Otolaryngology Quiz on Ear Health
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Questions and Answers

What is the typical characteristic of a normal tympanic membrane?

  • Translucent and mobile (correct)
  • Opaque and immobile
  • Coloured and concave
  • Thickened and perforated

In which situation is cerumen removal recommended?

  • For patients who cannot express symptoms (correct)
  • For patients with a history of ear infections
  • When earwax is visible but not bothersome
  • For asymptomatic patients

What is the primary characteristic of conductive hearing loss as indicated in the Weber test?

  • There is no difference in hearing
  • Sound is louder in the affected ear (correct)
  • Sound is equally heard in both ears
  • Sound is louder in the normal ear

Which of the following statements about cerumen impaction is true?

<p>It can cause hearing loss and ear fullness. (D)</p> Signup and view all the answers

What test involves evaluating tympanic membrane mobility using pneumatic insufflation?

<p>Pneumatic otoscopy (C)</p> Signup and view all the answers

Which factor is NOT a common cause of cerumen impaction?

<p>Chronic ear infections (A)</p> Signup and view all the answers

Which method is considered the MOST COMMON for cerumen removal?

<p>Irrigation (A)</p> Signup and view all the answers

Which symptom is NOT typically associated with cerumen impaction?

<p>Palpitations (D)</p> Signup and view all the answers

Which type of hearing loss results in equal degrees of impairment in both air conduction (AC) and bone conduction (BC) during the Rinne test?

<p>Sensorineural hearing loss (D)</p> Signup and view all the answers

What is a common complication associated with the irrigation method of cerumen removal?

<p>Water retention and TM perforation (C)</p> Signup and view all the answers

Which test checks for equality of sound between the ears?

<p>Weber test (D)</p> Signup and view all the answers

What is NOT a criterion for referral to an otolaryngologist for cerumen impaction?

<p>Severe unilateral earache (D)</p> Signup and view all the answers

What is the primary reason diagnostic imaging is not required for uncomplicated acute rhinosinusitis (ARS)?

<p>Clinical signs and symptoms are sufficient for diagnosis. (D)</p> Signup and view all the answers

What does the pinna do in the auditory system?

<p>Collects and directs sound waves (D)</p> Signup and view all the answers

Which of the following imaging findings is consistent with acute rhinosinusitis on a CT scan?

<p>Air-fluid levels (C)</p> Signup and view all the answers

What is typically not indicated in the treatment of acute viral rhinosinusitis?

<p>Antibiotics (C)</p> Signup and view all the answers

Which of the following conditions is NOT considered a complication of acute bacterial rhinosinusitis (ABRS)?

<p>Dental infection (B)</p> Signup and view all the answers

In what scenario is referral for complicated acute bacterial rhinosinusitis (ABRS) typically warranted?

<p>High, persistent fevers exceeding 102 degrees F (D)</p> Signup and view all the answers

What characteristic defines Chronic Rhinosinusitis (CRS)?

<p>Inflammation lasting 12 weeks or more (D)</p> Signup and view all the answers

Which of the following is NOT a common risk factor for Chronic Rhinosinusitis (CRS)?

<p>Regular exercise (D)</p> Signup and view all the answers

What is required for the diagnosis of Chronic Rhinosinusitis (CRS)?

<p>Objective evidence of mucosal inflammation (C)</p> Signup and view all the answers

Which option describes an appropriate supportive care method for uncomplicated Acute Bacterial Rhinosinusitis (ABRS)?

<p>Use of nasal saline irrigation (B)</p> Signup and view all the answers

Which component is NOT associated with the clinical features of Chronic Rhinosinusitis?

<p>Fever exceeding 102 degrees F (A)</p> Signup and view all the answers

Which symptom is considered a cardinal sign of sinusitis in adults?

<p>Facial pain (A)</p> Signup and view all the answers

What is a major concern in diagnosing GABHS pharyngitis?

