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Clinical Medicine I > HEENT > Flashcards

HEENT Flashcards

1
Q

Lesion is at the optic chiasm

A

Bitemporal Hemianopsia

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2
Q

Occlusion of a branch of the central retinal artery; Ischemia of the optic nerve can also produce the similar defect

A

Horizontal Defect

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3
Q

Causes Ptosis (3)

A
  • Myasthenia Gravis
  • CN 3 damage
  • Damage to sympathetic nerve supply (Horner Syndrome)
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4
Q

A harmless yellowish triangular nodule in the bulbar conjuctiva

A

Pinguecula

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5
Q

Localized ocular inflammation of the episcleral vessels

A

Episcleritis

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6
Q

Causes Episcleritis (3)

A
  • Rheumatoid Arthritis
  • Sjogren Syndrome
  • Herpes Zoster
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7
Q

A painful, tender, red infection at the margin of the eyelid

A

Hordeolum (Stye)

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8
Q

A subacute non-tender nodule caused by a blocked meibomian gland

A

Chalazion

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9
Q

Slightly raised, yellowish, well-circumscribed cholesterol-filled plaques that appear along the nasal portions of one or both eyelids

A
  • Xanthelesma
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10
Q

A thin grayish white arc or circle not quite at the edge of the cornea

A

Corneal Arcus

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11
Q

A golden to red brown ring, sometimes shading to green or blue, from copper deposition in the periphery of the cornea found in Wilsons Disease

A

Kayser-Fleischer Ring

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12
Q

A superficial grayish white opacity in the cornea, secondary to an old injury or to an inflammation

A

Corneal Scar

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13
Q

A triangular thickening of the bulbar conjunctiva that grows slowly across the outer surface of the cornea, usually from the nasal side.

A

Pterygium

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14
Q

Opacities of the lenses visible through the pupil.

A

Cataract

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15
Q

Risk factors of Cataract (4)

A
  • Older age
  • Smoking
  • Diabetes
  • Corticosteroid use
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16
Q

Cataract that looks gray when seen by a flashlight

A

Nuclear Cataract

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17
Q

Cataract - if the pupil is widely dilated, the gray opacity is surrounded by a black rim

A

Nuclear Cataract

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18
Q

Cataract - produces spokelike shadows that point - gray against black, as seen with a flashlight, or black against red with an ophthalmoscope

A

Peripheral Cataract

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19
Q

Effect on pupil when Anisocoria is greater in dim light than in bright light

A

the smaller pupil cannot dilate properly caused by an interruption of the sympathetic nerve supply

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20
Q

Effect on pupil when Anisocoria is greater in bright light than in dim light

A

the larger pupil cannot constrict properly

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21
Q

Causes of Anisocoria where it is greater in bright light than in dim (4)

A
  • blunt trauma
  • open-angle glaucoma
  • impaired parasympathetic nerve supply to the iris
  • occulomotor nerve paralysis
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22
Q

Pupil is large, regular and usually unilateral

A

Tonic Pupil (Adie’s Pupil)

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23
Q

The dilated pupil is fixed to light and near effort

A

CN III Paralysis

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24
Q

Horner’s Syndrome symptoms (6)

A 
S ympathetic
A nhidrosis
M iosis
P tosis
L oss of Ciliospinal Reflex
E nopthalmos
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25
Q

Small, irregular pupils that accommodate but do not react to light

A
  • Argyll Robertson

- Central Nervous System Syphilis

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26
Q

The affected pupil, though small, reacts briskly to light and near effort

A

Horner’s Syndrome

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27
Q

Caused by an imbalance in ocular muscle tone

A

Developmental Dysconjugate Gaze

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28
Q

CN6 Paralysis

A

Estropia appears when looking straight ahead

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29
Q

CN 4 Paralysis

A

cannot look down and in

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30
Q

Test for convergence is poor in ____

A

Hyperthyroidism

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31
Q

A small whitish depression in the optic disc, the entry point for retinal vessels

A

Physiologic Cup

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32
Q

These are developmental variations that appear as either white sclera, black retinal pigment, or both, especially along the temporal border of the disc

A

Rings and Crescents

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33
Q

What is the normal appearance of the Optic Disc (4)

A
  • Color yellowish orange to creamy pink
  • Disc vessels are tiny
  • Disc margins are sharp (except perhaps nasally)
  • Physiologic cup is located centrally or somewhat temporally
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34
Q

