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baileys questions Flashcards

1
Q

which of the following is LEAST likely to cause tachyarrhytmias? dopamine, epinephrine, dobutamine, norepinephrine

A

norepinephrine. The others most likely cause HR >130

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2
Q

which antibiotics inhibit 30s ribosomal subunit?

A

aminoglycosides (neo, gent); clinda inhibits 50s.

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3
Q

what numbers of Na, urine osmol, BUN/cr ratio are consistent with prerenal oliguria

A

Na <20; urine osmolal >500, BUN/cr ratio >20

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4
Q

which of the following most likely to present with HL? migraine, vertebrobasilar insufficiency, AICA occlusin, cerebellar infarction

A

AICA supplies blood to membranous labryinth. migraine and vertebrobasilar insuff lead ot disequilibrium, while cerebellar infarction is assoc w gait ataxia and paretic gaze nystagmus

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5
Q

how is evidence graded in practice of EBM?

A

overall grade is a compilation of the level of the BEST studies (not the highest level of study available…)

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6
Q

in RA, are the ossicles involved? TMJ? what do you ahve to do if pt has neck pain prior to DL?

A

no ossicles, yes TMJ–badly, cervical spine imaging b/c recurrent tenosynovitis of transverse ligament of atlas can cause laxity and/or odontoid process erosion and C1 instability/cord compression

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7
Q

rapamycin improves the woudn healing process by which mechanism?

A

inhibition of mTOR

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8
Q

primary sjogren is associated with increased risk of what dz?

A

lymphoma >33% increased risk

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9
Q

what is a common side efect associated with phenylephrine?

A

reflex bradycardia

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10
Q

what reverses heparin?

A

protamine sulfate, not FFP

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11
Q

mecA gene, which is associated with methicillin resistance among staph aureus, encodes for which of the following resistance mechanisms? penicillinase, penicillin-binding protein, beta lactamase, dec drug permeability by efflux pumps

A

mecA encodes for a PBP with low affinity for beta lactamase antibiotics

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12
Q

leaving a periorbital sling over medial rectus during orbital decompression prevents what complication? diplopia, epistaxis, retro-orbital hematoma, overreccession of globe

A

diplopia–sling over medial rectus stops it from prolapsing and reduces diplopia

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13
Q

what cytokine does eosinophils release? IL 2, 4, 5, or 12?

A

IL4

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14
Q

which is the MC organism in intracranial abscess d/t dinsuitis? subperiosteal abscess?

A

strep viridans, same

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15
Q

which CD marker is present on all t-cells?

A

CD3

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16
Q

during orbital decompression, what do you do to stop outflow tract obstruction?

A

pan sinus surgery, and leave 1cm of lam pap in region of frontal outflow tract to prevent frontal obstruction

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17
Q

occupational rhinitis can be caused by low-molecular weight or high molecular-weight compounds, what is true about low molecular weight compounds?

  • animal dander is an ex of one
  • they more commonly cause occupational rhinitis
  • there are standardized extracts of them for skin testing
  • they must be couples w a protein to form a hapten protein complex to elicit IgE response
A

last one–they’re too small to function as an epitope and must couple w protein to elicit response

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18
Q

what’s mcc of epiphora in old woman? middle aged woman?

A

lacrimal duct stenosis, dacryolith

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19
Q

what’s MC complication of ESS? synechia, CSF leak, orbital violation, epistaxis

A

synechia formation

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20
Q

what use to tx acut invasive fungal rhinosinusitis w Pseduoallescheria boydii

A

voriconazole (resistant to ampho)

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21
Q

what’s MC skin lesion of sarcoidosis?

A

lupus pernio (not erythema nodousum, subvutaneous nodules, or ulcerative lesions)

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22
Q

in which form do bacterial most commonly exist?

  • 10% planktonic, 90% biofilm
  • 30:70
  • 90:10
  • 1:99
A

1:99, most bacteria are not free floating, most exist in biofilm, which is the source of 65% of all infections

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23
Q

TH2 cells secrete alll the following cytokines except: INF-gamma, IL4, IL6, IL13

A

INF-gamma; TH1 cells secrete it

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24
Q

Which of the following is an imaging characteristic of most sinus malignancies?- CT high density

  • T1 hyper\intense
  • T2 hypointense
  • orbital invasion
A

T2 hypointense, usu T1 isointense, CT high density indicative of dense insipissated secretions or fungal ball

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25
Q

for frontal sinus obliteration, what is the Riedel procedure?

A

removal of anterior table and frontal floor. frontal scalp stays in direct contact with the posterior table of the frontal sinus or dura and obliterates the frontal sinus, resulting in forehead concavity

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26
Q

the bony ridge that extends between teh maxillary antrostomy inferiroly adn the lam pap superiorly allows what anatomic relationship to be noted?

