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Medicine & Surgery > ENT > Flashcards

ENT Flashcards

1
Q

What are 4 risk factors for head and neck cancer?

A
  1. smoking
  2. alcohol use
  3. HPV infection
  4. EBV infection
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2
Q

What are 5 diagnostic considerations in the ddx of peritonsillar abscess

A 
peritonsillar cellulitis
epiglottitis 
retropharyngeal cellulitis/abscess
parapharyngeal space cellulitis/abscess
severe tonsillarpharyngitis
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3
Q

What are 5 ddx considerations in otitis externa?

A 
otomycosis
contact dermatitis
psoriasis
carcinoma of the ear canal
chronic suppurative otitis media
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4
Q

What is the nonoperative management strategy for parotitis?

A 
MASH acronym
Massage
Analgesia +/- antibiotics
Sialogogues
Heat
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5
Q

What are 5 complications of acute suppurative parotitis?

A 
Deep space neck infection with sepsis
Airway obstruction
Osteomyelitis of facial bones
Septic jugular thrombophelbitis (Lemierre's)
Facial nerve palsy
Fistula
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6
Q

What is the definition of chronic rhinosinusitis?

A

Inflammation of the nasal passages and paranasal sinuses >12 weeks

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7
Q

What are the 4 cardinal features of chronic rhinosinusitis?

A

anterior or posterior mucopurulent nasal discharge
nasal obstruction/blockage/congestion
facial pain/fullness
reduction or loss of sense of smell
*in children sense of smell is replaced by cough

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8
Q

What are the 4 facial sinuses?

A

Frontal
Sphenoid
Ethmoid
Maxillary

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9
Q

What are the 2 mainstays of medical treatment in chronic rhinosinusitis?

A

nasal saline rinses

intranasal steroid sprays

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10
Q

What is the definition of sudden sensorineural hearing loss?

A

acute (30 db in 3 different frequencies, idiopathic

often associated with tinnitus, vertigo

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11
Q

Where is the localization of hearing loss in acute stroke?

A

anterior inferior cerebellar artery (AICA)

may be associated with ipsilateral horner’s syndrome, diplopia, nystagmus, facial weakness, limb/central ataxia, contralateral spinothalamic findings

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12
Q

How does the Weber test work?

A

Place tuning fork on center of head
lateralizes to affected ear = conductive loss
lateralizes to opposite ear = sensorineural loss

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13
Q

How does the Rinne test work?

A

Place tuning fork on mastoid - once patient ceases to hear it hold it next to ear
If AC > BC = normal
If BC > AC = conductive loss

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14
Q

What is an alternative to the Weber test?

A

Hum test

If sound lateralizes to affected side = conductive loss

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15
Q

What are 10 complications of acute otitis media?

A 
Hearing loss
Vestibular problems (balance)
Labrynthitis
Cholesteatoma 
Facial nerve palsy
Perforated TM 
Chronic suppurative otitis media
Mastoiditis
Meningitis
Brain abscess
Epidural abscess
Lateral sinus thrombosis
Cavernus sinus thrombosis
Subdural empyema
Carotid artery thrombosis
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16
Q

What are 10 non viral pharyngitis causes of sore throat?

A 
Infectious mononucelosis
Epiglottitis
Retropharyngeal abscess
Foreign body aspiration
Diphtheria
Lemierre's syndrome 
Peritonsillar abscess
Herpes stomatitis
Hand foot and mouth syndrome
Steven Johnson Syndrome/TEN
Gonoccocal pharyngitis
Kawasaki's disease
Chemical exposure and injury
Candida esophagitis 
Referred pain from dental abscess, AOM
PFAPA
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17
Q

What 3 systems contribute to balance equilibrium

A

Visual
Proprioception
Vestibular

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18
Q

What are 8 causes of peripheral vertigo

A 
BPPV
Vestibular neuritis
Labrynthitis
Meniere's disease
Foreign body
Acute otitis media
Perilymphatic fistula
Trauma (labrynth concussion)
Motion sickness
Acoustic neuroma
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19
Q

What are 8 causes of central vertigo

A 
CNS infection (encephalitis, meningitis)
Vertebral artery dissection
Cerebellar infarct/hemorrhage
Subclavian steal syndrome
Vertebral basilar artery steal syndrome
Vertebrobasilar migraine
Post traumatic injury (temporal bone fracture)
Post concussive syndrome 
Temporal lobe epilepsy
Tumor
Multiple sclerosis
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20
Q

What are 4 important structures to identify and think about when landmarking the drainage of a PTA?

A

anterior tonsillar pillar = palatoglossus muscle
posterior tonsillar pillar = palatopharyngeus muscle
palatine tonsil
superior constrictor muscle

21
Q

What is a risk factor for PTA development?

A

smoking

22
Q

What are 2 major microbes that cause PTA?

A

Streptoccocus pyogenes
Staphylococcus aureus
mostly polymicrobial

23
Q

What are clinical features of PTA?

