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ENT, Forensics, Stroke rehab > ENT flashcards > Flashcards

ENT flashcards

1
Q

at risk of second primary cancerization

A

entire upper aerodigestive tract

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2
Q

high risk pts for head and neck cancer

A

tabacco and alocohol users

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3
Q

leukoplakia

A

white plaque cannot be easily scraped off without bleeding. 5% chance of becoming cancerous

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4
Q

erythroplasia

A

More severe than leukoplakia. 75% chance of becoming cancerous

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5
Q

stridor

A

noisy breathing ingeneral. Oftenassociated with croup.

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6
Q

2 most common premalignant signs in the oropharynx

A

erythroplakia and leukoplakia

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7
Q

oral lesion persisting more than 3 weeks…

A

needs a biopsy

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8
Q

Most common type of cancer of the oropharynx.

A

squamous cell carcinoma

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9
Q

most common lip cancer located..

A

lower lip – tobacco, alcohol, chronic sun exposure

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10
Q

cancer of the upper lip is most commonly…

A

BCCA – basal cell carcinoma

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11
Q

neck mass referral if longer than…

A

3 weeks

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12
Q

adenoid cystic carcinoma

A

bucal mucosa

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13
Q

HPV associated oropharyngeal cancer

A

has gone up. 50% of SCCA oropharynx is HPV +

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14
Q

considered non-smoker

A

<10 pack year

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15
Q

HPV basaloid squamous cell ca

A

younger pts, with cystic neck mass, low tobacco and OH utilization.

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16
Q

HPV high risk

A

more than 7 sexual partners, more than 4 oro-genital sex partners. Associated with open mouth kissing.

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17
Q

How come HPV?

A

dysregulation of molecules. E6 decreases P53 activity. E7 decreases RB activity

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18
Q

HPV possitive cancers have an ______ survival rate when compared with other oropharyngeal cancers.

A

increased

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19
Q

what structure are you most likely to injure when operating on parotid gland?

A

VII – facial

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20
Q

Stensen’s duct …

A

pierces buccinator at the 2nd molar

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21
Q

parotid, submandibular, and sublingual glands

A

parotid has the highest proportion of neoplasms, minor salivary glads have highest proportions of malignancy.

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22
Q

Bicellular theory

A

neoplastic development within the salivary glands originates from basal cells seen in excretory and intercalated ducts.

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23
Q

excretory duct neoplasms

A

SCCA and mucopeidermoid carcinoma.

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24
Q

intercalated duct neoplasms

A

pleomorphic adenoma, warthin’s tumor, oncocytoma, acinic cell carcinoma, and adenoid cystic carcinoma.

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25
Q

Multicellular theory

A

neoplasm development is from DIFFERENTIATED cells within the salivary gland unit.

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26
Q

striated duct neoplasms

A

oncocytic tumors

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27
Q

acinar cell neoplasms

A

acinic cell carcinoms

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28
Q

parotid tumors

A

mostly painless, if painful – pain, facial nerve paralysis or numbness, trismus.

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29
Q

pleomorphic adenoma

A

benign mixed tumor, parotid, 30s-50s, women, slow growing, painless, firm. Solitary, tail of superficial lobe – no effect on CN VII. Well encapsulated – demarcated. Chondroid stroma.

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30
Q

Warthins tumor

A

2nd most common benign parotid neoplasm. Papillary cystadenoma lymphomatosum. Males 30+. Only neoplasm associated with tobacco and EtOH. Aspirate straw colored fluid. Cysts with shaggy irregular lining. Pathognomonic features – epithelial cells forming papillary projections into cystic spaces in a backround of lymphoid stroma.

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31
Q

Oncocytoma

A

rare. 50s. Benign salivary neoplasms. Mostly in parotid gland. Lots of mitochondria. Special staining to make diagnosis.

32
Q

Mucoepidermoid carcinoma

A

most common parotid malignancy, then the palate. Not associated with drinking and smoking. Uniform age distribution. Most common gland malignancy in pediatrics. White women.

33
Q

the following should raise suspicion of a High Grade Tumor.

A

pain, fixation to surrounding tissues, skin or facial paralysis.

34
Q

Grade of mucoepidermoid carcinoma determined by ratio of mucoid to epidermoid cell composition.

A

Low grade – more mucoid cells. High grade – more epidermoid cells.

35
Q

mucoepidermoid carcinoma stages

A

I and II – tx by excission alone. III and IV – additional therapy and more complex approach.

36
Q

adenoid cystic carcinoma

A

second most common. Perineural invasion. Metastatic to lung. Cribriform. Swiss-cheese pattern. Poor prognosis.

