BOOK Q's Flashcards
Vitamin C (V)
Vascular
Vitamin C (I1)
Infectious
Vitamin C (T)
Traumatic
Vitamin C (A)
Autoimmune
Vitamin C (M)
Metabolic
Vitamin C (I2)
Iatrogenic or idiopathic
Vitamin C (N)
neoplastic
Vitamin C (C)
Congentical
A complete head and neck exam includes examination of the ___, as well as the ___ ___?
Skin of the h & n, mucosal, and cranial nerves
The five Ws of post of fever?
Wind, water, walking, wound, wonder drugs
POD 1-2 Fever
Atelectasis
POD 3-5 Fever
Water (UTI)
POD 4-6 Fever
Walking (DVT)
POD 5-7 Fever
Wound
POD 7+ fever
Wonder drugs
Abscessed teeth can rupture through the medial mandibular cortex
into the sublingual space. This can cause the tongue to be pushed up
and back. The biggest danger in this is loss of _____________.
Airway
The easiest way to ensure that the airway isn’t lost in this situation is
to perform a ____________.
Tracheotomy
Immunocompromised patients, especially patients with diabetes, can
get a devastating fungal infection of the sinuses called
________________.
Mucormycosis
Necrotizing otitis externa is a Pseudomonas infection of the _______
and _____, which can lead to fatal complications.
Skull base or temporal bone
Often, _______ tissue is seen at the junction of the bony-cartilaginous
junction in the external auditory canal in patients with necrotizing
otitis externa.
Granulation
The most common cause of a nosebleed in children is injury to vessels
in ________________.
Kiesselbach’s plexs
A posterior nosebleed in an adolescent male is considered to be a
___________ until proven otherwise.
Juvenile nasopharygneal angiofibroma
Two topical vasoconstrictors often used in the nose are __________
and __________.
Oxymetazoline, phenylephrine
The most common organisms causing acute otitis media are
________, __________, and ________.
S. pneumoniae, H. influenzae, M. catarrhalis
The first-line antibiotic therapy for acute otitis media in children is
_______.
Amoxicillin
Children with persistent otitis media with effusion for ___ months
and evidence of hearing loss are candidates for PE tube placement.
Three
Ear drainage in patients with PE tubes in place should be treated with
_______________________.
Ototopical fluoroquinolone drops
The presence of bilateral fluid in the ears may cause up to a
__________ dB conductive hearing loss.
30-40
It is important to examine the ____________ in any adult with unilateral
otitis media with effusion.
Nasopharynx
In a patient with acute otitis media, in addition to being opaque and
bulging, the eardrum has ____________ mobility on pneumatic otoscopy.
Decreased
The collection of trabeculated bony cavities lined with mucosa and
connected with the middle ear is called the mastoid ______________.
Air Cells
The pars flaccida of the eardrum can become _______________when
there is chronic negative pressure in the middle ear.
Retracted
The outside of the TM, including the pars flaccida, is lined with
____________ epithelium.
Squamous
_________________ is suspected in a child presenting with fever, ear
pain, a protruding auricle, and fluctuance behind the ear.
Acute mastoiditis
In patients with chronic eustachian tube dysfunction, desquamated
debris, consisting mainly of keratin, collects in the retracted pars flaccida.
Over time, this can grow and become a __________.
cholesteatoma
If a patient presents with a draining ear, appropriate therapy includes
drops and ________________.
Oral antibiotics
If ear drainage persists despite medical therapy, the patient requires
referral to an otolaryngologist to rule out ______________.
Cholesteatoma
____________________is the firm submucosal scarring that can
appear as a chalky white patch on the eardrum.1. S. pneumoniae, H. influenzae, M. catarrhalis
Tympanosclerosis
The most common cause of a conductive hearing loss in children is
________________.
OM c effusion
The magnitude of a hearing loss is documented in the _______.
Audiogram
Conductive hearing loss is present when there is a difference between
__________ and _____________ conduction thresholds.
Air, Bone
Sensorineural hearing loss is present when air and bone conduction
thresholds are ______ but show a hearing loss.
Approximate, similar
Noise-induced hearing loss often produces a high-frequency
_________________ in the audiogram.
Notch
Otitis media with effusion produces a ______________ tympanogram.
Type B (flat)
Presbycusis produces a hearing loss that slopes to the _____________
side of the audiogram.
Downword, right
A patient with an asymmetric sensorineural hearing loss must be
evaluated for the potential of having an ________.
