INI CET Ophthalmology And Otorhinolaryngology Flashcards

24 sample cards from the Ophthalmology And Otorhinolaryngology deck

Sampled from the end of the deck, so these are different cards from the ones shown on the syllabus page.

1. What visual field defect results from a lesion at the optic chiasm?

   Bitemporal hemianopia (due to compression of crossing nasal fibers), classically from a pituitary adenoma or craniopharyngioma.

2. What is the most common optic nerve disorder in young adults, and its key association?

   Optic neuritis (retrobulbar) — presents with painful monocular vision loss, dyschromatopsia, and RAPD; strongly associated with multiple sclerosis. 'The patient sees nothing and the doctor sees nothing.'

3. State the emmetropic eye's refractive condition and the basic lens (vergence) formula.

   In emmetropia, parallel rays focus on the retina with accommodation relaxed. Lens power formula: P (dioptres) = 1 / f (focal length in metres).

4. Differentiate myopia and hypermetropia and their correcting lenses.

   Myopia: image focuses in front of retina (eye too long/cornea too steep) — corrected with concave (minus) lens. Hypermetropia: image focuses behind retina (eye too short) — corrected with convex (plus) lens.

5. What is presbyopia and how is it corrected?

   Age-related loss of accommodation due to lens hardening (decreased elasticity), usually after age 40; corrected with convex (plus) reading lenses or bifocals.

6. Define astigmatism and name its types based on focal lines (Sturm's conoid).

   Astigmatism: unequal corneal/lens curvature in different meridians causing two focal lines. Types: simple, compound, and mixed (myopic/hypermetropic), corrected with cylindrical lenses.

7. Differentiate concomitant from paralytic (incomitant) squint.

   Concomitant: angle of deviation is constant in all gaze directions, no diplopia (usually childhood) — measured by cover test. Paralytic: deviation varies with gaze, with diplopia and limited movement, from nerve/muscle palsy.

8. What is amblyopia and what is the critical principle of its treatment?

   Amblyopia ('lazy eye') is reduced best-corrected vision without an organic lesion, due to abnormal visual development. Treated by occlusion (patching) of the better eye to force use of the amblyopic eye, effective within the sensitive period (<7-8 years).

9. Name the parts of the temporal bone containing the ear and the three smallest bones of the body.

   The petrous part of the temporal bone houses the ear. The ossicles (smallest bones) are: malleus, incus, and stapes (stapes is the smallest).

10. What is the most common cause of acquired conductive hearing loss in adults, and its characteristic sign?

    Otosclerosis (stapes fixation at the oval window). Schwartze sign (reddish hue over the promontory) and paracusis Willisii (hears better in noise); shows Carhart's notch (dip at 2000 Hz) on audiometry.

11. Differentiate safe (tubotympanic) from unsafe (atticoantral) chronic suppurative otitis media.

    Safe CSOM: central perforation, mucoid non-foul discharge, no cholesteatoma, low complication risk. Unsafe CSOM: attic/marginal perforation with cholesteatoma, scanty foul discharge, high risk of intracranial complications.

12. What is a cholesteatoma and why is it dangerous?

    A collection of keratinizing squamous epithelium in the middle ear/mastoid (not a true tumor) that produces bone-eroding enzymes, causing ossicular destruction and intracranial complications. Treatment is surgical (mastoidectomy).

13. Interpret Rinne and Weber tests in conductive vs. sensorineural hearing loss.

    Conductive loss: Rinne negative (BC>AC) in affected ear, Weber lateralizes to the affected ear. Sensorineural loss: Rinne positive (AC>BC), Weber lateralizes to the better (normal) ear.

14. What are the characteristic features and triad of Meniere's disease?

    Triad: episodic vertigo, fluctuating sensorineural hearing loss (low frequencies first), and tinnitus, with aural fullness. Caused by endolymphatic hydrops; managed with low-salt diet, diuretics, and betahistine.

15. What is the most common cause of malignant otitis externa, and in whom does it occur?

    Pseudomonas aeruginosa, occurring in elderly diabetics/immunocompromised; it is an osteomyelitis of the temporal bone with granulation tissue at the bony-cartilaginous junction, treated with prolonged anti-pseudomonal antibiotics.

16. What is the most common benign tumor of the nasopharynx, in whom does it occur, and a key clinical caution?

    Juvenile nasopharyngeal angiofibroma, occurring in adolescent males; presents with recurrent epistaxis and nasal obstruction. Biopsy is contraindicated due to risk of severe hemorrhage (highly vascular).

17. What is Little's area (Kiesselbach's plexus) and its clinical significance?

    An anastomotic vascular area in the anteroinferior nasal septum (sphenopalatine, greater palatine, superior labial, anterior ethmoidal arteries); it is the most common site of anterior epistaxis, especially in children.

18. What is the most common cause of unilateral foul-smelling blood-stained nasal discharge in a child?

    A nasal foreign body. (In adults, unilateral blood-stained discharge raises suspicion of malignancy or fungal sinusitis.)

19. Differentiate the laryngeal innervation: what does the superior vs. recurrent laryngeal nerve supply?

    Superior laryngeal nerve: external branch supplies cricothyroid (tension/pitch), internal branch gives sensation above vocal cords. Recurrent laryngeal nerve supplies all other intrinsic muscles and sensation below the cords.

20. What is the position of the vocal cord and the voice change in recurrent laryngeal nerve palsy (unilateral)?

    The affected cord lies in the paramedian position; voice is initially hoarse but often compensates as the normal cord crosses the midline. Bilateral RLN palsy causes stridor/airway obstruction (cords in median position).

21. What is the most common malignancy of the larynx and its commonest site?

    Squamous cell carcinoma; the glottis (true vocal cords) is the most common site, presenting early with hoarseness, and has a good prognosis due to poor lymphatic drainage of the glottis.

22. What is Ludwig's angina?

    A rapidly spreading bilateral cellulitis of the submandibular, sublingual, and submental spaces (floor of mouth), usually of odontogenic origin, causing tongue elevation and life-threatening airway obstruction.

23. What is the most common site and a major risk factor for oral cavity / head and neck squamous cell carcinoma in India?

    Buccal mucosa/oral cavity is very common in India; the major risk factor is tobacco use (especially chewing tobacco/betel quid), along with alcohol and HPV (for oropharyngeal cancers).

24. What is the most common cause of unilateral serous otitis media (middle ear effusion) in an adult, and what must be excluded?

    Eustachian tube obstruction; in an adult with unilateral effusion, nasopharyngeal carcinoma must be excluded by nasopharyngoscopy.

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