<p>Absence of cough (B)</p> Signup and view all the answers

Which of the following is NOT a sign of diphtheria?

<p>Severe throat pain (C)</p> Signup and view all the answers

What is the first-line treatment for confirmed GABHS pharyngitis?

<p>Penicillin VK (D)</p> Signup and view all the answers

Which evaluation method is recommended for documenting mucosal disease in sinusitis?

<p>Nasal endoscopy (C)</p> Signup and view all the answers

In children, which symptom acts as the cardinal sign for sinusitis?

<p>Cough (B)</p> Signup and view all the answers

What complication can result from GABHS pharyngitis?

<p>Rheumatic fever (A)</p> Signup and view all the answers

Which symptom indicates a need for immediate evaluation in a patient with sinusitis?

<p>High fever (C)</p> Signup and view all the answers

What is a characteristic feature of allergic fungal rhinosinusitis?

<p>Purulent mucus (B)</p> Signup and view all the answers

Which test is preferred for diagnosing GABHS pharyngitis?

<p>Rapid antigen detection test (RADT) (A)</p> Signup and view all the answers

Which of the following is NOT a typical treatment for sialadenitis?

<p>Topical steroid creams (C)</p> Signup and view all the answers

What is the common outcome if GABHS pharyngitis is left untreated?

<p>Post-streptococcal glomerulonephritis (C)</p> Signup and view all the answers

What is an essential step if a rapid antigen detection test (RADT) is negative in a high-risk patient for GABHS?

<p>Perform a follow-up culture (B)</p> Signup and view all the answers

What is the most common cause of malignant otitis externa?

<p>Pseudomonas aeruginosa (A)</p> Signup and view all the answers

Which of the following is NOT a symptom of otitis externa?

<p>Persistent cough (A)</p> Signup and view all the answers

What is the first line treatment for moderate acute otitis media in children who have not received antibiotics in the past month?

<p>Amoxicillin (B)</p> Signup and view all the answers

What is indicated if a child with acute otitis media has a bulging and opaque TM?

<p>Immediate treatment with antibiotics (D)</p> Signup and view all the answers

In a physical exam for otitis externa, which sign would suggest severe inflammation?

<p>Intense pain and complete canal occlusion (C)</p> Signup and view all the answers

What condition could be a differential diagnosis for middle ear effusion?

<p>Acute otitis media (A), Chronic otitis media (C)</p> Signup and view all the answers

Which factors could increase the risk of foreign body insertion in the ear for children?

<p>Attention-deficit hyperactivity disorder (ADHD) (A)</p> Signup and view all the answers

Which of these bacteria is NOT commonly associated with acute otitis media?

<p>Candida albicans (D)</p> Signup and view all the answers

What is the recommended treatment for severe otitis externa?

<p>Topical antibiotic plus glucocorticoid (A)</p> Signup and view all the answers

How should the ear canal be protected during recovery from otitis externa?

<p>Inserting cotton balls while bathing (D)</p> Signup and view all the answers

What condition is characterized by the presence of fluid in the middle ear without infection?

<p>Otitis media with effusion (A)</p> Signup and view all the answers

What is the mainstay treatment for moderate signs of ear infection in children?

<p>Topical antibiotics and glucocorticoids (A)</p> Signup and view all the answers

Which diagnostic tool is essential for confirming acute otitis media in young children?

<p>Otoscopy (A)</p> Signup and view all the answers

What is a typical first treatment approach for Suppurative Parotitis?

<p>Inpatient hydration and IV antibiotics (B)</p> Signup and view all the answers

Which of the following is a sign or symptom of a parotid gland infection?

<p>Increased pain and swelling with meals (D)</p> Signup and view all the answers

What is the recommended diagnosis method for conditions involving the parotid gland?

<p>Ultrasound (D)</p> Signup and view all the answers

Which factor is NOT a risk factor for developing Oral Hairy Leukoplakia?