Acoustic neuroma
Dizziness lasting 30min-hours
Meniere’s
Vertigo less than one minute
BPPV
Vertigo lasting 24-48 hours
vestibular neuronitis
BPPV =
benign paroxysmal positional vertigo
Bell’s palsy is commonly due to __________ and should be treated
with ___________ and ________.
Viral or herpetic infection, steroids, antivirals
A patient complains of fatigue, low-grade fever, purulent rhinorrhea,
and headache that resolves within seven days. The most likely diagnosis
is a ______________________.
Common cold
A patient had a typical cold that did not resolve in 10 days and has
now had fatigue, purulent rhinorrhea, low-grade fever, and headache
for three weeks. The most likely diagnosis is________.
Acute rhinosinusitis
Another patient has similar symptoms for more than three months.
This patient has ____________.
Chronic rhinosinusitis
A common cause of nasal obstruction that is easily corrected by surgery
is a _________.
deviated septum
Triad asthma (Samter’s triad) consists of asthma, nasal polyposis, and \_\_\_\_\_\_\_\_\_\_\_\_.
asa allergy
Unilateral nasal polyps can either be caused by or be a manifestation
of a _________________, and therefore warrant referral to an otolaryngologist.
neoplasm
Any patient with symptoms of sinusitis and ____________ should be
referred to an otolaryngologist immediately.
double vision (why?)
Patients should see an otolaryngologist if they have ____ episodes of
sinusitis per year or if they have any ________ of sinusitis.
3-4, complication
In inhalant allergies, the T-helper cell system is abnormally weighted
toward the __________.
Th2
If both parents have inhalant allergies, a child has a __________ percent
chance of developing allergies.
60%
Mast cells contain preformed allergic mediators, including
__________, or _______________, or________________.
Histamine, proteoglycans, proteases
Medications that are a contraindication to allergy skin testing include
___________, or _____________, or ________________.
beta blockers, tricyclic antidepressants, monoamine oxidase inhibitors
Two reasons that oral endotracheal intubation may be contraindicated
are _______ and ___________.
A broken neck, massive trauma with distortion of landmarks and bleeding
A contraindication to blind nasotracheal or nasogastric intubation is
________________.
cribiform plate fracture
A fractured nose can be reduced in up to 14 days without complications;
however, a __________________________ must be ruled out
at the time of the initial fracture.
septal hematoma
Bacterial parotitis is most commonly caused by _________________.
Staph aureus
The most common tumor in the parotid gland is benign and is a
_____________________.
pleomorphic adenoma
The most common type of thyroid cancer is __________.
Papillary
The second most common type of thyroid cancer is ________.
Follicular
Patients with medullary carcinoma should have a urinary
___________ screen.
metanephrine
. The thyroid malignancy with the worst prognosis is __________
carcinoma.
Anaplastic
The most common histopathologic diagnosis for cancer of the upper
aerodigestive tract is _______________.
Squamous cell caricinoma
People who have one cancer of the upper aerodigestive tract may have
another primary malignancy in the upper aerodigestive tract. This is
called synchronous primary, which is one of the reasons why
______________ is performed.
triple endoscopy
Taking a biopsy and evaluation of the actual size of a tumor are two
other reasons why _________ is performed before final treatment of a
head and neck cancer.
endoscopy
Small head and neck cancers can often be treated with either
Surgery or radiation therapy
Large head and neck cancers are often treated with
Surgery, radiation, chemo
Squamous cell carcinoma of the head and neck usually metastasizes
to the lymph nodes in the ______________before going to other
sites.
neck
A radical neck dissection (RND) involves removing the sternocleidomastoid
muscle, the spinal accessory nerve, and the _____________,
jugular
The three most common types of skin cancer are__________,
_________ and___________.
Basal cell, squamous cell, malignant melanoma
Most basal cell carcinomas are nodular in appearance, with very distinct
borders, and are easily treatable. There is, however, a certain type
that has very indistinct borders. This is called _____.
morpheaform carcinoma
Certain basal cell carcinomas have a higher incidence of recurrence
than others. These include ________________, _______________
and _____________________.
recurrent, large, and morpheaform
Some basal cell carcinomas may be very close to vital structures, such
as the lower eyelid or the ala of the nose. In this case, maximum preservation
of tissue is a consideration, and these patients are candidates
for ______ surgery.
mohs’
Squamous cell carcinoma of the face is aggressive and commonly
metastasizes to the _______________.
cervical lymph nodes
The metastatic potential of malignant melanoma depends on
_____________.
tumor thickness
Four indications for performing tonsillectomy are ___________,
____________, ____________, and _____________.
Recurrent tonsillitis, chronic tonsillitis, obstructive sleep apnea,
asymmetric tonsils
A two-year-old boy presents with otitis media with effusion. The fluid
has been present in his ears for three months, despite treatment with a
three-week course of trimethoprim and sulfamethoxazole. His mother
says that he is having trouble hearing. He has had one set of PE
tubes in the past. You plan to place another set of PE tubes, and at this
time you think that the child may also benefit from an ________.
