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Clinical Medicine > ENT > Flashcards

ENT Flashcards

1
Q

What is the main cause for ear squeeze

A

inability of eustachian tube/ear drum to equalize

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2
Q

what is the cause for ear squeeze

A 
changes in pressure low or high
could be because of pre-existing condition
infection
PE tubes
Iatrogenic
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3
Q

How does someone with ear squeeze present to you upon examination

A

They may have ear pain, rupture, hemorrhage
damage to ossicles or round window
there is tinnitus (immediate or delayed)
If they have vertigo they will have severe damage

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4
Q

If someone presents with ear squeeze what type of tests would you want to order/preform to confirm the diagnosis

A

Check hearing and balance
check the mobility of the Tympanic Membrane
See if there is bleeding or rupture of the Tym. Mem

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5
Q

How would you treat someone with Ear squeeze

A

If they have a mild condition- decongestant (oxymetazalone, psedophedrine)
moderate cinditions- steroid and antibiotics as well as decongestants
Severe condition- myringotomy, pain control and ENT follow up as well as decongestant and antibiotic

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6
Q

What is a myringotomy

A

it is a tiny incision that is made into the ear to relieve the pressure of excess fluid build up in the middle ear

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7
Q

What causes sinus squeeze

A

changes in air pressue
pre-existing condition such as polyps, allergies, previous surgery
Chronic inflammation
sinus squeeze

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8
Q

What tests/exam would you do to check to see if someone was having sinus squeeze

A

transilluminate sinus

palpate the sinus with your hands

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9
Q

how will a patient present in your office with sinus squeeze

A

they may have blood vessel ruptures

pain from pressure/ blood and epistaxis

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10
Q

How do you treat a patient with sinus squeeze

A

hyperbaric chamber
decongestants, pain control
oxymetazalone (afrin)
ENT follow up

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11
Q

What causes tooth squeeze

A

Air that get trapped between a tooth filling

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12
Q

How will a patient with tooth squeeze present to you

A

pain or pressure in their tooth

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13
Q

What test/exam would you check to see if they had tooth squeeze

A

use a tongue depressor to apply pressure on the tooth and also check for possible tooth infection

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14
Q

How would you treat a patient with tooth squeeze

A

use a hyperbaric chamber

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15
Q

What causes a Tympanic membrane perforation

A

Infection, trauma, iatrogenic, irrigation, PE tube

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16
Q

How will a patient with Tym Mem perforation present to you

A

They will have hearing loss

Pain and sounds with equalization they will hear a whistling noise

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17
Q

What test/exam would to perform to see if they had an ear drum perforation

A

Otoscopy

Bubble test

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18
Q

How would you treat a patient with a Tym Mem perforation

A

antibiotic for perforation
often self healing
surgical repair

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19
Q

What causes an external hematoma

A

Trauma to the ear lobe
The auricular perichondrium and cartilage separate
Very common in wrestlers

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20
Q

How will a patient with External hematoma present to you in the office

A

The outer helix of the ear will be inflamed there is blood accumulation in the helix
can cause the ear to become deformed or get cauliflower ear

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21
Q

How do you treat a patient with an external hematoma

A

Incision and Drainage then wrap the ear properly

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22
Q

What is the cause for someone who has conductive hearing loss

A

they have some blockage of the external canal because of cerumen impaction
They could have inflammation of the external ear (OM)
Middle ear fluid collection
otosclerosis
eustachian tube dysfunction
Foreign Body in ear

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23
Q

What test/exam would you want to preform on a patient who you think has conductive hearing loss

A 
Hearing test (bedside) finger rub
Weber test Rinne test
tympanometry
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24
Q

How will a patient present who has conductive hearing loss

A

they will have better hearing in the blocked ear

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25
Q

How do you treat a patient who has a conductive hearing loss

A

Hearing aids, removal of cerumen

cochlear implants and surgical removal of cholesteotoma

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26
Q

What is the etiology of a sensorineural hearing loss?

