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PCM 1 Final > Upper Respiratory System > Flashcards

Upper Respiratory System Flashcards

1
Q

Conditions found with:

  • Sore Throat (2)
  • Ear Infection (2)
  • Common cold
  • acute childhood illnesses( 2)
  • Dizziness
A

Sore throat

  • streptococcal
  • viral and allergic etiology

Ear infections

  • acute otitis media
  • acute otitis externa

Common Cold
- acute rhinosinusitis

Acute childhood illness

  • croup
  • epiglottis

Dizziness
- benign positional vertigo

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2
Q

Sinus development- when?

A

8-10 years of age

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3
Q

Abnormal vs Normal nose

A

abnormal:
- pale and swollen turbinates
- clear rhinorrhea

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4
Q

Abnormal vs Normal throat

A

Abnormal:

  • tonsillar erythema
  • swelling
  • exudate
  • tonsillar swelling
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5
Q

Cobblestoning

A

appearance of pharynx

- cobblestone like in tonsils, pharynx

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6
Q

Oral Exam

A
  • more extensive than neede for patients with sore throat
  • use gloves
  • get good view of oral mucosa and gingiva
  • palpate oral mucosa and gingiva
  • check ventral aspect of tongue
  • grip tongue with gauze to check lateral borders
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7
Q

Anatomy of Mouth

A
  • gingiva
  • mucosa
  • vestibule
  • hard palate
  • tonsillar area
  • soft palate
  • tongue
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8
Q

What to check for in the ear?

A
  • check external ear
  • check for any drainage, redness
  • check for tenderness of tragus
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9
Q

Anatomy of Ear

A
  • Helix
  • antihelix
  • tragus
  • lobule
  • entrance to ear canal
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10
Q

Whisper Test

A
  • softly whisper into each ear then ask patient to repeat what was whisper
  • rub fingers near patient ear one at a time
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11
Q

Abnormal Ear condition

A
  • Otitis media

- bulging TM with varying erythema

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12
Q

What to check for in Lymph Nodes?

A
  • use pads of middle three fingers
  • check texture (rubbery, soft)
  • check size (pea size, quarter size)
  • check for tenderness
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13
Q

Possible differentials for upper respiratory tract (6)

A
  • streptococcal pharyngitis
  • viral pharyngitis
  • acute otitis media
  • otitis externa
  • bacterial sinusitis
  • acute rhinosinusitis
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14
Q

Strep Throat

A
  • beefy red soft palate
  • uvula
  • enlarged red tonsils
  • white or yellow patches on the tonsils
  • tiny red hemorrhages on the soft palate
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15
Q

Pharyngitis

A
  • inflammation of pharynx with resulting sore throat
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16
Q

Cause of pharyngitis (infectious cause)

A
  • Viral (adenovirus, rhinovirus, coronaviruses, enterovirus, influenza A and B, parainfluenza viruses, respiratory syncytial virus)
  • Bacterial ( GABHS, chlamydia pneumoniae, mycoplasma pneumoniae)
17
Q

Symptoms of viral pharyngitis

A
  • coryza ( inflamed mucus membrane)
  • malaise, fatigue
  • hoarseness
  • low grade fever
18
Q

Other differential diagnosis of pharyngitis

A

mononucleosis, gerd, postnasal drip secondary to persistent cough, thyroiditis, allergies, foreign body, smoking

19
Q

Streptococcal Pharyngitis

A

Group A beta-hemolytic streptococcus (pyogenes)

20
Q

Symptoms of Streptococcal Pharyngitis (6)

A
  • sore throat
  • headache
  • fatigue
  • fever
  • body aches
  • nausea
21
Q

Pharynx location

A
  • right next to intraabdominal organs on homunculus

- “ felt so good it made my toes curl”

22
Q

Highest likehood of GABHS (5)

A
  • children 5-15
  • winter and spring season
  • absence of cough
  • tender anterior cervical lymphadenopathy
  • tonsillar exudate
  • fever
23
Q

Tests/ Labs for Upper Respiratory Tract (3)

A

1) Rapid Antigen Detection/ rapid streptococcal antigen test
- detect presence of group A streptococcal
2) Throat culture
- throat swab of posterior tonsilopharyngeal and inoculated onto agar plate
3) Monospot test
- rapid slide agglutination test for mononucleosis

