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PM3A: Spring > Therapeutics: Ear, Nose, Throat > Flashcards

Therapeutics: Ear, Nose, Throat Flashcards

1
Q

Describe what is in the outer ear

A

Air filled

Comprised of auditory and auricle canal

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2
Q

Describe what is in the middle ear

A

Air filled

Contains timpani membrane (eardrum)

Chain of small bones in body (auditory ossicles) called malleus, incus and stable

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3
Q

Describe what is in the inner ear

A

Fluid filled shaped

Consists of three semi circular canals

Cochlea (spiral three-piece shaped series of tubular canals)- contains Corti/organ of sound

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4
Q

Describe what is in the cross section of cochlea

A

Ducts:
Scale Vestibule
Scala Media
Scala tympani

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5
Q

Describe what is in the Organ of Corti

A

Inner and outer hair cells: for auditory transduction

Bodies of hair cells in contact with auditory nerve fibres

Cilia of the hair cells in contact with tectorial membrane

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6
Q

Describe the physiology of the inner ear (hair cells)

A

Vibration of basement membrane activates inner/outer hair cells to cause cilia bending

Hair cells are depolarised, excitatory neurotransmitters are released to activate afferent cochlear auditory nerves

Hair cells are hyper polarised: afferent cochlear auditory nerves are inhibited

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7
Q

Describe the vestibular region role and what is consists of

A

Used to maintain equilibrium of the head by detecting angular and linear accelerations of the head

Semi circular canals: detects angular rotation

Otolithic organs: detect linear accelerations

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8
Q

Describe what is in a hair cell

A
  1. 50 to 70 small cilia called Stereo cilia
  2. One large cilium called kino-cilium
  3. Stereo cilia bends in direction of kino-cilium to cause ion channels to open and cause membrane depolarisation and nerve fibre activation
  4. Other way round (stereo cilia to kinocilium) does reverse effect and hyperpolarisation
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9
Q

What is otitis externa

A

Inflammatory disease caused by bacterial infection (staphylococcus aureus) or fungal infection (candida and aspergillus)

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10
Q

How do you treat acute otitis externa

A

Anti-inflammatory corticosteroid

Anti-infective chloramphenicol ear drops

Astringent: aluminium acetate

2% acetic acid (EarCalm)

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11
Q

What are the anti-infective antibiotics used for otitis externa

A
  1. Topical antibiotic and glucocorticoid: Neomycin and polymyxin
  2. Bumethasone/dexamethasone and hydrocortisone: such as otomize spray
  3. Flumetaozone and clioquinol
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12
Q

How do you treat chronic otitis externa

A

Antibiotics: oral flucloxacillin (or Clarithromyin if penicillin allergic

IV cephalosporin: used if patient seem unwell

Anti-fungal agent: Neomycin, polysorbate, gentian violet

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13
Q

How do you remove ear wax

A

Use of olive oil, almond oil, sodium bicarbonate ever drops

Cerumenolytic products soften ear wax

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14
Q

If otitis externa comes with a perforated eardrum, what is the likely cause

A

Amino glycoside antibiotics such as gentamicin and neomycin which may cause ototoxicity

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15
Q

What does otitis media present itself as and caused by

A
  1. Sudden onset of otalgia (ear ache), fever, hearing loss
  2. Preceded by upper respiratory tract infection that lasts a couple of days
  3. Bacterial (streptococcus pneumoniae, Hemophilus influenza)
  4. Fungal (candida or aspergillus) infection
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16
Q

How do you treat otitis media

A

Local cleansing

Anti-infective antibiotics

Systemic antibacterial like oral amoxicillin (or clarithromycin)

Ciproflolaxin or oflolaxin are both unlicensed ear drops

17
Q

What is labyrinthitis and its symptoms

A

Inner ear dizziness

Symptoms: vertigo, loss of balance, loss of hearing, tinnitus

18
Q

How do you treat labyrinthitis

A

Antibacterial: Oral amoxicillin or IV cephalosporin

Anti-viral: valacyclovir

Treatment of vertigo and nausea: prochlorperazine (dopamine D2 receptor antagonist)

Symptomatic treatment:
Anxiety (benzodiazepines)
Depression (SSRIs)
Vestibular rehabilitation therapy

19
Q

Give examples of drugs that cause ototoxicity

A

Analgesics: salicylates, quinine

Antibacterials:
Amino glycosides: gentamicin, neomycin
Glycopeptide: Vancomycin
Macrolide: Erythromycin
Antineoplastics: Cisplatin
Loop Diuretics: Furosemide
20
Q

What is rhinitis

A

Allergic acute or chronic inflammation of the nasal mucosa (hay fever)

21
Q

What is Rhinorrhoea and its causes

A

Production of excessive watery secretions by nasal mucosa

Viral infection of the nasal mucosa or interaction between antigens and tissue bound Ig-E antibodies within nasal mucosa

Leads to increased nasal mucosal blood flow and/or blood vessel permeability

22
Q

How do you treat nasal blood flow on rhinitis and rhinorrhoea treatment

A

Sympathomimetic agents (ephedrine): leads to vasoconstriction

23
Q

How are you able to have an anti-inflammatory effect on rhinitis and rhinorrhoea treatment

A

Glucocorticoids (beclomethasone, momethasone)

Anti inflammatory steroid

24
Q

How are you able to suppress mediator release on rhinitis and rhinorrhoea treatment

A

Cromolyn sodium
Omalizumab

Inhibits histamine release and monoclonal antibody prevents Ige interaction

25
Q

How are you able to perform mediator receptor blockade on rhinitis and rhinorrhoea treatment

A

H1 receptor antagonists- azelastine

Leukotriene antagonists (montelukast)

Blocks vasodilation and inflammation

26
Q

How do you treat nasal congestion

A

Ephedrine or pseudo ephedrine- indirect sympathomimetic acts as substrate for noradrenaline release

Sodium chloride used to liquefy mucous secretions

27
Q

How do you treat nasal staphylococci

A

Mupirocin (inhibits bacterial protein and RNA synthesis): eradicates MRSA

28
Q

Where is the oropharynx located

A

back of the mouth behind oral cavity, includes back third of tongue, soft palate, side walls and back walls of throat

29
Q

Why do oral ulceration and inflammation occur

A

Infections, trauma, dietary deficiencies, carcinoma, haematopoietic disorders, drug therapies

30
Q

How do you treat oral ulceration and inflammation

A

Benzydamine (NSAID oromucosal spray): oropharyngeal inflammation

Choline salicylate gel: mild to moderate oral perioral lesions aka bonjela

Croscarmellose gelatin paste

Inflammation: treated by hydrocortisone or betamethasone

31
Q

What causes oropharyngeal fungal infection and how do you treat them

A

Candida species (candidiasis)

Thrush: nystatin or miconazole

Fluconazole

Amphotericin: severe one

32
Q

How do you treat primary heretic gingivostomatitis

A

Bezydamine or chlorhexidine mouthwash

33
Q

What are mouthwashes used for and give an example of the active ingredient of one

A

Oral candidiasis, gingivitis

Chlorhexidine: corsodyl

34
Q

How do you treat dry mouth caused by antimusicarinic or diuretic drugs

A

Artificial saliva in forms of lozenges

PM3A: Spring (16 decks)

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