Appearance of Optic Disc during Papilledema (5)

A
  • Color pink, hyperemic
  • Often loss of venous pulsations
  • Disc vessels more visible, more numerous, curve over the borders of the disc
  • Disc swollen with margins blurred
  • Physiologic Cup is not visible
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35
Q

Appearance of Optic Disc during Glaucomatous Cupping (2)

A
  • Physiologic cup is enlarged, occupying more than half of the disc’s diameter, at times extending to the edge of the disc
  • Retinal vessels sink in and under it, and may be displaced nasally
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36
Q

Appearance of Optic Disc during Optic Atrophy (2)

A
  • color white

- Tiny disc vessels are absent

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37
Q

Small, linear, flame-shaped, red streaks in the fundi

A

Superficial Retinal Hemorrhages

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38
Q

Diplopia in one eye, with the other closed suggests a problem in the

A

Cornea

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39
Q

What do tragal or mastoid tenderness signify?

A

Middle ear infection (Otits Media)

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40
Q

Movement of the auricle and tragus (tug test) is painful in

A

Acute otitis externa

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41
Q

Rounded bony growth in the inner surface of the mandible. It is typically bilateral, asymptomatic and harmless.

A

Torus mandibularis

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42
Q

Valsalva maneuvers and leaning forward may increase pain from

A

Acute sinusitis

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43
Q

A subacute nontender, usually painless nodule caused by a blocked meibomian gland may become acutely inflamed usually points inside the lid.

A

Chalazion

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44
Q

There is thickening of the arterial wall, causing focal or generalized narrowing of the lumen and the light reflex.

A

Retinal arteries in hypertension

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45
Q

Occasionally the wall of narrowed artery becomes opaque so there is no visible blood.

A

Silver Wiring

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46
Q

Sometimes the arteries become full and somewhat tortuous and develop an increased light reflex with a bright coppery luster.

A

Copper Wiring

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47
Q

This headache is generalized, very severe “the worst of my life”

A

Thunderclap (Subarachnoid hemorrhage)

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48
Q

A sudden visual loss that is painless and unilateral. Consider the following causes (6)

A
  • Vitreous Hemorrhage from Diabetes
  • Trauma
  • Macular Degeneration
  • Retinal Detachment
  • Retinal Vein Occlusion
  • Central Retinal Artery Occlusion
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49
Q

Sudden, Unilateral, Painful Visual Loss (5)

A
  • O ptic Neuritis from Multiple Sclerosis
  • T raumatic Hyphema
  • A cute Angle Closure Glaucoma
  • C orneal Ulcer
  • U veitis
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50
Q

there specks in the vision or areas where the patient cannot see

A

Scotomas

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51
Q

Headache:

One side of the head, light and sound sensitivity

A

Migraine

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52
Q

Headache:

Band around the head, Aching pressure, triggered by stress

A

Tension Headache

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53
Q

Headache:
• Behind one eye at a time
• Sometimes a series of headaches
• Swelling, redness, and sweating

A

Cluster Headache

54
Q

Headache:
• Top of head
• Runny nose, sneezing, and watering eyes

A

Allergy Headache

55
Q

Headache:
• Pain in Eyes and cheeks
• Pressure and facial pain

A

Sinus Headache

56
Q

Red painless eye

A
  • Subconjunctival Hemorrhage

- A red eye with a gritty sensation in Viral Conjunctivitis

57
Q

Hearing disorders of the external and middle ear cause conductive hearing loss. This includes (4)

A
  • P erforated eardrum
  • O titis media
  • O tosclerosis of ossicles
  • F oreign body
58
Q

Hearing disorders of the inner ear cause sensorineural hearing loss. This includes (6)

A
  • loud noise exposure
  • inner ear infections
  • trauma
  • tremors
  • congenital and familial disorders
  • aging (Presbycusis)
59
Q

Diagnostic criteria of acute bacterial sinusitis (Rhinosinusitis)

A
  • Purulent Drainage

- Facial Pain

60
Q

If the nasal congestion is only on one side, consider the following (4)

A
  • Deviated Nasal Septum
  • Foreign Body
  • Wegner Granuloma
  • Carcinoma
61
Q

This headache is sharp, intense, continuous, severe, unilateral, usually located behind or around the eye or temple. Associated symptoms are lacrimation, rhinorrhea, miosis, ptosis, eyelid edema and conjunctival infection.

