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ChiroBoards2:EENT
ChiroBoards2: EENT (Currently Incomplete)
| Question | Answer |
|---|---|
| Eyebrows: Scaly indicates = | seborrhea (dandruff) |
| Eyebrows: loss of lateral 1/3 indicates... | myxedema (aka hypothyroidism) |
| Drooping of eyelid is called | ptosis |
| In Horner's syndrome, we lose... | sympathetics |
| Horners presents with 3 classic signs : | ptosis, anhydrosis, meiosis |
| CN III paralyisis will ____________ pupil = (constrict or dilate?) | dilate |
| T/F? Myasthenia Gravis can cause ptosis | true |
| DDX factor, differentiating horners and CN3 paralysis from Myasthenia Gravis? | In MG, the patient cannot close their eyes all the way |
| Term describing Lid lag/failure to cover the eyeball | Exophthalmosis |
| Exophthalmosis in Grave's is : (bilateral vs. unilateral) | bilateral |
| Exophthalmosis seen with tumors are : (bilateral vs. unilateral) | unilateral |
| Lid is turned outward and seen in the elderly = | Ectropion |
| Lid is turned inward and seen in the elderly = | Entropion |
| Periorbital Edema is seen with 3 conditions = | Allergies; Myxedema; and Nephrotic Syndrome (HEP) |
| Inflammation of the eye; seen with seborrhea, staph, and inflammatory processes. | Blepharitis |
| Opacities seen in the lens | cataracts |
| Cataracts are commonly seen with 2 groups | Those with diabetes and the elderly |
| Does cataracts allow for a red light reflex? | No, it is absent |
| Corneal Arcus | Grayish Opaque ring around the cornea. |
| Corneal Arcus in those under 50 usually due to = | Hypercholesterolemia |
| Corneal Arcus in those over the age of 50 = | normal (Arcus Senalis) |
| Triangular thickening of the bulbar conjunctiva that grows across the cornea and is brought on by dry eyes = | Pterygium |
| Which structure thickens with Pterygium? | Bulbar Conjunctiva |
| Yellow sclera is seen with | Jaundice |
| Pt. has yellow sclera. what are your 2 ddx's? | Jaundice vs. Beta Carotenemia |
| Blue sclera seen in | Osteogenesis Imperfecta |
| What color is seen with a normal conjunctiva? | Pink |
| What condition causes a pale conjunctiva? | Anemia |
| What causes a bright red conjunctiva? | Infection |
| An infection of the sebaceous lands causing a pimple or boil on the eyelid = | Hordoleum (sty) |
| Hordoleum, aka = | Sty |
| A sty is an infection of what glands? | sebaceous glands |
| An infection of the meibomian gland causing a nodule which points inside the eyelid. | Chalazion |
| A chalazion is an infection of what glands? | meibomian glands |
| A yellowish triangular nodule in the bulbar conjuntiva that is harmless and indicates aging = | Pinquecula |
| Fatty yellow plaques on the nasal surface of the eyelids that is normal or indicates hypercholesterolemia = | Xanthelasma |
| Xanthelasma can be normal or indicative of what condition? | hypercholesterolemia |
| Bilateral small and irregular pupils that accomodate but do not react to light | Argyll Robertson pupil |
| This pupil presentation is seen with Syphilis (3rd stage) | Argyll Robertson pupil |
| Dilated pupil with ptosis and lateral deviation and doesnt react to light or accomodation | Internal Ophthalmoplegia |
| Internal Ophthalmoplegia is seen in what neurological disorder? | MS |
| Dilated and fixed pupils seen with anticholinergic drugs | Mydriasis |
| What 3 things can cause dilated, fixed pupils (mydriasis)? | Atropine drops/mushrooms/death |
| Fixed and constricted pupils that react to light and accomodate | Miosis |
| Miosis is seen in 3 scenarios = | Brain damage; Pilocarpine Medications; Narcotic use |
| Unequal pupil size | anisicoria |
| Sluggish pupillary reaction to light that is UNILATERAL and caused by parasympathetic lesion of CN III | Adie's Pupil |
| Normal Vision, aka | Emmetropia |
| Emmetropia, aka | Normal Vision |
| Farsighted, aka | Hyperopia |
| Loss of lens elasticity due to aging | Presbyopia |
| Direct light reflex tests ... | CN II and III |
| Consensual light reflex tests... | CN III |
| Accommodation tests... | CN II and III |
| Visual acuity <--- what tool do you test this with = | Snellen Chart |
| Cardinal field of gaze tests... | CN III, IV, VI |
| Inflammation of the iris = | Iritis |
| Iritis is commonly seen with this condition = | Ankylosing Spondylitis (Early sign of arthritic condition) |
| Ringing in the ears | tinnitus |
| Sensorineural hearing loss that occurs in people as they age. May be genetic or acquired factors = | Presbycussis |
| This condition is often associated with swimming, especially if the water is contaminated = | Acute otitis externa |
| Often referred to as "swimmers ears" = | Acute otitis externa |
| Tugging on pinna is painful with = | Acute otitis externa |
| Presents clinically with same s&s of acute otitis media, with the addition of inflammation and palpable tenderness over the mastoid. Hearing loss is commonly assoc. with = | Acute Mastoiditis |
| Tympanic membrane presents with red appearance, dilated blood vessels, and bulging. = | Purulent Otitis Media (Bacterial Otitis Media) |
| Purulent Otitis Media, aka = | Bacterial Otitis Media |
| Symptoms = prostrating, sensory hearing loss, tinnitus, and a feeling of fullness in the ear = ? | Meniere's Disease |
| Benign tumor of CN VIII (schannoma), causing hearing loss, tinnitus, vertigo, = | Acoustic Neuroma |
| Your patient has hearing loss, tinnitus, vertigo, You suspect an acoustic neuroma. What test do you do next to detect it = | CT or MRI |
