EENT Comp - Sheet1 Flashcards
1
Q
A white plaque-like oral lesion which does scrape off?
A
Oral candidiasis
2
Q
A white plaque-like oral lesion which does not scrape off?
A
Oral leukoplakia
3
Q
What type of oropharyngeal infection are patients who use inhaled steroid inhalers likely to have?
A
Fungal
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
5
Q
What underlying disorders may be related to nasal polyps?
A
Asthma and ASA or NSAID allergy
6
Q
Treatment for brachial cleft cyst?
A
Antibiotics for acute infection; surgical excision for definitive treatment
7
Q
Worst and most aggressive type of thyroid cancer?
A
Anaplastic thyroid cancer
8
Q
Risk factors for thyroid cancer?
A
Hx of radiation exposure - HX of goiter - female gender - Asian
9
Q
Most common type of thyroid cancer?
A
Papillary
10
Q
Most common type of laryngeal cancer?
A
Squamous cell
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
12
Q
Most common type of oral cancer?
A
Squamous cell (90%)
13
Q
Do thyroid masses move with swallowing.
A
Yes
14
Q
What disease is unilateral painless persistent cervical lymphadenopathy often linked to?
A
Hodgkin’s lymphoma
15
Q
What is left supraclavicular adenopathy called?
A
Virchows node (often associated with lung/gastric malignancy)
16
Q
Does thyroglossal duct cyst move with tongue protrusion?
A
Yes
17
Q
What is the preferred treatment for a thyroglossal duct cyst?
A
Excision of cyst and tract (after acute infection resolves)
18
Q
Medications that commonly cause gingival hyperplasia?
A
Phenytoin - Calcium Channel Blockers - Cyclosporine
19
Q
What virus causes mumps?
A
Paramyxovirus
20
Q
What is the Dx? Immigrant presents with fever and bilateral parotid swelling.
A
Mumps
21
Q
Which salivary gland is most often affected with sialadenitis?
A
Parotid gland
22
Q
Which salivary gland is most often affected with sialolithiasis?
A
Submandibular gland
23
Q
Most common pathogen causing sialadenitis?
A
Staph aureus
24
Q
Findings seen on lateral neck X-ray in patient with epiglottitis?
A
Thumbprint sign
25
Most common organism causing epiglottitis in children?
Haemophilus influenzae
26
Most common cause of Mononucleosis?
Epstein-Barr Virus (EBV)
27
What is the Dx? Pharyngitis with diffuse cervical lymphadenopathy and fever.
Mononucleosis
28
What is the Dx? A patient with pharyngitis is given amoxicillin and develops a macular-papular rash.
Likely mononucleosis (not bacterial)
29
What is the DX? Severe sore throat fever drooling muffled/hot potato voice uvula deviation.
Peritonsillar abscess
30
Pharyngitis with progressive growth of grey-white membrane?
Diphtheria
31
Complications of Strep throat (Group A strep)?
Rheumatic fever - Post streptococcal glomerulonephritis
32
Gold standard to diagnose bacterial pharyngitis?
Throat culture
33
Is the most common cause of pharyngitis viral or bacterial?
Viral
34
Treatment for nasal polyps?
Steroids or surgical removal
35
A child presents with foul smelling unilateral purulent nasal discharge. Most likely Dx?
Nasal foreign body
36
Most common site for posterior nose bleeds?
Woodruff's plexus
37
Location of most anterior nose bleeds?
Kiesslebach's plexus
38
Is the most common type of nosebleed an anterior or posterior bleed?
Anterior bleed
39
What is the Dx? Recurrent nasal congestion associated with pale/bluish boggy turbinates and allergic shiners.
Allergic Rhinitis
40
3 most common bacterial organisms causing sinusitis?
Strep Pneumo #1 - H. Influenzae #2 - M. Catarrhalis #3
41
Is the most common cause of sinusitis in adults viral or bacterial?
Viral
42
Recurrent episodes of vertigo exacerbated by head movements?