A

Cluster Headache

62
Q

The eyes are conjugate in right lateral gaze but not in left lateral gaze.

A

Left CN VI paralysis

63
Q

A red eye with a gritty sensation is seen in

A

Viral conjunctivitis

64
Q

Tongue that has lost its papillae, sometimes just in patches, suggests a deficiency in riboflavin, niacin, folic acid, vitamin B12, pyridoxine, or iron, or treatment with chemotherapy

A

Smooth Tongue (Atrophic Glossitis)

65
Q

Benign condition, Food debris may accumulate in

the crevices and become irritating

A

Fissured Tongue

66
Q

A painful, round or oval ulcer, white or yellowish gray, surrounded by a halo of reddened mucosa in oral cavity

A

Aphthous Ulcer (Canker Sore)

67
Q

The dorsum shows scattered smooth red areas denuded of papillae.

A

Geographic Tongue

68
Q

A yellowish to brown or black elongated papillae on the tongue’s dorsum

A

Hairy Tongue

69
Q

Light rays of images focus in front of the retina rather than directly on the retina causing blurred vision at a distance

A

Myopia (Nearsightedness)

70
Q

Condition occurs when light entering the eye focuses behind the retina instead of directly on it

A

Hyperopia (Farsightedness)

71
Q

Posterior pathway defects

A
  • Stroke

- Chiasmal Tumors

72
Q

Anterior Pathway defects

A
  • Glaucoma
  • Optic Neuropathy
  • Optic Neuritis
  • Glioma
73
Q

A condition of abnormal bone growth in the ear

A

Otosclerosis

74
Q

WHO epidemiologic classification of cervical goiter Grade 1

A

palpable goiter, not visible when neck is held in normal position

75
Q

A triangular thickening of the bulbar conjunctiva that grows slowly across the outer surface of the cornea, usually from the nasal side. May interfere with vision as it encroaches on the pupil.

A

Pterydium

76
Q

Enlargement by downward growth extends behind the Sternum

A

RETROSTERNAL GOITER

77
Q

Enlarged Thyroid Gland with 2 or more identifiable nodules

A

Multinodular goiter

78
Q

Diffuse enlargement of the thyroid in the absence of nodules and hyperthyroidism is referred to as

A

Hashimoto’s thyroiditis

79
Q

Age of onset of Conductive Hearing Loss

A

Childhood and young adulthood, up to age 40

80
Q

Hearing seems to improve in noisy environment

A

Conductive Hearing Loss

81
Q

Hearing worsens in noisy environment

A

Sensorineural Hearing Loss

82
Q

Voice may be loud because hearing is difficult.

A

Sensorineural Hearing Loss

83
Q

Teeth may be affected by chemical action. This results from recurrent regurgitation of stomach contents, as in bulimia.

A

Erosion of teeth

84
Q

The biting surface of the teeth by recurrent trauma

A

Abrasion of Tooth

85
Q

Teeth are smaller, more widely spaced, biting surface are notched

A

Hutchinson’s Teeth

86
Q

If hoarseness lasts over 2 weeks, consider

A

Voice overuse

87
Q

Which part of the oral cavity is most sensitive to elicit gag reflex?

A

Posterior pharyngeal wall

88
Q

Cancer of the tongue occurs most often on

A

side of the tongue, next most often is at the base

89
Q

A precancerous condition that results from excessive exposure to sunlight and affects primarily the lower lip

A

Actinic cheilitis

90
Q

The nasal mucosa may be pale, bluish or red.

A

Allergic rhinitis

91
Q

Enlargement of a Supraclavicular node, especially on the left, suggests possible

A

Metastasis from a thoracic or abdominal malignancy

92
Q

In assessing the extraocular muscle test, look for:

A

Lid Lag

93
Q

(3) most important attributes of headache

A
  • Severity
  • Chronologic Pattern
  • Associated Symptoms
94
Q

Pupil is large (dilated), regular, and usually unilateral. Reaction to light is severely reduced and slowed, or even absent. Constriction during the near vision is present, although very slow.