<p>Socioeconomic status (B)</p> Signup and view all the answers

What does not typically occur in Esophageal Foreign Body cases?

<p>Severe chest pain (A)</p> Signup and view all the answers

What is the primary method used to manage an acute airway foreign body in children under three?

<p>Back blows and chest thrusts (B)</p> Signup and view all the answers

Which of the following describes the characteristics of Oral Cancer - Squamous Cell Carcinoma?

<p>Raised, firm white lesions with ulcers at base (A)</p> Signup and view all the answers

What is a treatment option for Pre-Cancer (Leukoplakia)?

<p>Watchful waiting (C)</p> Signup and view all the answers

What is the most common bacteria associated with Suppurative Parotitis?

<p>Staphylococcus aureus (D)</p> Signup and view all the answers

Which method is NOT typically required for performing a formal tracheostomy?

<p>Small round airway (D)</p> Signup and view all the answers

What is the hallmark symptom of Chronic Otitis Media (COM)?

<p>Purulent aural discharge (B)</p> Signup and view all the answers

Which of the following is a risk factor for Otitis Media with Effusion (OME)?

<p>Daycare attendance (D)</p> Signup and view all the answers

What treatment is recommended for children with persistent hearing loss following Acute Otitis Media?

<p>Ear tubes placement (D)</p> Signup and view all the answers

What is the most common cause of Acute Viral Rhinosinusitis?

<p>Viral infection (A)</p> Signup and view all the answers

Which of the following treatments is NOT proven effective for Otitis Media with Effusion in children?

<p>Topical steroids (D)</p> Signup and view all the answers

The treatment of allergies in pregnancy should focus on which of the following options?

<p>Intranasal cromolyn sodium (D)</p> Signup and view all the answers

What diagnostic test is recommended for evaluating suspected Acoustic Neuroma?

<p>MRI (C)</p> Signup and view all the answers

Which of the following conditions is associated with recurrent episodes of Acute Otitis Media?

<p>Cholesteatoma (A)</p> Signup and view all the answers

What is a common complication of untreated Acute Otitis Media?

<p>Mastoiditis (A)</p> Signup and view all the answers

Which statement about the prognosis of Acute Otitis Media with TM perforation is true?

<p>Most heal spontaneously (C)</p> Signup and view all the answers

What is a primary management option for children with Chronic Otitis Media with Effusion?

<p>Watchful waiting (D)</p> Signup and view all the answers

How is Non-Allergic Rhinitis differentiated from Allergic Rhinitis?

<p>Triggers from weather conditions and irritants (C)</p> Signup and view all the answers

Which of the following symptoms is NOT commonly associated with Allergic Rhinitis?

<p>Fever (D)</p> Signup and view all the answers

Flashcards

Cerumen Impaction

Accumulation of earwax causing symptoms or obstructing ear canal assessment.

Cerumen

Naturally occurring substance from the external auditory canal.

Disrupted Cerumen Migration

Disrupted movement of epithelial cells in the ear canal, leading to cerumen impaction.

Otitis Externa

Inflammation of the external auditory canal.

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Pseudomonas aeruginosa

Most common cause of acute bacterial otitis externa.

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Staphylococcus aureus

A common bacterium responsible for otitis externa.

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Hearing Loss

A common symptom of cerumen impaction.

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Tinnitus

A term for perceived noises not originating from an external source.

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Ear Irrigation

A common treatment for cerumen impaction.

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Digital Otoscopy

A type of otoscopy using a small camera to visualize the ear.

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Pneumatic Otoscopy

Used to assess tympanic membrane (TM) mobility.

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Conductive Hearing Loss

Hearing loss due to problems in the outer or middle ear.

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Sensorineural Hearing Loss

Hearing loss due to damage in the inner ear or auditory nerve.

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Rinne Test

Test that compares the conduction of sound through air and bone.

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Weber Test

Test that determines the lateralization of sound.

