ENT Flashcards
Symptoms of episodic paradoxical vocal fold dysfunction (PVFD). (aka vocal cord dysfunction) vs. asthma
Usually exercise induced. Abrupt onset and resolution. Other symptoms that may help differentiate PVFD from asthma include stridor as opposed to wheezing, difficulty in inspiration as opposed to expiration, throat tightness as opposed to chest tightness, and onset of symptoms early during physical activity as opposed to late or after completion. Vocal quality or pitch may change because of narrowing of the glottis.
Paradoxical Vocal Fold Dysfunction definition
adduction of the vocal cords during inspiration, or during inspiration and expiration, with preservation of a posterior region of glottic opening known as a “posterior glottic chink.”
Severe odynophagia, no TM findings, + papule of gum, ipsilateral cervical LAD, think ____
dental abscess
Viruses associated with parotidis aside from mumps
CMV, enterovirus, EBV, influenza, parainfluenza, HIV
Painless preauricular swelling that persists over time, think ___
malignancy
Diagnosis of acute bacterial sinusitis
- Persistence of sx beyond 10 days without improvement
- Worsening of symptoms or new onset of symptoms after initial improvement
- Severe symptoms at onset lasting for 3 consecutive days
Diagnosis of acute bacterial sinusitis
- Persistence of sx beyond 10 days without improvement
- Worsening of symptoms or new onset of symptoms after initial improvement
- Severe symptoms at onset lasting for 3 consecutive days
Pathogen most likely to be culprit in acute otitis media and acute mastoiditis
strep pneumo
Protruding erythematous masses after facial trauma and epistaxis. Dx and what would you do next?
septal hamatomas
ENT consult for rhinoscopy and emergent drainage
Consequence of not draining septal hematoma within 72-96 hrs
necrosis of nasal septum (obstruction of blood flow from mucoperichordium to cartilage)
–> permanent deformity (saddle-nose)
MEN 2B
Marfanoid
Medullary thyroid carcinoma (100% of people)
Pheochromocytoma (late onset)
+ mucosal neuromas
Optic glioma is associated with what disease
NF1
MEN 2A and 2B gene mutation
RET proto-oncogene
Autosomal dominant, but most 2B are de novo
Most common midline neck mass and how to diagnose it, tx?
thyroglossal duct cyst
Ultrasound
Surgical removal
When should we repeat a hearing test if a neonate fails?
3 mo
Myringosclerosis
calcium and phosphate crystal deposits within the tympanic membrane that appear as whitish plaques on otoscopy and may demonstrate decreased mobility on pneumatic otoscopy.
chronic suppurative otitis media (CSOM) timing n tx
greater than 6 weeks of ear drainage from a perforation in her tympanic membrane
Ofloxacin ear drops
Implants appropriate for sensorineural hearing loss by age
2mo: behind the ear
5 yo: bone-anchored
Cochlear implant if nothing works
Brainstem implant on very special occasions
Most common pathogen associated with retropharyngeal abscess
Strep pyo
Cleft lip, Palate repair age and why
cleft lip can be repaired between 2 to 6 months of age. Palate repair often takes place between 9 to 19 months of age; repair before 7 months of age is associated with an increased risk of midface hypoplasia. A maxillary bone graft to fill the alveolar cleft is often needed between 6 to 8 years of age.
Criteria for getting myryngotomy tube placement
Otitis effusion for 3mo or more with conductive hearing loss, OR 3 mo or more with risks of speech language development difficulties
OR 3 mo with middle or tmpanic membrane damage
Antibiotic and aftercare for for tooth avulsion replacement
Chlorhexidine 0.1% solution rinses bid for 1 week
Doxy bid for 7 days
OR amox
Up to 35% of children with meningitis from S. pneumo will develop ____
hearing loss
Should have hearing evaluation at dx, 4-8 weeks, 6 mo, and 12 mo after discharge
Normal ability of hearing in decibels
0-15
Minimal to severe hearing loss in decibles
Minimal 16-25
Mild 26-40
Moderate 41-55
Severe 71-90
Profound >90 dB
If hearing screen is abnormal, what do you use for repeat
automated auditory brainstem response
Most common cause of bacterial CONJUNCTIVITIS and acute otitis media in young todds (12mo-18 mo)
nontypable h. flu
Young child with URI sx, developed otorrhea, no pain of external ear. Dx and treatment?
Acute otitis media with TM rupture (NOT otitis externa)
Oral amox