A

Tonic Pupil (Adie’s Pupil)

95
Q

Small, irregular pupils that accommodate but do not react to light

A

Argyll Robertson Pupils

96
Q

The affected pupil, though small, reacts briskly to light and near effort. Ptosis of the eyelid is present, perhaps with loss of sweating on the
forehead

A

Horner’s Syndrome

97
Q

Skin of the ear canal is thickened, red, and itchy

A

Chronic Otitis Externa

98
Q

Canal is often swollen, narrowed, moist, pale, and tender

A

Acute Otitis Externa

99
Q

Poorly formed Helix

A

SATYR EAR

100
Q

May be due to nutritional deficiency or more commonly due to over-closure of the mouth, seen in people with no teeth or with ill-fitting dentures.

A

ANGULAR CHEILITIS

101
Q
  • A diffuse, non-pitting, tense swelling of the dermis and subcutaneous tissue
  • It does not itch
A

ANGIOEDEMA

102
Q

Congenital failure of the fusion of the Maxillary Process

A

Cleft Palate

103
Q

Types of Primary Headache (4)

A
  • Migraine Headache
  • Tension Headache
  • Cluster Headache
  • Chronic Daily Headache
104
Q

It is a category containing pre-existing headaches that have been transformed into more pronounced forms

A

Chronic Daily Headache

105
Q

When does Secondary Headache more likely to occur?

A

after age 50 yrs with a sudden severe onset

106
Q

Subarachnoid Hemorrhage is a bleeding from: (3)

A
  • ruptured Cerebral Saccular Aneurysm
  • Mycotic Aneurysm
  • rarely from AV malformations
107
Q

Progressive frequent or severe headache over 3-month period (3)

A
  • Tumor
  • Abscess
  • Mass Lesion
108
Q

Ear canal is often swollen, narrowed, moist, pale, tender; it may be reddened.

A

Acute Otits Externa

109
Q

Most commonly involved sinuses in Acute Rhinosinusitis (in order):

A
  • Maxillary
  • Ethmoid
  • Frontal
  • Sphenoid
110
Q

Artery involved in posterior epistaxis

A

Sphenopalatine Artery

111
Q

Watershed area in the nose where Anterior bleeding occurs

A

Kiesselbach’s Plexus

112
Q

if there is sudden, unilateral, painful visual loss, what structures are usually involved (2)

A
  • Cornea

- Anterior Chamber

113
Q

Disease of the bones that may cause enlargement and deformity of the skull among ADULTS

A

Osteitis Deformans (Pagets Disease)

114
Q

common cause of Hydrocephalus

A

Obstruction in the internal circulation of the CSF

115
Q

Pagets Disease age of onset

A

> 45 years men

116
Q

Premature closure of the Lamboid and Coronal sutures

A

Craniosynostosis (Oxycephaly / Steeple Skull)

117
Q

Congenital Muscular Torticollis (CMT) is more common in:

A

Males on the right side

118
Q

Edema + Change in Urine

A

Nephrotic Syndrome

119
Q

where is mild jaundice seen

A
  • Sclera
  • Under the tongue
  • posterior portion of the Hard Palate
120
Q

Corneal Arcus in young people suggests a possible:

A

Hyperlipoproteinemia

121
Q

Inflammation of the Lacrimal Sac

A

Dacryocystitis

122
Q

Diffused Thyroid Enlargement is associated with: (3)

A
  • Hashimoto’s Thyroiditis
  • Graves Disease
  • Endemic Goiter
123
Q

PE findings is Retrosternal Goiter (2)

A
  • Venous Engorgement

- Tracheal Displacement

124
Q

Retinal Spot: Hard Exudate is due to:

A

Lipid deposition from leaking capillaries

125
Q

Retinal Spots: Soft Exudate is often accompanied by:

A

Microaneurysm

126
Q

Bulging Tympanic Membrane is seen in ______ Otitis Media

A

Acute Suppurative Otitis Media

127
Q

Retracted Tympanic Membrane is seen in ______ Otitis Media

A

Serous Otitis Media

128
Q

Pigmented spots on the lips, buccal mucosa, hands, face

A

Peutz-Jeghers Syndrome

129
Q

Red, soft, tumor-like mass on internal papillae seen in Pregnancy Tumor, Pyogenic Granuloma

A

Epulis

130
Q

Candidiasis is due to: (2)

A
  • prolonged antibiotics or corticosteroid use

- AIDS

131
Q

A sac of dead skin cells that forms in a pocket in the Middle Ear

A

Cholesteatoma

Clinical Medicine I (4 decks)

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