Term
| describe the positioning of the pars tensa and pars flaccida |
|
Definition
flaccida = superior
tensa = inferior |
|
|
Term
| what is significant about the eustachian tube in infancy? |
|
Definition
| it is nearly horizontal --> increased rate of middle ear infections |
|
|
Term
| what structures are responsible for vestibular control? |
|
Definition
| cochlea and semicircular canals |
|
|
Term
| MC skin cancer on the ear? what does it look like? |
|
Definition
basal cell carcinoma
rolled border, pearly appearance, nodule, telangeictasias |
|
|
Term
| what is a precursor to squamous cell carcinoma? |
|
Definition
|
|
Term
| what is tenderness when you palpate the tragus indicative of? |
|
Definition
|
|
Term
| who is at increased risk of MOE? |
|
Definition
|
|
Term
| inability to equalize middle ear pressure during descnet in diving or aircraft |
|
Definition
|
|
Term
|
Definition
viral etiology after a URI
strep pneumonia, H.Flu, moraxella
tx = amox |
|
|
Term
| best study to dx mastoiditis? |
|
Definition
|
|
Term
| sensation of movement either of oneself or their environment |
|
Definition
|
|
Term
| MCC of SNHL? greatest risk factor? |
|
Definition
|
|
Term
|
Definition
| streptomycin and gentamycin are the worst. Also salicylates, Loop diuretics, and antineoplastic agents |
|
|
Term
| growth of desquamated, stratified, squamous epithelium that often occurs in the pars flaccida area from chronic negative pressure/retraction |
|
Definition
|
|
Term
| slowly progressive hearing loss with onset in the 3rd-4th decade, abnormal removal of mature bone and abnormal remodeling - tends to run in families |
|
Definition
|
|
Term
| triad of hearing loss, tinnitus, vertigo |
|
Definition
|
|
Term
|
Definition
valium for severe vertigo
HCTZ 50-100mg po qd |
|
|
Term
| viral URI followed by vertigo, tinnitus, and hearing loss. |
|
Definition
|
|
Term
| short episodes (seconds to minutes) of vertigo brought on by head movements |
|
Definition
|
|
Term
| what is the procedure to dx BPPV? to tx it? |
|
Definition
dx = Dix Hallpike
tx = Epley |
|
|
Term
| tumor that presents with hearing loss, tinnitus, vertigo, facial numbness and weakness |
|
Definition
|
|
Term
|
Definition
|
|
Term
| what type of nystagmus indicates a central lesion? |
|
Definition
|
|
Term
| what autoimmune disease may present as a vestibular disease? |
|
Definition
|
|
Term
| vertigo, hyperacusis, facial numbness, nystagmus, diplopia. diagnosis made with MRI |
|
Definition
|
|
Term
| what is the etiology behind "drop attacks" that are precipitated by neck motion? |
|
Definition
| vertebrobasilar insufficiency |
|
|
Term
| infection of your facial nerve that's accompanied by a painful rash and facial muscle weakness caused by varicella zoster |
|
Definition
|
|
Term
| describe the nasal mucosa in a pt with allergic rhinitis |
|
Definition
| pale, boggy, bluish tinge, clear rhinorrhea, sneezing, allergic shiners, allergic salute, nasal polyps |
|
|
Term
| what type of cells might be seen on a nasal smear of a pt with allergic rhinitis? |
|
Definition
|
|
Term
| what type of cells might be seen on a nasal smear of a pt with allergic rhinitis? |
|
Definition
|
|
Term
| cornerstone of tx of allergic rhinitis |
|
Definition
nasal corticosteroids
others = antihistamines, mast cell stabilizers, leukotriene inhibitors |
|
|
Term
| how is vasomotor rhinitis dx? |
|
Definition
|
|
Term
| what causes rhinitis medicamentosa |
|
Definition
| overuse of nasal decongestants |
|
|
Term
| MC sinuses involved in sinusitis |
|
Definition
|
|
Term
| gold standard for eval of the sinuses? |
|
Definition
|
|
Term
| which plain film view is best for visualization of teh maxillary sinuses |
|
Definition
|
|
Term
| how long should tx sinusitis with abx? |
|
Definition
|
|
Term
| what is vestibulitis and why is it dangerous? |
|
Definition
| infection of the nasal vestibule - can lead to retrograde infection via the cavernous sinus into the cranium |
|
|
Term
|
Definition
aspirin allergy, nasal polyps, asthma
associated wiht allergic rhinitis |
|
|
Term
| MCC of olfactory dysfunction |
|
Definition
| anatomic blockage by polyps, septal deformities, nasal tumors or head trauma |
|
|
Term
| what is the MCC of unilateral nasal obstruction and purulent rhinorrhea in children? |
|
Definition
|
|
Term
| what area of teh septum is most often involved in anterior epistaxis? |
|
Definition
|
|
Term
| what pts are at greater risk for posterior epistaxis? |
|
Definition
eldery due to HTN, blood thinners, poor tolerance of hemodynamic change.
