Week 1 ENT 3 of 4

Question 1

What would allergy related symptoms look like? (presenting physical symptoms)

Answer 1

Clear, watery discharge; itchy or watery eyes; congestion; and fatigue
Clear discharge is usually related to allergies.

Question 2

What makes a person more likely to have allergies?

Answer 2

History of allergies and family history of allergies

Allergies often have familial component.

Question 3

What are two common seasonal allergens?

Answer 3

mold and pollen

Question 4

What are the two types of rhinitis and what causes it?

Answer 4

May be allergic or vasomotor/idiopathic
Allergic – Sneezing, rhinorrhea, and pharyngeal itching after exposure to allergen.
Vasomotor – Nonallergic, noninfectious perennial nasal congestion.

Question 5

Subjective findings of Rhinitis?

Answer 5

Scant, watery discharge after exposure to allergen, odors, temperature changes, sunlight, environmental factors.

Question 6

Objective findings of Rhinitis types?

Answer 6

Allergic rhinitis – pale mucosa with/without polyps

Idiopathic – erythema to mucosa

Question 7

Management of Rhinitis types?

Answer 7

Allergic rhinitis – antihistamines, oral decongestants, avoidance
Idiopathic – avoidance of irritants

Question 8

Health promotion for rhinitis?

Answer 8

smoking, spicy foods, and the use of perfumes/colognes should be monitored closely.

Question 9

What is Sinusitis and what causes it?

Answer 9

A viral, bacterial or fungal inflammatory process in the paranasal sinuses. S. pneumoniae is the most causative agent.

Question 10

Sinusitis subjective findings?

Answer 10

Nasal congestion, facial or dental pain, postnasal drip, headache, fever, discolored nasal discharge.

Question 11

Sinusitis Objective findings?

Answer 11

Fever, symptoms x 2 week, frontal/maxillary sinus tenderness, pharyngeal edema, inflammed nasal mucosa.

Question 12

Management of Sinusitis?

Answer 12

Symptomatic treatment, antibiotics may be needed for bacterial infections (Amox, Bactrim, Biaxin, Zithromax, etc.)

Question 13

Health promotion related to Sinusitis?

Answer 13

Sinusitis often manifests after repeated allergen exposure.

Question 14

Test question on being able to tell the diff. between sinusitis and rhinitis. So what is the difference between the two?

Answer 14

Rhinitis- watery discharge, pale mucosa, sneesing, runny nose, itching, congestion due to allergen typically.

Sinusitis - pain, HA, DISCOLORED NASAL DISCHARGE, fever, 2 weeks or more of symptoms and caused by bacterial or fungal process.

Question 15

what is anosmia?

Answer 15

loss of sense (of smell)

Question 16

what is hyposmia?

Answer 16

loss of taste

Question 17

With taste and smell disturbances Subjectively you should be able to distinguish between anosmia and hyposmia. How would you do this?

The slide literally just says: Subjective findings:
Distinguish between anosmia and hyposmia

Answer 17

(no answer for this in the ppt but I will guess below)- is this the chicken or the egg? :)

anosmia- loss of smell can be tested for by having someone smell something and see what they can smell.

hyposmia is loss of taste, so if they can smell it but then the taste is just super dull it would be more of a loss of taste than smell?

I mean if your smell is gone your taste is going to suffer but if your taste is “gone” then smell should be normal and just no taste.

Question 18

Management of a taste and smell disturbance?

Answer 18

Will depend on causative diagnosis

Question 19

Objective finding for taste and smell disturbance?

Answer 19

Complete medical, social and medication history is warranted.

Question 20

Health promotion with taste and smell disturbance?

Answer 20

Aging, tobacco usage, medications, toxins, malignant neoplasms, nasal inflammation, infection, malnutrition, facial trauma, Parkinson’s, Alzheimers’, diabetes may contribute to anosmia and hyposmia.

Question 21

The nose can be a primary site for malignant tumors such as ?