A

loss of hearing from the inner ear to the brain
auditory
cranial nerve

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27
Q

What causes a sensorioneural hearing loss

A 
Most common is presbyacusis associated with aging
chronic noise exposure
menieres disease
ototoxicity
neoplasms
vascular disease
demyleniating, infections and trauma
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28
Q

What is presbyacusis

A

it is an age related hearing loss that is usually symmetric loss. People with this tend to lose their quality of hearing. Usually starts with high frequency and the affects all frequencies of hearing

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29
Q

What causes Menieres disease

A

starts in the 5th decade of life intermittent hearing loss it is associated with vertigo
Tx: low sodium diet, thiazide diuretic, short course of steroids

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29
Q

What causes Menieres disease

A

starts in the 5th decade of life intermittent hearing loss it is associated with vertigo
Tx: low sodium diet, thiazide diuretic, short course of steroids

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30
Q

what is ototoxicity

A

hearing loss that is caused by medications which damages the hair cells of the organ of corti

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30
Q

what is ototoxicity

A

hearing loss that is caused by medications which damages the hair cells of the organ of corti

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31
Q

What meds have an increased risk of ototoxicity

A 
salicylates(NSAID, Asprin)
Quinine
Aminoglycosides
loop diuretics
cisplatin
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31
Q

What meds have an increased risk of ototoxicity

A 
salicylates(NSAID, Asprin)
Quinine
Aminoglycosides
loop diuretics
cisplatin
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32
Q

What is an acoustic neuroma (schwanoma)

A

brain tumor affecting auditory pathway if this is the case most patients will present with unilateral hearing loss

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32
Q

What is an acoustic neuroma (schwanoma)

A

brain tumor affecting auditory pathway if this is the case most patients will present with unilateral hearing loss

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33
Q

what is the cause of tinnitus

A 
associated hearing loss
can be first symptoms of serious conditions (schwanoma)
acoustic trauma
vascular tumor
If caught early enough can use steroids
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33
Q

What is the underlying problem with someone who suffers from a acoustic neuroma

A

issues with cranial nerve 8

  • acoustic
  • vestibular where this tumor arises from schwann cells of the myelin sheath of the nerve cell
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34
Q

What causes mixed hearing loss

A

from trauma to neoplasm which causes a combination of conductive and sensorineural loss

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34
Q

What causes mixed hearing loss

A

from trauma to neoplasm which causes a combination of conductive and sensorineural loss

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35
Q

How to test for mixed hearing loss

A

finger rub test or whispered word in each ear

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35
Q

How to test for mixed hearing loss

A

finger rub test or whispered word in each ear

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36
Q

What is tinnitus

A

perception of sound when there is no sound.

they will hear the sound of buzzing or ringing

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37
Q

what is the cause of tinnitus

A 
associated hearing loss
can be first symptoms of serious conditions (schwanoma)
acoustic trauma
vascular tumor
If caught early enough can use steroids
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38
Q

What is the underlying problem with someone who suffers from a acoustic neuroma

A

issues with cranial nerve 8

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39
Q

Where does this tumor arise in the brain

A

at the cerebellopontine angle in the posterior fossa of the brain near CN7

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40
Q

How will a patient with a acoustic neuroma

A

they will have asymmetric sensorineural hearing loss or unilateral tinnitis. They wont have true vertigo. They will also have unilateral facial weakness (bells palsy)

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41
Q

How do you treat a patient with acoustic neuroma

A

send patient for a consult with a neuro for tumor removal. The CN 8 gets sacrificed and they are very careful to spare the CN7

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42
Q

What is vertigo

A

is it a pathology of the cochlea, middle ear and the acoustic portion of the CN8

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43
Q

How will a patient present with vertigo?

A

they will have a false sense of movement. The environment will be spinning to them. They may be nauseous and vomit. They can also have ataxia

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44
Q

What is the treatment for a patient with vertigo

A

Bed rest, IV fluids, antihistamine, benzodiazapine and vestibular exercises. The CNS will adjust itself

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45
Q

What is the etiology of peripheral vertigo

A

pathology of the cochlea, middle ear, and the acoustic portion of the CN8

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46
Q

How does a person with peripheral vertigo present

A

they will have hearing loss, tinnitus and unidirectional nystagmus

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47
Q

What is the etiology of a person suffering from central vertigo

A

it affects their brainstem or cerebellum

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48
Q

How will a patient with central vertigo present

A

rarely causes hearing loss and tinnitus.
Diplopia (double vision), homonymous hemianopsia, facial weakness/numbness. They will have sensory complaints. The will have dysarthria (trouble speaking)/swallowing. Ataxia and they will have persistent multidirectional nystagmus after vertigo resolves