| What affect does an eustachian tube block cause on the tympanic membrane? | Causes retraction of the t.m. (due to Acute OM) |
| Normal Hearing: Weber test results (A)____ ; Rinne Test results (B)____ | Equal sound bilaterally ; AC>BC (Rinnes +) |
| Conduction Hearing Loss: Weber test results (A)____ ; Rinne Test results (B)____ | Lateralizes to bad ear; AC = BC (Rinnes -) |
| Sensorineural Hearing Loss: Weber test results (A)____ ; Rinne Test results (B)____ | Lateralizes to good ear ;AC>BC, with less time in bad ear |
| Nasal mucosa appears red and swollen with a clear runny nose | Viral Rhinitis |
| Nasal mucosa appears pale or blue and boggy | Allergic Rhinitis |
| Thinning of the nasal mucosa with sclerosis, crust formation, and foul odor | Atrophic Rhinitis |
| Typically occurs as a consequence chronic inflammation of the nasal mucosa = | Polyps |
| Thick white fungal patches easily scraped off | Candidiasis |
| Candidiasis, aka = | Thrush |
| Cadidiasis can commonly occur in these 2 groups = | diabetics and pregnant women |
| Pre-cancerous lesion of white patche, adherent, and not easily removed | leukoplakia |
| Smooth gloss tongue = | atrophic glossitis |
| Atrophic glossitis can be caused by deficiency of these 2 things: | B vitamins or Iron |
| Fissured tongue, aka = | scrotal tongue |
| Deep furrows on the surface of the tongue - | Fissured tongue (considered a normal variant) |
| Excessive production of growth hormone prior to skeletal maturity | Gigantism |
| Excessive production of growth hormone beginning in middle age | acromegaly |
| Eats a lot, cant gain weight, can't stand the heat = | Hyperthyroidism |
| Hyperthyroidism's most common cause = | Graves Disease (autoimmune) |
| Hyperthyroidism = TSH ________ (increased or decreased) | decreased |
| Most common cause of hypothyroidism in US= | Hoshimoto's thyroiditis |
| Congenital hypothyroid is called | cretinism (a physical and mental capacity) |
| Increase T3; Increased T4; and Decreased TSH = (Hyper vs. Hypothyroid) | Hyperthyroidism |
| Decreased T3; Decreased T4; and Increased TSH = (Hyper vs. Hypothyroid) | Hypothyroidism |
| Headache DDX = pt. presents with photophobia, throbbing pain, worse behind eye, familial, and can occur bilaterally or unilaterally. The pain is provoked by bright light, red wine, menstrual cycle, and tension. The patient does not know it is coming. = | Common Migraine |
| Common migraine occurs more in males or females? | females |
| Headache DDX = pt. presents with photophobia, throbbing pain, worse behind eye, familial, and can occur bilaterally or unilaterally. The pain is provoked by bright light, red wine, menstrual cycle.. The patient knows its coming and has an aura. | Classic Migraine |
| Headache DDX = the pain occurs in the occipital area and vertex. The patient wakes up with the H/A and its throbbing. Onset is in adults, and labs/tests include BP and lipid profile. = | Hypertensive Headache |
| Headache DDX = Occurs more commonly in males and occurs unilaterally, in orbital and temoral region. The H/A wakes pt. at night, lasting 15-180 min. Facial sweating occurs. Provoked by ALCOHOL. VERY PAINFUL = | Cluster Headache |
| Headache DDX = Occurs in a band-like distribution and feels like pressure/muscle tightness. Provoked by fatigue, tension, stress and work. This H/A actually improves with alcohol. | Muscular tension headache |
| Headache DDX: pt. is over 50 years old and the oain is unilateral in temporal region. It feels like persistent burning, aching, throbbing. The scalp is sensitive and arteries are tender. Combing hair makes it worse. ESR elevated. Biopsy may be needed. | Temporal Arteritis (Giant Cell) |
| Headache DDX = Occurs in adults, and pain is in upper cervical/ occipital region. Pain occurs daily, decreased ROM in upper neck, pain in neck that refers to the head. Provoked by head movement. Flexion/extension views can be taken to evaluate. | Cervicogenic, aka Vertebrogenic H/A |
| Headache DDX = pt. wakes up with the pain. It feels like steady thob, local tenderness, and worse in the morning. The site changes with body position but is localized. Provoked by chronic allergies and sinusitis | Sinus Headache |
| Headache DDX = pt. has pain in the basilar area. It has an abrupt onset, feels constant, stiff neck, excruciating pain like never before experienced. Provoked by hypertension, stress. Tests seen include high blood pressure and fever. = | Subarachnoid Hemorrhage |
| Headache DDX = pt. has pain that changes location with body position. Onset is in morning and evening It feels mild to severe, throbbing, neck stiffness is worse than ever, and is progressively getting worse. Provoked by tumor growth. = | Brain Tumor |
| Heachache DDX = pt. has a stiff neck, fever, photophobia, severe pain, and nuchal rigidity. It occurs in a single, intense episode, and is worse in flexion. Kernig/Brudzinski's tests and CSF tap = | Meningeal Irritation (meningitis) |
| Headache DDX = Generalized pain that gets provoked from skipping meals. A fasting blood glucose test may be positive = | Hypoglycemic cause |
| Headache DDX = Localized general pain with loss of memory and visual disturbances. Provoked by a fall, MVA, whiplash injury, and trauma. Refer t a neurologist/ER = | Post Concussive H/A |
Created by:
bglasman
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