BPPV (Benign Paroxysmal positional vertigo)
43
Treatment for acute labyrinthitis?
Bed rest hydration diazepam and short course steroids if needed
44
What is the DX? Acute vertigo associated with N/V tinnitus hearing loss in patient with no HX of vertigo.
Acute labyrinthitis (usually post infectious/viral)
45
Is Meniere's disease a peripheral or central cause of vertigo?
Peripheral vertigo
46
What is the most likely type of vertigo in a patient with vertigo who has a positive Dix Hallpike maneuver?
BPPV (Benign Paroxysmal positional vertigo)
47
What is the treatment for small tympanic membrane perforation?
Avoid water until healed in all types of rupture - oral antibiotics if caused by infection/AOM
48
Treatment for otitis externa?
Topical antibiotic drops to affected ear (fluoroquinolone or other covering pseudomonas)
49
Organism which causes malignant otitis externa?
Pseudomonas
50
What is the Dx? Acute painful swollen auricle tragal tenderness and otorrhea.
Otitis externa
51
Common cause of Cauliflower ear (recurrent damage to cartilage)?
Hematoma of the external ear
52
What type of hearing loss is associated with Meniere's disease?
Sensorineural hearing loss
53
What type of hearing loss is associated with aging (presbycusis)?
Sensorineural hearing loss
54
What type of hearing loss occurs with tympanic membrane rupture?
Conductive hearing loss
55
What type of hearing loss is experienced with cerumen impaction?
Conductive hearing loss
56
What should be done to remove a live insect from an ear?
Kill insect first with mineral oil or viscous lidocaine before attempting removal
57
Treatment for cholesteatoma?
Surgical/possible stapedectomy with prosthesis placement
58
Acute ear pain hemotympanum hearing loss after flying?
Barotrauma
59
Slow growing benign tumor of the eight cranial nerve?
Acoustic neuroma/Schwannoma
60
Treatment for chronic otitis media?
Myringotomy with T- Tube insertion
61
3 most common organisms causing AOM (Acute Otitis Media)?
Strep Pneumo #1 - H. Influenzae #2 - M. Catarrhalis #3
62
What is the Dx? Acute deep ear pain erythematous bulging tympanic membrane middle ear fluid and hearing loss.
Acute otitis media
63
List two infectious diseases which may cause hearing loss?
Syphilis - Lyme disease
64
What type of hearing loss will the Weber and Rinne tests assist in diagnosing?
Conductive
65
Which topical antibiotics are not ototoxic and may be used with a tympanic membrane perforation?
Fluoroquinolones
66
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?
Excisional biopsy and pathology to rule out Hodgkin lymphoma
67
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?
Thyroglossal duct cyst
68
Most thyroid cancer is successfully treated and has a very good prognosis. What type of thyroid cancer is aggressive and has a poor prognosis?
Anaplastic thyroid cancer
69
Which multiple endocrine neoplasms (MEN) have medullary thyroid cancer?
MEN 2a and MEN 2b
70
What is the most common primary source for metastasis to the lymph nodes of the neck?
85% of metastasis to the lymph nodes of the neck originates from primary tumors of the aerodigestive tract
71
What is the most common cause of head and neck malignancy?
Metastasis to the lymph nodes of the neck
72
An unvaccinated 6 year old male presents with bilateral parotid swelling and pain with eating. What is the most likely pathogen causing his condition?
Paramyxovirus
73
What is the most common cause of acute non-suppurative sialadenitis in childhood?
Mumps
74
A 45 year old male presents with progressive enlargement of his right submandibular gland over the last week. What is the most likely diagnosis?
Sialolithiasis
75
What is the most common pathogen associated with sialadenitis? Which empiric antibiotic class should be used?
Staph. Aureus - Cephalosporins are first line
76
What gastrointestinal disorder can lead to laryngitis if not treated?
GERD can cause laryngitis as acid may burn the laryngeal structures at night
77
A 68 year old male drinker presents with 3 months of hoarseness. What condition must be considered?
