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Random CM ENT
CMI - Fall 2011
| Question | Answer |
|---|---|
| Nerves to TM? | Mandibular, Vagus, Glossopharyngeal |
| Blood supply to ossicles? | Ext carotid |
| Innerv of larynx? | 2 branches of vagus: Superior and inferior/recurrent laryngeal nerves |
| Blood supply to nose? | Ex and int carotid |
| MC cause of URI? | rhinovirus |
| Acute vs chronic sinusitis? | <4wks; >12wks |
| MC sinuses involved in bact sinusits? | Maxillary #2-ant ethmoid |
| Early introduction of formula and food and maternal smoking in first yr of life can increase likelihood of pt to develop? | Allergic rhinitis |
| Late phase response of alleg rhinitis involves which cells? | 4-8 hrs later: Macrophages, Lymphocytes, neutrophils, eosinophils |
| Shiners and dennie morgan lines assoc w/? | Allergic rhinitis |
| Intranasal steroids are not for? | KIDS |
| What is the idiopathic rhinitis that is assoc w/ enhanced reactivity of nasal mucosa to various triggers? | Vasomotor rhinitis (NO allergic component) |
| COngenital condition involving blockage or narrowing of the posterior nasal airway by membrane or bone? | Choanal Atresia |
| What occurs exclusively in males age 7-19 yrs and presents with recurrent epistaxis, obstrux? | Juvenile nasal angiofibroma |
| A risk of juvenile nasal angiofibroma is that it can expand into where? | Base of skull, sinuses |
| 80% of genetic HL is....? | non-syndromic |
| Eyes of those w/ Down Synd? | Brushfield's Spots (light spots on irises of eyes) |
| Who @ risk for cleft lip/palate? | American Indian, Asian, Male |
| Which condition involves a mutation in the type IV collagen protein? | ALport's |
| When do you see kidney failure in ALport's? | Teens-Recessive and X-linked 40's-Dominant |
| What kind of HL w/Alport's and when do you see it? | SNHL; not present at birth, but develops by late childhood |
| What condition involves a gene mutation during fetal devt that is involved in the production of 3 difft types of collagen? | Stickler SYndrome |
| Those w/ stickler synd are usually deaf by? | Teen years |
| Which condition is assoc w/ MVP? | Stickler synd |
| Goldenhar synd aka? | Oculoauricular dysplasia |
| Which condition involves abn devt of pharyngeal arches #1 and 2 on one side of face? | Goldenhar synd |
| What condit is assoc w/ preauric pits/tags? | Goldnhar |
| When can fix pinna and jaw in goldnhar? | Jaw-3yo Pinna-6yo |
| Which condition involves alteration of chrom 5? | Treacher collins synd |
| Which condit involved hypoplasia of zygoma and mandible? | Treacher collins |
| OF the congenital synds learned--which have SNHL? | Alport's , STickler |
| Which congen conditions are assoc w/cleft issues and what kind? | Down-Cleft L or P Stickler-Cleft P Treacher-CLeft P |
| Sjogren's synd involves? | Swelling of parotid or submandub glands w/ xerostomia and xerophthalmia |
| Sjogren's seen more in who? | Women (9:1) and >40yo |
| Sjogrens is #2 mc rheumatol d/o..what is #1? | SLE |
| GOld std for sjogrens dx? | bx of lip-----lymphocytic infil, ductal hyperplasia |
| Schirmer's test? | For sjogren's....filter paper at lower conjunctival sac....less than 5mm wetness in 5min = + |
| TX for sjogrens? | Steroids for inflamm, sx trtmen |
| Parotitis? | Swellin of one parotid gland-seen in elderly |
| PSeudomembranous thrush? | Can be wiped away |
| Atrophic thursh? | Loss of papilla and burning sensation |
| Hyperplastic thrush? | Chronic condit-stuck on |
| Etiology of glossitis? | Vit B defic, anemia, irrita, infex, poorly fit dentures, rought teeth, trauma, burns, alc, tobacco |
