
Q

URI

A

= the common cold

MCC -> rhinovirus, coronavirus, adenovirus, RSV

SX: sore throat, rhinitis, fever, fatigue, +/- myalgias, cough, sinus pain

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11
Q

Group A Streptococcal Pharyngitis

A

= strep throat

**Centor criteria: +1 tonsillar exudates, +1 tender cervical LAD, +1 fever, +1 absence of cough

TX via abx to reduce infectious period

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12
Q

Laryngotracheitis

A

= croup…narrowing of subglottic airway (below vocal cords)

Etiology -> parainfluenza virus (MC in kids < 3 yo)

Sx: INSPIRATORY stridor, barking cough, hoarseness, fever

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13
Q

Sinusitis

A

= sinus infection

MCC: anatomic abnormalities, inflammatory occlusion (viral/allergy)

Sx/PE: nasal congestion, purulent discharge, HA, PND, tenderness to palpation along sinuses, nasal turbinate erythema

TX: saline washes and decongestants…abx ONLY if sx’s >7-10 days

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14
Q

Allergic Rhinitis

A

= hay fever…edema and hypersecretion of NP mucosa d/t seasonal pollens/allergns, animal dander, dust, etc

Sx/PE: rhinitis, scratchy throat, itchy eyes, pale and edematous mucosa on exam

PEDS!! atopic triad with eczema and asthma

Complications -> sinusitis and nasal polyps…recurrent edematous mucosa causes polyps

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15
Q

Acute Otitis Media (AOM)

A

= inflammation of the middle ear MC in infants & young children

**Strep pneumo, H. flu, Mor. catarrhalis

URI -> pharyngeal edema -> blocked ET tube -> infection

Sx/PE: otalgia, fever, irritability, erythematous bulging TM on PE +/- fluid in middle ear and decreased TM mobility

TX: abx

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16
Q

Suppurative Otitis Media

A

pus-forming bacteria form purulent drainage in middle ear -> higher risk of TM rupture

MC in kids -> ET tube sits at a more horizontal angle in kids so it is not as capable at draining middle ear

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17
Q

Otitis Externa

A

= external ear infection aka swimmers ear

**MC d/t Pseudo. aeruginosa, Staph. epidermidis, Staph. aureus

Sx/PE: otalgia, discharge, pruritis, hearing loss, tenderness to palpation of external ear, erythema in ear canal

TX: topical or ggt abx

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18
Q

Sensorineural hearing loss

A

cochlea and/or auditory nerve damage

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19
Q

Conductive hearing loss

A

external or middle ear that conduct sound waves are damaged

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20
Q

Pediatric Hearing Loss Etiologies

A

Congenital = TORCH (toxo, rubella, CMV), genetic, prematurity, teratogenic drugs

Infectious = recurrent O.M.

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21
Q

Adult Hearing Loss Etiologies

A

Prebycusis = degenerative (hearing loss with increasing age)

Meniere disease = endolymphatic hydrops resulting in sensorineural hearing loss….degenerative disease of vestibular apparatus

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22
Q

Meniere Disease

A

= sensorineural hearing loss

*TRIAD: sudden vertigo, tinnitus, hearing loss +/- N/V

TX: diuretics/antihistamines (decrease fluid in vestibular apparatus) & PPX vasoconstrictive agents (caffeine and chocolate)

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23
Q

Benign Paroxysmal Positional Vertigo

A

aka BPPV

D/T canalithiasis (Ca debris in canal) -> episodic vertigo often provoked by positional changes +/- N/V

DX: induce sx’s + nystagmus w/ Dix Hallpike Maneuver

TX: Epley maneuver

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24
Q

Otosclerosis

A

adult hearing loss d/t new bone growth in middle ear…impedes ossicles vibration

**MC gradual onset in young females…no other sx’s with normal PE

TX: hearing aids…surgery to replace involved bone with prosthesis

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25
Q

Sialoliths

A

stones in salivary glands -> obstruction

Sx: pain and swelling of gland

TX: sour candy, hydration, massage gland

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26
Q

Sialoadenitis

A

inflammation of a salivary gland

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27
Q

Mumps

A

Sxs: parotitis (painful swelling of parotid glands), orchitis (testicular inflammation), fever, malaise