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49
Q

How does benign paroxsmal positional vertigo (BBPV) start

A

Most common form of vertigo and most recurrent. Onset of vertigo seconds after assumption of certain head position. Usually lying supine

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50
Q

How do you diagnosis a person with BBPV

A

you will do the dix-hallpike maneuver. The pt sit on the exam table and turn head 45 degrees to right. The examiner brings patient to the supine position on the table with head extended over the table at 30 degree. look for nystagmus
With BPPV there with be a fatigue ability of the vertigo symptoms

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51
Q

How will a patient present with movement related vertigo

A

they will have vertigo in almost any position. There is no latency period and there is not fatigue ability

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52
Q

How will a patient present with meniere’s disease

A

recurrent episodes of vertigo, hearing loss, tinnitus, aural fullness, typically all symptoms are present with each episode. Attacks last 30min-24hr

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53
Q

How will a patient present acute peripheral vestibulopathy

A

gradual onset of peripheral vertigo attacks, incapacitating form. mild ataxia toward side of lesion

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54
Q

What is the cause of presyncope

A

CV problems with neurological symptoms,

causes-hypertventilation syndrom, anxiety, othrostatic hypertension, hypoglycemia

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55
Q

what type of test would want to do for a person with presyncope

A

reproduce with hyperventilation and use an EKG

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56
Q

How will presyncope present in patients

A

lightheadness will occur while pt is standing. It will accompanying sudden pain or strong emotion. More likely in a hot crowded room. premonition of syncope, yawing, diaphoresis, pallor can be associated symptoms. Occurs in young health people

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57
Q

how do you treat someone with presyncope

A

adjust medication, slow postural changes, elastic stockings, avoidance of precipitants

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58
Q

what causes disequilibrium

A

visual impairment, vetibulopathy, medication, slow growing neoplasm of posterior fossa, peripheral neuropathy in lower extremities

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59
Q

How will a patient present with disequilibrium?

A

more common in the elderly, dizziness is more constant and maximized with standing or ambulation (walking), they complain of feeling off balance or unsteady

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60
Q

How do you treat a person who has disequalibrium

A

dopamine agents, vp shunt, cane, vestibular exercises

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61
Q

What is the cause of ceruminosis

A

debris off of canal which is normal shedding. Q tips can cause it to get worse

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62
Q

How do you treat a patient with pericondritis

A

systemic antibiotics, I&D

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63
Q

What is the cause of otitis externa

A

inflammation of the skin of the external ear canal and surrounding soft tissue

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64
Q

What causes Auricular cellulitis

A

infection of skin overlying the external ear mostly caused by S. aureus, strepococci

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65
Q

How will a person with auricular cellulitis present

A

tenderness, erythema, swelling, and warmth of external ear, no involvement of inner ear of canal rubor, calor, dolor, tumor

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66
Q

How do you treat a person with auricular cellulitis

A

warm compress, oral antibiotics, IV antibiotics

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67
Q

What is pericondritis

A

it is an infection of the perichondrium of the auricular cartilage due to local trauma, ear piercing, burns, or lacerations. caused by S aureus

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68
Q

how will a person with otitis media present

A

history of acute onset signs and symtpoms of middle ear inflammation and middle ear effusion
bulging and limited mobility of air/ fluid behind T M or otorrhea and a fever

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69
Q

How do you treat a patient with pericondritis

A

systemic antibiotics, I&D

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70
Q

What is the cause of otitis externa

A

inflammation of the skin of the external ear canal and surrounding soft tissue

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71
Q

What is the pathogen that causes otitis externa

A

S aureus, P aeruginosa

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72
Q

How will a patient with otitis externa present

A

maceration from loss of protective function of cerument and increase moisture, increased pH in the canal, trauma, ear plugs, contact dermatitis, secondary infection with MC perforation

