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Year 3 > MedEd ENT and opthamology > Flashcards

MedEd ENT and opthamology Flashcards

1
Q

What is BPPV/

A

Recurrent and brief attacks of positional vertigo

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2
Q

What is the most common cause of vertigo?

A

BPPV

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3
Q

How does BPPV arise?

A

Canalith particles break loose and fall into the wrong part of the semicircular canals of the inner ear causing vertigo

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4
Q

How will BPPV present?

A

Recurrent brief (<1min) attacks of vertigo
Quick onset
Attacks related to body position change eg looking up
Nausea and vomitting
No precipitating event

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5
Q

How long are vertigo attacks in BPPV?

A

<1 min

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6
Q

What position of the head triggers BPPV?

A

Looking up

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7
Q

What invetsigations are done for BPPV?

A

Hallpike’s manourvere

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8
Q

How is Hallpike’s manourvere done?

A

Sit patient up
Slowly rotate their head to 45 degrees on one side
Liw the patient down and hold head at 20 degree angle on bed
See if they have vertigo

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9
Q

How is BPPV managed?

A

Canalith repositioning manoevures

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10
Q

What is menieres disease?

A

Disorder of inner ear caused by change in fluid volume in the labyrinth causing tinnitus and vertigo

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11
Q

What is the difference between meniere disease v syndrome?

A 
Disease= idiopathic
Syndrome= secondary to condition
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12
Q

What causes menieres disease?

A

Allergy
Viral infection
Lyme disease
Hypothyrodism

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13
Q

How does menieres disease present?

A

Vertigo that lasta mins or hrs
NV
Tinnitus
May have hearing loss in affected ear

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14
Q

How do you differentiate menieres disease and BPPV?

A 
Menieres= vertigo lasts mins/hrs
BPPV= vertigo lasts <1min
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15
Q

What test can you do for menieres disease?

A

Fukudas stepping test

Rombergs test

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16
Q

What investigations are done for menieres and what will you see?

A

Audiometry- will reveal sensorineural hearing loss

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17
Q

How is menieres disease managed?

A

No cure- manage acute attacks
Vestibular supressants- benzodiazipines and antihistamines
Prophylactic- limit salt, caffeine and alcohol, exercise to improve management
Maintenance- thiazide diuretics to reduce endolymph volume

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18
Q

What is thyroglossal cyst?

A

Epithelial lines cyst between adams apple and chin

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19
Q

What age is likely to get thyrogloassal cyst?

A

5 years

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20
Q

How will thyroglossal cyst present?

A

Lump in midline of neck
Compressible
Cyst moves up on swallowing and sticking out tongue

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21
Q

How is thryoglossal cyst managed?

A

Surgical removal

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22
Q

What is a cataract?

A

Opacification of lens

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23
Q

How will cataract present?

A

Cloudy lens visible

Gradual loss in visual acuity over years

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24
Q

How does cataract arise?

A

Normal proteins that make up lens of the eye degrade overtime and become opaque

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25
Q

What are RF for cataract?

A 
ageing 
smoking
alcohol
UV exposure
diabetes
trauma
uveitis
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26
Q

How do you investigate catarct and what will you see?

A

Slit lamp reveals cataract as black against red light reflex
Reduced red reflex on fundoscopy
reduced visual acuity

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27
Q

How is cataract managed?

A

Control RF

Surgical management when affects lifestyle- phaecomulsification with intraocular lens implant

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28
Q

What is conjuctivits?

A

Inflammtion of the conjunctiva

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29
Q

Where is the conjunctiva?

A

Inner eyelid and covers sclera

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30
Q

Who is conjunctivits most common in?

A

Children

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31
Q

What are causes of conjunctivits? What is most common? Include organisms

A

Viral most common- EBV, herpes, adenovirus
Bacterial- staph aureus, strep pneu, heam infl
Allergy
Wearing contacts
Mechanical- floppy eyelid syndrome

32
Q

How will conjunctivits present?

A

Eye redness
Discharge
Itchy eye
Crust formation- especially in morning

33
Q

Describe discharge in viral v bacterial v allergic conjunctivitis

A 
Viral= clear
Bacterial= thick, purulent, yellow
Allergic= clear
34
Q

Describe eye involvement in viral v bacterial v allergic conjunctivitis

A 
Viral= first unilat then becomes bilat
Bacterial= unilat, no bilat progression
35
Q

What is glaucoma?

A

Increased intraocular pressure which results in damage ro retina and optic nerve

36
Q

How is conjunctivits managed?

A

Viral= gets better with time, can give antihistamine drops

37
Q

What are the types of glaucomona?

A

Open angle

Closed angle

38
Q

What is open angle glaucoma?

A

Iridocorneal angle is unaffected

Defect in trabecular meshwork

39
Q

What are RF for open angle glaucoma?

