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Questions and Answers
What is the most common infectious cause of blindness and how is it treated?
What is the most common infectious cause of blindness and how is it treated?
Which condition is characterized by a fleshy triangular growth and often necessitates removal?
Which condition is characterized by a fleshy triangular growth and often necessitates removal?
What is the appropriate treatment for allergic conjunctivitis characterized by itchiness?
What is the appropriate treatment for allergic conjunctivitis characterized by itchiness?
Which test measures the rate of production of the aqueous component for diagnosing dry eyes?
Which test measures the rate of production of the aqueous component for diagnosing dry eyes?
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Which of the following is true regarding Herpes Simplex Keratitis?
Which of the following is true regarding Herpes Simplex Keratitis?
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What is the most common type of Diabetic Retinopathy?
What is the most common type of Diabetic Retinopathy?
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What treatment is recommended for Hypertensive Retinopathy?
What treatment is recommended for Hypertensive Retinopathy?
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Which sign is associated with Optic Neuritis?
Which sign is associated with Optic Neuritis?
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What is a common symptom of Oculomotor Palsies?
What is a common symptom of Oculomotor Palsies?
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What condition is characterized by dancing eyes and rapid eye movements?
What condition is characterized by dancing eyes and rapid eye movements?
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What is the primary treatment for a nasal septal hematoma?
What is the primary treatment for a nasal septal hematoma?
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What is a common symptom of septal perforation?
What is a common symptom of septal perforation?
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What should be monitored when a patient is on Warfarin?
What should be monitored when a patient is on Warfarin?
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What is a common cause of nasal foreign body incidents?
What is a common cause of nasal foreign body incidents?
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What is an urgent removal indication for a nasal foreign body?
What is an urgent removal indication for a nasal foreign body?
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Which of the following is NOT a center criterion for the rapid strep antigen test screening?
Which of the following is NOT a center criterion for the rapid strep antigen test screening?
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What type of imaging is typically used to evaluate salivary gland tumors?
What type of imaging is typically used to evaluate salivary gland tumors?
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Which of the following symptoms is NOT associated with allergic rhinitis?
Which of the following symptoms is NOT associated with allergic rhinitis?
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What is the primary treatment recommended for allergic rhinitis?
What is the primary treatment recommended for allergic rhinitis?
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Which of the following is considered a risk factor for perennial allergic rhinitis?
Which of the following is considered a risk factor for perennial allergic rhinitis?
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What condition can develop from prolonged use of topical decongestants?
What condition can develop from prolonged use of topical decongestants?
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Anosmia is defined as the inability to detect which of the following?
Anosmia is defined as the inability to detect which of the following?
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What is a common complication associated with olfactory dysfunction?
What is a common complication associated with olfactory dysfunction?
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Which type of allergic rhinitis is most commonly linked to dust, mites, and indoor molds?
Which type of allergic rhinitis is most commonly linked to dust, mites, and indoor molds?
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What is a significant side effect of using leukotriene antagonists as add-on therapy for allergic rhinitis?
What is a significant side effect of using leukotriene antagonists as add-on therapy for allergic rhinitis?
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Which type of hearing loss is characterized by a dysfunction of the cochlea or neural components?
Which type of hearing loss is characterized by a dysfunction of the cochlea or neural components?
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In the Rinne Test, which outcome indicates a conductive hearing loss?
In the Rinne Test, which outcome indicates a conductive hearing loss?
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What is the most common location affected by otosclerosis?
What is the most common location affected by otosclerosis?
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Which condition is associated with progressive bilateral sensory-neural hearing loss and treated with corticosteroids?
Which condition is associated with progressive bilateral sensory-neural hearing loss and treated with corticosteroids?
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Which symptom is characteristic of hyperacusis?
Which symptom is characteristic of hyperacusis?
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What is the primary treatment strategy for sudden sensory-neural hearing loss?
What is the primary treatment strategy for sudden sensory-neural hearing loss?
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Which feature is NOT typical of seborrheic dermatitis affecting the external ear?
Which feature is NOT typical of seborrheic dermatitis affecting the external ear?
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What is a common consequence if external ear trauma is not promptly treated?
What is a common consequence if external ear trauma is not promptly treated?
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Which term describes the presence of ringing, buzzing, or roaring noises in the ears?
Which term describes the presence of ringing, buzzing, or roaring noises in the ears?
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What type of hearing loss is primarily age-related and characterized by hair cell loss at the basal turn of the cochlea?
What type of hearing loss is primarily age-related and characterized by hair cell loss at the basal turn of the cochlea?
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Study Notes
Hearing Loss
- Conductive hearing loss is caused by dysfunction of the external auditory canal, ossicles, or tympanic membrane (TM).
- Sensory-neural hearing loss is caused by dysfunction of the cochlea or neural components.