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73
Q

How would you treat a patient with OE

A 
otic drops (fluoroquinolone, neosporin, steroids) Ear wicks, moist heat, 
Can be prevented with one footed dance, 1:1 white wine and 70% ethyl alcohol, 2% acetic acid drops
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74
Q

how to treat a person with eustachian tube dysfunction

A

PE tubes MEE >4months, hearing impairment

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75
Q

How would you test/ examine a pt with OM

A

otoscopy to check for red bulging T M, see if cerumen needs to be removed

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76
Q

How would you treat a patient with patient with a cholesteotoma

A

surgical repair of the Tympanic membrane (tympanoplasty, myringoplasty, mastoidectomy

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77
Q

how will a person with eustachian tube dysfunction present

A

middle ear fills with serous fluid which is caused by Eustachian tubes that don’t drain properly

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78
Q

How would you check to see if someone had eustachian tube problems

A

pneumatic otoscopy, tympanometry, toynbee test, MRI/CT/ET cath, nasopharyngoscopy

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79
Q

What are risk factors for eustachian tube dysfunction

A

younger than 6yo, tobacco, suction, obesity

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80
Q

how to treat a person with eustachian tube dysfunction

A

PE tubes MEE >4months, hearing impairment

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81
Q

what is the cause of foreign bodies in children

A

present in children >9mo

food particles, organic material, small toys, beads pencils erasers, rocks

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82
Q

how to remove foreign bodies from ears

A

reduce swelling, vasoconstriction meds, suction/glue, forceps immobilize insects, positive pressure

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83
Q

How would you treat a patient with patient with a cholesteotoma

A

surgical repair of the Tympanic membrane (tympanoplasty, myringoplasty, mastoidectomy

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84
Q

What causes mastoiditis

A

inflammation of the mastoid periosteum to bony destruction of the mastoid air system

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85
Q

How will a patient present with mastoiditis

A

unilateral, tender inflamed, painful abcess

86
Q

How do you treat a patient with mastoiditis

A

ENT consult, drainage, myringotomy, mastoidectomy( last result) ct scan

87
Q

what is the cause of foreign bodies in adults

A

insects, teeth, hardened concrete, illicit drugs,

88
Q

what is the cause of foreign bodies in children

A

present in children >9mo

food particles, organic material, small toys, beads pencils erasers, rocks

89
Q

how to remove foreign bodies from ears

A

reduce swelling, vasoconstriction meds, suction/glue, forceps immobilize insects

90
Q

what is the etiology for allergic rhinitis

A

atopic triad -eczema,asthma, allergic rhinitis

91
Q

How will a patient with allergic rhinitis present to you

A

clear watery rhinorrhea, sneezing, nasal congestion/obstruction, increased lacrimation/red eyes, pruritis of conjunctiva, nasal mucosa and oropharynx, post nasal drip with sore throat, cough. allergic salute. It shows a patter of seasonality linked to environmental history, occupational exposure

92
Q

What labs/exam would you want to perform on someone you suspect had allergic rhinitis

A

look up their nose with a scope it will appear pale bogy nasal mucous, they may have nasal polyps, nasal smears, allergen specific IgE

93
Q

How to treat a patient with allergic rhinitis

A

avoid allergens, antihistamines, nasal spray, decongestants, afrin, glucocorticoids, immunotherapy

94
Q

What is the cause of vasomotor rhinitis

A

resembles perennial rhinitis but is secondary to non-specific stimuli like chemical odors, temp, humidity variation and position changes, pregnancy

95
Q

How to treat a person with vasomotor rhinitis

A

treated with topical antihistamines, topical decongestants and topical anticholinergics

96
Q

what are nasal polyps

A

pale edematous mucosally covered masses
mostly benign
can cause chronic nasal congestion and decreased sense of smell. There can be single or multiple polyps. They are seen in pt’s with asthma, allergies, CF

97
Q

What are the signs or symptoms of a person with nasal polyps

A

nasal obstruction, anomia (lack of smell), chronic sinusitis, snoring and bad breath,

98
Q

How would to determine if someone had nasal polyps

A

physical exam of anterior rhinoscopy, check ears and pharynx, CT scan

99
Q

How would you treat nasal polyps

A

topical steroids is primary treatment, oral steroids- short taper. Treating co-morbities. ENT referral for surgical removal if needed

