Medical Terminology guide Chapter 7 A.Aural discharge 1. Key points - Aural discharge-otorrhea arises from external or middle ear - Impaired hearingltinnitus - Purulent/nonpurulent/blood - Perforated ear drum on otoscopy - Tenderness over mastoid ‘ - Throat-enlarged! infected tonsils as cause of middle ear infection - Ipsilateral upper cervical lymphadenopathy - Pyrexia in those with infectious etiology 2. Diagnosis and Comments -Branchial fistula: Rar -Trauma: Blood in external canal -Furundes/Otitisn externa -Bacterial-Maliggnant Otitis externa: Caused by Pseudomonas pyocaneus, Severe, may be fatal. Affect elderly, diabetics and immunocompromised -Osteomyelitis: Osteomyelitis-temporal bone/base of skull.green dischargune -Fungal (can also follow overuse of eardrops): Fungal-Aspergillus Niger (black spots inexternal canal). Candida albicans, especially in immuncocom promised -Viral: Herpes. Severe pain present. LMN fac nerve paralysis may be present. Flumyringitis bullosa hemorarhagica-bloody discharg with episodes of pain -Ruptured drum-direct/indirect: Bleeding. CSF leak in basal skull fracture -Indirect-barotrauma -Fracture termporal bone -Following syringing of ear: Posterior half of drum ruptured -Otitis media-acute/chronic: Pain in acute otitis.Discharge only after drum -Suppurative: perforates. Mucopurulent, no offensive odor Due to streptococcus/pneumoccus/hemophil.Chronic suppurative -Tubotympanic otitis media-anterior/central Tympanic membrane perforation. ConstantDischarge due to blocked eustachian tube. -Attic disease-more serious than It Due to a cholesteatoma, which result from Unterated chronic serou otitis media.Cholesteatoma can extend to mastoid or erode middle fossa forming an epidural or even a brain abscess. Facial nerve paralysis may be presen -Hypersensitivity: Allergic eczematous reaction secondary to some wax solvents, hair sprays, Perfumes& ear drops (especially neomyscin containing) B.Nipple discharg 1. Test and Reason -Cytological exam of fluid: To exclude pathology -Fine needle biopsy: To obtain specimen for biopsy -CT scan of abdomen: To exclude possibility of underlying metastases -Pregnancy test: To exclude pregnancy -Free T4 and TSH level: Elevated in hypothyroidism -Radio immune assay free T4: Elevated in hyperthyroidism -Radioactive iodine uptake: Elevated in hyperthyroidism induced Thyrotoxicusi (toxic multinodular goiter, toxic adenoma, Hashimoto thyrotoxicosis, TSH secreting pituitary adenoma). Decreased in thyrotoxicosis not due to hyperthyroidism (thyroiditis, surreptitious exoge-nous intake, metastatic thyroid cancer, ectopic thyroid tissue) -Cranial CT: scan to detect microadenoma of the pituitary gland -Serum prolactin level: Elevated in the presence of a prolactinoma

Medical Terminology Guide For Nurse Students Chapter 7

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