tx = posterior nasal packing and hospitalize |
|
|
Term
| why do nasal papillomas need wide excision? |
|
Definition
| 10% undergo malignant change to SCC |
|
|
Term
| MC malignancy of the maxiallary and ethmoid sinuses |
|
Definition
|
|
Term
| why is erythroplakia more serious than leukoplakia? |
|
Definition
| greater risk of malignancy |
|
|
Term
| most important aspect of the exam in a pt with a nasal fracture |
|
Definition
| visualize the nasal septum |
|
|
Term
| presence of nasal polyps in children should raise suspicion of what disease? |
|
Definition
|
|
Term
MCC of tongue cancer?
which location at the poorest prognosis? |
|
Definition
|
|
Term
| pain of the gingiva and the tissue appears eroded with superficial grayish pseudomembranes |
|
Definition
| trench mouth - NUG (necrotizing ulcerative gingivitis) |
|
|
Term
| MC pathogen in pharyngitis |
|
Definition
|
|
Term
| MC bacterial pathogen in pharyngitis |
|
Definition
|
|
Term
| what CBC result suggests mono? |
|
Definition
|
|
Term
| what do pts with mono need to avoid? |
|
Definition
|
|
Term
|
Definition
PCN, erythromycin
tx to avoid complications |
|
|
Term
| what autoimmune disease causes dry mouth and dry eyes? |
|
Definition
|
|
Term
| cellulitis of hte sublingual and submaxillary space from a dental abscess |
|
Definition
|
|
Term
|
Definition
|
|
Term
| most prominent feature of sleep apnea |
|
Definition
|
|
Term
| tender, swollen glands in the mouth. exacerbated with meals. ductal openings are red and may express pus. |
|
Definition
|
|
Term
|
Definition
| elderly with poor hydration |
|
|
Term
| why would someone's voice be too "breathy" |
|
Definition
| too much air passes through incompletely closed vocal cords |
|
|
Term
| what test should be done for persistent hoarseness (>2 wks) |
|
Definition
|
|
Term
| viral inflammation of the upper and lower respiratory tracts - characterized by stridor, subglottic swelling, and respiratory distress. |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| dysphagia, dysphonia, dyspnea, drooling |
|
|
Term
| what should you AVOID in a child with suspected epiglottitis? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| what causes vocal cord nodoules? |
|
Definition
|
|
Term
| what type of pts have laryngeal leukoplakia? |
|
Definition
|
|
Term
| MC cancer of the larynx, what pt? |
|
Definition
SCC
male smoker, drinker > 50yo |
|
|
Term
| what type of laryngoscopy requires general anesthesia? |
|
Definition
|
|
Term
| MCC of vocal cord paralysis? second? |
|
Definition
|
|
Term
what is vocal cord dysfunction?
what is it often misdiagnosed as?
what type of pt? |
|
Definition
vocal cord adduction(closure) during inspiration.