A

Over 40
DM
FHx
African descent

40
Q

How will open angle glaucoma present?

A

Bilateral progressive visual field loss

Visual loss of peripheral to central

41
Q

What investigations are done for open angle glaucoma? What will you see

A

Clinical diagnosis
Tonometry- may get IOP >21 mmHg
Fundoscopy- increase in cupping of optic disc

42
Q

What is closed angle glaucoma?

A

Narrowing of iridocorneal angle- aqeuous flow into trabecular meshwork is disrupted

43
Q

What type of glaucoma is and emergency?

A

Closed angle

44
Q

What are RF for closed angle glauxoma

A

Old

Mydriasis (drug induced by anticholinergics)

45
Q

How does closed angle glaucoma present?

A 
Sudden onset
Red eye
NV
Unilateral pain
Dilated pupil in one eye
46
Q

What inevstigations are done for closed angle glaucoma? What will you see?

A

Tonometry- IOP >21 mmHg
Slit lamp- narrowing of iridocorneal angle
Gonioscopy
Fundoscopy- increased cupping of optic disc

47
Q

How is open agle glaucoma managed?

A

Prostaglandin analogues to increase aqeous humor flow (latanoprost and travoprost)
Topic beta blockers- decreas production of aqueous production
If bad surgical= trabeculectomy

48
Q

How is closed angle glaucoma managed?

A

Topical beta blockers- timolol to decrease aqeous humor production
Carbon anhydrase production to decrease aqeous humor profuction- acetazolamide
Immediate surgery- high intensity laser treatment

49
Q

What is anterior uveitis?

A

Inflammation of the iris and ciliary body

50
Q

What is the most common type of uveitis?

A

Anterior

51
Q

What are causes of anterior uveitis?

A

Idiopathic

52
Q

What conditions is anterior uveitis associated with? Give examples

A

Non infectious, systemic autoimmune disease- HLA B27 pos eg ankylosing spondylitis

53
Q

What is posterior uveitis?

A

Inflammation of retina, choroid, retinal vasculature, optic nerve

54
Q

What causes posterior uveitis?

A

Viruses

Syphillis

55
Q

How does anterior uveitis present?

A 
Pain dull and progressive
eye redness
photopobia
decreased visual acuity
lacrimation
flares
56
Q

How is anterior uveitis investigated?

A

Clinical diagnosis

Can do slit lamp exam

57
Q

What is seen on examination in anterior uveitis?

A

Keratic precipitates- white fluid in inferior part of anterior chamber
Protein in aqueous humor
Red eye
Hypopyon

58
Q

How will post uveitis present?

A

Painless
Decreased visual acuity
Lacrimation
Floaters or flashers

59
Q

What do you see on examination in post uveitis?

A

Leukocytes in vit humor

60
Q

What are complications of uveitis?

A

Cataract
Glaucma
Synechiae

61
Q

How is uveitis managed?

A 
Steroid drops
systemic or oral steroids 
Treat underlying inflammation
cycloplegic eye drops
Simple analgesia
ABX or antiviral for post uveitis
62
Q

What is optic neuritis?

A

inflammation of the optic nerve

63
Q

Who is most likely to get optic neuritis?

A

20-40 yo females

64
Q

What causes optic neuritis?

A

Demyelination of optic nerve- ofetn due to MS, can be encephalitis, meningitis, sinusitis, or drugs

65
Q

How will optic neuritis present/

A 
Visual loss
Hours to days
Decreased visual acuity
Eye pain worse on movement 
Reduced colour vision
Usually unilateral, can be bilateral
66
Q

How is optic neuritis investigated?

A

Gadolinium enhanced MRI of orbit and brain- enlarged optic nerve may be seen

67
Q

How is optic neuritis managed?

A

High dose steroids

68
Q

What are complications of optic neuritis?

A

Decreased long term visual acuity

69
Q

What is scleritis?

A

Inflammation of sclera

70
Q

Who is more likely ot get scleritis?

A

40-60 y/o

71
Q

What causes sleritis?

A 
Systemic disorder eg
RA
SLE
IBD
Ankylosing spondylitis
72
Q

Is sclerits uni or bilat?

A

Bi

73
Q

How does scleritis present?

A 
Dull boring eye pain
May disturb slep
Pain worse on eye movmeent
Pain radiates to face
Red eye- violet or blue tinge
Over several days
Photophobia
Lacrimtion
74
Q

How can you differentiate scleritis and episcleritis?

A 
Scleritis= painful
Episcleritis= painless
75
Q

Why do you get violet/ blue tinge in scleritis?

A

Thinning of sclera

76
Q

How is optic neuritis managed?

A

urgent referral ro opthamologist
NSAIDs if mild/moderate
Treat cause
Systemic steroids if necrotising

77
Q

What are complications of optic neuritis?

A

cataract

Year 3 (104 decks)

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