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Inservice BV > Abo-oto > Flashcards

Abo-oto Flashcards

1
Q

Aminoglycosides and incidence of HL? which part of the cochlea does it effect? how soon after therapy do pt’s start to experience HL?

A

-10% -basal and inner row of hair cells -3-4 days

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2
Q

Branchial Arches define?

A
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3
Q

Dermal filler for patients with AIDS

A
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4
Q

Treatment for anaphylaxis

A
  1. 3-0.5mg of 1:1000 epi every 15-20min.
    - repeat every 15-20min
    - parenteral anti-histamine
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5
Q

Serum markers for anaphylaxis

A
  • histamine have an immediate raise and lasts for 30-60min
  • tryptase elevates 30-60min after and stays elevated up to 6 hrs
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6
Q

Innervation of the carotid sinus and/or carotid body tumor?

A
  • Afferent CN IX: info about hypoxia, hypercap, acidosis
  • Efferent: superior cervical plexus
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7
Q

Bacteriocidal antibiotics?

Bacteriostatic?

A

Very Finely Proficient At Cell Murder

-Vanco, Fluoroquinolones, Pens, Aminoglycosides, Cephs, Metro

ECSTaToC

  • Erythro (macrolides)
  • Clinda
  • Sulfa
  • Tetra
  • Trimethoprim
  • Chloramphenicol
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8
Q

PTC staging

A
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9
Q

Sunderland Classifications

A
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10
Q

Contributing vessels to Little’s area

A
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11
Q

Growth pattern of hemangioma’s of infancy

A

Rapid growth over first 6 mo’s.

50% resolve by 5 yo

70% resolve by 7 yo

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12
Q

Hemangioma of infancy subgottic risks

A

50% of subglottic will have cutaneous manifestations

60% of hemangiomas in the bearded area will be assc with subglottic ones

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13
Q

2nd most common region for otosclerosis?

A

Round window

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14
Q

Phases of wound healing

A
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15
Q

Friedman staging for UPPP and success?

A
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16
Q

What is the definition of surgical success and UPPP?

A

50% reduction or AHI < 20

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17
Q

Indication for RAI for follicular thyroid CA

A
  • tumor > 4cm
  • gross extracapsular extension
  • extensive intravascular invasion
  • elevated post op TG
  • known or suspected metastatic disease.
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18
Q

Only facial muscle not innervated by FN?

A

levator palpebrae superioris - innervated by CNIII

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19
Q

What kind of hearing loss do you get with quinine?

A

reversible at 4kHz

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20
Q

Contra-Indications for a partial laryngopharyngectomy?

A
  • involvement of the pyriform
  • extension to the post cricoid region
  • ipsilateral TVC paralysis
  • encroachment into the cricopharyngeus
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21
Q

Sequence of local anesthetic blockage

A

-Sympathetic fibers -> pain/temp -> touch/motor

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22
Q

Relationship between pH and pKa for local anesthetics

A

-the closer the pKa is to pH, the more likely the anesthetic will be in unprotonated/hydrophobic state and therefore faster onset of action

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23
Q

Dennie Lines

A

Assc with AR

-occur due to spasm of Mueller’s muscles in chronic AR

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24
Q

Brow lift and facial nerve anatomy in relation

A
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25
Q

What is Galactomannan?

A

Polysaccharide found in aspergillous, elevated in invasive pulmonary aspergillosis. No utliity in mucor.

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26
Q

T staging for supraglottic cancer

A

T1: Limited to one subsite

T2: Extends to adjacent subsite, still with vocal fold mobility

T3: Vocal cord paresis and/or invading inner cortex of thyroid cartilage, post cric, pre-epiglottic, paraglottic space.

T4a: Invades beyond prior

T4b: Encases carotid, mediastinum or prevertebral invasion.

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27
Q

What is Jessner’s solution

A

salicylic acid, lactic acid, resorcinol, ethanol.

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28
Q

What meds do you give for anaphalyxis of a pt experiencing anaphylaxis

A

antihistamines, steroid, glucagon (increases cardiac output/HR).

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29
Q

semicircular canal dehiscence, what kind of hearing loss?

