ENT

Question 1

what are the role of the sinuses?

Answer 1

mucus production- for immune response
air filtration
cilia to trap bacteria/ move mucus

Question 2

what would be the immune response shown by sinuses?

Answer 2

nasal congestion or secretion (runny nose) or running of secretion into sinuses ( blocked nose)- processes of what is causing them is the same

Question 3

what is the most likely causes of sinus inflamation?

Answer 3

viral cause/ cold
- if it self limiting
upper resp tract infections

Question 4

what are the treatments for sinus inflamation?

Answer 4

antihistamines

Question 5

what is nasal congestion?

Answer 5

Excessive nasal secretions

•Inflamed and swollen nasal mucosa

Question 6

what are the role of histamine receptors?

Answer 6

• Mediator of allergic/ inflammatory reactions

- Antihistamines competitive antagonism at histamine receptors

Question 7

how many histamine receptors are there and what are they used for?

Answer 7

• 4 different types
• Both h1 and h4- involved in allergic inflammation
• Only use h1 for target rec for drugs- antihistamines
• H2- in gastric mucous- gastric acid sec
• H3- brain- for sleep and wake cycle
• H1- in smooth muscle in resp tract- keep blood vessels dilated/ bronchoconstriction/ mucous secretion

Question 8

what effect does histamine have on smooth muscle?

Answer 8

Bronchial SM H1receptor activation produces bronchoconstriction
Activation inc Ca2+ in SM leading to SM contraction

Question 9

what receptors are histamine coupled to?

Answer 9

• Coupled to g proteins- main function is to transmit and extracellular stimulate and transfer to intracellular stimuli

Question 10

what are histamines effects on blood vessels?

Answer 10

• H1 – causes influx of calcium ions

- This causes release of certain mediators like nitric oxide-stim cGMP- smooth muscle relaxaction

Question 11

how do decongestants work?

Answer 11

• Work on alpha 1 receptors
• Bind in upper resp tract
• Cause vasoconstriction- reverse effect of histamine

Question 12

what are the 2 types of decongestants?

Answer 12

Adrenergics–Largest group–Sympathomimetics

•Anticholinergics–Less commonly used–Parasympatholytics

Question 13

what is relief of nasal congestion associated with?

Answer 13

–Acute rhinitis–Common cold–Sinusitis–Hay fever–Reduce swelling of the nasal passage and facilitate visualization of the nasal/pharyngeal membranes

Question 14

are oral decongestants fast acting?

Answer 14

no delayed action as they have to be absorbed from GI tract but longer duration of action

Question 15

what is rebound congestion?

Answer 15

it is associated with topical decongestants when they are overused and when taken off medication they have congestion still present

Question 16

what are 3 examples of oral decongestants?

Answer 16

–Pseudoephedrine (Sudafed)
–Phenylephrine (no better than placebo in many trials)
–Ephedrine

Question 17

when may you not give oral decongestants to someone?

Answer 17

depends what medication they are on as some are CNS stimulants- so inc hr / bp- so not to hypertensives

Question 18

what are topical decongestants called? and how do they work?

Answer 18

Adrenergics–- Work by constricting blood vessels in upp resp tract- any nasal sec can drain better

Question 19

what are 2 examples of topical decongestants?

Answer 19

Oxymetazoline–Xylometazoline

Question 20

how do nasal steroids work and when may they be given?

Answer 20

Anti-inflammatory effect
–Work to turn off the immune system cellsinvolved in the inflammatory response
–Decreased inflammation results in decreased congestion
work for long term- hayfever that is seasonal

Question 21

what are two examples of nasal steroids?

Answer 21

Beclomethasone dipropionate nasal spray (BeconaseHayfever)

•Fluticasone nasal spray (PirinaseHayfeverRelief)

Question 22

what are the potential abuses present with pseudoephridine and ephidine?

Answer 22

can be converted to meth

Question 23

what does the outer ear consist of?

Answer 23

pina ( what you can see) and ear canal-

Question 24

what does the middle ear consist of?

Answer 24

• Middle ear= ear drum to ossicles( smallest bones in body)- sound waves will hit ear drum and vibrate- tipanic membrane

Question 25

what does the inner ear consist of?

Answer 25

- Ustasion tube- | not sure

Question 26

what is Otitis media?

Answer 26

Middle ear inflammation •It occurs in the area between the tympanic membrane and the inner ear •It is one of the most common causes of earache•Often preceded by upper respiratory symptoms, including a cough and rhinorrhoea. When the middle ear becomes acutely infected (bacterial, viral or fungal), pressure builds up behind the eardrum causing intense pain (otalgia), fever, hearing loss

Question 27

what are the treatments for oitis media?

Answer 27

Antibiotics are not necessarily useful for most children with acute otitis media •Cochrane review found that antibiotics did not alter pain within the first day, only slightly reduced it in the few days following Analgesics should be the mainstay of treatment •Paracetamol preferred treatment -both adults & children. •Ibuprofen

Question 28

are antihistamines and decongestants recommended for otitis media?

Answer 28

no- they do not work

Question 29

what is Otitis media with effusion?

Answer 29

Glue ear” inflammation of the middle ear accompanied by accumulation of fluid...blockage of the eustachian tube

Question 30

why may ptitis media with effusion be more serious in young children?

Answer 30

can lead to behavioural issues because inability to hear and inturprut info

Question 31

what is Otitis Externa also known as?

Answer 31

swimming ear- as thrives in moist environemnt

Question 32

what is the treatment for Otitis Externa?

Answer 32

Treat infection and return ear canal to healthy state–Dilute acetic acid (Earcalm)..useful if infection is superficial–Steroid drops and antibacterial drops (POM)

Question 33

what causes Pharyngitis/Acute tonsilitis?

Answer 33

Normally a symptom of a bacterial (group A streptococcus) or viral infection (EBV)

Question 34

what other symptoms may someone with a sore throat have?

Answer 34

–Headache–Muscle aches–Cough–Dysphagia | Inflammation (redness and swelling) and exudate in the throat

Question 35

how do you diagnose a throat problem?

Answer 35

Symptoms and examination •PoC-Rapidstrep testinvolves swabbing thethroatand running ateston the swab. Thetestquickly shows if group Astrepis causing the illness allowing antibiotics

Question 36

what are some topical treatments for sore throats?

Answer 36

lozenges/throat sprays:–Menthol/local anaesthetics eglidocaine •Mechanism of action:–local anaesthetic effect on nerve receptors in the pharynx aim to numb throat/ lubricate

Question 37

what do lozenges contain?

Answer 37

Often also often contain hexylresorcinol or amylmetacresol which are antiseptic agents

Question 38

when do you refer a sore throat?

Answer 38

Most sore throats are self limiting and pass within 3-7 days a persistent high temperature above 38°C not reduced by medication–symptoms do not improve after two weeks–Recurrent sore throats

Question 39

what can sore throat be another sign of?

Answer 39

–weakened immune system for example because of HIV and AIDS–take certain medications e.g. disease-modifying anti-rheumatic drugs (DMARDs), cancer chemotherapy