ENT and endoscopy

Question 1

management for coin and battery ingestion (not button battery)

Answer 1

most will pass in stool; if still in stomach at 2 weeks, endoscopic retrieval is warranted

Question 2

emergent endoscopy for foreign body indications:

Answer 2

esophageal obstruction with inability to handle oral secretions, disk batteries in esophagus, sharp pointed objects in esophagus

Question 3

true or false. aspirated peanuts break down to peanut oil which is an intense irritant of the airway and can lead to pneumonitis

Answer 3

true. patients must be monitored after cases as an inpatient until symptoms resolve

Question 4

what types of polyps require follow up with repeat colonoscopy in 3 years

Answer 4

single tubular adenomas >10mm
multiple tubular adenomas 3-10mm
adenomas with villous features
sessile polyps
serrated adenomas

Question 5

damage to what during a surgical airway can result in vocal cord dysfunction or paralysis

Answer 5

thyroid cartilage

Question 6

initial treatment of chyle leak from neck dissection:

Answer 6

low fat diet or medium chain fatty acid diet; or NPO with TPN

Question 7

only absolute contraindication to bronchoscopy

Answer 7

severe refractory hypoxia

Question 8

most common complication of PEG placement

Answer 8

infection at the site

Question 9

most common indication for parotidectomy

Answer 9

neoplasm

Question 10

cyst-like lesion of temporal bone that contains epithelium and desquamated keratin; presents with foul otorrhea and requires surgical resection

Answer 10

cholesteatoma

Question 11

most common cancer of upper lip

Answer 11

basal cell carcinoma

Question 12

most common cancer of lower lip

Answer 12

squamous cell carcinoma

Question 13

signs of damage to recurrent laryngeal nerve on laryngoscopy

Answer 13

ipsilateral adduction of vocal cord (moved to midline trachea)

Question 14

what does the superior laryngeal nerve innervate

Answer 14

cricothyroid

Question 15

most common type of branchial cleft cyst

Answer 15

second branchial cleft arising in mid- to lower neck along anterior border of SCM

Question 16

what nerve arises from C3-C5, courses anterior to the anterior scalene and posterior to the subclavian vein as it enters the thorax

Answer 16

phrenic nerve - motor innervation to diaphragm; sensory innervation to pericardium and diaphagmatic pleura

Question 17

location of neck lymph nodes

Answer 17

level 1 - submental
level 2-4 - upper, middle, and lower jugular
level 5 - posterior triangle of the neck
level 6 - central compartment
level 7 - superior mediastinal

Question 18

Frey syndrome cause

Answer 18

aberrant regrowth of parasympathetic nerve fibers associated with the auriculotemporal nerve into the sweat glands of the skin overlying the parotid gland

Question 19

Symptoms of Frey syndrome

Answer 19

sweating and flushing on the cheek or temple or near the ear particularly when eating foods with intense flavors (sour, spicy, salty)

Question 20

What nerve is often sacrificed during mobilization of the inferior pole of the parotid for parotidectomy

Answer 20

greater auricular nerve (provides sensation to lower earlobe and post-auricular skin)