100
Q

What is the pathology for sinus infections

A

most common due to viral URI. IT can be very hard to tell if it is viral or bacterial

101
Q

What bacteria are responsible for infecting sinuses

A

S. pneumonia, and H. Influenza they make up about <2% of infection

102
Q

What causes acute sinusitis

A

mucosal edema which decreases mucus transport which leads to the mucus not moving which promotes viral or bacterial proliferation

103
Q

What are some risk factors for sinusitis

A

smoking, rhinitis, asthma, structural deformities (deviated septum,polyps, tumor, foreign bodies)

104
Q

What are some of the complications of acute sinusitis

A

orbital cellulitis, osteomyelitis, subcutaneous abcesses, CNS complications, potts puffy tumor

105
Q

what are the signs and symptoms of a person with acute sinusitis

A

purulent discharge, facial pain, nasal obstruction, fever,headache, halitosis, fatigue, dental pain, ear fullness, cough, anosmia

106
Q

what is the best test/exam you can preform to acute sinusitis

A

sinus aspiration and culture

107
Q

how do you treat sinusitis

A

analgesics and antipyretics, fluids, intranasal corticosteroids, decongestants, mucolytics, saline irrigation, antibiotics

108
Q

What causes chronic sinusitis

A

symptoms lasting longer than 12 weeks due to infections with MRSA, fungal

109
Q

How will a patient present with xerostomia

A

dry mouth,lips, throat, difficulty chewing, swallowing, speaking, oral pain and pale mucosa

110
Q

What is epistaxis what causes it

A

bleeding in the nose from anterior to posterior

111
Q

where does most anterior epixtaxis occur

A

in kiesselbach’s plexus which are capillary in origin more common in young patients less severe and easier to control

112
Q

Where does posterior epistaxis occur and whats its origin

A

common in woodruffs plexus harder to control because they are aterial in origin can compromise the airway. more common in adults

113
Q

what are causes of epistaxis

A

trauma, irritation, inflammation, tumors, dessication, foreign body, infection, ateriosclerosis, bleeding problems, hypertension

114
Q

How do you treat epistaxis

A

use PPE, have pt blow nose first, use anesthetic, vasoconstricting meds, cautery, silver nitrate , nasal packing, antiobiotics, plug nose for 10minutes, sticks monitor vitals NEVER USE EPINEPHRINE

115
Q

what causes xerostomia

A

decreased salivary flow, constant antimuscarinic meds, chemotherpay, autoimmune disorders (sjorgen’s syndrome) and social habits

116
Q

How will a patient present with xerostomia

A

dry mouth,lips, throat, difficulty chewing, swallowing, speaking, oral pain and pale mucose

117
Q

How do you treat a patient with xerostimia

A

preventative measure to prevent decay and erosion of teeth, fluoride, good dental hygiene,
Oral rinses and gels, mouthwash, water and decrease caffeine and ETOH, Chew gum or sugar free candy
Pilocarpine and cevimeline

118
Q

What is a mucocele

A

it is a fluid filled cyst caused by trauma or obstruction which usually occurs on the lower lip that is usually painless

119
Q

How will a patient present with mucocele

A

fluid filled cyst on lower lip, it is as big as a few mm to a few cm. The cyst will be painless

120
Q

How would you treat a person with a mucocele

A

small ones will go away on their own larger ones will sometimes need surgical excision particularly ranula’s (located on the floor of the mouth

121
Q

how will a patient present with salivary gland enlargement

A

there will be an area of hardness, erytherma, edema, heat would suggest infection, dry mucous membranes, look for lymphadenopathy and look for facial nerve function

122
Q

How do you treat a patient with bacterial parotiditis

A

stimulate salivary glands, Antibiotics, Surgery I&D if no improvement after 2-3 days on antibiotics, warm compress

123
Q

how will a patient with mumps parotitis present

A

usually age 4-6, short prodrom with a low temp maliase, ear pain, sudden painful lump of salivary gland