A
  • CHL
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30
Q

How long abx for pott’s puffy tumor

A

6-8 wks

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31
Q

When to consider SLNB in melanoma?

A

-T1b - T4, no gross nodal disease.

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32
Q

Staging for melanoma?

A
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33
Q

how to treat methemoglobinemia?

A

1% meth blue 1mg/kilo total slow infusion

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34
Q

2nd MCC OC cancer?

A

adenocarcinoma

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35
Q

innervation of the ear canal?

A
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36
Q

MCC presenting sx of NPC?

A
  • 75% neck mass
  • 73% nasal obstruction
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37
Q

What to do if AOM during CI?

SOM during CI?

A
  • place tubes, implant once clear of infection for min 2 wks
  • irrigate, topical gtts, post op ceftriaxone
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38
Q

Meds that increase T4 catabolism?

A

phenytoin, carbamazepine, phenobarbital, rifampin

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39
Q

Vessels of Woodruff’s plexus

A

SPA, ascending pharyngeal

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40
Q

Cidofovir?

A

inhibits DNA polymerase, used in respiratory papillomatosis

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41
Q

What meds are used in respiratory papillomatosis?

A

Cidofovir, avastin

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42
Q
A
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43
Q

organisms in ARS most likely to self resolve?

A

moraxella catarrhalis, sometimes haemophilus.

S pneumo will not self resolve.

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44
Q

how many dB do you need to double the sound

A

3 dB

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45
Q

Sx of Churg Strauss?

A
  • Granulomatis nasal lesions but no epistaxis
  • > 10% serum eosinophilia
  • allergic rhinosinusitis
  • granulomatous lesions of lungs
  • asthma
  • vasculitis w extravascular eosinophils
  • mononeuritis multiplex
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46
Q

what is the risk for cervical mets in lip SCCa?

A

10%

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47
Q

most common dental cysts?

A

Radicular cysts > dentigerous cysts

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48
Q

Gorlin syndrome?

A
  • mulitiple basal cells
  • odontogenic keratocysts
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49
Q

What is the chance for malignancy in a cold nodule in Graves?

A

45%

they also tend to be more aggressive in Graves patients

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50
Q

Vestibular neuritis typically effects which vestibular nerve?

How to test for laterality?

A

Superior

  • fast phase away from the affected side
  • symptoms worse with head movements
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51
Q

Dedo classifications

A

Class 1: minimal defects, no surgery

Class 2: lax skin, rhitidectomy

3: submental/submandibular adiposity: liposuction and consider anterior platysmoplasty
4: anterior banding of platysmal banding -
5: microgenia/micrognathia
6: inferior positioned hyoid: division of suprahyoid muscles, suturing of anterior diagstric muscles, chin augment

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52
Q

Blood supply to the temporalis muscles?

A

Ant/Posterior branches of the deep temporal artery which are branches from the IMAX

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53
Q

Nerves involved with orbital apex syndrome?

A
  • CN 2, 3, 4, 6, nasociliary/frontal nerves, superior ophthalmic vein.
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54
Q

MCC reason for b/l facial paralysis

A

Lymes

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55
Q

Positive hitsilberger sign is what? and what does it signify

A
  • Posterior superior concha numbness
  • space occupying lesion of the IAC compressing facial nerve.
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56
Q

Path of foamy histiocytes and bloated plasma cells?

A

foamy histiocytes -> mikulicz cells

bloated plasma cells -> Russell bodies

sign of rhinoscleroma caused by klebsiella rhinoscleromatis.

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57
Q

Serum Ig changes with immunotherapy?

A
  • 1st: there’s a spike in specific IgE: total IgE levels (up to 16)
  • 2nd: then’s it will drop to below pre therapy levels.
  • 3rd: get a rise in IgA and IgG4
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58
Q

Innervation of taste of the soft palate?

Posterior tongue?

A

Greater superficial petrosal nerve.

lingual branch of glosspharyngeal n.

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59
Q

Diplacusis?

Rollover?

Parascusis of Willis?

A

Diplacusis: subjective perception of more than one pitch when 1 tone is presented. Sign of cochlear dysfunction.

