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ChiroBoards2:EENT

ChiroBoards2: EENT (Currently Incomplete)

QuestionAnswer
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 on 2012-03-04



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