- Mixed hearing loss includes both conductive and sensory-neural components.
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Weber test involves placing a tuning fork on the center of the forehead.
- In normal hearing, sound is heard equally in both ears.
- In conductive hearing loss, sound is perceived as louder in the affected ear.
- In sensory-neural hearing loss, sound is perceived as louder in the unaffected ear.
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Rinne test involves placing the tuning fork on the mastoid bone and then near the ear.
- In normal hearing, air conduction (AC) is greater than bone conduction (BC).
- In conductive hearing loss, AC may be equal to or less than BC.
- In sensory-neural hearing loss, AC is still greater than BC.
- Middle ear effusions can lead to conductive hearing loss, characterized by a nonmobile TM. Observation for 3 months is the initial treatment, as antihistamines and oral steroids are ineffective.
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Otosclerosis is a disorder in which the stapes loses mobility due to excessive bony growth at the oval window, leading to progressive bilateral conductive hearing loss.
- Treatment involves referral to ENT. Medications include sodium fluoride and bisphosphonates.
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Sudden sensory-neural hearing loss involves rapid onset within 72 hours, typically affecting one ear.
- Viral infection and environmental allergies are risk factors.
- Immediate referral and high-dose oral steroids are recommended.
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Acoustic neuroma, a Schwann cell derived tumor of the vestibular portion of CN VIII, often presents with unilateral sensory-neural hearing loss, tinnitus, and balance problems.
- Risk factors include neurofibromatosis.
- Treatment options include observation, high-dose oral steroids, and surgical resection.
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Hereditary sensory-neural hearing loss can be syndromic or non-syndromic.
- Syndromic hearing loss presents with a typical symmetrical pattern, while non-syndromic hearing loss exhibits specific patterns like "cookie bite" or "U-shaped".
- Treatment involves amplification.
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Autoimmune sensory-neural hearing loss is often associated with conditions like rheumatoid arthritis and SLE, presenting as bilateral and progressive hearing loss.
- Treatment involves referral to ENT and corticosteroids.
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Presbycusis, age-related sensory-neural hearing loss, results from loss of hair cells at the basal turn of the cochlea.
- Treatment involves amplification.
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Acoustic noise trauma is the second most common cause of sensory-neural hearing loss, typically affecting high frequencies initially.
- Treatment focuses on noise and hearing protection.
- Tinnitus involves ringing, buzzing, or roaring noises.
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Hyperacusis, excessive sound sensitivity, is often exacerbated by stress, anxiety, fatigue, caffeine, aspirin, and ibuprofen.
- Treatment options include amplification and antidepressants.
External Ear Disorders
- Seborrheic dermatitis causes scaling and erythema, primarily affecting the auricular fold. It can predispose to cellulitis.
- Psoriasis is characterized by scaly silver plaques on the skin.
- Atopic dermatitis is characterized by prominent excoriation on the skin.
- Contact dermatitis is often caused by irritants, such as nickel present in earrings.
- Skin cancer, particularly squamous cell carcinoma, is common in this area due to lack of subcutaneous tissue.
- Cellulitis, infection of the pinna, is most commonly caused by staphylococcus.
- Perichondritis is most commonly caused by Pseudomonas.
- Relapsing polychondritis is a rheumatologic disorder affecting the tracheobronchial tree, treated with steroids.
- Epidermoid cyst is a benign proliferation of epidermal cells.
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External ear trauma, common in wrestlers, can lead to cauliflower ear.
- Prompt drainage is essential, with needle aspiration within 6 hours or incision up to 7 days.
Eye Disorders
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Conjunctivitis, inflammation of the conjunctiva, is classified into bacterial, allergic, and viral subtypes.
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Bacterial conjunctivitis is often self-limiting and can present with copious discharge.
- Gonococcal conjunctivitis is a medical emergency, treated with IM Ceftriaxone.
- Chlamydial conjunctivitis is the most common infectious cause of blindness, treated with oral antibiotics.
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Allergic conjunctivitis is characterized by itchiness.
- Vernal conjunctivitis presents with cobblestone papillae, treated with topical antihistamines.
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Bacterial conjunctivitis is often self-limiting and can present with copious discharge.
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Dry eyes(Keratoconjunctivitis Sicca) is caused by inadequate tear production or accelerated tear evaporation, presenting with bilateral symptoms of dryness, gritty sensation, and eye strain.
- Treatment involves artificial tears.
- Pinguecula is a raised, yellowish white mass, rarely requiring removal.
- Pterygium is a fleshy, triangular growth, often requiring removal.
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Infectious keratitis, infection of the cornea, presents with eye pain, discharge, and redness.
- Treatment involves high-concentration topical antibiotic drops, with emergency room evaluation.
- Herpes simplex keratitis, characterized by corneal ulceration and dendritic branching, is treated with antivirals.