Rollover: Speech reception scores drop with increasing loudness

Paracusis of Willisii: phenomenom where people with CHL can have an enhanced ability to hear in noisy environment.

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60
Q

When to treat with Augmentin/fluoroquinolone in sinusitis?

A

If failed abx therapy or treated w abx in last 6 wks

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61
Q

Which HPV with RRP?

A

6, 11 (11 has worse course)

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62
Q

Which HPV for cancer?

A

16 and 18

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63
Q
A
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64
Q

Define level III neck radiographically?

A

inferior cricoid to inferior hyoid.

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65
Q

Most sensitive test for central vestibular dysfunction?

A

Smooth pursuit tracking.

If impaired, suggests unilateral or posterior fossa lesion.

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66
Q

Head shake test and nystagmus?

A

horizontal nystagmus will beat away from affected side.

If vertical/rotarary -> suggestive of cns disorder.

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67
Q

MOA of mitomycin C?

A

DNA crosslinking to prevent cell replication

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68
Q

Criteria for anterior cricoid split?

A
  • failed 2 extubations
  • >1500g weight
  • no assisted ventilation for 10 days
  • otherwise healthy
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69
Q

What is the definition of sleep hypoventilation?

A

increase paCo2 to 10mmhg

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70
Q

Treatment of Ramsay Hunt?

A
  • Valcyclovir for 14 days
  • or Famcyclovir for 10 days

both w steroids

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71
Q

Describe normal occlusion?

A

Mesiobuccal cusp of the 1st maxillary molar is aligned with the buccal groove of the mandibular 1st molar.

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72
Q

two MCC viruses that cause rhinitis?

A

rhinovirus > coronavirus

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73
Q

Proper sequence to treat cleft palate/lip kids?

A
  • determine syndromic, feeding issues, evaluate ears, speech eval

3 mo’s: tip rhino, cleft lip, tubes

1yr: palate
5yrs: columellar lengthening

8-16: orthodontics

10 yrs: alveolar grafts

14 yrs: definitive rhino

74
Q

Closing eye lid defects?

A

up to a third: primary

1/3-2/3: lateral canthotomy, semicircular advancement flap

50-100%: Hughes tarsoconj flap

75
Q

What is in Baker’s solution?

A

phenol, septisol, croton oil, distilled h2o

-croton oil is the key ingredient for depth of chemical peel

76
Q

Correct auriculocephalic angle?

How far apart should mustarde stitches be placed?

A

25-35 degrees.

at least 16mm, place at least 3

77
Q

Pendred Syndrome?

A

AR

goiter, enlarged vestibular aqueduct, cochlear hypoplasia, mondini malformation.

-defective pendrid protein affecting chloride and iodide transport

78
Q

Appropriate MRD-1/2?

A

4-5mm

5-5.5mm respectively

79
Q

Goldenhar Syndrome?

A

AD

hemifacial microsomia (1/2nd branchial arch defect)

80
Q

Mobius Syndrome?

A

congential FN paralysis

81
Q

5 ethmoturbinals?

A

1) agger/uncinate
2) MT
3) superior turb

4/5) supreme

82
Q

Early signs of lidocaine tox?

A

metallic taste, tinnitus, numbness around mouth.

83
Q

What immunodeficiency cannot surmount a host response to encapsulated bacteria?

A

IgG2 defiency.

Encapsulated bacteria would include H influenzae

84
Q

MCC immunodeficiency in adults?

A

IgG3

-more susceptible to URIs, AR, asthma

85
Q

How much bone can you harvest for a fib flap?

A

25cm

86
Q

Histology of schwannoma?

A

Spindle cells arranged in Antoni type A/B patterns

  • A: densely packed spindle cells w aligned or palisading nuclei
  • B: loosly arranged myxoid stroma
87
Q

MOA of 5 fluorouracil?

A

Binds to thymidylate synthetase

88
Q

MOA of methotrexate?

A

binds to dihydrofolate reductase

89
Q

When do frontal sinuses appear in development?

A

5-6 yrs

90
Q

Alexander’s law

A

Nystagmus is worse in the direction of the healthy ear

91
Q

How is central vertigo different from peripheral?