Answer 21

carcinomas, lymphomas, sarcomas, and melanomas

Question 22

Tumors and Polyps of the Nose: Subjective findings?

Answer 22

May be asymptomatic, nasal obstruction, pain, nasal discharge, epistaxis, anasomia, headache

Question 23

Tumors and Polyps of the Nose: Objective findings ?

Answer 23

Erythema, edema, discharge, bleeding, visualization of tumor or polyp.

Question 24

Tumors and Polyps of the Nose: Management?

Answer 24

Referral for biopsy by otorhinolaryngologist

Question 25

Tumors and Polyps of the Nose: Health Promotion?

Answer 25

Smoking and smokeless tobacco may contribute to cancers of the nasal cavity.

Question 26

What are three allergy studies, and tell me a little about them?

Answer 26

Radioallergosorbent test (RAST) 
Blood assay of the IgE antibodies

Interdermal sensitivity studies
The introduction of specific suspected allergens under the skin and evaluation of the response

Eosinophil counts
Accomplished by the submission of a mucous smear from the nasal passage

Question 27

IgE involves what cells and what kind of reaction?

Answer 27

mast cells and basophils, anaphylactic reaction.

Question 28

What must you use in order to view the oropharynx well?

Answer 28

Use of brightly lit otoscope is a necessity to view the oropharynx.

Question 29

When would you avoid using a tongue depressor for viewing the oropharynx?

Answer 29

should be avoided in suspected cases of epiglottitis

Question 30

Inspection of the Mouth and Throat, what are you looking for?

Answer 30

Observe movement of the mouth and lips and note any asymmetry
Inspect the lips for symmetry, color, edema, and lesions
Note odor with mouth open
Observe for the parotid gland openings (Stensen’s ducts)
Inspect the tongue
Observe position, color, and number of teeth
Inspect the hard and soft palates
Observe the movement of the uvula
Inspect the posterior throat

Question 31

What are some common disorders of the Oropharynx?

Answer 31

Dental Abscess
Salivary gland disorders
Epiglottitis 
Oral infections
Parotitis
Peritonsillar abscess
Pharyngitis/Tonsillitis

Question 32

What all will you palpate in the mouth and throat?

Answer 32

Palpate lips in patients with cosmetic augmentation
Palpate the gums for tenderness, firmness, and bleeding
Palpate the tongue for texture and consistency
Palpate the lymph nodes in the neck area

Question 33

What is a Dental Abscess/Dental pain?

Answer 33

Acute infection of the periapical tissue caused by various agents – usually is accompanied by dental caries.

Question 34

Subjective findings of Dental abscess/dental pain?

Answer 34

Localized pain, poor dental hygiene, edema, purulent discharge, sensitivity to heat/cool, swelling of the jaw.

Question 35

Objective findings of dental abscess/dental pain?

Answer 35

Edema and erythema of the soft tissue surrounding the carie.

Question 36

Health Promotion of Dental abscess/dental pain?

Answer 36

Dental expertise will be needed for root canal, extraction, or surgical intervention. Antibiotics and pain medications only treat the infection but do not eliminate the causative agent. .

Question 37

What types of salivary glad disorders can you have?

Answer 37

Neoplastic – benign or malignant

Non-neoplastic – infectious or non-infectious.

Question 38

Where does a salivary gland disorder typically occur?

Answer 38

Consist of the paired parotid glands, submandibular, and sublingual glands.

Question 39

Subjective findings of a salivary glad disorder?

Answer 39

Painless swelling of the salivary gland in non-infectious cases
Infectious cases will include painful edema of the affected gland with increased symptoms at meals.

Question 40

Objective findings of a salivary glad disorder?

Answer 40

Unilateral or bilateral swelling of the affected gland, inflammation, edema.

Question 41

What patient population is at greater risk for salivary glad disorders?

Answer 41

HIV patients are at greatest risk for salivary gland disorders. Hydration, good oral hygiene and current immunizations are important for prevention. .