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SmartyPance:EENT > EENT Comp - Sheet1 > Flashcards

EENT Comp - Sheet1 Flashcards

1
Q

A white plaque-like oral lesion which does scrape off?

A

Oral candidiasis

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2
Q

A white plaque-like oral lesion which does not scrape off?

A

Oral leukoplakia

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3
Q

What type of oropharyngeal infection are patients who use inhaled steroid inhalers likely to have?

A

Fungal

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4
Q

Presence of the Centor criteria are suggestive of group A strep pharyngitis. List the criteria.

A

Fever - Absence of cough - Tonsillar exudates - Tender cervical lymphadenopathy

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5
Q

What underlying disorders may be related to nasal polyps?

A

Asthma and ASA or NSAID allergy

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6
Q

Treatment for brachial cleft cyst?

A

Antibiotics for acute infection; surgical excision for definitive treatment

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7
Q

Worst and most aggressive type of thyroid cancer?

A

Anaplastic thyroid cancer

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8
Q

Risk factors for thyroid cancer?

A

Hx of radiation exposure - HX of goiter - female gender - Asian

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9
Q

Most common type of thyroid cancer?

A

Papillary

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10
Q

Most common type of laryngeal cancer?

A

Squamous cell

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11
Q

What is the Dx? Bacterial infection/cellulitis of the floor of the mouth (stems from root of the teeth) potentially life threatening.

A

Ludwig’s angina

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12
Q

Most common type of oral cancer?

A

Squamous cell (90%)

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13
Q

Do thyroid masses move with swallowing.

A

Yes

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14
Q

What disease is unilateral painless persistent cervical lymphadenopathy often linked to?

A

Hodgkin’s lymphoma

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15
Q

What is left supraclavicular adenopathy called?

A

Virchows node (often associated with lung/gastric malignancy)

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16
Q

Does thyroglossal duct cyst move with tongue protrusion?

A

Yes

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17
Q

What is the preferred treatment for a thyroglossal duct cyst?

A

Excision of cyst and tract (after acute infection resolves)

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18
Q

Medications that commonly cause gingival hyperplasia?

A

Phenytoin - Calcium Channel Blockers - Cyclosporine

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19
Q

What virus causes mumps?

A

Paramyxovirus

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20
Q

What is the Dx? Immigrant presents with fever and bilateral parotid swelling.

A

Mumps

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21
Q

Which salivary gland is most often affected with sialadenitis?

A

Parotid gland

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22
Q

Which salivary gland is most often affected with sialolithiasis?

A

Submandibular gland

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23
Q

Most common pathogen causing sialadenitis?

A

Staph aureus

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24
Q

Findings seen on lateral neck X-ray in patient with epiglottitis?

A

Thumbprint sign

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25
Q

Most common organism causing epiglottitis in children?

A

Haemophilus influenzae

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26
Q

Most common cause of Mononucleosis?

A

Epstein-Barr Virus (EBV)

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27
Q

What is the Dx? Pharyngitis with diffuse cervical lymphadenopathy and fever.

A

Mononucleosis

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28
Q

What is the Dx? A patient with pharyngitis is given amoxicillin and develops a macular-papular rash.

A

Likely mononucleosis (not bacterial)

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29
Q

What is the DX? Severe sore throat fever drooling muffled/hot potato voice uvula deviation.

A

Peritonsillar abscess

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30
Q

Pharyngitis with progressive growth of grey-white membrane?

A

Diphtheria

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31
Q

Complications of Strep throat (Group A strep)?

A

Rheumatic fever - Post streptococcal glomerulonephritis

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32
Q

Gold standard to diagnose bacterial pharyngitis?

A

Throat culture

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33
Q

Is the most common cause of pharyngitis viral or bacterial?

A

Viral

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34
Q

Treatment for nasal polyps?

A

Steroids or surgical removal

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35
Q

A child presents with foul smelling unilateral purulent nasal discharge. Most likely Dx?

A

Nasal foreign body

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36
Q

Most common site for posterior nose bleeds?

A

Woodruff’s plexus

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37
Q

Location of most anterior nose bleeds?

A

Kiesslebach’s plexus

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38
Q

Is the most common type of nosebleed an anterior or posterior bleed?

A

Anterior bleed

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39
Q

What is the Dx? Recurrent nasal congestion associated with pale/bluish boggy turbinates and allergic shiners.

A

Allergic Rhinitis

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40
Q

3 most common bacterial organisms causing sinusitis?

A

Strep Pneumo #1 - H. Influenzae #2 - M. Catarrhalis #3

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41
Q

Is the most common cause of sinusitis in adults viral or bacterial?