Adenoidectomy
Unilateral, foul-smelling rhinorrhea in a child is most commonly due
to a ____________.
Foreign body
A four-year-old girl presents at the emergency room with inspiratory
stridor and a fever of 103°F, and she is drooling and leaning forward.
Her mother states that the child was well four hours ago, and she
thinks that the child swallowed a stick because her throat hurts now
and she was playing with small sticks in the yard outside. Your first
concern is that this child may have ____________.
acute epiglottitis
You then call the anesthesiologist and pediatrician, but while waiting
for them to arrive, you notice that the child is starting to tire out. In
fact, she becomes so tired from trying to breathe that she simply
faints and ceases all attempts at respiration. The first thing you do for
this child is __________________.
bag and mask ventilation
Your next patient in the emergency room is a one-year-old boy who
presents with a chief complaint of stridor. He had a cold during this
past week. On examination, he is not sitting up or leaning forward,
and he is not drooling, but he has biphasic stridor. He does not have a
fever, but he has a barking cough. The most likely diagnosis in this
case is ________________________________.
croup
You therefore obtain a soft-tissue x-ray of the neck and a chest x-ray
to look for the classic steeple sign. You are surprised when you find
the child has actually aspirated a small metal object that appears to be
the tip of a pen. Removal is with a rigid ______________________.
bronchoscope
A multiloculated cystic neck mass in a newborn child that transilluminates
is most probably a __________________.
lymphatic malformation (lymphangioma)
A midline neck mass in a child that moves when the child sticks out
his tongue, but is otherwise not tender and is found in the area of the
hyoid bone, is most probably a ___________________________.
Thyroglossal duct cyst
A two-year-old child presents to you with a high fever and large,
painful, and inflamed left posterior triangle lymph nodes. The most
likely diagnosis is __________________.
cervical adentitis
Another two-year-old child presents without fever and with no pain,
but with large, firm lymph nodes in the posterior triangle of the neck.
There are no lesions in the scalp seen on examination. In fact, the
child seems to be almost oblivious to these nodes. The child does not
have a cat, and has not been recently scratched by a cat or a dog. The
most common cause of this type of neck mass in a child is
________________________.
atypical mycobacterial infection
A two-year-old boy presents to you with a fever of 103°F. His mother
says he has not eaten anything all day and has vomited once. His neck
is very stiff, and he will not move his head. He has had a cold over the
last three to four days. You do an exam and find that his ears are not
infected and he will not open his mouth at all, and he still will not
move his head. You obtain CSF with a lumbar puncture (after noting
the absence of papilledema on physical exam), and you send this to
the lab. It returns with normal glucose and protein concentrations
and no white blood cells. The opening and closing pressures are normal,
and the fluid is clear. Every time you try to look in the patient’s
throat, he turns away, gags, and screams. You are thinking he may
have retro or parapharyngeal cellulites or abscess, so you order a
_____________________________.
soft-tissue lateral neck x-ray
The lateral neck x-ray shows increased soft tissue thickness in the prevertebral
area, but the child’s head is bent down, and it is somewhat
difficult to diagnose a retropharyngeal abscess. The next diagnostic
study you need is _____________________.
Neckk CT with contrast
The CT scan shows a large retropharyngeal node that is rim enhancing
and has a central lucency. Appropriate antibiotic coverage for this
child would include covering the following organisms: _________
_______________, ____________, and ___________.
S. pneumoniae, H. influenzae, S. aureus, anaerobes
A two-year-old girl is brought by her mother for treatment of sinusitis.
She has been ill for two days and has a low-grade fever. Thick,
clear mucus is streaming from both nostrils, and her ears are clear.
She is otherwise awake, alert, and in no distress, and the rest of your
physical exam is normal. You should __________________.
Reassure the mother and recommend follow-up if symptoms worsen
or do not resolve within the next 10–14 days.
