ENT

Question 0

aspirin related hearing loss

Description and time course

Answer 0

Described as high pitched tinnitus

reversible in a week after its off

Question 1

squamous debris on TM after chronic purulent ear infx OR foul smelling discharge despite tx of perfed TM
Dx and tx?

Answer 1

Choleastoma, refer to ENT

Question 2

what is the deal with hearing loss assoc w/ meningitis

Answer 2

usu w/in 1st 24 hours, not related to severity of illness etc.

Question 3

what is behavioral observational audiometry and when is it used?

Answer 3

for infants < 6 mos, screening only. if failed need ABR

Question 4

what is visual reinforcement audiometry and when is it used?

Answer 4

for preschools to test for b/l hearing loss that interferes with language

Question 5

tympanometry, describe and the dz:

1. flat
2. high
3. volume

Answer 5

flat: stiff membrane/middle ear fluid/obstructed tube
high: hypermobile TM
high volume: perfed TM/continuity between middle/outer ear, absence of pressure or mobility

Question 6

acute onset of unsteadiness and decreased hearing

Dx and tx

Answer 6

acute perilymph fistula - refer to ENT

Question 7

benefit of tympanostomy tubes in recurrent AOM

Answer 7

prevent cholesteoma

Question 8

most common cause of suppurative otitis media AND how to dx from cholesteatoma. How to distinguish. Tx?

Answer 8

absence of keratinized epithelial tissue rules out cholesteatoma
Cause of suppurative otitis is psedomonas or staph, tx w/ topical ofloxacin

Question 9

complication of tympanostomy tube causing bloody d/c and red mass

Answer 9

granuloma

Question 10

cyanosis with feeding, resolves with crying

Dx

Answer 10

choanal atresia (blocked nasal)

Question 11

widening of retropharyngeal space… child is < 4, and will hyperextend neck

Answer 11

retropharyngeal abscess

Question 12

greyish coagulum w/ thin rim of bright erythema

Answer 12

aphthous ulcer / canker sore

Question 13

tender red nodule on cheek after cold pacifier?

Answer 13

cold induced panniculitis

self resolves

Question 14

wet variably pitched stridor vs high pitched stridor and weak cry vs hoarseness

Answer 14

wet: laryngomalacia
hi/weak: paralyzed vocal cords (b/l)
hoarse: unilateral cord paralysis

Question 15

weak cry w/ no effect changing positions. Constant

Answer 15

laryngeal web

Question 16

tracheo vs laryngomalacia

Answer 16

tracheal: expiratory stridor
laryngo: inspiratory stridor

Question 17

feeding difficulties and expiratory stridor

Answer 17

think of a vascular ring around the trachea and esoph

Question 18

biphasic stridor (insp/exp)

Answer 18

congenital / acquired subglottic stenosis often with louder inspiratory stridor
supraglottic / epiglottitis

Question 19

position difference in epiglottitis vs bacterial tracheitis

Answer 19

sitting forward drooling in epiglottitis

supine in tracheitis

Question 20

which test to order?

1. subglottic stenosis
2. vocal cord dysfunction
3. vascular ring

Answer 20

1. direct laryngoscopy, bronchoscopy
2. flexible nasolaryngoscopy/DLB, CXR, barium swallow
3. barium swallow

Question 21

viral croup other name

Answer 21

laryngotracheobronchitis

Question 22

bifid uvula should have you think of what? study?

Answer 22

submucus cleft palate

do tympanometry to assess mobility of TM

Question 23

preauricular adenopathy and conjunctivitis

Answer 23

adenovirus

Question 24

chronic adenopathy, HSM, exposure to farm animals or unpasteurized milk ingestion

Answer 24

brucellosis

Question 25

most common cause of bacterial parotitis

Answer 25

staph aureus

Question 26

cleft lip/palate combo more common in boys or girls?

Answer 26

more common in boys.