A
  • does not improve w fixation
  • does not improve with repeated stimulation
  • multidirectional nystagmus
92
Q

What congenital condition is assc w endolymphatic sac tumors?

A

Von hippa lindau

  • hemangioblastomas of retina and CNS
  • endolymphatic sac tumors
  • clear cell renal ca
  • pheochromocytoma
93
Q

Pedicle artery for ALT flap?

A

-Descending branch of lateral circumflex femoral

94
Q

MCC benign sinonasal tumors?

A
  1. osteoma
  2. IP
95
Q

MCC affected sites for IP?

A

Lateral nasal wall > max

96
Q

What anatomically is the greatest predictor OSA?

A

Man neck circ > 17cm

Woman neck circ > 15cm

97
Q

Dosing for propanolol for infantile hemangioma?

A

Propranolol dose for infantile hemangioma

2-3mg/kg per day

98
Q

Wound tensile strength by time?

A

3% at 1 wk

20% at 3 wks

80% at 3 mo’s

99
Q

What is the inheritance pattern of Osler Weber Rendu?

A

AD

100
Q

Medication and diet stoppage prior to RAI?

A

Cytomel stoppage 2 wks prior, synthroid 6 wks prior

amiodarone 9 mo’s prior

low iodine diet 2 wks prior

101
Q

For adductor vs abductor dysphonia, which #’s would they have difficulty saying?

A

adductor -> 80-89

abductor -> 60-69

102
Q

How to diagnose and monitor malignant OE?

A

Tc99 scan for dx

then follow w Gallum 67 scan every 4 wks

tx usually 2-4 mos

103
Q

Inheritance of otosclerosis?

A

AD

104
Q

Mean sleep latency of people w OSA?

A

5 min

105
Q

MCC cardiac arrhythmia of those w OSA?

A

sinus brady

106
Q

Inflammatory marker assc w OSA?

A

CRP

107
Q

Most prominent pharyngeal dilators

A

Genioglossus and tensor palitini

108
Q

Esthesio and Kadish staging?

A
109
Q

What % of hyperparathyroidism is due to adenoma? hyperplasia? lithium? carcinoma?

A
  • 70% single adenoma
  • 26% double adenoma
  • 1.5% hyperplasia
  • 1.5% lithium
  • 1% carcinoma
110
Q

cervical vestibular evoked myogenic potentials pathway?

A

stimulation of saccule -> inferior vestibular n -> vestibulospinal tract -> SCM

oVEMPs stimulates utricle -> superior nerve.

111
Q

Markers for B cells? T cells? NK cells? Eosinophils?

A

B: CD19, 20, 22

T: CD2,3,4,8

NK: CD56,16

Eosinophils: CD69

112
Q

Histo for Warthin’s?

A

Cyst surrounded by double epithelium, papillary fronds with lymphoid stroma

113
Q

How long is re-epithelization after dermaabrasion?

A

5-7 days

114
Q

Neutrophil count below what number is ominious in mucor?

A

below 1000

115
Q

Which antithyroid med is ok during 1st trimester?

A

PTU

116
Q

In the scalp, how large should the tissue expander be? When should inflation occur after placement? How often?

A

2.5x the size of the defect

2 wks after

1-2 times/wk

117
Q

Abx treatment for Lemierre’s syndrome?

What bug?

What location is the source?

A

Metronidozole

Fusobacterium necrophorum

Peritonsillar region

118
Q

Nerve contributions to pterygopalatine ganglion

A

deep petrosal

GSPN

Max nerve

nerve of pterygoid canal

119
Q

Wiskot Aldrich syndrome?

A
  • X linked
  • Eczema
  • elevated IgE/A but decreased IgM
  • thrombocytopenia
120
Q

Bruton’s agammaglobinemia?

A
  • defect in tyrosine kinase therefore B cells cannot mature and have decreased amounts of Ig’s across the board
  • Infections start at 6mo’s once they lose mothers Igs
  • Inheritance X linked
121
Q

IgA deficiency, what do you have to watch out for?

A

anaphylaxis during blood transfusion

122
Q

Describe segments of ICA?

A
123
Q

Godtfredson’s syndrome?

