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Misc. Notes Year 2 > ENT notes > Flashcards

ENT notes Flashcards

1
Q

What is the thinnest part of the skull

A

Pterion

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2
Q

Which bones make up the pterion

A

Temporal, Sphenoid, Frontal, Parietal

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3
Q

Anterior cranial fossa bones

A

Frontal
Ethmoid
Sphenoid

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4
Q

Middle cranial fossa bones

A

Sphenoid

Temporal

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5
Q

Posterior cranial fossa bones

A

Temporal

Occipital

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6
Q

Innervation of superior EAM

A

CN V3

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7
Q

Innervation of inferior EAM

A

CN X

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8
Q

How does the avascular elastic cartilage of the ear acquire nutrients

A

From skin

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9
Q

Does the pars tensa sit inferiorly or superiorly

A

Posteroinferiorly

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10
Q

What supplies the tympanic membrane (external and internal surfaces)

A

External - CN V3 (auriculotemporal branch)

Internal - CN IX

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11
Q

What is the stapedius

A

Muscle which reduces stapes movement

Protects inner ear from excessive noise

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12
Q

What type of tissue is present in the middle ear

A

Columnar-lined mucosa

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13
Q

What type of tissue is present in the nasal vestibule

A

Squamous

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14
Q

What is Schneiderian epithelium and where is it present

A

Pseudostratified ciliated columnar
(respiratory epithelium)
Nose & sinus

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15
Q

Which cells in the salivary glands contain digestive amylase

A

Serous cells

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16
Q

Which cells in the salivary glands are contractile

A

Peripheral myoepithelial cells

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17
Q

How does a cholesteatoma usually arise

A

Chronic otitis media with a perforated tympanic membrane

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18
Q

Which gene is mutated in NF type 2 and which protein does it code for

A

NF 2 gene

Merlin protein

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19
Q

What should you include in your Ddx if a young person has nasal polyps

A

Cystic Fibrosis

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20
Q

Which GI disease can cause a contact ulcer in the throat

A

GORD

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21
Q

What is paramyxovirus of the salivary glands

A

Mumps + Bilateral parotitis

With associated orchitis

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22
Q

What is the most common salivary gland tumour and how does it present

A

Pleomorphic adenoma

Usually in females over 60 in the parotid gland

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23
Q

What is the 2nd most common salivary gland tumour(associated with smoking) and how does it present

A

Warthin’s tumour

usually in males over 50 (bilateral and multicentric)

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24
Q

What is the most common malignant tumour of the salivary glands in the UK and the world

A

Adenoid Cystic Carcinoma - UK

Mucoepidermoid carcinoma - World

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25
Q

Which amino acid in particular triggers an umami/meaty/savoury taste

A

Glutamate

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26
Q

What kind of deficiency can cause Dysguesia (altered taste)

A

Zinc deficiency

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27
Q

Which cell type in the olfactory mucosa secrete mucus

A

Basal cells

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28
Q

Which brain surface are the olfactory bulbs on

A

Inferior brain surface

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29
Q

Name the 4 components of the Centor score

A

Tonsillar exudate
Fever
Tender anterior cervical lymphadenopathy
The absence of a cough

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30
Q

What is the most common cause of bacterial tonsilitis

A

Strep. Pyogenes

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31
Q

What are 2 late complications of bacterial tonsilitis

A

Rheumatic fever

Glomerulonephritis

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32
Q

What antibiotic is first line for the treatment of otitis media

A

Amoxicillin

Clarithromycin if allergic (2nd line - erythromycin)

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33
Q

What antibiotic is first line for the treatment of bacterial sinusitis

A

Penicillin V

Doxycycline if allergic (not in children)

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34
Q

Name 4 complications of Infectious Mononucleosis

A

Splenic rupture
Increased risk of lymphoma
Airway obstruction
Anaemia

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35
Q

Where does necrosis in the brain occur, with regards to untreated herpes simplex encephalitis