- Herpes zoster ophthalmicus involves the trigeminal nerve, presenting with malaise, fever, and Hutchinson's sign. Treatment involves aspirin but requires referral for management.
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Diabetic retinopathy is a noninflammatory disorder that affects the retina, leading to retinal capillary closure and microaneurysms.
- Type 1 diabetes is associated with a higher prevalence.
- Pregnancy can worsen retinopathy due to blood glucose fluctuations.
- Nonproliferative retinopathy develops first, presenting with vision loss and blurriness.
- Proliferative retinopathy is a more severe form involving neovascularization, presenting with black spots or floaters, and vision loss.
- Treatment involves optimizing diabetes control.
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Hypertensive retinopathy/choroidopathy is characterized by arteriovenous nicking, blurry vision, visual field defects, superficial flame-shaped hemorrhages, yellow hard exudates, and optic disc edema.
- Risk factors include smoking and diabetes.
- Treatment involves aggressive blood pressure control.
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Optic neuritis, inflammation of the optic nerve, is strongly associated with demyelinating diseases like multiple sclerosis (MS).
- It presents with abrupt vision loss, periorbital pain, and brow ache.
- Treatment involves corticosteroids.
- Optic disc swelling can be seen in drusen associated with farsightedness.
- Papilledema is swelling of the optic disc due to elevated intracranial pressure, typically bilateral.
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Oculomotor palsies, involving cranial nerves III, IV, and VI that innervate extraocular muscles, present with double vision and pain on eye movement.
- Third nerve palsy results in eye movement downward and outward.
- Fourth nerve palsy results in vertical hypertropia.
- Sixth nerve palsy affects lateral movement.
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Nystagmus is a condition marked by rapid eye movements and limited vision.
- Congenital nystagmus presents between 6 weeks and 6 months.
- Acquired nystagmus is usually associated with medical conditions.
- Symptoms include rapid eye movements and sensitivity to light.
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Salivary gland tumors, often benign but requiring evaluation, are most frequently found in the parotid gland.
- Submandibular and sublingual tumors are less common and have a higher risk of malignancy.
- Symptoms include painless swelling with gradual onset.
- Treatment involves referral to ENT.
Nose Disorders
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Allergic rhinitis, a type I hypersensitivity reaction, is typically present from a younger age and can be perennial (year-round) or seasonal.
- Risk factors include family history.
- Symptoms include nasal congestion, rhinorrhea, pruritus, and sneezing.
- Diagnosis can be made through skin testing or by evaluating the presence of increased eosinophils on CBC.
- Treatment options include corticosteroid nasal sprays, second-generation antihistamines, mast cell stabilizers, leukotriene antagonists, and saline irrigation.
- Oral allergy syndrome, an IgE-mediated response to raw fruits, vegetables, and tree nuts, presents with itchy mouth/throat or swollen lips/tongue/throat.
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Rhinitis medicamentosa, a rebound effect from prolonged use of topical decongestants, can lead to nasal mucosa atrophy.
- Treatment involves discontinuing the nasal spray and using alternative therapies like nasal steroids, oral steroids, or IM steroids.
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Olfactory dysfunction is a condition affecting the sense of smell.
- It can be related to transport loss (damage to CN I), sensorineural loss (damage to olfactory receptors), or both.
- Treatment options vary depending on the underlying cause.
- Safety counseling is crucial to address potential risks like food poisoning or environmental exposure.
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Epistaxis (nosebleed) can be anterior or posterior.
- Anterior epistaxis is generally less severe than posterior epistaxis.
- Treatment options include direct pressure, packing, cauterization, and referral to ENT.
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Nasal septal hematoma, a rare condition that occurs secondary to nasal/septal fracture, requires drainage within 24 hours.
- Nasal packing is often needed.
- Complications include infection, sepsis, and cartilage death.
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Nasal foreign body, common in young children and disabled adults, can be organic or inorganic.
- Inorganic foreign bodies are often accompanied by unilateral, purulent, foul-smelling drainage and inflamed nasal vestibule.
- Treatment options include removal, with urgent removal required for foreign bodies such as button batteries or paired magnets.
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Septal perforation can result from past drug use (cocaine), rhinitis medicamentosa, or systemic disease.
- It presents with increased nasal sound, dryness, and epistaxis.
- Treatment includes increasing nasal moisture, using a nasal button, and limited reconstruction.
- Inverted papilloma (Schneiderian papilloma), a rare condition believed to be associated with HPV, is characterized by a flesh-colored growth on the lateral nasal wall and middle meatus.
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Description
Explore the different types of hearing loss, including conductive, sensory-neural, and mixed hearing loss. Learn about the Weber and Rinne tests used for diagnosis and how they help differentiate between types of hearing impairment. This quiz will test your understanding of audiological concepts.
