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Head and Neck > ENT > Flashcards

ENT Flashcards

1
Q

which is more common syndromic or non syndromic hearing loss

A

non syndromic is 70% of congenital hearing loss cases. Its due to genetic mutations of connexin genes found on ch13 (SNHL)

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2
Q

timing of hearing loss

A

antenatal, perinatal, postnatal

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3
Q

is congenital hearing loss more genetic or not

A

genetic

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4
Q

syndromic HL is associated with 5 syndromes

A
  • usher syndrome (+retinitis pigmentosa)
  • pendred syndrome (+goiter)
  • alport syndrome (+nephropathy/keratoconus)
  • treacher collins (+misformed features)
  • jervell and lange neilson syndrome (+cardiac arrythmia-long QT)
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5
Q

speaking ages

A
  • preverbal (<1yr)
  • periverbal (1-3yr)
  • postverbal (>3yr)
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6
Q

SNHL is related to what genes

A

AR-CONNEXIN 26 (GJB2)
GJB6-CONNEXIN 30
AD-CONNEXIN 31

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7
Q

severe HL and deep HL

A

severe>75-95 dB

deep >95 dB

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8
Q

when do adenoids start to decrease in size

A

beyond 7 years

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9
Q

TM athelectasis is

A

retraction of TM

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10
Q

complications of AOM

A

mastoiditis, meningitis, petrositis, VII defect, cerebral abscess, sigmoid sinus thrombosis

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11
Q

contrast viral and bacterial acute pharyngotonsillitis

A

viral (65% of cases): tonsil inflammation+low fever(<38) for a few days+non productive cough
bacterial (30% of cases): tonsil inflammation+high fever for >4 days+exudate+uvulitis+no cough

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12
Q

symptoms of rhinosinusitis

A

chronic cough for more than 4 weeks+rhinorrhea+nasal congestion+post nasal drip+facial pain

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13
Q

otoacoustic emission tests for

A

cochlear functioning

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14
Q

when does the E tube acquire adult conformation

A

after 7 years old

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15
Q

frontal and sphenoidal sinuses achieve pneumatization when?

A

9-13 years old

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16
Q

conductive hearing loss levels

A

30-40 dB

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17
Q

bugs causing AOM

A

m. catarrhalis
S. pneumonia
H.influenza
S. pyogenes

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18
Q

treatment of pharyngotonsillitis

A

first symptomatic treatment. If fever lasts more then 4 dyas start antibiotics (amoxicillin)

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19
Q

neck masses in kids

A
  • HL or NHL
  • branchial cyst infection
  • thyroglossal duct cysts
  • ectopic thyroid
  • plunging ranula
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20
Q

otohematoma is

A

cauliflower ear

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21
Q

ramsay hunt syndrome

A

reactivation of herpes zoster oticus along VII/VIII near geniculate ganglion.

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22
Q

exostosis

A

bilateral multiple bony growths in EAC. can be due to periostitis due to cold water

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23
Q

osteoma

A

benign unilateral neoplasm of bony EAC. Has narrow base of implant

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24
Q

differentiate a transverse from a medial temporal fracture

A

medial (longitudinal) has secretion in EAC.

transverse can affect TMJ and mastoid

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25
Q

furunculosis is? Therapy is?

A

a localised pustular folliculitis due to staph aureus. Treat with antibiotics

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26
Q

otomycosis is most often due to

A

aspergillus and candida

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27
Q

external ear imaging

A

CT no contrast

MRI contrast

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28
Q

EAC bony vs fibrocartilagenous. E. tube bony vs cartilage?

A

EAC: cartilage 1/3+bony 2/3

E tube: cartilage 2/3+bony 1/3

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29
Q

cough reflex

A

stimulation of auricular branch of vagus

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30
Q

cholesteatoma is

A

s an abnormal skin growth that can develop in the middle ear. It usually begins as a collection of dead skin cells and develops into a cyst-like pocket behind the eardrum. It can significantly impair a person’s hearing and balance, as well as the function of their facial muscles.

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31
Q

the middle ear is divided into 3 parts

A

epitympanim, mesotympanum, hypotympanum

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32
Q

jacobson nerve

A

is in hypotympanum, is IX, eventually enters otic ganglion

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33
Q

bullous myringitis

A

small fluid filled blisters form on the eardrum. Are painful

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34
Q

stages of AOM

A

hyperemia, exudation, suppuration, resolution

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35
Q

COM can be

A

cholestetomatous (rarely)(is keratinizing squamous epithelial growths. Presents as recurrent otorrhea, hypoacusia, VII palsy, vertigo))
non-cholesteatomatous (can be active suppuration or dry NO PAIN)

36
Q

what is meningoencephalic herniation

A

bone defect or erosion that results in herniation of meningeal wall and so encephalic tissue (a pulsating mass) goes into middle ear

37
Q

glomus tympanicus tumors

A

vascular mass of epitheliod cells in jugular bulb. Pulsating reddish blue mass present in low TM. Treat with surgery

38
Q

sound greater than x dB damages the cochlea

39
Q

pure tone vs speech audiometry

A

pure tone is beeps, speech is words

40
Q

tympanometry does what

A

measures pressure at middle ear with varying acoustic impedence (tests mobility of eardrum and conduction of ossicles - NOT A HEARING TEST)

41
Q

define presbyacusis

A

age related loss of hair cells in inner ear

42
Q

treatment of sudden SNHL

A

steroids, antivirals, neurotrophic agents (VB), anticoagulants, hyperbaric O2 therapy

43
Q

duct of parotid gland. What does the parotid house?