| Herpetic stomatitis is primarily seen in? | Children 9m0-5yrs |
| When should herpetic stomatitis resolve? | 1-2 wks |
| Which stomatitis assoc w/fever? | Herpetic stomatitis (aphthous=afebrile) |
| Who gets aphthous stomatitis? | Females>m, age 10-19 |
| When should expect aphthous stoma to go away? | 1-2 wks |
| High anterior bleed....in who? where? | Anterior ethmoid A (& above midd turbinate) -Older, HTN |
| What labs can be checked for ant bleed? | Pt/PTT, hct, INR |
| What labs can be checked w/high ant bleed? | Hct and evaluate for shock! |
| Who gets post bleeds? | Smokers, older, htn |
| Labs to order for post bleed? | Hct/hgb, coags, electrolytes, EKG |
| When would a bleed develop with a frx of temp bone? | w/in first 48 hrs |
| Most temp bone frxrs are? | longitudinal (80%) |
| HL w/ longitudinal temporal frx? | CHL (SNHL possibly from concussion to area) |
| Longitudinal temporal bone frx happen in what area? what about transverse frxrs? | Parietal; Occipital |
| HL w/ transverse temp frxr? | SNHL (loss of vestibular fxn, blood behind TM, and CSF from nose) |
| What might you see later, after a transverse temporal frxr? | Bruising behind ear...mastoid |
| What 2 things are indicative of transverse temporal skul frxr? | Raccooon eyes and battle sign |
| W/flat, depressed nasal bridge, need facial films and to check what? | Extra ocular movement -- for entrappment of CN 3,4,6 |
| Order an orthopentogram and panorex to check for what? | Mandible frxr (very rare to be unilat...usually see on both sides) |
| Penetrating laryngeal trauama always needs what, even if stbale? | Surgical referral |
| Major concern with facial frxrs? | Resp probs |
| Nerves involved with face numbness? | 5 and 7 |
| 3 grades of Le Fort frxrs | 1. Transverse frxr above teeth 2. +involv of inferior orbital rim 3. Complete disruption-involvement of zygomatic arch |
| Name of bilat submandibu space infex w/ diffuse cellulitis usualy an odontogenic etiology from periodontal dz/signif dental caries? | Ludwig's angina |
| Etiology of adults and children w/retropharyngeal/prevert abscess? | Children=infectious Adult=trauma |
| Causative orgs or prevert/retropharyn absces? | Strep pyogenes, staph aureus, anaerobes |
| Imaging for ludwigs angina and prevert/retrophar abscess? | CT w/contrast |
| Most head and neck CA is? | SCC (90%) |
| Pattern of SCC? | Regnl lymph system>lungs>liver>bones |
| Gradual unilateral SNHL w/ tinnitus and possibly vertigo/unsteadiness may sugg? | Acoustic neuroma |
| 85% of malignant tumors of ear will be where? | Pinna/Auricle |
| Type of CA of external ear and canal? | 1/3 BC, 2/3SC |
| Causes of nose/sinus CA? | Expos to nickel, wood dust, thorotrast (usually not d/t tobacoo) |
| Usual first finding for nasophar ca? | Asymptomatic enarged cervical node or unilateral serous OM in adult (w/no URI sx) |
| Risks for nasophar ca? | Mono, smoking, EBV expos, Asian |
| What kind of CA is usually foudn in the ethmoid sinus and is slow-growing? | Adenocarcinoma (under 40 yo) |
| What cancer has a 20% chance of metas and is slow-growing, in the roof of the nose and usually found in the 20's? | Esthesioneuroblastoma |
| sxs of esthesioneuroblastoma? | Unilat nasal obtrux, loss of smell, epistaxis |
| Lymph nodes with CA of larynx? | Will only feel with late dz! BAD! usualy = metas |
| Major contrib of larynx ca? | smokin and alc |
| To determine laryngeal ca...must do 5 of what 6 things? | 1. palpate cervical soft tiss 2. indir laryngoscoyp w/ mirror 3. direct laryngos w/bx 4. xray neck n chest 5. ct or MRI larynx 6. other contrast studies |