**Risk of Male Infertility!!!

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28
Q

Sjogren Syndrome

A

= constellation of sx’s rather than functional dx…autoimmune dz

SX: dry eyes & mouth (xerostomia)

risk of eye damage & dental caries with absence of moist surfaces

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29
Q

Squamous Cell CA

A

MC cancer etiology in head and neck region…tobacco and ETOH increase risk

VIRAL -> HPV (90%), HIV, HSV

SX: Leukoplakia (white plaque that doesn’t scrape away), ulcerating expanding lesion, dysphagia

PE: LAD, palpable/visible tumor

TX: excision difficult…

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30
Q

Undifferentiated Nasopharyngeal Carcinoma

A

Etiology = Epstein-Barr virus (EBV) or mono

MC in asia/africa

aggressive!! but responds well to radiation

31
Q

Most Common Malignant Salivary Gland tumor

A

Mucoepidermoid carcinoma

32
Q

Obstructive Sleep Apnea (OSA)

A

= cessation of breathing during sleep (up to 1 min) then semi-awaken to resume breathing d/t obstruction of pharyngeal passages

MC in obese pt’s and trisomy 21 peds

-> hypoxia and sleep deprivation

TX: Tonsillectomy, CPAP

33
Q

3 layers of Eye

A

Sclera - tough fibrous layer
Uvea - vascular/nerve layer
Retina - inner retinal layer

34
Q

Cornea

A

transparent, allows light passage and refraction

continuous with sclera

35
Q

Conjunctiva

A

bulbar - loosely attached to sclera, blood vessels!!

palpebral - undersurface of eyelid

36
Q

Mydriasis

A

pupil dilation

37
Q

Miosis

A

pupil contraction

38
Q

Aqueous humor

A

secreted by ciliary body -> diffuses through pupil -> nourishes avascular lens

39
Q

Vitreous humor

A

gelatinous substance, fills spaces posterior to lens

**Stagnant! not replenish like aqueous humor so floaters etc stay unless surgically removed…

40
Q

Uvea

A

= layer of tissue that delivers O2/nutrients

-> choroid, ciliary body, and iris

41
Q

Choroid

A

connective tissue b/w retina and sclera

42
Q

Ciliary body

A

muscle that controls shape of lens, body produces aqueous humor

43
Q

Iris

A

colored portion of eye, controls shape of pupil by smooth muscle contraction (& therefore amount of light reaching lens)

44
Q

Retina

A

site of light and color sensing rods and cones -> transmit via optic nerve back to visual cortex of brain

45
Q

Macula

A

spot on retina with highest visual acuity

46
Q

Fovea

A

central portion of macula

47
Q

Optic disc

A

raised disk on retina, point of optic nerve entry, creates a blind spot

48
Q

Rods

A

= photoreceptor that works in low levels of light

**night vision…100 million rods

49
Q

Cones

A

= photoreceptor that requires more light and used to see COLOR

**daytime vision…6 million cones (many packed in fovea)

50
Q

Eye History Important Q’s

A

Pain?
Trauma?
Infection?
Blurred/double vision?
Itching?
Discharge?
Photophobia?
Floaters? Flashers? Curtains? Halos?
Anything tried?

51
Q

Snelling chart

A

20/20 vision -> see at 20ft what avg person sees at 20 ft

20/40 vision -> pt needs to approach 20ft to see what avg person does at 40ft

52
Q

Papilledema

A

swelling of optic nerve visualized during fundoscopic exam

53
Q

Tonometer

A

place on eyeball, measures intraocular pressure (glaucoma!!)