A

Abducens and hypoglossal nerve palsy

Due to tumor of clivus or NPC

124
Q

Hering’s Law

A

Equivalent innervation of matched muscles may cause non physiological overactivity of the normal side while compensating for the weak side.

To pre-op test, manually elevate the ptoticl lid, the opposite normal lid will then become ptotic

125
Q

Furnas technique?

A

Conchal setback: suture technique tacking concha to mastoid periosteum

126
Q

What % of Downs have atlanto-axial instability?

What do you look for on scan?

A

10-20%

>4mm from dens to anterior edge of atlas.

127
Q

Jugal point?

A

point at the anteror end of the upper border of the zygomatic arch where the masseteric and maxillary edges meet at an angle.

128
Q

Syndrome: FAP, sinonasal osteomas, supranumery teeth?

A

Gardner syndrome

129
Q

Associated features along with pyriform aperture stenosis?

A

premaxillary dysgenesis, central mega incisor, flat nasal bridge, hypertelorism, holoproencephaly

130
Q

What deficiency is RLS assc with?

Assc with what medication use?

Tx?

Associated pathology?

A
  • Deficient in CNS iron
  • SSRIs, SNRIs, TCAs, lithium, antiemetics, dopamine antagonists
  • Tx: pramipexole, ropinirole
  • loss of dopaminergic cells in substantia nigra
131
Q

What pyriform apex tumors can you avoid a TL?

A

< 2cm in size

1.5cm above the pyriform apex

no cord fixation

no invasion

appropriate PFTs

132
Q

How does frontal sinusitis track to the cavernous sinus?

A

superior ophthalmic vein

133
Q

When to perform Laryngeal EMG in setting of RLN injury?

A

3-6 mo’s after injury

134
Q

pathphysio for DKA being susceptible to mucor?

A

-altered transferring binding which leads to increased serum iron which enhances fungal growth

135
Q

What is Kasabach Merrit phenomenom?

A

It’s a consumptive coagulopathy associated w tufted angiomas

136
Q

Sturge Weber syndrome

A

V1 capillary malformation, leptomeningeal angiomas, intellectual instability, glaucoma

137
Q

What pt features correlate w worse prognosis in PTC?

A

Males > 41yo; Females > 51yo

nodule > 5cm

138
Q

How far prior to RAI does levothyroxine have to be stopped? Liotyronine?

A

6 wks

2 wks

139
Q

Management of sialocele after face lift?

A

Pressure dressing, glycopyrrolate, botox, transdermal scopalamine

consider drain placement.

140
Q

Cidofovir MOA? What is it used for?

A

inhibits DNA polymerasae

used for RRP but off label

141
Q

How does a vestibular schwannoma appear on MRI?

A

T1 hypointense, T2 heterogenous, T1 enhancement w gad

142
Q

What does Ristocetin test test for?

A

vWF deficiency

143
Q

What is the ultimobranchial body and what does it test for?

A

part of the 4th branchial pouch and gives rise to calcitonin producing parafollicular cells.

144
Q

For cutaneous squam, level neck dissection per subsite?

A

face: 1-3

anterior scalp: 2-3

ear: 2-3

posterior scalp: 2-5

145
Q

Abx tx for nec fasc?

A
146
Q

boundaries of pre-epiglottic space?

A

hyoid, thyrohyoid membrane, epiglottis, thyroepiglottic ligament, hyoepiglottic ligament

147
Q

avg palpebral fissure diameter?

A

9mm

148
Q

number of cartilage in larynx?

A

9

cric, thyroi, epig, cuneiform, corniculate, arytenoids

149
Q

Where is the toxicity to the ear in platin medications?

A

Cisplatin: changes to stria vascularis, spiral ganglion, outer hair cells

Carboplatin: toxic to inner hair cells

150
Q

What other things should you check for in pts with mumps (specific to ENT)?

A

check hearing: degeneration to stria vascularis

151
Q

Innervation of parotid gland parasympathetics?

A

inferior salivatory nucleus -> CNIX -> Jacobsen’s -> tympanic plexus -> lesser petrosal -> otic ganglion -> auricular temporal -> parotid

152
Q

how do aminoglycosides cause damage?

