Week 2 Flashcards
What frequency of tuning fork is used for the ear?
512 Hz
What type of tuning fork is used for the diabetic foot exam?
128
What are the 6 D’s of ear disease?
- Deafness
- Discomfort
- Discharge
- Dizziness
- Din Din - tinnitus
- Defective movement of face
What are the nerves that could cause earache?
V, VII, IX, X C2 and C3
Give three examples of conditions involving discharge of the ear?
AOM, COM AND CSF
What is another term otitis media with effusion?
glue ear
What ear condition involves skin in the wrong place?
Cholesteatoma - looks like a collection of ice
What imaging is good for cholesteatomas?
CT scan of temporal bone
Is benign positional paroxysmal vertigo very common?
Yes - commonest cuse of vertigo looking up
What might be observed in vestibular pathologies?
Nystagmus
Name a haematological condition that causes dizziness>?
Anaemia
What condition has this pathophysiology: otolith material from urticle displaced into semicircular canals. Most commonly in posterior SCC?
Benign Positional Paroxysmal Vertigo
What is the difference between benign positional paroxysmal vertigo and vertebrobasilar insufficiency?
Need other symptoms of impaired circulation in posterior brain for example visual disturbance, weakness and numbness
What condition involves vertigo on looking up, turnng in bed, bending forward and moving the head quickly?
Benign Positional Paroxysmal Vertigo
How long does BPPV attacks normally last?
Brief episodes
Name three treatments for BPPV?
- Epley Manouevre
- Semont Manoeuvre
- Brandt-Daroff Exercises
What is the test for BPPV?
Hallpike’s Test
What is the name for this test: sit on couch so that head will be off end, turn head 45 to one side, warn patient not to close eyes, lie back quickly as comfortable and hold in position to observe?
Dix-Hallpike test - nystagmus
What condition involves prolonged vertigo (days), no associated tinnitus or hearing loss and probably has viral aetiology?
Vestibular Neuronitis
What is the difference between labrynthitis and vestibular neuronitis?
Labrynthitis may be associated with tinnitus or hearing loss
What disease involves a history of recurrent, spontaneous, rotational vertigo with at least two episodes > 20 mins often lasting hours?
Menieres disease
What other symptoms are felt in an attack of Menieres other than dizziness?
Occurence or worsening of tinnitus on the affected side, occurence of aural fullness on the affected side and other causes excluded
What preventative meausres can be used for Menieres disease?
- Salt restriction
- Betahistine
- Caffeine
- Alcohol
- Stress
Give three management options for Menieres?
- Grommet insertion
- Intratympanic gentamicin/steroids
- Surgery
What condition involves episodic vestibular symptoms of at least moderate severity with at least one of migranous headache, photophobia, phonophobia, visual or other aura?
Probable Migrainous Vertigo
What are the vocal cords doing during phonation?
Closed
What do neonates breathe through ?
Nasal breathers
What can be said about the tongue size and sublgottis shape in neonates?
Relatively large tongue
Narrow subglottis 3.5mm at thh cricoid
What gives a tad pole appearance in the larynx?
Recurrent respiratory papillomatosis
Should you do a tracheostomy in children?
They should be avoided at all possibilites
What condition is usually felt as being soft and boggy on the nose?
Septal haematoma
What condition could a cribiform plate fracture lead to/
Anosmia
What is the management of epistaxis?
Arrest/slow flow: pressure, ice, topical vasoconstrictor +/- lignocaine and adrenaline
How are CSF leaks from the nose treated?
Often settle spontaneously - need repair after 1 days
What clinical sign suggests a temporal bone fracture?
Battle sign bruising
What blow does a longitudinal fracture of the temporal bone result in?
Lateral blow
What does a frontal blow result in?
Transverse fracture
What can cause conductive hearing loss in a normal looking ear?
Stapes fixation - otosclerosis
Name the weak point of orbit?
Infraorbital groove
What does the tear drop sign on CT suggest?
Blow out fracture - medial wall and floor
Wjat type of drug is cetirizine?
Anti-histamines
Name a decongestant?
Pseudoephedrine
What type of drug is ipratropium?
Anti-cholinergics
What are the four s’s of nasal disease?
Stuffy, smell, snot and sore
Which is more worrying in nasal symptoms - unilateral or bilateral?
Unilateral
What can cause infective rhinitis?
Viral upper respiratory tract infection
Give a cause of non-infective rhinitis?
Allergic
Name a few intermittent causes of allergic rhiniits and some persistent?
Grass pollen
Tree pollen
Fungal spores - intermittent
House dust mite
Cat
Dog - persistent
Name the three pillars of treatment for allergic rhinitis?
- Allergic avoidant
- Symptomatic therapy - antihistamines, topical steroids
- Immunotherapy
What are often associated with non-allergic asthma, are treated with oral then topical steroids and if no better are surgically removed?
Nasal polyps
What can acute infective rhinosinusitis present with?
- Facial pain
- Discharge
- Nasal blockage
What investigations should you not do when managing infective rhinitis?
Nasal x-ray
Sinus x-ray
What must you exclude in nasal trauma?
Septal haematoma
What must you do if a child or adult presents with unilateral discharge?
Refer urgently
What is an emergency complication of acute sinusitis?
Orbital cellulitis
What is the name for the ring of lymphoid aggregation in the subepithelial layer of oropharynx and nasopharynx?
Waldeyer’s ring
What is the tonsil contiguous inferiorly with?
The lingual tonsil
What is the lining of the tonsils?
Stratified squamous epithelium
What is the lining of the adenoids?
Ciliated pseudostratified columnar epithelium
What are the 3 layers of adenoids?
- Ciliated pseudostratified columnar
- Stratified squamous
- Transitional
Describe the differences in crypts and folds with tonsils and adenoids?
Tonsils - deep crypts
Adenoids - deep folds
What is the biggest viral cause of acute tonsillitis?
EBV
Then rhinovirus, influenza, parainfluenza, enterovirus and adenovirus
What are the four centor criteria for bacterial tonsilitis?
- History of fever
- Tonsillar exudates
- Tender anterior cervical adenopathy
- Absence of cough
What antibiotic should be given for bacterial tonsilitis?
Penicillin
Name a complication of acute tonsillitis?
Peritonsilar abscess
What presents with unilateral throat pain and odynophagia, trismus (difficulty opening mouth) and 3-7 days of preceding acute tonsilitis?
Peritonsilar abscess
How is peritonsilar abscess treated?
With aspiration and antibiotics
What presents with gross tonsillar enlargement with membranous exudate, marked cervical lymphadenopathy, palatal petechial haemorrhages, generalised lymphadenopathy and hepatosplenomegaly?
Glandular fever
How do you test for glandular fever?
Atypical lymphocytes in peripheral blood - IgM or positive monospot
What happens if you give amoxilcillin to a glandular fever or tonsilitis patients?
Macular rash will result
What presents with chronic sore throat, malodorous breath, presence of tonsilliths, peritonsillar erythema, persistent tender cervical lymphadwenopathy?
Chronic tonsillitis
What presents with obligate mouth breathing, hyponasal voice, snoring and AOM/OME?
Adenoid obstructive hyperplasia
What presents with snoring and muffled voice?
Obstructive hyperplasia of tonsils
What are some signs of OME/glue ear?
TM retraction and dullness
Visible fluid or bubbles
Conductive hearing loss