A

Viral

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42
Q

Recurrent episodes of vertigo exacerbated by head movements?

A

BPPV (Benign Paroxysmal positional vertigo)

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43
Q

Treatment for acute labyrinthitis?

A

Bed rest hydration diazepam and short course steroids if needed

44
Q

What is the DX? Acute vertigo associated with N/V tinnitus hearing loss in patient with no HX of vertigo.

A

Acute labyrinthitis (usually post infectious/viral)

45
Q

Is Meniere’s disease a peripheral or central cause of vertigo?

A

Peripheral vertigo

46
Q

What is the most likely type of vertigo in a patient with vertigo who has a positive Dix Hallpike maneuver?

A

BPPV (Benign Paroxysmal positional vertigo)

47
Q

What is the treatment for small tympanic membrane perforation?

A

Avoid water until healed in all types of rupture - oral antibiotics if caused by infection/AOM

48
Q

Treatment for otitis externa?

A

Topical antibiotic drops to affected ear (fluoroquinolone or other covering pseudomonas)

49
Q

Organism which causes malignant otitis externa?

A

Pseudomonas

50
Q

What is the Dx? Acute painful swollen auricle tragal tenderness and otorrhea.

A

Otitis externa

51
Q

Common cause of Cauliflower ear (recurrent damage to cartilage)?

A

Hematoma of the external ear

52
Q

What type of hearing loss is associated with Meniere’s disease?

A

Sensorineural hearing loss

53
Q

What type of hearing loss is associated with aging (presbycusis)?

A

Sensorineural hearing loss

54
Q

What type of hearing loss occurs with tympanic membrane rupture?

A

Conductive hearing loss

55
Q

What type of hearing loss is experienced with cerumen impaction?

A

Conductive hearing loss

56
Q

What should be done to remove a live insect from an ear?

A

Kill insect first with mineral oil or viscous lidocaine before attempting removal

57
Q

Treatment for cholesteatoma?

A

Surgical/possible stapedectomy with prosthesis placement

58
Q

Acute ear pain hemotympanum hearing loss after flying?

A

Barotrauma

59
Q

Slow growing benign tumor of the eight cranial nerve?

A

Acoustic neuroma/Schwannoma

60
Q

Treatment for chronic otitis media?

A

Myringotomy with T- Tube insertion

61
Q

3 most common organisms causing AOM (Acute Otitis Media)?

A

Strep Pneumo #1 - H. Influenzae #2 - M. Catarrhalis #3

62
Q

What is the Dx? Acute deep ear pain erythematous bulging tympanic membrane middle ear fluid and hearing loss.

A

Acute otitis media

63
Q

List two infectious diseases which may cause hearing loss?

A

Syphilis - Lyme disease

64
Q

What type of hearing loss will the Weber and Rinne tests assist in diagnosing?

A

Conductive

65
Q

Which topical antibiotics are not ototoxic and may be used with a tympanic membrane perforation?

A

Fluoroquinolones

66
Q

A 21 year old female presents with a solitary firm right cervical node for the last 2 months. What is the most appropriate next step?

A

Excisional biopsy and pathology to rule out Hodgkin lymphoma

67
Q

A 7 year old male presents with a soft, mid-line neck mass which rises with protrusion of his tongue. What is the most likely diagnosis?

A

Thyroglossal duct cyst

68
Q

Most thyroid cancer is successfully treated and has a very good prognosis. What type of thyroid cancer is aggressive and has a poor prognosis?

A

Anaplastic thyroid cancer

69
Q

Which multiple endocrine neoplasms (MEN) have medullary thyroid cancer?

A

MEN 2a and MEN 2b

70
Q

What is the most common primary source for metastasis to the lymph nodes of the neck?

A

85% of metastasis to the lymph nodes of the neck originates from primary tumors of the aerodigestive tract

71
Q

What is the most common cause of head and neck malignancy?

A

Metastasis to the lymph nodes of the neck

72
Q

An unvaccinated 6 year old male presents with bilateral parotid swelling and pain with eating. What is the most likely pathogen causing his condition?

A

Paramyxovirus

73
Q

What is the most common cause of acute non-suppurative sialadenitis in childhood?

A

Mumps

74
Q

A 45 year old male presents with progressive enlargement of his right submandibular gland over the last week. What is the most likely diagnosis?

A

Sialolithiasis

75
Q

What is the most common pathogen associated with sialadenitis? Which empiric antibiotic class should be used?

A

Staph. Aureus - Cephalosporins are first line

76
Q

What gastrointestinal disorder can lead to laryngitis if not treated?

A

GERD can cause laryngitis as acid may burn the laryngeal structures at night

77
Q

A 68 year old male drinker presents with 3 months of hoarseness. What condition must be considered?

