ENT Flashcards by Sam Biniazan

Most common cause of conductive hearing loss

Effusion

How well did you know this?

Not at all

Perfectly

Keratinization of the epithelial cells in the middle ear
Cystic-like mass
Result of chronic suppurative otitis media or chronic Eustachian tube dysfunction
Develop behind mid anterior quadrant of TM
Dissolve bone and reach CNS

Cholesteatoma

How well did you know this?

Not at all

Perfectly

Most common cause of sensorineural hearing loss

Congenital CMV

How well did you know this?

Not at all

Perfectly

Sudden onset of bilateral sensorineural hearing loss

Viral labyrinthitis

How well did you know this?

Not at all

Perfectly

Most common cause of acquired sensorineural hearing loss in childhood

Bacterial meningitis

How well did you know this?

Not at all

Perfectly

Most common cause of acquired sensorineural hearing loss on childhood

Bacterial meningitis

How well did you know this?

Not at all

Perfectly

Test the vestibulocochlear nerve’s response to sound

Auditory brainstorm response (ABR)

How well did you know this?

Not at all

Perfectly

Test the hair cell function
Measures sounds that are made by the cochlea

Otoacoustic emissions (OAE)

How well did you know this?

Not at all

Perfectly

Middle ear function
Response to change in air pressure

Tympanometry

How well did you know this?

Not at all

Perfectly

Type A tympanogram

Normal

How well did you know this?

Not at all

Perfectly

Type As tympanogram

Shallow amplitude

TM scarring
Otisclerosis
Ossicular fixation

How well did you know this?

Not at all

Perfectly

Type Ad tympanogram

Higher amplitude

Ossicular disarticulation

How well did you know this?

Not at all

Perfectly

Type B tympanogram

No peak, Flat line, Low amplitude

Stiff membrane
Middle ear fluid
Obstructed tympanostomy tube

High amplitude - continuity between middle and outer ear with perforated TM

Absence of pressure or mobility

How well did you know this?

Not at all

Perfectly

Type C tympanogram

Left shifted peaked graph

Eustachian tube dysfunction
Conductive hearing loss is likely

How well did you know this?

Not at all

Perfectly

Diagnostic criteria for acute otitis media

Best diagnostic test

Recent abrupt onset (< 48 hr)
Bulging TM with effusion
Erythema of TM

Pneumatic otoscopy

How well did you know this?

Not at all

Perfectly

Most common bacterial for acute otitis media

Strep pneumo
H flu
Moraxella catarrhalis
GAS

How well did you know this?

Not at all

Perfectly

Most common bacteria for acute otitis media

How well did you know this?

Not at all

Perfectly

Purulent ear drainage for > 6 wk

Most common cause
Treatment

Chronic suppurative otitis media

Pseudomonas
Topical/otic ofloxacin

How well did you know this?

Not at all

Perfectly

Treatment of choice for recurrent otitis media

Tympanostomy tubes

How well did you know this?

Not at all

Perfectly

Antibiotic choose for otitis media

1) high dose Amoxicillin (90mg/kg/day)

2) Augmentin

3) ceftriaxone IM x 3 days

How well did you know this?

Not at all

Perfectly

Pain with pinna manipulation

Usual cause

Otitis externa

Pseudomonas

How well did you know this?

Not at all

Perfectly

Most common suppurative complication of acute otitis media
Postauricular swelling
Tender masotoid
Outwardly displaced pinna

Diagnostic test

Mastoiditis

CT and tympanocentesis

How well did you know this?

Not at all

Perfectly

Self-limited vertigo
No vomiting or LOC
Nystagmus
1-4 yo
Strong family h/o migraines

Benign paroxysmal vertigo of childhood

How well did you know this?

Not at all

Perfectly

Most common causes of rhinitis

Allergy
Sinusitis
Polyps
Cystic fibrosis
Foreign body

How well did you know this?