124
Q

How do you treat mumps parotitis

A

treat symptoms, MMR vaccine

125
Q

what causes bacterial parotitis/ sialadentitis

A

caused by S. aureus including MRSA anaerobic bacteria the most common

126
Q

What are some risk factors for bacterial parotiditis/Sialadenitis

A

dehydration, chronic illness, advanced age, postop state, immuno compromised, poor oral hygiene, trauma

127
Q

How will a patient present with bacterial parotitis/ Sialadenitis

A

its an acute sudden onset of unilateral swollen and painful salivary gland, tender, purulent discharge coming from duct which may be expressed

128
Q

what causes parotitis

A

it can be viral, bacterial, sialolithiasis, tumors, chronic disease. These are parotid gland disorders

129
Q

What are the most common places these salivary gland tumors are found

A

in parotid gland most common is pleomorphic adenoma (begnin) the most common malignant is warthrins. treatment id based on staging

130
Q

what type of test/exam would you want to perform for a patient with salivary gland enlargement

A

X-ray to rule out stones, Ultrasound, Sialography, CT/MRI

131
Q

How do you treat a patient with bacterial parotiditis

A

stimulate salivary glands, Antibiotics, Surgery I&D if no improvement after 2-3 days on antibiotics, warm compress

132
Q

What is the etiology of Sialolithiasis

A

its unknown, occurs primarily in the submandibular gland

133
Q

How does a pt present with Sialolithiasis

A

history of acute, painful intermittent swelling of the affected gland, swells when the pt eats

134
Q

How would you test/examine for sialolithiasis

A

history and palpation, X-ray, U/S, CT, Sialoendoscopy

135
Q

How do you treat a patient with sialolithiasis

A

supportive (analgesics, hydration, antipyretics, Abx) and referral to ENT surgery

136
Q

How will a patient present with salivary gland tumors

A

slow growing, painless, that are non-tender mobile and firm

137
Q

What are the most common places these salivary gland tumors are found

A

in parotid gland most common is pleomorphic adenoma (begnin) the most common malignant is warthrins. treatment id based on staging

138
Q

What is the pathophysiology of viral croup

A

parainfluenza virus that usually occurs during the fall/winter months.

139
Q

How will a patient present who has viral croup

A

afebrile or low grade fever, stridor barking cough, most common at night

140
Q

How do you treat a patient with croup

A

cool moist air, O2, epinephrine via nebulizer, steroid

141
Q

What is the pathology of epiglottitis

A

hemophilus influenza type B

142
Q

how will a patient present with epiglottitis

A

high fever, toxic appearance, drooling, dysphagia, muffled voice, inspiratory retractions, soft stridor, tripod breathing stance, sniffing dog positon

143
Q

What would you want to test/examine to determine if a pt had epiglottitis

A

An x-ray will show a thump print sign

144
Q

How do you treat a patient with epiglotitis

A

immediate intubation, blood work, IV antibiotics, then tailor Abx after culture, extubate

145
Q

What is the cause of laryngitis

A

it can be because of infection viral, bacterial, non-infectious (cancer, overuse, reflux)

146
Q

how will a patient present with laryngitis

A

they will have hoarness, reduced vocal pitch or aphonia, pt will point to larynx, red swollen vocal cords will irregular edges

147
Q

how to treat a patient with laryngitis

A

treat symptoms decrease time talking even whispering, hydration, inhale humidified air

148
Q

what is the pathology of laryngopharyngeal reflux

A

larynx is sensitive to small amounts of acid or pepsin

149
Q

how will a pt present with laryngopharyngeal reflux

A

they will frequently clear their throat, dry cough, hoarsness, globus sensation (feels like you have something in your throat) lacks heartburn

150
Q

how will you treat a pt with laryngopharyngeal reflux

A

modify diest and behavior, avoid greasy and acidic foods, tobacco, alcohol, caffeine, lose weight, avoid laying down after meals, proton pump inhibitors

151
Q

How will a patient present with GERD

A

heartburn, indigestion, regurgitation, vomitus does not reach the larynx or upper aerodigestive tract

152
Q

what is the pathophys of leikoplakia

A

premalignant lesion which is basically a scab in larynx

153
Q

how will a patient present with leukoplakia

A

they will have a hoarseness

154
Q

what do you do with a patient who might have leikoplakia

A

biopsy

155
Q

How will a patient present with squamous cell carcinoma

A

its most common in males, pts will have SOB, odynophagia, globus sensation, stridor, hemoptysis, mass in their neck, weight loss