A

posterior ethmoid air cells will be superior, sphenoid sinus inferior

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27
Q

which presenting symptoms of intracranial complication of sinusitis in order of most to least common? purulent rhinorhrea, fever, headache, AMS

A

HA>fever>AMS>purulent rhinorrhea

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28
Q

which tastes transduce via ion channels?

A

salty, sour (not sweet and bitter)

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29
Q

which is the most robust taste sensation?

A

sweet (present even in utero)

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30
Q

what are typical oral manifestations of Chron’s? Becets” GPA?

A

40% of patients with Crohn disease have oral symptoms at presentation, including cobblestoning of the buccal mucosal, angular cheilitis, or deep linear ulcerations in the gingivalbuccal sulcus. Strawberry gingivitis is a manifestation of granulomatosis with polyangiitis. Ulcers that heal with scarring are typical of Behc;et disease.

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31
Q

what is palifermin?

A

Palifermin is a recombinant human keratinocyte growth factor 1 that is thought to offer mucosal protection esp to prevent chemoxrt mucositis by inducing epithelial hyperplasia.

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32
Q

mucoepidermoid carcinoma arises from which cells? pleo? adeno?

A

The excretory duct cells can give rise to either mucoepidermoid or, perhaps, squamous cell carcinoma. The intercalated duct cells are supposed to give rise to pleomorphic adenoma, Warthin tumor, and adenocarcinoma.

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33
Q

how many cells types are in a taste bud?

A

The life span of a taste cell is about 1 0 days. The taste bud contains sensory cells, supporting cells, and basal cells. As the sensory cells die, the basal cells differentiate
into new receptor cells

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34
Q

what taste differentiates tasters vs nontasters?

A

6-n-proypl-thiuracil. Tasters can be distinguished from nontasters based on the ability to perceive
PRO P. Compared with supertasters, non tasters experience less-negative (e.g., bitterness)
and more-positive (e.g., sweetness) sensations from certain foods and beverages like
alcohol

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35
Q

whcih gland is most sensitive to XRT?

A

The parotid glands are more susceptible to radiation injury. D amage is severe
when exposed to 2 0 Gy to 3 0 Gy.

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36
Q

with Lemierre’s, what’s the MC complication to examien for?

A

lung abscesses (not intracranial complications)

37
Q

which muscle does a singer use to keep VFs approximated when using chest voice?

A

interarytenoid; TA for pitch adjustment

38
Q

what is the esophageal B ring?

A

A mucosal narrowing at the GE junction usu associated with a hiatal hernia. Also known as a Schatzki ring, represents a mucosal
stricture rather than a thickening of muscle at the LES (A ring) or external compression from the diaphragm .

39
Q

what is the rate of failed ED intubations and need for surgical airway?

A

0.5-1%

40
Q

what is a bullard laryngoscope?

A

it has a stylet port to the right of the the viewing lens for difficult airways

41
Q

MC organism from cat bite?

A

pasturella sp.

42
Q

a child with a biphasic washing machine breathing sound is indicative of what?

A

tracheal stenosis

43
Q

NF1 vs NF2?

A

NF1: cafe au lait, cutaneous NF’s, lisch nodules
NF2: schanomas, cataracts

44
Q

MC to least common types of TEF?

A
  1. esophageal atresia w distal TEF 85%
  2. EA alone 8%
  3. TEF alone (H-type) 4%
  4. EA wiht proximal and distal TEF
  5. EA wiht proximal TEF
45
Q

branchial cleft anamalies may contain tissue from what germ layer(s)?

A

ectoderm and mesoderm

46
Q

treatment for extensive rhabdomyosarcomas?

A

if morbidity of surgical resectio nis excessive or unobtainable, chemoXRT is indicated

47
Q

most common inflammatory d/o of salivary glands in children in US? gen pop worldwide?

A

US–JRP (juvenile recurrent paroittis), worldwide–mumps

48
Q

what is a congenital hemangioma?

A

different from infantile hemangioma, present at birth, full grown, no additional postnatal growth, will or will not involuate after birth

49
Q

what percentage of CHARGE pts have choanal atresia? bilatearal or unilateral?

A

65%, 2/3 are bilateral

50
Q

kid s/p MVA, with upper eyelid hematoma and AMS, where is the likely fx?

A

orbital roof (not frontal sinus bc kids don’t have fully formed frontal sinus)

51
Q

lead toxicity results in hearing loss from which mechanism?

A

impairment of neural transmission in auditory pathways (neurogenic issue, nothing to do wit organ of corti)

52
Q

what direction is nystagmus in BPPV of the right? which SCC is it?

A

posterior right–upbeating, geotrophic, torsional (counter clockwise)

53
Q

what virus is associated w otosclerosis?

A

measles virus

54
Q

spontaneous recovery of SSNHL occurs in what timeframe?

A

2 weeks

55
Q

what’s the MC ossciular abnormality in congenital aural atresia?

A

fused malleus-incus

56
Q

what mechanism causes what type of hearing loss in Paget’s dz?

A

bony remodeling of otic capsule leads to conductive and SNHL.

