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Physical Diagnosis I Final > Nose, Sinus, Mouth, and Throat > Flashcards

Nose, Sinus, Mouth, and Throat Flashcards

1
Q

What two conditions account for the majority of antibiotics prescribed in outpatient clinics even though they are usually self-limiting viral infections?

A

URIs and otitis media

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2
Q

What is the issue with the unnecessary and overuse of antibiotics?

A

Emergence of super strains of drug-resistant bacteria

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3
Q

What is the clinical term for the common cold?

A

Viral rhinitis

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4
Q

What are the signs and symptoms of viral rhinitis?

A

Symptoms: stuffy nose and sinuses with watery discharge, sneezing, post nasal drip, cough, itchy eyes, nose, and throat
Signs: swollen nasal tissues and cervical lymph nodes

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5
Q

What is the major difference between allergic and viral rhinitis?

A

Allergic rhinitis lasts longer and is recurrent

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6
Q

75% of those with what other condition will get sinusitis?

A

Asthma

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7
Q

What are the signs and symptoms of acute sinusitis?

A

Symptoms: stuff nose and sinuses with green purulent discharge with aggravated face, teeth, or eye pain while bending over
Signs: swollen nasal tissues and cervical lymph nodes

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8
Q

What two test findings can be seen indicating sinusitis?

A

Digital pressure eliciting aggravated pain

No transillumination due to thick discharge

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9
Q

What are the grape-like inflammatory swelling of the nasal linings called that are seen in adults who have had allergies or chronic sinus infections for years?

A

Polyps

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10
Q

What issue can nasal polyps cause?

A

Interference of nasal drainage

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11
Q

What is the most common cause of a deviated septum?

A

Trauma

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12
Q

What is the “nasal cycle”?

A

Normal cycle of mild congestion (unilateral blood vessel engorgement) and decongestion alternating between nostrils about every 4 hours to make it easier to breath out of one side than the other

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13
Q

What should be considered first when examining a children with a one-sided runny nose?

A

Foreign object

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14
Q

More than half of the reported cases of loss of smell are due to what causes?

A

1 head injuries
2 post URIs
3 nasal/sinus conditions

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15
Q

What are Mullin’s 5 “Ts” of the mouth and throat that are analyzed during examination?

A 
1 teeth
2 tongue
3 tissues
4 tonsils
5 throat
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16
Q

What should be considered when viewing a patient with crowded teeth?

A

Cranial misalignment

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17
Q

What visible sign of the teeth appears due to asymmetrical forces being transmitted into the temporomandibular-cranial-cervical complex?

A

Malocclusions

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18
Q

What is the term for a red, swollen smooth tongue due to the loss of the papillae?

A

Glossitis

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19
Q

What is the form of glossitis where the papillae are temporarily lost leaving smooth, irregular patches with a white outline that can change location on a weekly, sometimes daily, basis?

A

Geographic tongue (aka migratory glossitis)

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20
Q

What is the term for a tongue that presents with grooves of varying depth and width?

A

Fissured tongue

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21
Q

Fissured tongue is frequently associated with what other condition of the mouth?

A

Geographic tongue

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22
Q

What is the timeline of onset and progression for a fissured tongue?

A

Starts in childhood and becomes more prominent with age

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23
Q

What causes a black, hairy tongue?

A

Long-term antibiotic use

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24
Q

What is the anatomical reason for the appearance of a black, hairy tongue?

A

Failure of the papillae to naturally fall off causing them to elongate allowing fungi or bacteria to attach to them and cause discoloration

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25
Q

What is the clinical term for a cankersore?

A

Aphthous stomatitis

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26
Q

What is unique about the healing process of the ulcers of aphthous stomatitis?

A

Heal without scarring

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27
Q

What is the condition of the mouth that is a noncancerous or precancerous oral lesion common to those who use tobacco daily that appears as while leathery ridges on the buccal mucosa?

A

Leukoplakia

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28
Q

What is the clinical term for red, swollen, sensitive, and bleeding gums?

A

Gingivitis

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29
Q

What is the order of progress of developing gingivitis?

A

Bacteria and saliva form plaque which hardens into tartar then causes gingivitis

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30
Q

What can prevent or reverse gingivitis?

A

Brushing and flossing

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31
Q

What are the common locations for an oral carcinoma?

A

Sides of tongue, lips, floor of mouth

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32
Q

What activities are associated with 70-80% of oral carcinoma cases?

A

Smoking and smokeless tobacco (another risk factor = alcohol)

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33
Q

What is the condition of benign exostosis of either the hard palate or mandible?

A

Torus palatinus and mandibularis

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34
Q

When do torus palatinus or mandibularis occur?

A

Around age 30

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35
Q

What is tonsillar debris?

A

Mucous, sulfur-producing bacteria, and debris condense into small particles and collect in the crypts on the surface of the tonsils

36
Q

Which is more common: viral or bacterial pharyngitis?

A

Viral (60%)

37
Q

What is the major difference in symptoms between viral and bacterial pharyngitis?

A

Bacterial is associated with a fever and purulent, colored exudate

38
Q

What are the three forms of pharyngitis?

