face

Question 1

what causes ramsay hunt syndrome

Answer 1

reactivation of varcilla zoster virus in geniculate ganglion of CNVII

Question 2

symptoms ramsay hunt sydnrome

Answer 2

auricular pain // facial nerve palsy // vesicular rash on ear // vertigo + tinnitus

Question 3

mx ramsay hunt syndrome

Answer 3

oral aciclovir + steroids

Question 4

function CNVII

Answer 4

muscles facial expression + nerve to stapedius // ant 2/3 taste tongue // parasympathetic fibres to tears + salivary glands

Question 5

causes bilateral facial nerve palsy

Answer 5

sarcoid // GBS // lyme // bilateral acoustic neuroma

Question 6

causes unilateral facial palsy

Answer 6

Bells // ramsay hunt // acoustic neuroma // parotid // HIV

Question 7

facial LMN vs UMN

Answer 7

UMN spared forehead

Question 8

causes unilateral facial UMN

Answer 8

stroke

Question 9

where does CNVII pass through

Answer 9

tempiral bone –> internal auditory meatus (alongside vestibulococlear nerve) –> combine togetehr to become facial nerve –> through parotid

Question 10

branches CNVII

Answer 10

greater petrosal // nerve to stapedius // chorda tympani

Question 11

features bells palsy

Answer 11

LMN facial palsy (includes forehead) // post-auricular pain // altered taste, dry eyes // hyperacusis (facial nerve palsy)

Question 12

age bells palsy

Answer 12

20-40 (common in pregnancy)

Question 13

what is thought to cause bells palsy

Answer 13

herpes simplex

Question 14

mx bells palsy

Answer 14

oral pred within 72hrs // eye care (eg artificial tears) // antivirals

Question 15

what warrants referral to ENT in bells palsy

Answer 15

paralysis not improving at 3 weeks

Question 16

how long does bells last

Answer 16

3-4 months

Question 17

symptoms trigeminal neurlagia

Answer 17

severe unilateral pain on face // triggered by light touch

Question 18

mx trigeminal neurlagia

Answer 18

carbamezepine

Question 19

symptoms temporal bone fracture

Answer 19

battle sign behind ear // tinnitus, hearing loss, discharge from ear, CNVII/VIII damage

Question 20

what are the 3 pairs of salivary glands

Answer 20

parotid // submandibular // sublingual

Question 21

where do most tonsil stones occur

Answer 21

submandibular

Question 22

symptoms of salivary stones

Answer 22

unilateral pain + swelling on eating // smell bad

Question 23

invx salivary stones

Answer 23

plain x ray

Question 24

what can cause ludwigs angina

Answer 24

infected salivary stones // tooth infection –> submandibular space

Question 25

what is ludwigs angina

Answer 25

cellulitis that invades the floor of the mouth + soft tissue of the neck

Question 26

symptoms ludwigs angina

Answer 26

neck swelling, dysphagia, fever, airway obstruction

Question 27

mx ludwigs angina

Answer 27

airway + IV abx

Question 28

where do the majority of salivary gland tumours occur

Answer 28

parotid

Question 29

what is a pleomorphic adenoma

Answer 29

most common tumour of parotid gland - benign

Question 30

symptoms + o/e pleomorphic adenoma

Answer 30

men 50s // slow growing, painless, unilateral swelling // mobile

Question 31

why do pleomorphic adenoma need removed

Answer 31

risk of malignant transformation (2-10% if not excised)

Question 32

symptoms warthins tumour

Answer 32

bilateral // males 60-70

Question 33

type of parotid tumour seen in children <1

Answer 33

haemangioma

Question 34

most common parotid malignant tumour

Answer 34

mucoepidermoid carcinoma

Question 35

invx parotid tumours

Answer 35

xrays (for stones) // FNAC!! // CT or MRI for malignancy

Question 36

mx parotid tumour

Answer 36

benign = superficial parotidectomy // malignant = radical

Question 37

HIV manifestation in parotid

Answer 37

lymphoepithelial cysts - bilateral