A

Temporal lobe necrosis

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36
Q

What is the range of human hearing

A

20- 20,000Hz

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37
Q

What is the ratio and pressure gain between the tympanic membrane and oval window

A

18: 1

Pressure gain of x22

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38
Q

What are the 4 inputs to regulate balance

A

Visual
Proprioceptive
Cardiovascular
Vestibular

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39
Q

What are the 5 key vestibular end-organs

A 
Macula of Utricle 
Macula of Saccule 
Ampulla of Lateral Semi-Circular Canal 
Ampulla of Superior Semi-Circular Canal 
Ampulla of Posterior Semi-Circular Canal
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40
Q

What is the name of the special calcium carbonate crystals on the ends of the stereocilia in the otolith organs

A

Otoconia

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41
Q

Which salivary gland secretes 90% of the saliva

A

Parotid

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42
Q

Which major artery is the lingual artery a branch of

A

External carotid

43
Q

Name the 5 muscles of the soft palate

A 
Tensor Veli Palatini 
Levator Veli Palatini 
Palatoglossus 
Palatopharyngeus 
Musculus Uvulae
44
Q

What is the medical term for the Adam’s apple

A

The laryngeal prominence of the thyroid cartilage

45
Q

What are the attachments of the true vocal cords

A

Vocal process of arytenoid to thyroid cartilage

46
Q

What are the attachments of the false vocal cords

A

Arytenoid cartilage to the epiglottis

47
Q

What does the quadrangular membrane connect

A

Vestibular ligament & epiglottis

48
Q

What does the vocal ligament connect

A

Vocal process & thyroid

49
Q

What does the conus elasticus connect

A

Cricoid and vocal ligament

50
Q

What is the Hippocratic method and what is it used for

A

The position adopted for epistaxis

Squeeze nose low and lean forward

51
Q

What is pinna haematoma

A

Sub-perichondral haematoma

52
Q

What does a ‘proper’ penetrating neck injury mean

A

An injury which penetrates the Platysma muscle

53
Q

How many Hz is the tuning fork used in Rinne’s and Weber test

A

512Hz

54
Q

How can you differentiate between CSF and other discharge from the ear

A

Glucose testing strip

55
Q

What is the name of the classification system used for retraction of the tympanic membrane

A

The Sade classification

56
Q

What is the immediate management of Otitis Externa to provide symptomatic relief

A

Suction Cleaning

57
Q

Compare the biochemistry of the Perilymph and the Endolymph in terms of Na & K concentrations, and explain why this is

A

Endolymph has low [Na] and high [K]

These concentrations drive the vibrations and allow depolarisation via Na influx

58
Q

What is the name of the special membrane which covers the organ of Corti

A

Basilar Membrane

59
Q

How do you test the vestibulo-ocular reflex

A

VNG

Videonystagmography

60
Q

How do you differentiate between BPPV & Vertebrobasilar insufficiency

A

Vertebrobasilar insufficiency presents with other symptoms apart from vertigo e.g visual disturbances, weakness, numbness

61
Q

Name 3 treatments for BPPV

A

Epley Manoeuvre (main one)
Semont Manoeuvre
Brandt- Daroff exercises

62
Q

What can Buccal Prochlorperazine be given for and why

A

Vestibular neuronitis
Labyrinthitis
(given to decrease vertigo

63
Q

Which disease out of vestibular neuronitis and labyrinthitis has associated tinnitus & hearing loss

A

Labyrinthitis

64
Q

What is phonophobia

A

Fear of loud sounds

65
Q

Which head and neck cancer is hardwood associated with

A

Sinus cancer

66
Q

What structures does the recurrent laryngeal nerve wrap around on the right and left