54
Q

Slit-Lamp

A

binocular magnifying instrument, projects beam into eye and allows detailed exam of anterior structures

55
Q

Hyphema

A

blood in anterior chamber d/t tearing of iris or ciliary body

56
Q

Open-Globe eye trauma

A

full-thickness or defect in wall of eye, loss of vitreous fluid

57
Q

Conjunctivitis

A

= pink eye MC d/t viral, bacterial, fungal, or allergy responses

***HIGHLY CONTAGIOUS

Sx/PE: irritation, blurred vision, redness, discharge

bacterial -> mucopurulent discharge, eye “stuck shut” in morning

TX: abx gets

58
Q

Corneal Abrasion

A

Sxs: foreign body sensation, pain, photophobia

PE: fluorescein stain, lid eversion

TX: abx ointment

**Contact lens wearers at risk of Pseudomonas

59
Q

Trachoma

A

= chlamydial conjunctivitis

chronic inflammation -> scarring -> entropion -> blindness

60
Q

Strabismus

A

= heterotropia = “crossed eyes” = improper alignment of line of vision d/t paralysis of extra ocular muscle, refractive errors, opacity of cornea/lens, etc

normal in babies until 3-4 months old

Tx: lenses, surgical alteration of EOM

-> if not corrected, can lead to amblyopia (lazy eye)

61
Q

Cataract

A

= opacification (clouding) of the lens w/ advanced age or trauma

RF: poorly controlled DM

Sx: slow and gradual decrease in vision

Tx: surgical extraction of opacified lens

62
Q

Glaucoma

A

= rise of intraocular pressure sufficient to damage nerve fibers d/t obstruction of normal exit of aqueous fluid (at angle where iris meets corneal-scleral junction)

PE: peripheral vision deficit

*Tonometer testing

63
Q

Primary Glaucoma

A

d/t closure of pre-existing narrow space angle with advance age

64
Q

Secondary Glaucoma

A

d/t uveitis or dislocation of lens

65
Q

Open-Angle Glaucoma

A

= gross of microscopic abnormalities in iris

insidious onset..most common

Sx: pain, peripheral vision loss, awareness with advanced dx

66
Q

Closed Angle Glaucoma

A

= obstruction of angle by iris…adhesion may be irreversible or permanent if inflammation & scarring have ocurred

SX: pain, N/V, sudden vision loss

67
Q

Hypertensive Retinopathy

A

= HTN -> progressive arteriosclerosis of retinal vessels -> lack of o2 to neurons -> vision loss

Fundo exam: AV nicking narrow, tortuous arteries…flame-shaped micro hemorrhages, cotton wool spots

SX: vision loss occurs (irreversible)

TX: HTN rx to prevent further damage

68
Q

Macular Degeneration

A

= degeneration of pigment in macula (area of retina with most visual acuity)

RF: smoking, females

Dry form (retina thins/drusen develop) vs Wet form (less common)

SX: blurred central vision -> blindness

69
Q

Diabetic Retinopathy

A

= arteriosclerosis -> retinal dx

Fundo exam: vessel narrowing, capillary aneurysms, microhemorrhages, neovascularization

SX: vision loss

Complications -> retinal detachment

70
Q

Myopia

A

= near sightedness, image focuses at point ANTERIOR to retina

d/t abnml curvature of cornea/lens, familial component

SX: decreased visual acuity for DISTANT objects

presents in childhood…stabilizes in adulthood

71
Q

Hyperopia

A

= far-sightedness, image focus POSTERIOR to retina

d/t short eyeball, inability to accomodate (lens change shape), progresses with age

SX: decreased visual acuity for near objects

72
Q

Astigmatism

A

uneven focusing of lighting entering the eye d/t unequal curvature of cornea or irregularities in cornea surface/lens

73
Q

Retinoblastoma

A

= rare malignant tumor of neurons that are precursors to retinal ganglion cells

MC in children (autosomal dominant)

SX: decreased vision, white reflex

TX: enucleation +/- chemo/radiation

74
Q
A

Clin Med 2 (4 decks)

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