In Nasopharyngeal Carcinoma:

-Commonest site of origin of NC in the nasopharynx is the fossa of Rosenmüller.

-Most common involved cranial nerve is VIth "Abducent" which is the first to be involved.

-Trotter’s triad:
1)Conductive deafness (eustachian tube blockage)
2)Ipsilateral temporoparietal neuralgia (involvement of CN V)
3)Ipsilateral palatal paralysis (CN X).

-The most common presentation in Ca Nx is Cervical lymphadenopathy (60–90%), then hearing loss and nasal obstruction.

-High-resolution, contrast-enhanced CT of neck and nasopharynx is the study of choice. "CECT"

-Radiotherapy is the treatment of choice for nasopharyngeal cancer.

#ENT

In Lateral sinus thrombosis:

-Hectic Picket-fence type of fever with rigors.
-Crowe–Beck test:
Pressure on jugular vein of healthy side produces engorgement of retinal veins (seen by ophthalmoscopy) and supraorbital veins. Engorgement of veins subsides on release of pressure.

#ENT

The characteristics of conductive hearing loss are:
1. Negative Rinne test, i.e. BC > AC.
2. Weber lateralized to poorer ear.
3. Normal absolute bone conduction.
4. Low frequencies affected more.
5. Audiometry shows bone conduction better than air conduction with air-bone gap. Greater the air-bone gap, more is the conductive loss.
6. Loss is not more than 60 dB.
7. Speech discrimination is good.

#ENT

The characteristics of sensorineural hearing loss are:
1. A positive Rinne test, i.e. AC > BC.
2. Weber lateralized to better ear.
3. Bone conduction reduced on Schwabach and absolute bone conduction tests.
4. More often involving high frequencies.
5. No gap between air and bone conduction curve on audiometry.
6. Loss may exceed 60 dB.
7. Speech discrimination is poor.
8. There is difficulty in hearing in the presence of noise.


#ENT

•Hennebert’s sign
A positive fistula sign in the absence of a fistula.This is due to fibrous adhesions between the stapes footplate and the membranous labyrinth.

•Tullio phenomenon in which loud sounds produce vertigo.

#ENT

•Sudden SNHL is defined as 30 dB or more of SNHL over at least three contiguous frequencies occurring within a period of 3 days or less.
-Mostly it is unilateral.It may be accompanied by tinnitus or temporary spell of vertigo.

#ENT

-Hearing loss is impairment of hearing and its severity may vary from mild to severe or profound, while the term deafness is used, when there is little or no hearing at all.

#ENT

-Allergy is the most common cause of nasal polyps.

#ENT

-On either side of the laryngeal orifice in humans is a recess, termed the pyriform fossa or sinus. " piriform recess".

#Anatomy

Cerebellar abscess 👉🏻Trautmann’s triangle or retrograde by tegmen.
Cerebral abscess👉🏻 Ttegmen.

In complicated COSM.

#ENT
#Medicine

Irreversible ototoxic effects from those drugs:
• Streptomycin
• Dihydrostreptomycin
• Gentamicin
• Tobramycin
• Neomycin
• Kanamycin
• Amikacin
• Netilmycin
• Sisomycin.
and drugs of chemotherapy.

#ENT
#Medicine

Secondary syphilis "Condylomata lata" Soft, flat-topped, moist, pink-tan papules and nodules on the perineum and perianal area. The lesions are full with T. pallidum.

DOC: Penicillin.

#Dermatology
#Medicine

CHANCROID

Cause: H.ducreyi
Transmission: sexual
Primary lesion: Chancroid
Tender papule with erythematous halo that evolves to pustule, erosion, and ulcer. Ulcer is usually quite tender or painful .Its borders are sharp, undermined, and not indurated.With surrounding oedema. Base is friable with granulation tissue and covered with gray to yellow exudate.
Painful inguinal lymphadenitis (usually unilateral).
Dx: culture
DOC: Azithromycin.


#Dermatology
#Medicine

Gonorrhea

Cause: Neisseria gonorrhoeae.
Transmission:Sexually,neonate during birth
Features: The most common presentation in males is a purulent creamy urethral discharge.
If not treated leads to "Disseminated gonococcal infection" which ccc by Hemorrhagic, painful pustules on erythematous bases on the palm and the finger of the other hand. These lesions occur at acral sites and are few in number.

DOC:
Ceftriaxone, 1 g IM or IV every 24 h.

#Dermatology
#Medicine

Primary syphilis"Chancre"
Cause: T. pallidum
Button-like papule then to painless erosion and then ulcerates with raised border and scanty serous exudate.
-Site: mostly penis.
-Surface: may be crusted.
-Size: few millimeters to 1 or 2 cm in diameter.
-Border: may be raised.
-Palpation: firm with indurated border; painless.

DX:clinical +dark-field microscopy.
DOC: Penicillin G benzathine.

#Dermatology
#Medicine

CHANCROID

Cause: H.ducreyi
Transmission: sexual
Primary lesion: Chancroid
Tender papule with erythematous halo that evolves to pustule, erosion, and ulcer. Ulcer is usually quite tender or painful .Its borders are sharp, undermined, and not indurated.With surrounding oedema. Base is friable with granulation tissue and covered with gray to yellow exudate.
Painful inguinal lymphadenitis (usually unilateral).
Dx: culture
DOC: Azithromycin.


#Dermatology

Tinea pedis
-Macerated interdigital type:
Local: Aluminum chloride hexahydrate 20%, with T.Antifungal.

Systemic
-Inflammatory or bullous and Moccasin:
Terbinafine
-Tinea manuum,Tinea ungium:
Terbinafine

-Tinea capitis:
Griseofulvin

With severe, painful kerion:
Prednisone

Tinea versicolor:
Ketoconazole shampoo.

#Dermatology

-In basal fractures of the skull, all cranial nerves are liable to be injured EXCEPT the 12th CN.

#Surgery

Nikolsky sign:
-SSSS
-Pemphigus
-TEN
-Von Zumbesch
-Severe EM major


Desqumation:
-SSSS
-Scarlet fever.

#Dermatology

•Intralesional Triamcinolone Uses:
(Dose is usually 3-5 mg /ml)

- Inflammatory Cysts & Nodules of acne.
- Alopecia areata.
- Keloids & Hypertrophic scars.
- Small Thick psoriatic plaques.
- Cutaneous Sarcoidosis.
- Lichen planus.
- Prurigo nodularis.
- Hydradenitis suppurativa.
- Dyshydrotic Eczema.
- Granuloma annulare.
-Lichen simplex chronicus.
-Recurrent localized Bullous pemphigoid
-Scabietic Nodules.

#Dermatology

Telangiectasia can be seen in:

1-Systemic sclerosis "CREST syndrome".
2-SLE.
3-Dermatomyositis.
4-Rosacea.
5-BCC.
6-Habitual corticosteroid use.
7-Alcoholism.
8-Pregnancy.
9-Hereditary.
10-Chronic exposure to the sun or extreme temperatures.

#Dermatology