A

Right - right subclavian artery

Left - arch of aorta

67
Q

What is the difference between dysphagia and odynophagia

A

Dysphagia - difficulty swallow

Odynophagia - pain on swallowing

68
Q

What are gabapentin and pregabalin normally used for

A

Anit-Convulsants

69
Q

What 2 pro-inflammatory molecules do mast cells release when activated

A

Histamine

Leukotrienes

70
Q

Name a nasal decongestant drug

A

Pseudoephedrine

71
Q

Name an anti-histamine drug

A

Cetirizine

72
Q

According to the ARIA classification, how is intermittent rhinitis defined

A

Symptoms < 4 days/week

OR symptoms < 4 weeks

73
Q

According to the ARIA classification, how is persistent rhinitis defined

A

Symptoms > 4 days/week

AND symptoms > 4 weeks duration

74
Q

What is the treatment ladder for allergic rhinitis (including the background continuous management)

A

Anti-histamine
Topical steroid
Anti-histamine + Topical steroid
(Allergen avoidance constant)

75
Q

What is Samter’s triad

A

Asthma, Nasal Polyps, Aspirin sensitivity

76
Q

What is the purpose of giving a topical cholinergic drug in non-infective rhinitis

A

Supresses rhinorrhoea

77
Q

What are the differentials from a presentation of unilateral nasal discharge and what is the next step

A

Foreign Body or Neoplasia

Refer urgently

78
Q

Which tonsils make up Waldeyer’s ring of lymphoid tissue

A

Palatine tonsils
Adenoid tonsils
Lingual tonsils

79
Q

Which tonsils have a transitional layer and what is the function of it

A

Adenoid tonsils

Antigen processing layer

80
Q

Which tonsils have stratified squamous epithelium on its luminal surface

A

Palatine tonsils

81
Q

What kind of epithelium is present on the surface of the adenoid tonsils

A

Ciliated pseudostratified columnar

82
Q

What two things will be seen in the blood which could aid in the diagnosis of Infectious Mononucleosis

A

Low CRP

Atypical lymphocytes

83
Q

When should you refer otitis media with effusion

A

Persistent >3 months
Bilateral
Speech/ language problems
Developmental delay

84
Q

What would a mass found in the tail of the parotid gland make you think of

A

Pleomorphic adenoma

85
Q

How can a cholesteatoma cause hearing loss and vertigo

A

A large enough one can invade the otic capsule

86
Q

Which systemic autoimmune disease could cause bilateral parotid gland swelling and facial nerve palsies

A

Sarcoidosis

87
Q

What would halitosis + a painless neck mass make you think of

A

Pharyngeal pouch

88
Q

Which abnormality is fixed using the Sistrunk procedure

A

Thyroglossal cyst

89
Q

Which growth has a typically biphasic growth on histology and why is this

A

Pleomorphic adenoma

due to stromal & epithelial elements

90
Q

What is a side effect of using topical decongestants for a prolonged period

A

Tachyphylaxis

Greater doses are needed to produce the same effect

91
Q

What should you do on the first presentation of a perforated eardrum

A

Watch and wait for 6 weeks

92
Q

What can be given for acute attacks of Meniere’s

A

Buccal or IM Prochlorperazine

93
Q

What can be given for prevention of Meniere’s

A

Betahistine

94
Q

What test will be positive for Meniere’s and BPPV respectively

A

Meniere’s –> Romberg

BPPV –> Dix-Hallpike

95
Q

What are crista galli

A

A special feature of cribriform plate of ethmoid

96
Q

What makes up the nasal septum

A

Perpendicular plate of ethmoid

97
Q

Which bones make up the medial wall of the nasal septum

A

Ethmoid and Vomer

98
Q

What are vibrissae and where are they found

A

Small hairs found in the stratified keratinised epithelium in the nasal vestibule
Filter the air we breathe in

99
Q

What is a microscopic feature of vestibular schwannomas

A

Verocay bodies

100
Q

Describe the 2 ends of an olfactory neurone

A

Thick short dendrite and expanded olfactory rod

101
Q

What causes oral thrush and what is the treatment

A

Candida Albicans

Topical Nystatin suspension

102
Q

What is the causative organism of herpangina

A

Coxsackie

103
Q

What is thought to be the pathology of Meniere’s

A

Membrane separating perilymph and endolymph tears, resulting in mixing of the two fluids

Misc. Notes Year 2 (30 decks)

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