A

forms a free radical complex w iron which damages outer hair cells

153
Q

Most common bug of OE?

A

Pseudonomas

154
Q

How soon prior to skin testing should you stop antihistamies?

TCAs?

A

72 hrs, loratidine -> 7 days

TCAs ->2-4 days

155
Q

How long does it take for a FTSG to get a new blood supply?

A

Diffusion

1-2 days vascular inosculation

2-4 days neovascularization

3-5 days blood supply established.

156
Q

blood supply to trap?

A

occipital, dorsal scapular, transvserse scapular

157
Q

Within what time window should you give IV abx for CI for AOM?

A

within 2 mo’s.

Otherwise oral is ok if uncomplicated.

158
Q

Indications for primary hyperparathyroid surgery?

A
  • serum ca 1.0mg/dl above upper limit nml
  • creatinine clearance reduced by 30%
  • < 50 yo
  • 24hr urine > 400mg/dL
  • bone density <2.5 std
159
Q

Ideal helix to mastoid measurements?

A

Upper: 10-12mm

Middle: 16-18mm

Lower: 20-22mm

160
Q

What is the inheritance of Bruton’s agammaglobinemia?

Defect?

A

X linked

tyrosine kinase deficiency -. B cells cannot mature

161
Q

What kind of cell deficiency if you get a lot of viral infections/fungual infections?

A

T cell deficiency

162
Q

Vemurafinib?

A

mitogen active protein kinase pathway inhibitor effective for melanoma w BRAF mutation

163
Q

Staging for anaplastic thyroid ca

A

Stage IVA: confined to thyroid

IVB: regional mets

IVC: distant mets

164
Q

Suspicious features of thyroid nodule?

A

hypoechoic, mostly solid or solid, central vascularity, taller than wide on transverse, microcalfications, cervical adenopathy

165
Q

What % of hypopharyngeal masses have regional mets at time of diagnosis?

5yr survival?

A

up tp 70%

< 25%

166
Q

Innervation of parotid gland?

A

Parasympathetic: visceral motor fibers -> lesser petrosal n -> exits skull at foramen ovale -> synapse on otic ganglion -> post ganglionic fibers travel w auriculotempora n to parotid gland

167
Q

MCC symptom of glossopharyngeal cA?

A

Mid frequency SNHL

Vestibular schwannomas have high frequency

168
Q

what depth of tumor should a SLND be perform in oral cancer?

A

4mm or more

169
Q

Inheritance of pendred syndrome?

Best way to dx?

A

AR

Genetic testing for SLC264A4 gene

170
Q

Inheritance of aminoglycoside sensitivity?

A

Mitochondrial so from mother

171
Q

When should you get an EMG for traumatic facial paralysis?

What will it show?

What will it show if FN function is returning?

A

2-3 wks after trauma

fibrillations

polyphasic potentials

172
Q

Inheritance of connexin 26 hearing loss?

A

AR

173
Q

CENTOR criteria?

A

Likelihood of having Group A strep

absence of Cough

tonsil Exudates

+ Nodes

Temp

Old oR young (+1) if young

Score -1-5

174
Q

What feature on immunohistochemistry do infantile hemangiomas express?

A

Glut-1 transporter

175
Q

Angle of the laryngeal prominence in men/women?

A

90/120

176
Q

Orientation of cochlear aqueduct? Endolymphatic sac?

A

parallel to IAC. IAC is anterior to cochlear aqueduct.

perpendicular to IAC

177
Q

Villaret Syndrome?

A

paresis of 9,10,11,12 and cervical sympathetic chain

indicative of lesion of the retroparotid space

178
Q

If you have hyphema in an orbital floor fxr, what should you do?

A

Avoid surgery for 2 weeks min.

179
Q

How to remember the AD congenital conditions?

A

WANT CBS

Waardenberg

Aperts

Neurofibromatosis

Treacher Collins

Crouzon

Branchio oto renal

Stickler

180
Q

Rhinophyma is assc w what bug?

A

Demodex folliculorum

181
Q

TSH should be what level in order for RAI to be effective?

A

> 30

182
Q

How long should pt’s wait for RAI after receiving contrast for CT?

A

8 wks

Inservice BV (3 decks)

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