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Risk factors for Otitis Externa

Risk factors for otitis externa include water exposure, trauma to the ear canal, allergic reactions, skin conditions, and devices like hearing aids or ear buds.

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Symptoms of Otitis Externa

Symptoms of otitis externa can include ear pain, itching, discharge, and hearing loss.

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Physical Exam Findings of Otitis Externa

Signs of otitis externa on physical exam include redness, tenderness, canal swelling, pus, and a mobile eardrum.

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Severity of Otitis Externa

Otitis externa is classified based on severity into mild, moderate, and severe, with symptoms ranging from minor discomfort to intense pain, complete canal blockage, and fever.

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Diagnosis of Otitis Externa

Diagnosis of otitis externa is typically made based on clinical evaluation, but cultures can be done in cases of severe, recurrent, or chronic infections.

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Otitis Externa Treatment

Treatment for otitis externa involves cleaning the ear canal, managing inflammation and infection, and providing pain relief.

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Treatment for Mild Otitis Externa

Mild otitis externa is treated with topical acidifying agents and glucocorticoids.

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Treatment for Moderate Otitis Externa

Moderate otitis externa is treated with topical antibiotics and glucocorticoids.

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Treatment for Severe Otitis Externa

Severe otitis externa requires topical antibiotics and glucocorticoids, and may involve a wick placement and systemic antibiotics.

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Otitis Externa Treatment in Immunocompromised Individuals

Immunocompromised individuals with otitis externa are treated with the same antibiotics as those with severe disease.

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General Counseling for Otitis Externa

Otitis externa treatment involves keeping the ear dry during recovery, avoiding water sports, and practicing proper ear hygiene.

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Malignant Otitis Externa

Malignant otitis externa is a serious infection of the ear canal and skull base, commonly caused by Pseudomonas aeruginosa and affecting individuals with diabetes, HIV, or weakened immune systems.

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Foreign Bodies in the Ear

Foreign bodies in the ear are more common in children, particularly those with ear irritation, pica, or ADHD.

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Foreign Body Removal from the Ear

Removal of foreign bodies from the ear may require referral to an otolaryngologist in urgent cases, while non-specialists can use irrigation or instrumentation to remove them under direct visualization.

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Cholesteatoma

A buildup of fatty tissue in the ear, often associated with chronic otitis media.

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Mastoiditis

Inflammation of the mastoid bone, a complication of untreated acute otitis media.

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Labyrinthitis

Inflammation of the inner ear labyrinth, which includes the cochlea and vestibular system.

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Meningitis

An infection of the membranes surrounding the brain and spinal cord, a serious complication of untreated otitis media.

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Brain Abscess

A collection of pus within the brain, a serious complication of untreated otitis media.

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Epidural Abscess

An infection of the space between the skull bone and the dura mater, a serious complication of untreated otitis media.

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Subdural Abscess

An infection of the space between the dura mater and the arachnoid membrane, a serious complication of untreated otitis media.

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Lateral Sinus Thrombosis

A blood clot that forms in the sinuses that drain blood from the brain, a serious complication of untreated otitis media.

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Cavernous Sinus Thrombosis

A blood clot that forms in the cavernous sinus, which drains blood from the face and head, a serious complication of untreated otitis media.

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Recurrent Otitis Media

Recurrent ear infections, defined as more than two episodes within a six-month period.

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Persistent Hearing Loss Following AOM

Persistent hearing loss after acute otitis media, lasting more than one to two weeks.

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Chronic TM Perforation

A hole in the eardrum that lasts more than six weeks.

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Chronic Otitis Media (COM)

An infection of the middle ear and/or mastoid bone that is present alongside a hole in the eardrum.

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Otitis Media with Effusion (OME)

A buildup of fluid in the middle ear without signs of acute infection.

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Chronic OME

OME present for three months or longer.