24
Q

Treatments for Upper Respiratory Tract

A
  • antibiotics
  • NSAIDS
  • cough drip
  • chloraseptic rays
25
Q

Ear Infections in middle (2), outer, inner ear

A

1) Middle ( air filled behind eardrum)
- acute otitis media (AOM)
- otitis media with effusion
2) Outer
- otitis externa
3) Inner
- Labyrinithitis

26
Q

Otitis Media types ( 4)

A

1) Acute Otitis Media
- symptomatic inflammation caused by bacteria or virus
- TM is bulging
- Red
- TM has reduced mobility
2) Otitis Media with Effusion (serous)
- inflammation and buildup without bacterial or viral infection
- fluid behind ear drum
- can last 3 months
- can affect hearing especially if it is chronic
3) AOM ( suppurative)
- like #1 with purulent material in ear
4) Chronic suppurative otitis media
- persistent ear infection that often results in tearing or perforation of eardrum

27
Q

Otitis Externa

A
  • caused by bacteria entering a small break in skin of canal
  • drainage from ear
  • pain upon touching external ear structures
28
Q

Otosclerosis

- Types (2)

A
  • abnormal bone growth around stapes bone
  • progressive hearing loss btw 10-30 yo
  • affect 10 % of Caucasian
  • females> males

1) Conductive loss- ossicle sclerosis into single immovable mass
2) Sensory loss- otic capsule sclerosis

29
Q

Weber Test

A

Put tuning fork on forehead

Normal: hear equally
Conductive loss: lateralizes to affected side
Sensorineural loss: lateralizes to side opposite the affected ear

30
Q

Rinne Test

A

Normal: air conduction> bone conduction

Conduction loss: bone conduction> air conduction

31
Q

Causes of Conductive Hearing loss

A
  • middle ear fluid
  • lack of ossicles movement
  • trauma
  • obstruction ( Tumor)
32
Q

Causes of Sensorineural hearing loss

A
  • hereditary
  • MS
  • trauma
  • ototoxic drugs
  • barotrauma
33
Q

Rhinosinusitis/ Sinusitis

  • causes
  • symptoms
  • treatment
A
  • mucosal lining in paranasal sinuses and nasal cavity becomes inflamed
  • infectious/ virus causes
  • symptoms: nasal discharge, cough, sneezing, congestion, fever, headache
  • no lab or imaging needed

Treatment: analgesics, intranasal corticosteroids (flonase), nasal saline irrigation, decongestants, antihistamine

34
Q

Bacterial Sinusitis

- Treatment

A
  • double sickening, purulent rhinorrhea
  • acute bacterial sinusitis

Treatment

1st: amoxicillin, Augmentin
2nd: doxycycline, levaquin, clindamycin, cefixime

35
Q

Croup

  • causes
  • symptoms
  • treatment
A

aka Laryngotracheitis

  • swelling of larynx, trachea, bronchi causing inspiratory stridor/barking cough

Causes: parainfluenza virus, influenza, respiratory syncytial virus

Treatment: oxygen, dexamethasone, epinephrine,

36
Q

Epiglottitis

  • causes
  • symptoms
  • treatment
A
  • inflammation of epiglottis or adjacent structures

Causes: Haemophilus Type B influenza, Group A beta hemolytic steptococcus

Symptoms: sore throat, muffled voice, drooling, high grade fever, toxic appearance, CHILD SITTING or LEANING FORWARD

Treatment: Protect airway, antibiotics

37
Q

Differentials for ENT causes of Vertigo (5)

A

1) Eustachian Tube dysfunction
- tube get inflamed
- mucus/ fluid build up

causes: flu, sinus infection, allergies

2) Benign paroxysmal positional vertigo( BPPV)
- intense dizziness

3) Vestibular Neuritis
- inflammation of the nerve
- affect branches associated with balance
- dizziness
- neuronitis ( damage to sensory neurons of vestibular ganglion)
- NO changes in HEARING

4) Labyrinthitis
- inflammation of labyrinth
- infection affecting both vestibulo-cochlear nerve
- dizziness/vertigo

5) Meniere’s disease
- disorder in inner ear
- episodes of spinning (vertigo)
- fluctuating hearing loss-> could lead to permanent hearing loss
- ringing in ear
- typically affects 1 ear
- chronic

38
Q

Two Types of BPPV

A

1) Canalithiasis ( canal stones)
- otoconial debris floating freely in canal portion of SCC
- free floating
- most common
- Posterior SCC m/c involved

2) Cupulolithiasis (cupula stones)
- otoconial debris are adhered to cupula of crista ampullaris
- not free floating
- not common

PCM 1 Final (6 decks)

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