156
Q

How do you treat a person with squamous cell carcinoma

A

biopsy it,, then usually use surgery, radiation, chemoptherpy

157
Q

What is the cause of laryngeal papillomatosis

A

HPV 6,11, 16

158
Q

How will a patient present with Laryngeal papillomatosis

A

usually 1st born, teen mother, vaginal delivery. Mom has HPV. Pt will have hoarness, voice changes, croupy cough, and stridor

159
Q

how do you treat a person with laryngeal papillomatosis

A

surgical excision, HPV vaccine

160
Q

what causes vocal cord nodules

A

benign lesions arising from mechanical trauma, hyperthyroidism

161
Q

how will patient present with vocal cord nodules

A

hoarseness

162
Q

How will exam show vocal cord nodules

A

solid lesions usually in anterior 1/3 of vocal fold

163
Q

how do you treat a patient with vocal cord nodules

A

speech therapy, treat underlying condition, surgery if recalcitrant

164
Q

what causes a vocal cord cyst

A

it is a fluid filled lesion that arises from possible trauma, benign growth

165
Q

how to treat a person with vocal cord cyst

A

speech therapy, treat unerlying condition and surgery if necessary

166
Q

what causes cricopharyngeal spasms

A

dysfunction of upper most esophageal valve which doesn’t allow esophagus to open right

167
Q

how will a patient present with cricopharyngeal spams

A

dysphagia, collection of liquid or food in back of throat

168
Q

how do you treat a person with cricopharyngeal spams

A

its self limiting, can use muscle relaxers, decrease stress

169
Q

what causes vocal cord paresis (paralysis)

A

latrogenic surgical injury, nonlaryngeal malignancy, trauma, neuro cause, idopathic

170
Q

how do you treat a patient with glottic stenosis

A

tracheostomy with subsequent cartilage graft for reconstruction

171
Q

how to treat a patient with vocal cord paralysis

A

treat underlying cause, can inject substances to plump up paralyzed cord, surgery

172
Q

what is the patho of reinkes edema

A

its a bilateral edema which is most common in smokers, chronic edema

173
Q

how will a patient present with reinkes edema

A

hoarseness

174
Q

how to treat a person with reinkes edema

A

stop smokeing, speech therapy, possibly surgery

175
Q

what causes glottic stenosis

A

narrowing of the larynx at the glottis level, narrowed cricoid region, most common from prolonged intubation

176
Q

how will a patient present with glottic stenosis

A

stidor, recurrent croup, think neonates and infants

177
Q

how do you treat a patient with glottic stenosis

A

tracheostomy with subsequent cartilage graft for reconstruction

178
Q

what causes pharyngitis

A

viral or bacterial

179
Q

how will a patient with viral strep present

A

sore throat, cough, cold, joint and muscle pain, low fever

180
Q

how will a patient with bacerial strep present

A

sore throat, anorexia, maliase,headache, mid to high fever, cough is rare. tonsillar exudate, strawberry tongue

181
Q

how do you treat viral strep

A

tx symptoms

182
Q

how do you treat bacterial strep

A

Penicillin or erythromycin

183
Q

what are the causes of tonsillitis

A

can be bacterial or viral

184
Q

how will a patient with tonsillitis

A

sore throat, dysphagia, fever, headache, earache

185
Q

How to treat tonsillitis

A

culture, if viral treat symptoms, if bacterial penicillin or erythromycin

186
Q

How do you determine whether pharyngitis is bacterial or viral

A

rapid strep

187
Q

what causes perotonsillar abcess

A

an infection with an abscess and puss between the anterior and posterior tonsillar pillars and the superior pharyngeal constrictor muscle. called quinsy

188
Q

how will a patient present with peritonsillar abscess

A

worsening sore throat 1-2 wks, painful throat and neck, high fever, dysphagia, hot potato voice, usually follows pharyngitis, or tonsillitis