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Chronic Rhinosinusitis (CRS)

An inflammatory condition affecting the paranasal sinuses and nasal passage linings, lasting for 12 weeks or more.

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Facial Pressure

A cardinal sign of CRS, characterized by a feeling of fullness or pressure in the face.

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Periorbital Pain

Another cardinal sign of CRS, often described as pain or tenderness around the eyes.

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Hyposmia or Anosmia

A cardinal sign of CRS, often associated with a loss of smell.

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Mucous Discharge

A cardinal sign of CRS, characterized by a thick, discolored discharge from the nose.

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Facial Pain

A persistent and recurrent symptom of CRS, causing discomfort and often affecting sleep.

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Allergic Rhinitis

A risk factor for CRS often associated with allergies.

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Asthma

A risk factor for CRS, often associated with inflammation of the airways.

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Aspirin-Exacerbated Respiratory Disease (AERD)

A group of conditions that trigger asthma and nasal polyps, often associated with aspirin use.

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Immunodeficiency

A common risk factor for CRS that affects the immune system.

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Suppurative Parotitis

Inflammation of the parotid gland, often caused by bacteria like Staphylococcus aureus, with symptoms like firm swelling, pain, and possible fever.

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Leukoplakia

A pre-cancerous condition characterized by a white patch or plaque in the mouth, often caused by tobacco use or dentures. It has a low risk of developing into squamous cell carcinoma.

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Oral Hairy Leukoplakia

White, corrugated, and painless plaques on the lateral tongue, commonly associated with HIV, organ transplant, or steroid use. It is not considered pre-malignant.

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Oral Squamous Cell Carcinoma

A common type of oral cancer caused by factors like tobacco and alcohol use. It presents as raised, white lesions with ulcers, often on the side of the tongue, and is usually painful.

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Upper Airway Foreign Body

An emergency situation where a foreign object is lodged in the airway, often occurring in young children. Symptoms include choking, coughing, and wheezing.

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Esophageal Foreign Body

When a foreign object gets stuck in the esophagus, often caused by food bolus. Most cases resolve spontaneously, but some may require endoscopic removal.

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Cricothyroidotomy

A procedure for establishing an emergency airway by making an incision through the cricothyroid membrane. It can be performed quickly without anesthesia.

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Formal Tracheostomy

A surgical procedure to create an opening in the trachea, typically used for long-term ventilation.

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Sialadenitis

Swelling and pain in the duct opening of the salivary gland, usually associated with bacteria like Staphylococcus aureus. Symptoms often worsen with meals.

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Sialadenitis, Bacterial

Increased pain and swelling with meals, tenderness and erythema of the duct opening, and pus often massaged from the duct. It is treated with hydration, warm compresses, and antibiotics.

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Anterior/Posterior Nasal Mucopurulent Drainage

One of the 4 cardinal symptoms of CRS in adults. Characterized by opaque white or light yellow drainage from the nose.

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Nasal Obstruction

One of the 4 cardinal symptoms of CRS: Nasal passages are blocked, leading to difficulty breathing through the nose.

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Facial Pain/Pressure/Fullness

One of the cardinal symptoms of CRS in adults, characterized by pain, pressure, or fullness in the face or head.

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Nasal Polyps

Presence of polyp-like growths in the nasal cavity or middle meatus.

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Cough (in Children)

One of the cardinal symptoms of CRS in children. Characterized by a persistent cough that may be related to postnasal drip or sinus drainage.

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Group A Beta-Hemolytic Streptococcus (GABHS) Pharyngitis (Strep Throat)

A common bacterial infection of the throat, mainly affecting children aged 5-15. Characterized by sudden onset sore throat, fever, pharyngeal edema, tonsillar exudates, and tender anterior cervical lymphadenopathy.

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Sore Throat

A hallmark symptom of GABHS pharyngitis, characterized by a painful, red, and swollen throat.

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Pharyngeal Edema

A symptom of GABHS pharyngitis, characterized by swelling and inflammation of the throat.