Squamous cell carcinoma
78
You have hospitalized your patient who had presented with a peritonsillar abscess. What antibiotics would be appropriate choices for empiric therapy?
IV ampicillin/sulbactam or clindamycin
79
A 16 year old with infectious mononucleosis asks if he can play football this weekend. What should you advise him?
He may not - Activity must be limited due to the increased chance of splenic rupture
80
A patient with persistent pharyngitis, negative throat culture and a history of multiple sexual encounters is likely to have infection with what organism?
Neisseria gonorrhoeae
81
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?
Patient must be hospitalized with peri-tonsillar abscess - Needs airway monitored and I&D of abscess
82
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?
ASO titer in patient with signs of post-streptococcal glomerulonephritis
83
A patient with chronic sinusitis has large nasal growths which resemble peeled seedless grapes. What is the most likely cause of her chronic sinusitis?
Obstruction from nasal polyps
84
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?
Toxic Shock Syndrome
85
What anatomical location is the most common site of posterior epistaxis?
Woodruff's Plexus is the most common site for posterior nose bleeds
86
What anatomical location is the most common site of anterior epistaxis?
Kiesslebach's Plexus or Little's Area is the most common site of anterior nosebleeds
87
What is the first line treatment for bacterial sinusitis?
First line empiric treatment: Amoxicillin-clavulanic acid - Consider doxycycline, levofloxacin or moxifloxacin
88
A 6 year old male with chronic sinusitis presents for ENT evaluation. Enlargement of what structures is likely to be found?
Enlarged adenoids
89
A 33 year old male presents with chronic sinusitis. Cultures find fungal pathology. What underlying disorders should be considered?
Immunocompromise - Uncontrolled diabetes - Neutropenia - Glucocorticosteroid use - Nosocomial infection
90
What is the best imaging modality for acoustic neuroma?
MRI
91
Bilateral acoustic neuroma only occurs with which disorder?
Neurofibromatosis type II
92
What finding would help to differentiate between labyrinthitis and vestibular neuronitis?
Labyrinthitis commonly has hearing loss - Vestibular neuronitis does not have hearing loss
93
What condition is most likely in a patient with acute vertigo who was recently diagnosed with toxoplasmosis?
Vestibular neuronitis
94
Vertigo and hearing loss after acute otitis media with a normal otoscopic exam is the most likely what diagnosis?
Labyrinthitis
95
What symptoms comprise the classic triad of Meniere's?
Low frequency hearing loss - Tinnitus with aural fullness - Vertigo
96
What condition must be ruled out in a patient who presents with vertigo and syncope?
Vertigo + syncope = vertebral basilar insufficiency until proven otherwise
97
A 25 year old female has dizziness and a positive Dix-Hallpike. Her initial work up is negative. What is the most likely diagnosis?
Benign Paroxysmal Positional Vertigo
98
What is the most common pathogen in fungal otitis externa?
Aspergillus causes 90% of cases
99
Which medical condition predisposes patient to malignant otitis externa?
Diabetes
100
What pathogen is responsible for malignant otitis externa?
Pseudomonas
101
What diagnostic test can best confirm the diagnosis of mastoiditis?
CT scan
102
How long can a patient with an external hematoma of the ear wait to see the ENT?
He should be seen ASAP, goal < 7 days
103
A 5 year old female presents with large insect which is still moving in his ear. What must be done prior to further action?
Drown the insect before removal
104
Pain, decreased hearing and bloody drainage from the ear after a recent diving trip is the most likely what diagnosis?
Tympanic membrane perforation due to barotrauma
105
Most otitis media is caused by viral agents. What is the recommended first line treatment for a patient who has a bacterial otitis media?
Penicillin based antibiotics such as amoxicillin
106
What are the three most common organisms involved in otitis media?
Streptococcus pneumoniae - Hemophilus influenzae - Moraxella catarrhalis