often misdiagnosed as asthma
anxious female 20-40yo |
|
|
Term
| what is more permanent, tracheotomy or cricothyroidotomy? safer/easier to perform? |
|
Definition
permanent = tracheotomy
safer/easier = cricothyroidotomy |
|
|
Term
| neck mass with rapid growth and tenderness more likely to be inflammatory or cancerous? |
|
Definition
|
|
Term
| benign "mass" in the SCM of the neck |
|
Definition
|
|
Term
causative agent of mumps
MC gland involved
common complications |
|
Definition
paramyxovirus
partoid gland
comp = orchitis, oophoritis, meningoencephalitis, pancreatitis |
|
|
Term
| difference between brachial cleft and thyroglossal cysts |
|
Definition
brachial cleft = later neck, non tender, don't move with swallowing
thyroglossal = midline, move with swallowing |
|
|
Term
| MC pathogens for inflammatory masses of the neck (3) |
|
Definition
| staph aureus, group a strep, oral anaerobes |
|
|
Term
| MC neck mass at any age, when would you refer for biopsy? |
|
Definition
reactive LAD
persists > 6-8 wks or > 1cm and growing |
|
|
Term
MC sites of SCC on the head and neck.
what are strong risk factors |
|
Definition
tongue, tonsils, larynx
risk factors = smoking, ETOH |
|
|
Term
| what type of cell is seen in Hodgkin lymphoma |
|
Definition
|
|
Term
| MC type of thyroid cancer |
|
Definition
|
|
Term
| thyroid cancer with the worst prognosis |
|
Definition
|
|
Term
| at what decibal is haering loss considered profound? |
|
Definition
|
|
Term
| what does pure tone testing evaluate? |
|
Definition
| hearing loss of several types - need a cooperative pt |
|
|
Term
| what type of audilogy test can be performed on an uncooperative pt? |
|
Definition
|
|
Term
| what lateral neck radiograph sign is associated with epiglottitis? |
|
Definition
|
|
Term
| what is a flat tympanogram associated with? |
|
Definition
|
|
Term
| what does a left shifted tympanogram indicate? |
|
Definition
| negative middle ear pressure such as from a retracted TM |
|
|
Term
| typical age for epiglottitis? peak? |
|
Definition
|
|
Term
| typical age for croup? peak? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| causative agent in epiglottitis |
|
Definition
|
|
Term
| complication of auricular hematoma |
|
Definition
|
|
Term
|
Definition
| corticosteroids and referral to ENT |
|
|
Term
|
Definition
| debrox or H2O2 and H2O solution |
|
|
Term
| useful instruments for removing foreign objects from outer ear |
|
Definition
| alligator forceps and right angle hooks |
|
|
Term
| MCC of malignant external otitis (MEO) |
|
Definition
|
|
Term
| tx for mild MEO? moderate-severe? |
|
Definition
mild = oral ciprofloxacin
mod-severe = IV antipseudomonal abx (aminoglycosides and 4th generation cephalosporins) and surgical debridement |
|
|
Term
| what test should you do in pts with 1st brachial cleft anomalies? why? |
|
Definition
| renal U/S to r/o renal anomalies |
|
|
Term
| tx for AOM with beta-lactamase resistance |
|
Definition
| augmentin, cephalosporins |
|
|
Term
| what is the purpose of PET? |
|
Definition
| to vent the ear not drain it |
|
|
Term
| how is bullous myringitis treated? |
|
Definition
|
|
Term
| when should PE tubes be placed? |
|
Definition
|
|
Term
| untreatd AOM can lead to what? |
|
Definition
|
|
Term
| what topical abx are used for a perfed ear drum? |
|
Definition
| ofloxacin or cipro+hydrocortisone |
|
|
Term
| what kind of hearing loss does tympanosclerosis cause? |
|
Definition
|
|
Term
| what should be done with unilateral OME? |
|
Definition
| examination of the nasopharynx |
|
|
Term
| major complication of AOM |
|
Definition
| meningitis - usually from strep pneumo or H. Flu |
|
|
Term
| dizziness associated with the illusion of motion |
|
Definition
|
|
Term
| sudden vertigo that develops without ear symptoms and lasts for 24-48 hours is most likely... |
|
Definition
vestibular neuronitis or
labyrinthitis |
|
|
Term
| how long does BPPV normally last? |
|
Definition
| 10-30 seconds, almost always < 1 minute |
|
|
Term
| why shouldn't afrin be used for more than 3 days? |
|
Definition
|
|
Term
| oral calculus formation is most common where? |