A 
unilateral throat pain
fever
muffled voice
trismus (in 2/3)
neck swelling
ear pain 
medial displacement of tonsil
uvula displacement
24
Q

What is the recurrence rate of PTA post drainage?

A

5-10%

25
Q

What are 5 complications of PTA?

A 
Airway obstruction
Aspiration of drainage
Sepsis
Group A Strep complications
Internal jugular vein thrombosis
Jugular vein suppurative thrombophlebitis
Carotid artery rupture
Pseudoaneurysm formation (carotid)
Mediastinitis
Necrotizing fasciitis
26
Q

What are 4 vessels that supply Kiesselbach’s plexus?

A

Superior labial artery (septal branch)
Anterior ethmoid artery
Sphenopalatine artery (septal branch)
Greater palatine artery

27
Q

Where do posterior bleeds occur from?

A

posterolateral branch of sphenopalatine artery

or carotid artery branches

28
Q

What percentage of neck masses are neoplastic in adults?

What percentage of neck masses are benign in children?

A

80% of nonthyroid neck masses are neoplastic, 80% are malignant
80% of neck masses in children are benign

29
Q

What are 3 categories of neck masses?

A

congenital
infectious
neoplastic

30
Q

List 5 congenital neck masses

A 
branchial cleft cyst
thyroglossal duct cyst
laryngocele
ranula
teratoma
dermoid cyst
thymic cyst
vascular malformation/tumor
31
Q

List 5 congenital neck masses

A 
branchial cleft cyst
thyroglossal duct cyst
laryngocele
ranula
teratoma
dermoid cyst
thymic cyst
vascular malformation/tumor
cystic hygroma
32
Q

List 5 infectious causes of neck masses

A 
reactive viral lymphadenopathy
suppurative bacterial lymphadenopathy
cat scratch disease
HIV infection (primary)
Brucellosis
Parasitic lymphadenopathy
33
Q

What are 3 concerning histories for undiagnosed head and neck malignancy?

A
  1. unilateral recurrent epistaxis or discharge
  2. persistent unilateral otitis media with effusion
  3. hoarseness > 2 weeks
    (Needs ENT referral and quad scope)
34
Q

List 5 neoplastic causes of neck masses

A 
metastatic head and neck cancer
thyroid neoplasms
salivary gland neoplasms
paraganglioma (ie. carotid body tumor)
schwannoma
lymphoma
lipomas, benign skin cysts
35
Q

What are infectious indications for tonsillectomy?

A

Recurrent tonsillitis (Group A Strep)
>/= 7 episodes in 1 year
>/= 5 episodes yearly x 2 years
>/= 3 episodes yearly x 3 years

36
Q

What are 5 otologic complications of AOM?

A 
chronic middle ear effusion
hearing loss
speech delay
TM perforation
cholesteatoma
labrynthitis
facial nerve palsy
37
Q

What are 5 risk factors for acute otitis media?

A 
age (6-18 months)
daycare attendance
tobacco smoking in the house
family history
lack of breastfeeding
facial abnormalities (ie. cleft palate)
38
Q

What are the diagnostic criteria for acute otitis media?

A
  1. Signs and symptoms of middle ear inflammation (ie. bulging of the tympanic membrane, distinct erythema of the tympanic membrane or otalgia, fever) AND
  2. Middle ear effusion (ie. tympanic membrane opacity, decreased or absent tympanic membrane mobility, an air-fluid level, or otorrhea)
39
Q

What are the two salivary ducts in the neck?

A 
Parotid = Stenson's duct
Submandibular = Warton's duct
40
Q

What are 5 extra-otologic complications of acute otitis media?

A 
mastoiditis
meningitis
extradural abscess
subdural abscess
focal otic encephalitis
brain abscess
lateral venous sinus thrombosis
41
Q

What are the 5 facial sinuses?

A 
maxillary
ethmoid
sphenoid
frontal
mastoid
42
Q

What is the medical treatment for acute parotitis?

A

massage
analgesia/antibiotics if bacterial
sialogogues
heat

43
Q

What size salivary stones can usually pass without surgical intervention?

A
44
Q

What is the diagnostic imaging modality of choice in salivary stones?

A

CT**

U/S is 90% sensitive for stones >2 mm

45
Q

What is the diagnostic imaging modality of choice in salivary stones?

A

CT**

U/S is 90% sensitive for stones >2 mm

46
Q

What are 8 deep spaces in the neck (potential for infectiou)

A 
submandibular
parotid
peritonsillar
parapharyngeal
retropharyngeal
pretracheal
prevertebral
danger space
47
Q

What are 4 risk factors for suppurative parotitis?

A

elderly
debilitated
dehydrated (poor intake, diuretics)
dry mouth (anticholinergic, sjogren’s, radiation, chemo)

48
Q

What are the 5 branches of the facial nerve?

A 
temporal
buccal
maxillary
mandibular
cervical

Medicine & Surgery (10 decks)

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