A

Squamous cell carcinoma

78
Q

You have hospitalized your patient who had presented with a peritonsillar abscess. What antibiotics would be appropriate choices for empiric therapy?

A

IV ampicillin/sulbactam or clindamycin

79
Q

A 16 year old with infectious mononucleosis asks if he can play football this weekend. What should you advise him?

A

He may not - Activity must be limited due to the increased chance of splenic rupture

80
Q

A patient with persistent pharyngitis, negative throat culture and a history of multiple sexual encounters is likely to have infection with what organism?

A

Neisseria gonorrhoeae

81
Q

A patient presents with sore throat. She is drooling, unable to speak and exam finds deviation of her uvula. Should you send her home with oral antibiotics?

A

Patient must be hospitalized with peri-tonsillar abscess - Needs airway monitored and I&D of abscess

82
Q

A 26 year old male has dark urine 2 weeks after pharyngitis. UA shows red blood cell casts. What laboratory test can be drawn to support your suspicions?

A

ASO titer in patient with signs of post-streptococcal glomerulonephritis

83
Q

A patient with chronic sinusitis has large nasal growths which resemble peeled seedless grapes. What is the most likely cause of her chronic sinusitis?

A

Obstruction from nasal polyps

84
Q

Patients who have nasal packing placed to control epistaxis must a have close follow up to remove packing in order to decrease the chance of what complication?

A

Toxic Shock Syndrome

85
Q

What anatomical location is the most common site of posterior epistaxis?

A

Woodruff’s Plexus is the most common site for posterior nose bleeds

86
Q

What anatomical location is the most common site of anterior epistaxis?

A

Kiesslebach’s Plexus or Little’s Area is the most common site of anterior nosebleeds

87
Q

What is the first line treatment for bacterial sinusitis?

A

First line empiric treatment: Amoxicillin-clavulanic acid - Consider doxycycline, levofloxacin or moxifloxacin

88
Q

A 6 year old male with chronic sinusitis presents for ENT evaluation. Enlargement of what structures is likely to be found?

A

Enlarged adenoids

89
Q

A 33 year old male presents with chronic sinusitis. Cultures find fungal pathology. What underlying disorders should be considered?

A

Immunocompromise - Uncontrolled diabetes - Neutropenia - Glucocorticosteroid use - Nosocomial infection

90
Q

What is the best imaging modality for acoustic neuroma?

A

MRI

91
Q

Bilateral acoustic neuroma only occurs with which disorder?

A

Neurofibromatosis type II

92
Q

What finding would help to differentiate between labyrinthitis and vestibular neuronitis?

A

Labyrinthitis commonly has hearing loss - Vestibular neuronitis does not have hearing loss

93
Q

What condition is most likely in a patient with acute vertigo who was recently diagnosed with toxoplasmosis?

A

Vestibular neuronitis

94
Q

Vertigo and hearing loss after acute otitis media with a normal otoscopic exam is the most likely what diagnosis?

A

Labyrinthitis

95
Q

What symptoms comprise the classic triad of Meniere’s?

A

Low frequency hearing loss - Tinnitus with aural fullness - Vertigo

96
Q

What condition must be ruled out in a patient who presents with vertigo and syncope?

A

Vertigo + syncope = vertebral basilar insufficiency until proven otherwise

97
Q

A 25 year old female has dizziness and a positive Dix-Hallpike. Her initial work up is negative. What is the most likely diagnosis?

A

Benign Paroxysmal Positional Vertigo

98
Q

What is the most common pathogen in fungal otitis externa?

A

Aspergillus causes 90% of cases

99
Q

Which medical condition predisposes patient to malignant otitis externa?

A

Diabetes

100
Q

What pathogen is responsible for malignant otitis externa?

A

Pseudomonas

101
Q

What diagnostic test can best confirm the diagnosis of mastoiditis?

A

CT scan

102
Q

How long can a patient with an external hematoma of the ear wait to see the ENT?

A

He should be seen ASAP, goal < 7 days

103
Q

A 5 year old female presents with large insect which is still moving in his ear. What must be done prior to further action?

A

Drown the insect before removal

104
Q

Pain, decreased hearing and bloody drainage from the ear after a recent diving trip is the most likely what diagnosis?

A

Tympanic membrane perforation due to barotrauma

105
Q

Most otitis media is caused by viral agents. What is the recommended first line treatment for a patient who has a bacterial otitis media?

A

Penicillin based antibiotics such as amoxicillin

106
Q

What are the three most common organisms involved in otitis media?

A

Streptococcus pneumoniae - Hemophilus influenzae - Moraxella catarrhalis

SmartyPance:EENT (3 decks)

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