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Specialty Medicine > Exam One > Flashcards

Exam One Flashcards

1
Q

Is the pediatric airway located high or low in the neck?

A

high

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2
Q

Where does the epiglottis sit in the child airway?

A

behind soft palate

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3
Q

What is the shape of the pediatric airway?

A

funnel

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4
Q

What is the narrowest portion of the pediatric airway?

A

cricoid

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5
Q

Is Choanal Atresia more common in female or male?

A

female

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6
Q

Which membrane can persist during choanal atresia?

A

buccopharyngeal

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7
Q

Which congenital happening anamoly can pyriform stenosis present with?

A

holoprosencephaly

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8
Q

What type of tooth for Pyriform Stenosis?

A

central mega incisor

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9
Q

What is the most COMMON source of nasal obstruction in kids? Does this self resolve?

A

Rhinitis of Infancy

yes

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10
Q

What is the most common cause of (SUPRA-GLOTTIC) pediatric stridor? When does this resolve?

A

LARYNGO-malacia

by one year

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11
Q

What structure needs to be evaluated for congenital bilateral vocal fold paralysis?

A

foramen magnum

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12
Q

What malformation needs to be evaluated for congenital bilateral vocal fold paralysis?

A

chiari type one

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13
Q

What is the most common neoplasm of the vocal FOLD of children? What age do these kids present?

A

recurrent respiratory papillomatosis

2-4 years

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14
Q

What is the SECOND most common cause of stridor in infants?

A

bilateral vocal fold paralysis

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15
Q

What is the third most common cause of stridor in infants? What causes it?

A

subglottic stenosis

iatrogenic

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16
Q

What is the most common cause of subglottic stenosis?

A

iatrogenic

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17
Q

Are Subglottic Hemangiomas more common in females or males?

A

female

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18
Q

What is the most common neoplasm of the infant airway?

A

SUBGLOTTIC HEMANGIOMA

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19
Q

Where else do hemangiomas manifest if a child had a subglottic hemangiomas?

A

cutaneous

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20
Q

What else does tracheomalacia often present with?

A

TE fistula

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21
Q

What are the two causes of external compression in infant trachea?

A

vascular rings

mediastinal mass

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22
Q

What is the most common inhaled particle? What age range?

A

food

six months to two years

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23
Q

What is the most common ingested particle?

A

coin

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24
Q

Which virus causes croup?

A

Parainfluenza Type One

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25
Q

What is the most common neoplasm in kids?

A

hemangioma

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26
Q

Are most pediatric neck masses benign or malignant?

A

benign

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27
Q

Are most adult neck masses benign or malignant?

A

malignant

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28
Q

The majority of pediatric neck masses are what?

A

inflammatory

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29
Q

A posterior neck mass is behind what muscle?

A

SCM

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30
Q

What type of branchial cleft cyst is most common?

A

type two

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31
Q

A type two branchial cleft cyst is located between what two landmarks?

A

cricoid and SCM

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32
Q

Which two arches contribute to a Type Two Branchial Cleft Cyst?

A

second and third

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33
Q

A type One branchial clest cyst is close to what structure?

A

ear

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34
Q

Which two arches contribute to a Type One Branchial Cleft Cyst?

A

first and second

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35
Q

Which type of branchial cleft cyst can become intertwined with the facial nerve?

A

type one

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36
Q

A type Three branchial clest cyst arises most often in what sex? Where?

A

female

left neck

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37
Q

Which two arches contribute to a Type three Branchial Cleft Cyst?

A

third and fourth

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38
Q

Which two bacteria are the most common cause of Acute Bacterial Lymphadenitis?

A

S. aureus

Group A beta hemolytic strep

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39
Q

Which two antibiotics for an Atypical Mycobacterial neck mass?

A

azithromycin and ethambutol

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40
Q

Does a child with cat scratch disease present with mild or severe symptoms?

A

mild

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41
Q

How is cat scratch diagnosed?

A

serology

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42
Q

Which stain for cat scratch?

A

warthin starry silver

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43
Q

What type of EPITHELIUM for a congenital neck mass? Infection follows what?

A

respiratory

recent URI

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44
Q

Which bone during a thryoglossal duct cyst? Which part?

A

hyoid

central

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45
Q

Which triangle for a Plunging Ranula?

A

submental

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46
Q

What muscle for a Plunging Ranula?

A

mylohyoid

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47
Q

What gland for a Plunging Ranula?

A

Sublingual

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48
Q

What drug for hemangioma?

A

propranalol

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49
Q

Which two growths for an exit procedure?

A

teratoma

lymphatic malformation

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50
Q

What is the most common cause for a head and neck malignancy?

A

lymphoma

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51
Q

Over what age for a Lymphoma?

A

five

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52
Q

What neck malignancy under six?

A

neuroblastoma

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53
Q

What is the most common soft tissue malignancy in kids?

A

Rhabdomyosarcoma

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54
Q

A lymph node greater than what size in infants under the age of one is concerning?

A

1 cm

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55
Q

A lymph node greater than what size is concerning in a child over the age of ONE?

A

3cm

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56
Q

Does OME have effusion?

A

no

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57
Q

What percent of kids are diagnosed with OME by 9 months?

A

40%

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58
Q

What percent of kids are diagnosed with OME by Two years?

A

60%

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59
Q

Between how many months is the peak age for OME?

A

6-12 months

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60
Q

Which two Races of people are at the highest risk for OME?

A

native american and eskimo

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61
Q

Which two congenital disorders increase the chance of OME?

A

craniofacial

down syndrome craniosynastosis

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62
Q

Otitis media is considered universal in what population?

A

cleft palate

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63
Q

What type of infection can predispose to otitis media?

A

upper respiratory tract

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64
Q

Does OME have inflammation?