| 15% of those with what will also have LUNG ca? | laryn ca |
| types and mc laryn ca? | glottic>subglottic>marginal zone |
| cauliflwr looking tumor? | glottic |
| oral and pharyn can accounts for 50% in which 2 popus? | asian and indian (betel nut) |
| SC lip ca? | Verm border - mets late |
| BC lip ca? | lower lip - mets early |
| is erythroplakia or leukoplakia more assoc w/ malig? | eryth |
| Pharyngitis is most common in which seasons? | winter and early spring |
| EBV is a member of what virus grp? | Herpes virus group |
| If mono is caused by EBV, what will the monospot detect? | Heterophile ab positive |
| incub pd for mono? | 4-6 wks |
| mono virus can lay dormant in? | B cells |
| If mono is caused by a V other than EBV, what will see? | negative heterophile ab |
| If pt has mono and strep, dont give? why? | Amox/pen...bad rash |
| minimal elevation of what with mono? | LFTS |
| for strep thrt, abx therapy should be initiated w/in how many days to reduce risk for rheu fever? | 9 days |
| Scarlet fever typically casued by? | Pharyngtis |
| SB tongue can present w/? | scarlet fever |
| peritonsillar abscess aka? | Quinsy, pta |
| Airway narrowing above vs below folds? | above=inspir stridor below=expir stridor or both |
| 3 D's assoc w? | epiglottitis --drooling, dysphagia, distress |
| h.flu/epiglottitis px/eradication via? | rifampin |
| Croup usualy follows? WHen? | URI; fall, early winter |
| MC cause of stridor in kids? | Croup |
| etiology of croup? | parainflu viruses |
| steeple sign? | croup - subglottic narrowing |
| MC cause of hoarseness? | acute laryngitis |
| common major manifestations of rheu fev? | carditis, polyarth, chroea |
| rheu fever is an immune response to? | M-assoc surface prtein molecules of BHStrep |
| usually start to see rheu fev sxs when? | in 3-4 wks from infec |
| tx for rheu fev? | Aspirin, PCN, prednisone for carditis is present, PCN px |
| For irrigation to remove wax impaction...water should be what temp? why? | body temp, otherwise can cause vertigo |
| best way for manual cerumen removal? | otomicroscope exam |
| if otorrhea is present with perf...need to treat with? | FQ drops |
| which perfs should heal and which dont? | traumatic one does; tube and COM dont |
| What is a complication of untreated auricular hematoma? | cauliflower ear |
| BPPV | benign paroxysmal positional vertigo -prev trauma <50, >50 idiopathic -otoconia displaced into Post SCC -hallpike maneuver |
| Epley maneuver | for BPPV, canolith repositioning |
| Classic menierres | intermitt vertigo, low freq SNHL, buzzing/roaring tinnitus, aural fullness |
| menieres synd | w./ autoimmune |
| vestibular neuronitis | viral cause, inflamm of vestibular N, sudden onset vertigo lasting days-wks-mo's -no hring loss or pain |
| Labyrinthitis | infec of inner ear, severe vertigo and hring loss, viral or bact |
| bacterial labrynthitis can lead to? | bact meningitis |
| may be mc cause of vertigo? | migrain-assoc vert |
| mig-assoc vert | not always HA, motion sickness, n and v, no HL/tinnitius |
| swimmers ear caused by | pseudomonas, staph aureus |
| rfs for laryngeal ca? | smoking, alc, hpv, (NOT NODULES) |
| what is the 1-3-6 model? | screen by 1 mo, dx by 3 mo, have approp interven by 6 mo.....for hring loss |
| MC cause of genetic HL? | loss of mutation in connexin 26 gene on chrom 13 (SNHL) |
| bell's palsy? | swelling of CN7 at labyrinth segment -herpes simplex |
| ramsey-hunt synd | -herpes zoster oticus -severe hring pain, loss, vertigo **Poor prognosis |
Created by:
ferrier.kath
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