37
Q

Acinic cell carcinoma

A

excellent survival for low grade. 2nd most common parotid malignancy in peds.

38
Q

Diagnosing a parotid tumor

A

facial nerve involved. Trismus. Hx of skin cancer. CT or MRI. Fine needle aspirate.

39
Q

Superficial parotidectomy

A

cut from top of ear down to clavicle.

40
Q

frostbite

A

swollen pina, weeping serous fluid. Tx – slow warming and topical antibiotics.

41
Q

Neomycin allergy

A

contact dermatitis, weepy vesicular eruption. Tx – topical or systemic steroids (if severe)

42
Q

cellulitis of auricle

A

inflammation, without vessicles or weaping. Topical or systemic antibiotics if severe.

43
Q

auricular hematoma

A

wrestling injury. Tx – with incission and draining then compression.

44
Q

Osteoma (cold-water swimming) or Exostosis (congenital) Ear Canal

A

only removed if obstructive or holding cerumen in canal.

45
Q

Otitis externa – swimmer’s ear

A

Pain, drainage, debris. Moisture, trauma, infection. Tx – debridement, abiotics, wick.

46
Q

fluoroquinolone

A

antibiotics for otitis externa. NO neosporin (aminoglycoside drops)– ototoxicity

47
Q

Coalescent mastoiditis

A

bulge in post auricular area – medical emergency – cerebral involvement

50
Q

Malignant (necrotizing) Otitis Externa

A

Immunocompromised, Diabetics, pseudomonas. IV antibiotics.

51
Q

Otomycosis – fungal otitis externa

A

black or white mycelia – visible in the ear canal. Purulent discharge.

52
Q

Chondrodermatitis nodularis helicis

A

benign lesions. Unresponsive to topical abiotics/steroids – may require complete composite excision.

53
Q

Tympanosclerosis

A

Middle ear – white plaques of hyalinization or calcification. tympanic membrane – doesn’t effect hearing. Basement membrane – may affect hearing if extensive.

54
Q

AOM – acute otitis media

A

normal upper respiratory bacteria – S. pneumoniae, H. influenza, M. catarhalis.

55
Q

Neonatal AOM and chronic otitis media

A

Gram – bacilli (psuedomonas) and staph

56
Q

ET – eustacian tube

A

ventilation and clearance of mucous from middle ear. Opened by tensor veli palatine muscle (assoc with soft palate muscles)

57
Q

Barotrauma

A

rapid diving and flying with an ETD. Avoidance is Tx

58
Q

cholesteatoma

A

perforation of ear drum where skin grows inward. Congenital – epithelial cysts in middle ear (2-5). Pars flaccida – prone to retraction or perforation, related to ETD. Infected granulation tissue

59
Q

Meniere’s Disease

A

episodic vertigo, hearing loss, and tinnitis

60
Q

Balance – 3 factors

A

eye, ear, proprioception

61
Q

Perilymphatic fistula

A

rare sensoryneural hearing loss. Sensorineural hearing loss. Treat ASAP – do not let the sun set on a perilymphatic fistula.

62
Q

only muscle of abduction in the vocal cords and innervation.

A

Posterior Cricoarytenoid muscle. Recurrent laryngeal branch of the vagus.

63
Q

jackson’s watchdog of the larynx

A

Internal sensory branch of the superior laryngeal nerve

64
Q

best treatment of vocal cord nodules

A

speech therapy and voice rest.

65
Q

mayheida malignancy

A

follows leukoplakia of the cords so monitor cords.

66
Q

Croup

A

heamophilus influenza, causes seal bark in kids, epiglotitis – leaning forward and drooling.

67
Q

Middle ear transformer mechanism

A

hydraulic ratio creates a gain of 17:1 at oval window. Ossicular lever 1.3:1. - a total of 22 fold in gain.

68
Q

smallest bone in the body

A

stapes

69
Q

Organ of corti operation

A

transduction from mechanical to electric sound.

70
Q

Cochlear frequency distribution

A

high tones at the base and Bass tones at the apex

71
Q

fluid wave from …

A

oval window to round window

72
Q

function of semicircular canals

A

sensation of angular acceleration

73
Q

Meniere’s Disease

A

upsloping SNHL. Pure tone hearing in worse at low frequency.

74
Q

age related hearing loss

A

downsloping SNHL. High frequency loss.

75
Q

Noise induced SNHL

A

maximal hearing loss peaks at about 4000 Hz. Over time, mid-frequencies also become impaired

76
Q

youngest age for hearing aid or chochlear implant

A

6 mo

77
Q

ABR – auditory brainstem response

A

testing for pts unable or unwilling to cooperate.

ENT, Forensics, Stroke rehab (2 decks)

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