Clinical Fundamentals Flashcards
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___ therapy is associated with development of nutritional deficiencies, CAP, osteopenia, atrophic gastritis and C.diff.
PPI therapy
What is the role of HPV as a causative agent in laryngeal cancer?
has not been established
Idiopathic VF paralysis comprises ___ of all cases of unilateral VF paralysis.
25%
Tracheo-innominate fistula risk is highest between __ weeks following tracheostomy.
3-4 weeks
What hormone decreases LES pressure?
Glucagon
Approximately __% of VC paralysis in children is b/l.
50%
__ is the first-line treatment for VC nodules.
Voice therapy
The GRBAS voice assessment scale stands for ___, and evaluates voice quality.
Grade (overall degree of voice abnormality)
Roughness
Breathiness
Asthenia (voice weakness)
Strain
Graded 0-3 on 4pt scale
As we age, vocal cord tissue collagen ___ and elastin ___
Collagen increases, and Elastin decreases
An idopathic cough (no structural abnormality or laryngopharyntitis) can be treated with a trial of ___.
Amitriptyline
What component of refluxate causes pharyngeal and laryngeal inflammation?
Pepsin (**produced by chief cells)
laryngeal EMG (LEMG) is most reliable at identifying when a VC *will/will not recover?
will not
The earliest time point where LEMG fibrillation potentials and positive sharp waves may be seen on LEMG is ___ weeks?
3 weeks
Zargar classification:
Grade __: Edema and erythema of the mucosa
Grade I
Zargar classification:
Grade __: extensive deep gray necrosis or brownish/black ulcers
Grade 3B
Zargar classification:
Grade __: Normal mucosa
Grade 0
Zargar classification:
Grade __: circumferential and deep ulcerations
Grade 2B
Zargar classification:
Grade __: Perforation
Grade 4
Zargar classification:
Grade __: Hemorrhage, erosions, blisters, superficial localized ulcers
Grade 2A
Zargar classification:
Grade __: Focal deep gray or brownish/black ulcers
Grade 3A
Diagnosis and Treatment
Intubation granuloma.
Tx: anti-reflux meds, PPI, diet reflux precautions
_____ causes endothelial edema and thickening of arterioles/arteries.
Radiation therapy
_____ has been linked to reduced collagen synthesis.
Hypothyroidism
___ leads to diminished fibroblast activity and reduced collagen synthesis.
Protein deficiency
___ impairs wound healing by reducing RBC proliferation and O2 transport.
Nicotine
False negative stimulation using intraoperative nerve monitoring can occur due to:
1)_
2) distal stimulation relative to the injured nerve segment
3) delayed neuropraxia (traumatic peripheral nerve injury)
3) injury subsequent to the last testing stimulation
False negative stimulation using intraoperative nerve monitoring can occur due to:
1) posterior branch injury (branch to the PCA)
2) distal stimulation relative to the injured nerve segment
3) delayed neuropraxia (traumatic peripheral nerve injury)
3) injury subsequent to the last testing stimulation
False negative stimulation using intraoperative nerve monitoring can occur due to:
**1) **
2) distal stimulation relative to the injured nerve segment
3) delayed neuropraxia (traumatic peripheral nerve injury)
4) injury subsequent to the last testing stimulation
False negative stimulation using intraoperative nerve monitoring can occur due to:
1) posterior branch injury (branch to the PCA)
2) distal stimulation relative to the injured nerve segment
3) delayed neuropraxia (traumatic peripheral nerve injury)
4) injury subsequent to the last testing stimulation
False negative stimulation using intraoperative nerve monitoring can occur due to:
1) posterior branch injury (branch to the PCA)
2) _
3) delayed neuropraxia (traumatic peripheral nerve injury)
4) injury subsequent to the last testing stimulation
False negative stimulation using intraoperative nerve monitoring can occur due to:
1) posterior branch injury (branch to the PCA)
2) distal stimulation relative to the injured nerve segment
3) delayed neuropraxia (traumatic peripheral nerve injury)
4) injury subsequent to the last testing stimulation
False negative stimulation using intraoperative nerve monitoring can occur due to:
1) posterior branch injury (branch to the PCA)
2) _
3) delayed neuropraxia (traumatic peripheral nerve injury)
4) injury subsequent to the last testing stimulation
False negative stimulation using intraoperative nerve monitoring can occur due to:
1) posterior branch injury (branch to the PCA)
2) distal stimulation relative to the injured nerve segment
3) delayed neuropraxia (traumatic peripheral nerve injury)
4) injury subsequent to the last testing stimulation
False negative stimulation using intraoperative nerve monitoring can occur due to:
1) posterior branch injury (branch to the PCA)
2) distal stimulation relative to the injured nerve segment
3)_
4) injury subsequent to the last testing stimulation
False negative stimulation using intraoperative nerve monitoring can occur due to:
1) posterior branch injury (branch to the PCA)
2) distal stimulation relative to the injured nerve segment
3) delayed neuropraxia (traumatic peripheral nerve injury)
4) injury subsequent to the last testing stimulation
False negative stimulation using intraoperative nerve monitoring can occur due to:
1) posterior branch injury (branch to the PCA)
2) distal stimulation relative to the injured nerve segment
3) delayed neuropraxia (traumatic peripheral nerve injury)
4) _
False negative stimulation using intraoperative nerve monitoring can occur due to:
1) posterior branch injury (branch to the PCA)
2) distal stimulation relative to the injured nerve segment
3) delayed neuropraxia (traumatic peripheral nerve injury)
4) injury subsequent to the last testing stimulation
The use of __ significantly reduces the prevalence of dysphonia in long-term inhaler users
Metered dose inhaler + Spacer
How does menopause affect the voice (in terms of frequency)?
Decreases fundamental frequency by 25 Hz
___ medication can improve the chance of RLN and FN recovery after injury.
Nimodipine (Ca-channel blocker)
Patient intubated x3wks. On exam, you hear a breathy voice and decreased volume. b/l VCs are mobile and the membranous cords appear normal. A still of the larynx is shown. Diagnosis?
Post-intubation phonatory insufficiency (a.k.a. posterior glottic diastasis/insufficiency), resulting from ulceration of the arytenoids’ medial mucosa w/associated scar 2/2 prolonged orotracheal intubation.
Most common treatment options for posterior glottic stenosis:
Cordotomy w/arytenoidectomy