|
Definition
|
|
Term
| what is seen on CXR of foreign body aspiration? |
|
Definition
| hyperinflation seen on the ipsilateral side of foreign body obstruction due to air trapping |
|
|
Term
| where do most aspirated foreign bodies lodge? |
|
Definition
| right main stemp bronchus |
|
|
Term
| earliest sign of parotitis |
|
Definition
| sensitivity to acidic foods/drinks |
|
|
Term
| what is warranted prior to surgical abscess drainage? |
|
Definition
| hospitalization and IV abx |
|
|
Term
| tx of choice for thyroductal and brachial cleft cysts? |
|
Definition
|
|
Term
| what staging system is used for Hodgkin's lymphoma |
|
Definition
|
|
Term
| MCC of hearing loss in children |
|
Definition
|
|
Term
| MCC on conductive hearing loss in adults |
|
Definition
|
|
Term
| pts with asymmetric SNHL must be evaluated for what? how? |
|
Definition
| acoustic neuroma with MRI |
|
|
Term
| tympanogram that slops downward and to the right side of the audiogram is what? |
|
Definition
|
|
Term
| tympanogram with high frequency dip from what? |
|
Definition
| noise induced hearing loss |
|
|
Term
| air-bone gap usually signifies what? |
|
Definition
|
|
Term
| if air conduction and bone conduction thresholds are equal but higher than 25dB, what is it? |
|
Definition
| sensorineural hearing loss |
|
|
Term
| visual acuity is tested using |
|
Definition
|
|
Term
| what is used to check intraocular pressure? |
|
Definition
|
|
Term
| how should you evaluate the eye for a foreign body |
|
Definition
| stained with flourescein observed with a wood's lamp |
|
|
Term
| rust ring on the cornea indicates what? |
|
Definition
|
|
Term
| pt presents with eye swelling and misalignment. superior movement of the globe is restricted due to entrapment of the infraorbital nerve and musculature. double vision is common. subcutaneous emphysema and exopthalmos are present. |
|
Definition
|
|
Term
| with a corneal abrasion can you prescribe topical anesthetic? |
|
Definition
| No! used only to aid diagnosis |
|
|
Term
| follow up of all corenal abrasions should occur when? |
|
Definition
|
|
Term
| characteristic symptom of retinal detachment |
|
Definition
| curtain being drawn over the eye from top to bottom. May also sense floaters or flashing lights |
|
|
Term
| how should pts with retinal detachment be positioned? |
|
Definition
| supine with head turned to the side fo the retinal detachment |
|
|
Term
| leading cause of irreversible central vision loss |
|
Definition
|
|
Term
| pathophysiology of macular degeneration |
|
Definition
| Drusen deposits are found in Bruch's membrane, leading to degenerative changes, loss of nutritional supply, atrophy, and neovascularization |
|
|
Term
| phenomenon of wavy or distored vision associated with macular degeneration. how is it measured? |
|
Definition
| metamorphobsia, measured with Amsler grid |
|
|
Term
| cherry red spot on the retina |
|
Definition
central retinal artery occlusion,
emergency referral to ophtho |
|
|
Term
| "blood and thunder" or "spaghetti and meatball" retina |
|
Definition
| central retinal vein occlusion |
|
|
Term
| common causes of retinopathy |
|
Definition
| diabetes, HTN, pre-eclampsia, eclampsia, blood dyscrasias, HIV |
|
|
Term
| leading cause of blindness in adults in the US |
|
Definition
|
|
Term
| any opacity of the natural lens of the eye |
|
Definition
|
|
Term
| what predisposes are person to cataract formation? |
|
Definition
|
|
Term
| how does a cataract appear on fundoscopy? |
|
Definition
| black on a red background |
|
|
Term
|
Definition
| increased intraocular prsesure with optic nerve damage. Any impediment to the flow of aqueous humor through the trabecular meshwork and canal of Schlemm will incresae pressure in the anterior chamber. |
|
|
Term
| what type of glaucoma is an ophthalmic emergency? |
|
Definition
| angle closure glaucoma - painful eye and loss of vision accomanied by a steamy cornea |
|
|
Term
| findings with open angle glaucoma (2) |
|
Definition
defects in peripheral visual field
increased cup-to-disc ratio |
|
|
Term
| tx of angle closure glaucoma |
|
Definition