Not at all

Perfectly

Causes of nasal polyps

Cystic fibrosis (most common) Aspirin sensitivity Asthma Allergic rhinitis Chronic/recurrent sinusitis

Cyanosis while feeding Resolution with crying

Bilateral choanal atresia

Common bacteria of sinusitis

Pneumococcus H flu Moraxella

When sinuses develop Maxillary Ethmoid Frontal Sphenoid

Birth Birth 5-6 years 5-6 years

Study of choice for chronic recurrent sinusitis

Unilateral Blood tinged Nasal discharge Foul odor

Nasal foreign body

Recurrent/worsening epistaxis

Posterior nasopharyngeal angiofibroma

Reasons for recurrent strep pharyngitis symptoms following treatment

Chronic carrier state (repeat cultire) Second infection Noncompliance

Strep + HSM

Mono EBV or CMV

Diagnostic eval for mono

> 4 yo: monospot < 4 yo: viral-specific IgM

Sexually active teenager Erythematous patches

Gonococcal pharyngitis

Widening of retropharyngeal space or if the paravertebral soft tissue

Retropharyngeal abscess

Indications for tonsillectomy

Repeated infections —7 in 1yr —5 per year x2 —3 per year x 3 Airway obstruction Malignancy

Indications for adenoidectomy

Chronic sinusitis Chronic adenoiditis OSA

Complications of T&A Hypernasal voice

Velopharyngeal insufficiency

Biphasic stridor Refusal to lay down Leaning forward Drooling “Thumb sign” Treatment

Epiglottitis Airway management Ceftriaxone

4-5mm ulcers Posterior oral cavity Spares gums and tongue

Herpangina Coxsackievirus group A

Grayish-white coagulum Thin rim of bright erythema

Aphthous ulcer (Canker sore)

Tender red nodule on cheek Deep seated plaques and nodules Infant

Cold-induced panniculitis

Normal waiting time for first toot eruption

16 mo

Common causes of delayed eruption

Hypothyroid Hypopituitarism Ectodermal hypoplasia Hypohidrosis Rickets

Transportation of Avulsed permanent tooth

Saliva or milk

Micrognathia Posteriorly displaced tongue U-placed cleft palate

Pierre Robin sequence (Failure of mandible to grow properly)

When to repair cleft lip

10 weeks

When to repair cleft palate

9-12 mo + pressure equalizing tubes

Syndromes associated with cleft palate

Pierre robin Crouzon Apert Treacher collins

Treatment of choice for OSA

Adenoidectomy

Most likely cause for post T&A (for OSA) respiratory distress

Pulmonary edema

Causes of inspiratory stridor

4-6 wk: laryngo/tracheomalacia 1-4 yr: croup, Epiglottitis, foreign body > 5 yo: vocal cord dysfunction, PTA, anaphylaxis Tonsillar/adenoid hypertrophy Masses

Most common cause of congenital stridor

Laryngomalacia

Suprasternal/subcostal retractions Stridor worsens with agitation Stridor worsens in supine position Stridor improves with expiration and time No feeding difficulties

Laryngomalacia

Blunted inspiratory loop on spirometer Weak, high-pitched cry Diagnostic evaluation

Vocal cord paralysis Flex nasolaryngoscopy or direct laryngoscope CXR Barium swallow

Progressive, chronic hoarseness No stridor or dysphagia

Vocal cord nodules

Expiratory stridor Feeding difficulties Diagnostic evaluation

Vascular ring Barium swallow

Biphasic stridor Diagnostic evaluation

Subglottic stenosis Direct laryngoscope and bronchoscopy

Steeple sign on CXR Subglottic narrowing

Croup

Barky nonproductive cough Allergies Psychological No URI or fevers

Spasmodic croup

Preauricular adenoapthy Conjunctivitis

Adenovirus

Neck mass Reactive Mobile Tender Not warm or erythematous

Cervical adenopathy

Bilateral cervical lymphadenitis

Viral

Unilateral lymphadenitis Treatment

Bacterial Augmentin + clindamycin

Neck mass Infected Tender Red and warm

Lymphadenitis

Persistent sun mental and submandivular lymph node swelling PPD < 10 mm Violaceous (purplish) hue Management

Atypical (NonTB) mycobacteria Leave it alone

Cervical adenitis not improving with antibiotics

Mycobacterium TB (Positive IGRA)

Nontender lymph node Nonmobile

Neoplasm/malignant

#1 congenital cyst in the neck

Thyroglossal duct cyst

Midline anterior neck lesion Moves upward with swallowing or sticking tongue out

Thyroglossal duct cyst

Mass of dilated lymph vessels Turner syndrome

Cystic hygroma

Remnant located anterior to sternocleidomastoid muscle

Branchial cleft remnant

Cystic mass Pea sized Overlying pore Anterior sternocleidomastoid muscle

Branchial cleft cyst