189
Q

how to check for peritonsillar abscess

A

Ct will show cavity and edema

190
Q

how do you treat a patient with peritonsillar abscess

A

prompt ENT consult, needle apsiration, I&D, tonsillectomy, ABx

191
Q

what causes a retropharyngeal abscess

A

collection of puss in the tissues in the back of the throat, affects children under 5.
H. parainfluenzae, GABS, Staph

192
Q

how will a patient present with retropharngeal abscess

A

fever, dysphagia, drooling, neck rigidity, unilateral bulging, hot potato voice, stridor

193
Q

how to treat retropharngeal abscess

A

x-ray or Ct or culture

Secure air way if signs of respiratory distress, consult with ENT, I&D and broad spectrum Abx

194
Q

what is the cause of apthous ulcers

A

etiology is unknown

195
Q

how does a aphthous ulcers present

A

single or multiple recurrent round ulcerations that are yellow or gray surrounding erythema. found
if they are painful stage 7-10 day
healing stage 1-3 weeks

196
Q

how to treat aphthous ulcers

A

topical coritcosteroids, 1-2 weeks of prednisone

197
Q

who is at high risk for periodontal disease

A

diabetics, alcoholics, tobacco users, low economic status

198
Q

what are things that can affect teeth and gums

A

tetracycline, phenytoin, Ca blockers, cyclosporine

199
Q

what causes cavities

A

bacteria that change food to acids which form plaques

200
Q

what causes gingivitis

A

inflammation of the gums most common periodontal disease

201
Q

how does ramsey hunt syndrome present

A

painful rash around the ear and on one side of the mouth, hearing loss on one side and difficulty eating on one side

202
Q

What causes trigeminal neuralgia

A

involves entire branch or part of the mandibular or maxillary branches

203
Q

how does trigeminal neuralgia present

A

pain present in one or more teeth with normal neuro exam

204
Q

how to treat trigeminal neuralgia

A

relieve pain

205
Q

what is ramsey hunt syndrome

A

varicella zoster infection around the ear that infects the facial nerve

206
Q

how does ramsey hunt syndrome present

A

painful rash around the ear and on one side of the mouth, hearing loss on one side and difficulty eating on one side

207
Q

what causes oral herpes infection

A

mucocutaneous infection of the mouth and lips by HSV

208
Q

how to treat temporomandibular disorder

A

reat, heat, anti-inflammatories, referral to specialistmore common in women, pain is limited to the mandibular movements, myofacial pain reffered from muscle of mastication

209
Q

how will a patient present with HSV

A

it will be seen on the lips or vermillion border of people but can be anywhere in the mouth,
they will be painful, sore, with burning or tingling or itching

210
Q

what causes most of the oral lesion

A

HSV-1

211
Q

how does HSV spread

A

touching infected saliva or mucous membranes or skin it is highly contagious

212
Q

what is a stage 1 of HSV

A

primary infection where virus enters thought the small cracks in skin or mucous membranes

213
Q

what happens during stage 2 of latency

A

from indirect site virus moves to dorsal root ganglia

214
Q

what happens during stage 3

A

recurrence, the virus is reactivated by certain emotional or physical stress

215
Q

how to treat HSV

A

need to treat within 48 hrs of onset with acyclovir. most require no treatment

216
Q

what is the cause of candidiasis

A

species of yeast that involves the mucosal membranes including the oropharynx

217
Q

Who is most susceptible to Candidiasis

A

males more than females, more prevalent in infants.
PTs usually taking steroids, oral contraceptive or abx’s
seen in immunocompromised adults
Pts with DM

218
Q

How does candidiasis present in pts

A

develops suddenly, trouble feeding infants, sore throat, burning tongue, and sores slowly increase in size and number. The tongue will have white or gray plaques on gingiva or tongue. Sores bleed easily, Can scrape paques off

219
Q

how is the diagnosis usually made

A

made on physical exam, tongue scrapings can be sent for fungal culture

220
Q

how to treat a patient with candidiasis

A

sterilize nipples and bottle for infants,
mild cases acidophilus capsules are fine, diabetics need to get blood sugar in check,brush tongue, nystatin, clotrimazole, fluconazole,

228
Q

how to treat pts who cant take oral med for candidiasis

A

IV amphoterecon, anidulafungi

Clinical Medicine (1 decks)

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