A

stensons (2nd maxillary molar). The retromandibular vein, ECA, VII CN

44
Q

submandibular duct is

A

whartons duct (sublingual caruncle position)

45
Q

PNS to all salivary glands is via

A

VII and V2/V3

46
Q

Parotid gets PNS via

47
Q

all salivary glands above oral fissure (parotid) are innervated by

A

greater petrosal nerve from VII

48
Q

all salivary glands below the oral fissure are innervated by

A

chorda tympani

49
Q

chronic sialadenitis is

A

chronic inflammation of salivary glands

50
Q

what is the most common salivary tumor

A

pleomorphic adenoma of the parotid

51
Q

warthins tumors is

A

monomorphic adenoma of parotid gland

52
Q

where does the thyroid originate from

A

foramen cecum

53
Q

elevated serum calcitonin means you should suspect

A

thyroid medullary carcinoma

54
Q

halsted and evans anastomosis is for

A

parathyroid gland. its from superior and inferior thyroid arteries

55
Q

in what 3 cases would you perform a thyroidectomy

A
  • pathology not contolled by medication
  • airway obstruction
  • malignancy
56
Q

explain thyroid vascularization

A

arteries: ECA–> SUP. THYROID A–> ANT GLANDULAR A & POST GLANDULAR A.
SUBCLAVIAN a–> THYROCERVICAL TRUNK–> INF THYROID A & ASCENDING CERVICAL A
venous: SUP & MID & INF THYROID VEINS

57
Q

tirage

A

sign of bronchial obstruction showing at inspiration on soft chest walls

58
Q

cornage

A

loud laryngotracheal murmur heard during inspiration

59
Q

in what scenarios would you consider doing a tracheotomy

A
  • upper airway obstruction
  • pulmonary secretion
  • mechanical ventilation
  • prevent glottic stenosis/complications
60
Q

what is ludwigs angina? How do you treat?

A

Ludwig ‘s angina , also known as submandibular space infection , is an infection that leads to the rapid death of cells under the mouth. Doesn’t usually happen nowadays thanks to antibiotics, but if it did perform tracheotomy

61
Q

superfical/deep neck abscesses are most commonly due to

A

dental infections

62
Q

bells palsy, most associated to VII peripheral palsy presents as

A
  • drooping eyelid
  • cannot wrinkle forehead
  • paralysis of lower face (more for central VII palsy)
63
Q

nose cartilages

A

are hyaline; septum, ala (sesamoid complex), lateral cartilages

64
Q

vasculature of the nose, innervation of nose

A

A: supratrochlear A from occipital A from ICA
V: angular V to Sup labial V to facial V
N: VII (temporal/zygomatic/buccal)
V1 (supratrochlear) V2 (infraorbital)

65
Q

nasal turbinate comes from which bone

66
Q

roof of the nose

A

olfactory cleft, ethmoid bone (cribiform plate), orbital part of frontal bone

67
Q

modern therapy for paranasal sinus drainage?

A

enlarge natural ostea

68
Q

boundaries of maxillary sinus

A

floor of orbital cavity

  • post: ITF
  • inf: PPF
69
Q

frontal sinus boundaries

A

is connected to the nose via ethmoid bone

70
Q

borders of sphenoid sinus

A

-sup: anterior cranial fossa
-post: sella turcica/middle cranial fossa/post cranial fossa through clivus.
THE OPTIC NERVE/PITUITARY (MEDIAL)/INTERNAL CAROTID (LATERAL) PASS HERE

71
Q

tell me about the vidian nerve and what structure its for

A 
VII--> great petrosal N
\+
Sympathetic chain--> deep petrosal N
= vidian nerve goes to PPG
for autonomic control of nose
72
Q

anterior paranasal sinuses are

A

frontal, maxillary, anterior ethmoid (drain into nose via osteom to middle meatus)

73
Q

posterior paranasal sinuses are

A

sphenoid, posterior ethmoid (drain into nose via sphenoethmoid recess)

74
Q

kiesselbach plexus is for

A

the nose arteries

75
Q

fungal RHS types and subtypes

A

fungal can be invasive (acute(IC)/chronic(IC)/granulomatous) or non invasive (saphrophytic colonization/fungal ball/eosinophilic related)

76
Q

complications of RHS

A

orbital (cellulitis)
bony (poffy tumor)
intracranial (meningitis)
mucoceles (epithelium lined sac fills the paranasal space and causes remodling. if bacteriainfects it it become mucopyocele. often in fronto ethmoid region)

77
Q

what is osteoma? where is it most often? Imaging finding?

A
  • benign osteoblastic growth
  • in frontal sinus
  • ivory (hard bone)–> mixed–> spongiosum (mature)
78
Q

inverted papilloma is ? Most often in?

A

benign tumor of skin. Shows as focal hyperostosis (bony strut) can be with SCC
most common in maxilary/nasoethmoid/frontal/sphenoid sinus

79
Q

juvenile angiofibroma? D.d with what?

A

occurs in teen males. blood supply from internal maxillary and sphenopalatine. Point of origin is PPF.
D.D. with lobular capillary hemangioma: kids/teen males. due to injury/hormones.
D.D. with hemangiopericytoma: in old females. site of origin is nasal cavity

80
Q

wood and leather dust lead to? Nikel and radium lead to?

81
Q

trismus is

82
Q

most common midline lesions

A
  • cocaine induced
  • granulomatous with polyangitis (wegener)
  • eosinophilic with polyangitis (churgg strauss)
  • NK/T lymphoma
83
Q

what is affected most often with CIML

A

inferior turbinate

84
Q

3 phases of churgg strauss

A
  • prodromic: allergic rhinitis/polyps/asthma/cutaneous lesions
  • eosinophilic: gastroenteritis
  • vasculitic: multiorgan involvement LOOK AT PHOTO OF TABLE FOR ANCA/MPO
85
Q

Most common site of oral cancer

86
Q

does PPv have hearing loss?

Head and Neck (10 decks)

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