The Head and Neck - Bates Flashcards
H/A warrants careful eval for life-threatening causes such as ___, ___ ___, or ___ ___.
meningitis, subarachnoid hemorrhage, mass lesion
Migraines, tension, cluster, and chronic h/a are all ___ types of h/a
primary
Underlying structural, systemic, or infectious causes such as meningitis or subarachnoid hemorrhage are all ___ types of h/a
secondary
H/A warning signs include: progressively frequent or severe over a ___ month period, sudden onset like a “___” or “the ___ h/a of my life”, new onset after age ___, aggravated or relieved by change in ___, precipitated by the ___ maneuver, assoc sympt of ___, ___ ___ or wt ___, presence of ___, ___ inf, or ___, recent ___ trauma, assoc ___, ___ stiffness, or focal ___ deficitis.
3, thunderclap, worst, 50, position, valsalva, fever, night sweats, loss, CA, HIV, pregnancy, head, papilledema, neck, neurologic
Most important attributes of h/a are its ___ and ___ ___.
severity, chronologic pattern
If h/a is severe and of sudden onset, consider ___ ___ or ___
subarachnoid hemorrhage, meningitis
___ and ___ h/a are episodic and tend to peak over several hrs.
Migraine, tension
New and persisting, progressively severe h/a raise concerns of ___, ___, or ___ ___.
tumor, abscess, mass lesion
Unilateral h/a occurs in ___ and ___ h/a
migraine, cluster
___ h/a often arise in the temporal areas, whereas ___ h/a may be retro-orbital.
Tension, cluster
N/V are commonly seen w/___.
migraines
60-70% of pt’s w/migraines experience aura’s, such as ___ ___ (flashes of light), ___ (zig-zag arc of light), and ___ (area of visual loss w/surrounding normal vision).
spark photopsias, fortifications, scotomata
Women w/migraines of aura should avoid use of ___-___ contraceptives.
estrogen-progestin
Ask if ___, ___ or changing the ___ of the head affects the h/a.
coughing, sneezing, position
Ask about ___ hx. Genetic inheritance appears to be present in 30-50% of pt’s w/___.
family, migraines
\_\_\_ = farsightedness \_\_\_ = aging vision \_\_\_ = nearsightedness \_\_\_ = double-vision
hyperopia
presbyopia
myopia
diplopia
If sudden unilateral visual loss is PAINLESS, consider vitreous hemorrhage from ___ or ___, macular ___, retinal ___. If PAINFUL, causes are usually in the ___ and anterior chamber as in corneal ___, ___, and acute ___. If bilateral and painless, typically occurs d/t medications that change refraction such as ___, ___, and ___.
diabetes, trauma, degeneration, detachment
cornea, ulcer, uveitis, glaucoma
cholinergics, anticholinergics, steroids
Bilateral gradual visual loss usually arises from ___ or ___ ___.
cataracts, macular degeneration
Moving specks or floaters suggest ___ in the retina or visual pathways.
lesions
Ask about ___ in or around the eyes, ___, and excessive ___ or watering.
pain, redness, tearing
___ hearing loss results from problems in the external or middle ear, whereas ___ hearing loss arises from problems in the inner ear, the cochlear nerve, or its central connections in the brain.
Conductive, sensorineural
Ppl w/sensorineural loss have trouble understanding ___. ___ env help ppl w/conductive loss.
speech, noisy
Meds that affect hearing include:
NSAIDS, aminoglycosides, ASA, quinine, furosemide
In otitis ___, there is pain in the external canal, tragus, and pinna. In otitis ___, there is pain in the inner ear or may be referred from others structures in the mouth, throat, or neck.
externa, media
___ is ringing, rushing, or roaring in the ears and is commonly seen in ___ dis.
tinnitus, Meniere’s
Feeling light-headed, weak in the legs or about to faint points to ___.
presyncope
___ aka dizziness occurs in benign positional vertigo, labyrinthitis, and Meniere’s dis.
Vertigo
___ refers to drng from the nose ans is often assoc w/nasal congestion. Freq accomp by sneezing, watery eyes, throat discomfort, itching in the eyes, nose and throat.
Rhinorrhea
Seasonal onset or env triggers suggest ___ ___.
allergic rhinitis
___-___ rhinitis occurs in excessive use of decongestants, or use of cocaine.
Drug-induced
Acute bacterial sinusitis is unlikely until viral ___ sympt persist more than ___ days.
URI, 7
Will typically exp purulent nasal discharge and tooth/facial/maxillary pain w/___.
sinusitis
Consider deviated nasal septum, nasal polyp, or foreign body is nasal congestion on ___ side.
one
___ is blding from the nasal passages. Causes include ___, ___, drying/crusting of the ___ ___, ___, and ___ ___.
Epistaxis, trauma, inflam, nasal mucosa, tumors, foreign bodies
Sore throat and/or pharyngitis are freq complaints assoc w/___.
URI
Blding gums most often caused by ___.
gingivitis
Hoarseness occurs from ___ overuse and ___. Other risk factors are env ___, ___, ___, and inhalation of fumes or other irritants.
voice, laryngitis, allergies, GERD, smoking,
Enlged tender lymph nodes commonly accompany ___.
pharyngitis
Thyroid function may be increased, decreased, or normal w/___.
goiter
Intolerance to cold, preference for warm clothing or many blankets, and decreased sweating suggest ___.
hypothyroidism
Intolerance to heat, palpitations, and involuntary wt loss suggest ___.
hyperthyroidism
clouding of the lens = ___
subretinal hemorrhages or exudates = ___ ___
change in color and size of optic disc = ___
cataracts
macular degeneration
glaucoma
___ is the leading cause of blindness in African Americans and second leading cause of blindness overall.
Glaucoma
In ___ ___-___ ___, there is gradual loss of vision as a result of the loss of retinal ganglion cell axons. Risk factors include age over ___, ___ hx, ___-___ descent, ___, ___, and ___ ___
primary open-angle glaucoma (POAG), 65, family, African-American, diabetes, myopia, ocular HTN
USPTF recommends screening adults __ yrs of age and older.
50
Groups at risk for hearing loss are those w/a hx of ___ hearing loss, ___, ___, ___, or exposure to hazardous ___ levels at work or on the battlefield.
familial, syphilis, rubella, meningitis, noise