immediate referral to ophtho
start IV carbonic anhydrase inhibitors, topical BB, and osmotic diuresis |
|
|
Term
| ptosis, eyelid edema, exopthalmos, purulent discharge, and conjunctivitis, fever, decreased range of motion in the eye muscles and a sluggish pupillary response |
|
Definition
|
|
Term
|
Definition
| common in the first month of life and occurs when the tear duct does not open |
|
|
Term
| inflammation of the lacrimal gland caused by obstruction |
|
Definition
|
|
Term
| chronic inflammation of the eye lid margins, rims are red and eyelashes adhere. causes = seborrhea, stphylococcal or streptococcal infections or dysfunction of the meibomian glands |
|
Definition
|
|
Term
| acute development of a small, painful nodule or pustule within a gland in the upper or lower eyelid |
|
Definition
|
|
Term
| internal vs external hordeolum |
|
Definition
internal = inflammation/infection of the meibomian gland
external = sty = inflmmation and infection of the glands of Moll or Zeis. located immediately adjacent to hte edge of the palpebral margin. |
|
|
Term
|
Definition
|
|
Term
| relatively painless, indurated lesion deep from the palpebral margin. Secondary to chronic inflammation from an internal hordeolum of the meibomian gland |
|
Definition
|
|
Term
| eye lid and lashes are turned in |
|
Definition
| entropian scondary to scar tissue or spasm of the orbicularis oculis muscle |
|
|
Term
| the edge of the eyelid everts |
|
Definition
| ectropian secondary to advanced age, trauma, infection, or palsy of the facial nerve |
|
|
Term
| MCC of viral conjunctivitis |
|
Definition
|
|
Term
| acute onset of unilateral or bilateral erythema on the conjunctiva, copious water discharge, and ipsilateral tender periauricular LAD. |
|
Definition
|
|
Term
| MCC bacterial conjunctivitis |
|
Definition
strep pneumoniae
staph aureus
haemophilus aegyptius
moraxella sp. |
|
|
Term
| acute onset of copious, purulent discharge from both eyes. eyes may be "glued" shut upon awakening. |
|
Definition
|
|
Term
| slowly growing thickening of the bulbar conjunctiva, traingular mass that grows from the side of the eye, toward and eventually over the cornea |
|
Definition
|
|
Term
| small growth normally on the nasal side of the conjunctiva that does not cover the cornea. |
|
Definition
|
|
Term
| lesions anterior to the optic chiasm affect what? |
|
Definition
|
|
Term
| lesions at the optic chiasm affect what? |
|
Definition
|
|
Term
| lesions posterior to the optic chiasm will yield what? |
|
Definition
| corresponding defects in both visual fields |
|
|
Term
| causes of transient visual loss (3) |
|
Definition
TIA
emobli (amaurosis fugax)
temporal (giant cell) arteritis |
|
|
Term
| condition in which binocular fixation is not present |
|
Definition
|
|
Term
| inward misalignment of vision |
|
Definition
|
|
Term
| outward misalignment of vision |
|
Definition
|
|
Term
| if strabismus is left untreated after age 2, what develops? |
|
Definition
|
|
Term
| reduced visual acuity not correctable by refactive means |
|
Definition
|
|
Term
| yellowing of the sclera due to retention of bilirubin |
|
Definition
|
|
Term
| blue or cyanoic sclera may be normal or seen in infants with what disorder? |
|
Definition
|
|
Term
| lateralization to the affected ear on the Weber test indicates? |
|
Definition
|
|
Term
| bone conduction > air conduction on Rinne indicates? |
|
Definition
|
|
Term
| inadequate treatment of otitis media may cause |
|
Definition
|
|
Term
| causes of peripheral vertigo |
|
Definition
| labyrinthitis, Meniere's disease, positional vertigo, vestibular neuronitis, migrainous vertigo, obstructing anatomic abnormalities |
|
|
Term
| causes of central vertigo |
|
Definition
| brain stem vascular disease, arteriovenous malformations, tumosr of the brain stem or cerebellum, multiple sclerosis, or vertebrobasilar migraine syndrome |
|
|
Term
| severe sore throat, pain on swallowing or opening mouth wide, deviation of the palate and uvula and a muffled voice. "hot potato voice" |
|
Definition
|
|
Term
| MC location of bleeding for posterior epistaxis? |
|
Definition
|
|