57
Q

auditory brainstem implant contacts what part of brain?

A

dorsal cochlear nucleus

58
Q

how much protection do ear plugs really provide in reality db?

A

10db

59
Q

what is the diff bt AICA and PICA infact?

A

AICA has hearing loss

60
Q

vestibular schannomas most commonly originate from where?

A

intracanalicular vestibular nerves (lateral IAC near scarpa’s ganglion)

61
Q

if see a destructive lesion on the posterior face of petrous bone, what think it is? what else need to check?

A

adenocarcinoma of endolymphatic sac, assoc with von Hippel-Lindau dz and renal cyst tumors, so get renal us

62
Q

chondroradionecrosis MC happens to which structure?

A

arytenoid

63
Q

chronic exposure to what chemical inc cutaneous malignancy?

A

arsenic

64
Q

when resecting tumor of posterior pharyngeal wall, what structure do you take that leads ot significant dysphagia?

A

pharyngeal plexus

65
Q

a 50 year old with firm submucusal mass adjacent to maxillary first molar, what is it?

A

minor salivary gland tumor–MC on hard palate

66
Q

what subtype of melanoma is neurotropic and usu treated with post resection xrt?

A

demoplastic; bc of its predisposition for perineural invasion, xrt is recommended

67
Q

how many times increase risk do pts with Sjogren have for lymphoma?

A

40x greater RR of non-Hodgkin lymphoma within affected parotid gland compared to matched cohort

68
Q

T3N0 left lower lip CA requires what neck dissection?

A

lower lip is bilateral so right level I, left I-III

69
Q

where is the thoracic duct in relation to IJ and carotid?

A

medial and deep to the carotid artery and vagus nerve (and IJ), emptying into the IJ-subclavian junction

70
Q

how are chondrosarcomas, osteogenic sarcomsa, and adult rhabdomyosarcomas treated?

A

excision w xrt if vital structures involved vs chemoxrt vs excision (if possible)

71
Q

what marker is highly specific for Merkel cell carcinoma?

A

CK-20 (since it’s neural crest origin, cytokeratins)

72
Q

what are features of benign thyroid nodules?

A

coarse calcification, regular margins, hyperechogenicty

73
Q

how treat T2N1 HPV+ OP cancer?

A

xrt only (no add chemo)

74
Q

bethesda stages and %age of malignancy?

A 
I: undx <10%
II: benign <3%
III: FLUS 20%
IV: follicular 30%
V: maybe malign 60%
VI: malign 95%
75
Q

MC site of paraganglioma that can be malignant; what mutation predispose you to malignancy? are familial or sporadic more likely to be malignant?

A

orbitlal and laryngeal, then vagal, jugulotympanic, carotid body; but esp with PGL-4 mutation 54% ; sporadic more likley malignant

76
Q

what does a keratoacanthoma look like?

A

ulcerated, circumscribed lesion w elevated or rolled margins and keratinized central region

77
Q

most important indication for surgery in primary hyperaparathyroidism

A

relief of symptoms

78
Q

MC presenting symptom for tracheal SCC? tracheal adenoid cystic?

A

cough w hemoptysis; dyspnea and wheezing

79
Q

bilateral carotid body tumors. ECA is lateral to ICA, but w tumor, ECA splays anteromedially and ICA splays posterolaterally; shamblin criteria?

A

i: abutting ICA
II: >180 around ICA
III: 360 around ICA

80
Q

in a sestamibi scan, what lights up bright?

A

bilateral submandibular and salivary glands light up, so below that, thyroid weakly lights up, adenomas, heart on lower left should light weakly

81
Q

goal of sx in secondary hyperPTH

A

reduce CV events by decreasing PTH secretion and decreasing ectopic calcium deposition

82
Q

T3N0 floor of lateral mouth needs what neck dissection? oral tongue?

A

unilateral I-III; unilateral I-IV

83
Q

what is the overall 5 year survival rate of laryngeal CA?

A

63%

84
Q

T3N2c hypopharyngeal CA most likely will succeed in laryngeal preservation with what chemo XRT tx?

A

induction chemo w docetaxel, cisplatin, 5FU followed by XRT

85
Q

what areas of hypopharynx like to met to paratracheal and paraesophageal nodes?

A

piriform apex, postcricoid mucosa, subglottis

86
Q

which artery is at greatest risk of injury during endoscopic endonasal anterior cranial base resection?

A

frontoorbital artery, a branch off anterior cerebral artery that runs on the inferior surface of frontal lobe

87
Q

how stage scc of skin?

A

T1 <2cm
T2: >2cm or tumor of any size with 2+ high risk features (>2mm, clark level IV or more, perineural invasion, on ear or non-hair bearing lip, poorly differentiated, undifferentiated)

88
Q

what’s the most common particle used for xrt?

A

photon; electrons widely available, protons/neutrons very special/expensive

89
Q

angiosarcoma primarly treated with what? what if metastatic?

A

aggressive surgery, but if metastatic chemo

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