A

Viral, bacterial, streptococcal

39
Q

What progressive condition occurs in 1% of strep throat cases?

A

Rheumatic fever

40
Q

What is rheumatic fever so rare?

A

Antibiotics are 90% effective at preventing strep throat from progressing

41
Q

What condition is a progression of strep throat that is not prevented by antibiotic treatment?

A

Post-streptococcal glomerulonephritis

42
Q

What part of the heart may get damaged via post-streptococcal glomerulonephritis?

A

Mitral valve

43
Q

What conditions are considered upper respiratory conditions?

A

Common cold, allergic rhinitis, sinusitis, and pharyngitis

44
Q

What is the “in between” condition of upper and lower respiratory conditions?

A

Laryngitis

45
Q

What condition is inflammation of the mucous lining of the larynx and vocal cords resulting in a sore scratchy throat, hoarseness, or loss of voice?

A

Laryngitis

46
Q

Laryngitis that last longer than what time span warrants consultation?

A

4 weeks

47
Q

What cranial nerves can be assessed as part of the mouth and throat exam?

A

7, 9, 10, and 12

48
Q

How can you test for cranial nerve 7 in the mouth and throat exam?

A

Sweet and salty tastes of the anterior 2/3 of the tongue

49
Q

How can you test for cranial nerve 9 in the mouth and throat exam?

A

Sour and bitter tastes of the posterior 1/3 of the tongue

50
Q

How can you test for cranial nerve 9 and 10 together in the mouth and throat exam?

A

Perform gag reflex

51
Q

How can you test for cranial nerve 10 alone in the mouth and throat exam?

A

Have patient say, “coo la me”

52
Q

How can you test for cranial nerve 12 in the mouth and throat exam?

A

Have patient press tongue into each cheek

53
Q

What is another term for blackheads?

A

Comedones

54
Q

What type of facial eruption are pimples?

A

Pustules and papules

55
Q

What part of the body is usually affected by erysipelas?

A

Face and ears

56
Q

Erysipelas is usually secondary to what type of condition?

A

Preexisting skin infection or wound

57
Q

What causes erysipelas?

A

Type A beta hemolytic streptococcus (form of cellulitis)

58
Q

How is cellulitis different from erysipelas?

A

Lacks sharp, raised borders and usually affects limbs

59
Q

What is the mechanism of injury for cellulitis?

A

Enzymes produced by the organism break down cellular components that would normal contain the infection

60
Q

What condition is a chronic inflammatory disorder resulting in new superficial blood vessels?

A

Rosacea

61
Q

What population is more likely to be affected by rosacea?

A

Middle-aged women

62
Q

What sign of rosacea may occur in males?

A

Rhinophyma (soft tissue hypertrophy of the nose)

63
Q

What is the conventional treatment for rosacea?

A

Tetracycline

64
Q

What condition presents as red, painful inflammation of the nail fold?

A

Paronychia

65
Q

What pathogens can cause paronychia?

A

Bacteria or fungi (Candida)

66
Q

Paronychia due to fungi is more present among children in adults that participate in what activities?

A

Children that suck their thumb

Adults whose hands are frequently in water

67
Q

What kind of skin eruption is a verruca?

A

Benign papule

68
Q

What are the common locations of verruca plana?

A

Face, neck, wrist, back of hands and knees

69
Q

What condition is an eczema that affects hands and the sole and sides of the fingers?

A

Pompholyx (dyshidrotic eczema)

70
Q

What color should the nail bed be?

A

Variations of pink

71
Q

Vertical ridges of nails are a normal variation seen in what population?

A

Elderly

72
Q

Pigment deposits or bands in the nail beds may be normal in what group of people?

A

Those with darker skin

73
Q

White spots on the nails (leukonychia) are usually due to what?

A

Mild injury

74
Q

What condition is a fungal infection of the nail plate and appears as a yellow-brownish discoloration even causing the nail to become brittle, bent, and thick?

A

Tinea unguium

75
Q

What nail signs may occur in severe psoriasis?

A

Splinter hemorrhages and pitting

76
Q

Splinter hemorrhages are often associated with what condition?

A

Endocarditis

77
Q

What is the clinical term for nail spooning?

A

Koilonychia

78
Q

What can cause koilonychia?

A

Trauma or iron deficiency anemia

79
Q

What is the condition where the nail appears white except for a narrow zone at the distal tip?

A

Terry nails

80
Q

Terry nails is associated with what underlying serious condition?

A

Cirrhosis of the liver

81
Q

What condition presents with transverse, white depressions in the nail?

A

Beau’s line

82
Q

Beau’s line can be caused by what things?

A

Malnutrition, coronary artery disease, maybe trauma

83
Q

What is Schamroth’s technique?

A

Placing nails from each hand back to back and observing the space created (normal = diamond shaped due to 160 degree angle of nail base)

84
Q

What nail condition caused the diamond shape observed in Schamroth’s technique to disappear due to abnormal enlargement of the distal phalanges?

A

Nail clubbing

85
Q

Nail clubbing is associated with what kinds of underlying serious conditions?

A

Respiratory and cardiovascular diseases

Physical Diagnosis I Final (2 decks)

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