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Patchy Tonsillar Exudates

A symptom of GABHS pharyngitis, appearing as white or yellow patches on the tonsils.

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Prominent, Tender, Anterior Cervical Lymphadenopathy

A symptom of GABHS pharyngitis, characterized by swollen and tender lymph nodes in the neck.

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Rheumatic Fever

A rare complication of GABHS pharyngitis that primarily affects the joints, heart, skin, and nervous system. Symptoms may include joint pain and swelling, heart inflammation, skin rash, and involuntary movements.

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Poststreptococcal Glomerulonephritis

A rare and serious complication of GABHS pharyngitis, affecting the kidneys. Characterized by inflammation of the glomeruli, causing blood and protein to leak into the urine.

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Gonococcal Pharyngitis

A bacterial infection caused by Neisseria gonorrhoeae. Characterized by fever, sore throat, dysuria, and greenish exudate.

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Diphtheria

A rare and serious bacterial infection caused by Corynebacterium diphtheriae. Characterized by a sore throat, low-grade fever, and a grayish membrane at the back of the throat. Requires prompt treatment with antitoxin and antibiotics.

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Study Notes

ENT 1

  • Anatomy: The ear is divided into outer (external auditory meatus), middle (tympanic membrane and ossicles), and inner (cochlea) parts.
  • Physiology: Sound waves are collected by the pinna, transmitted through the tympanic membrane, and amplified by the ossicles to the cochlea.
  • Hearing tests: Weber and Rinne tests help differentiate conductive and sensorineural hearing loss.
  • Hearing Loss: Conductive hearing loss occurs when there's a problem in the outer or middle ear, while sensorineural loss involves damage to the inner ear or auditory nerve.
  • HAPE (Hearing Assessment): The Weber and Rinne tests assess hearing loss.

EAR DISORDERS

  • Cerumen Impaction: Buildup of earwax (cerumen) can cause hearing impairment and discomfort. Treatment includes cerumenolytic agents or irrigation.
  • Otitis Externa (Swimmer's Ear): This is an infection of the external auditory canal. Common causes include bacterial infection (often Pseudomonas aeruginosa) and fungal infection. Symptoms include pain, itching, and discharge.
  • Foreign Bodies: Objects lodged in the ear canal (common in children). Removal requires careful visualization and appropriate instruments.

Other Ear Disorders

  • Acute Otitis Media (AOM): Infection of the middle ear often following a viral upper respiratory infection. Symptoms include pain, fever, and possible fluid buildup behind the eardrum. Treatment commonly involves antibiotics and pain management.
  • Otitis Media with Effusion (OME): Middle ear fluid without infection. Common in children, sometimes following AOM. Symptoms include hearing loss. Treatment may be watchful waiting or myringotomy in severe cases.
  • Chronic Otitis Media (COM): Recurrent middle ear infection, frequently associated with a perforated eardrum. May involve a cholesteatoma (growth of skin cells). Treatment often involves surgical intervention.
  • Acoustic Neuroma (Vestibular Schwannoma): Benign tumor of the vestibular nerve (part of the auditory nerve), often characterized by hearing loss and/or vertigo. Diagnosis typically uses MRI.
  • Vertigo: Illusion of motion. Possible causes are benign paroxysmal positional vertigo (BPPV), vestibular neuritis, and other conditions.
  • Barotrauma: Pressure-related damage to the eardrum (during rapid changes in altitude, loud noises, etc.).
  • Epistaxis: Nosebleeds, a common experience that rarely requires significant emergency intervention. Anterior bleeds occur around Kiesselbach's plexus, while posterior bleeds are a more significant problem.

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Description

Test your knowledge on ear health and tympanic membrane characteristics with this quiz. Topics include cerumen removal, conductive hearing loss, and diagnostic tests related to the auditory system. Perfect for students or professionals in otolaryngology!

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