what causes hand foot and mouth disease?
coxsackie virus
what are apthous ulcers?
how long do they last?
- non viral self limiting ulcers
- less than 3 weeks, if last longer investigate other causes e.g. IBD, behcet’s
what is Behcet’s disease?
- inflammatory disease of unknown aetiology
- usually involves inflammation of mucous membranes/mucosa
what are the components of the centor criteria?
how must you get to receive AB?
- tonsillar exudate
- tender anterior cervical lymph nodes
- history of fever
- absence of cough
-3 or 4 (indicates 32-56% risk of bacterial cause)
symptoms of a peritonsilar abscess/quinsy
- unilateral throat pain
- odynophagia (painful swallowing)
- 3-7 post tonsillitis
- loss of concavity of palate o/e
treatment of diphtheria infection?
-antitoxin
diphtheria produces potent cardio and neurotoxic exotoxin
what is a side effect of chronic CO2 retention/sleep apnoea
- pulmonary hypertension
- cor pulmonale
treatment for oral thrush
- nystatin
- fluconazole
main causes of otitis externa
- staph aureus
- proteus!
- pseudomonas
- aspergillus
- candida
what is malignant otitis?
-extension of otitis externa to effect mastoid air cells and temporal bone
what cell type are cholesteatomas?
-squamous epithelium
middle ear is normally columnar/glandular epithelium
which sounds lost first in presbycusis?
-high frequency ones
which sounds tend to be lost in meniere’s disease?
-low frequency ones
symptoms of meniere’s
- rotational vertigo
- tinnitus on affected side
- aural fullness
- sensorineural hearing loss
- episodes last between 20mins and hours
In BPPV where does otolith usually enter?
-posterior semi-circular canal
gives rise to vertigo when looking up
Test/investigation for BPPV
Dix hallpike test
- lie patient down, move head in different directions
- look for nystagmus and ask patient if experiencing symptoms
what is likely to cause vertigo which lasts for days?
-vestibular neuritis
risk factors for nasopharyngeal carcinoma
- males form far east
- epstein-barr virus
- nitrosamine (chemical in smoked/preserved food)
what are patients who worked with wood or nickel at risk of?
-head/neck adenocarcinoma
features of pleomorphic adenoma
- single slow growing nodule on salivary gland
- usually affects parotids
- benign
- women 40-60Y
- v common
features of warthin’s tumour
- cytsic, multicentric, often bilateral
- almost always in parotids
- benign
- men 50+ who smoke
features of mucoepidermoid carcinoma
- non encapsulated, slow growing tumour
- contain mucous secreting cells
- parotids
- any age group
- malignant (but usually good prognosis)
features adenoid cystic carcinoma
- slow growing tumour of exocrine mucous glands (usually salivary glands)
- well differentiated
- often demonstrates neural invasion and metastasis
- prognosis not fab
how can hereditary haemorrhagic telangiectasia present
-recurrent severe nosebleeds