A

no

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65
Q

What is the key factor regarding long-term consequences of OME?

A

duration of disease

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66
Q

It is assumed that most cases of OME are caused by viral or bacteria?

A

viral

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67
Q

In descending order, what are the top three causes of bacterial infections of the ear?

A

S. pneumo

H. flu

moraxella catarrhalis

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68
Q

Which bacteria is increasing in the incidence of otitis media?

A

non-typeable H. flu

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69
Q

Which GI disease can cause a greater incidence of otitis media?

A

GERD

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70
Q

Which GI enzyme can be found in the middle ear during OME with GERD?

A

pepsin/pepsinogen

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71
Q

Does M. catarrhalis have a vaccine?

A

no

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72
Q

Which virus can cause otitis media?

A

Influenza A or B

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73
Q

What age is an absolute contraindication to observation?

A

6 months

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74
Q

A relative contraindication to OME observation occurs within how many days?

A

30

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75
Q

A relative contraindication to OME observation with bilateral otitis media under how many years?

A

two

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76
Q

What is the preferred drug for OME? What concentration? How many doses?

A

amoxicillin

90 mg/kg

two doses

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77
Q

Which antibiotic for severe otitis media?

A

amoxicillin and clavulanic acid

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78
Q

Which drug for otitis media with a penicillin allergy?

A

cephalosporin

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79
Q

Which drug for otitis media with a penicillin and cephalosporin allergy?

A

macrolide

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80
Q

First line antibiotic therapy is not considered if there is a relapse within how many days?

A

30

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81
Q

How many day course of antibiotic for a severe or young child case?

A

ten day

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82
Q

How many day course of antibiotic for a mild or child over age six case?

A

5-7 days

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83
Q

Which two drugs show no use for otitis media?

A

antihistamines

steroids

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84
Q

How many AOM infections for tubes?

A

three in six months

four in twelve months

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85
Q

What are the three causes of OME for tubes?

A

greater than four months

hearing loss/language delay

structural damages

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86
Q

Pain longer than how long may indicate not just a simple otitis media?

A

one week

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87
Q

Is foul smelling discharge from an ear an indicator of not just normal otitis media?

A

yes

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88
Q

Pain localized to what area may indicate not just simple otitis media?

A

retroorbital

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89
Q

Which nerve can become paralyzed during an severe bout of otitis media?

A

facial

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90
Q

Are anaerobics seen with acute otitis media? What infection are they seen with?

A

no

mastoiditis

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91
Q

Which otitis media bacteria is associated with meningitis?

A

strep pneumo

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92
Q

Which two organisms for Cholesteatoma?

A

pseudomonas and bacteroides

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93
Q

Sound is the what of acoustic energy?

A

perception

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94
Q

What is the ratio of hearing structures?

A

tympanic membrane to foot plate of stapes

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95
Q

What membrane in the ear for hearing? Tuned to?

A

basilar

different frequencies

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96
Q

What two things do the efferent signals of the organ of corti do?

A

fine tune and amplify

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97
Q

What does the efferent pathway create? What is another name for this?

A

cochlear microphone

cochlear microphone = otoacoustic emission

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98
Q

What is the gold standard for measuring hearing?

A

behavioral testing

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99
Q

What three things does adult behavioral testing measure?

A

hearing level for each frequency

speech repitition threshold

speech discrimination

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100
Q

What is the decibel range for normal hearing?

A

-10 to 25

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101
Q

What is the decibel range for mild hearing loss?

A

25 to 40

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102
Q

What is the decibel range for moderate hearing loss?

A

40 to 55

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103
Q

What is the decibel range for moderately severe hearing loss?

A

55 to 70

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104
Q

What is the decibel range for severe hearing loss?

A

70 to 90

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105
Q

What is the decibel range for profound hearing loss?

A

90 to 120

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106
Q

What does otoacoustic emission ENSURE?

A

cochlear function is intact

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107
Q

What doesnt otoacoustic emission measure?

A

hearing

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108
Q

Otoacoustic emissions have a very high rate of what?

A

false positive

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109
Q

Is ABR a measure of hearing?

A

no

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110
Q

What test is the gold standard for MIDDLE EAR status? What does this measure?

A

Typanometry

compliance of tympanic membrane

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111
Q

What is abnormal in conductive hearing loss?

A

amplification of signal

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112
Q

What is the most common cause of pediatric conductive hearing loss? Less common?

A

middle ear effusion

auricular atresia

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113
Q

What is the most common cause of adult conductive hearing loss? Less common?

A

long standing chronic ear disease

otosclerosis

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114
Q

What is the most common cause of pediatric sensorineural hearing loss? Less common?

A

congenital

hereditary and late onset

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115
Q

What is the most common cause of adult sensorineural hearing loss? Less common?

A

presbycusis

acoustic neuroma

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116
Q

What can decrease speech discrimination?

A

increased amplification

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117
Q

What does BAHA allow for?

A

direct stimulation of cochlea

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118
Q

Is rhinitis more caused by bacteria or virus? What is the cause of secondary infection?

A

virus

bacterial infection after virus

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119
Q

Purulent discharge for more than how many days suggests bacterial rhinitis?

A

five days

120
Q

What is the cause of rhinosinusitis is kids under four?

A

adenoiditis

121
Q

What pharynx pathology can cause recurrent need of ear tubes?

A

adenoids

122
Q

Which imaging modality has no role in sinusitis?

A

plain film Xray

123
Q

Which imaging modality has A role in sinusitis?

A

CT w/o contrast

124
Q

Do clear secretions get antibiotics?

A

no

125
Q

Can anaerobes cause sinusitus?

A

yes

126
Q

How many days of ABX for bacterial sinusitis?

A

ten

127
Q

What three conditions predispose to Polypoid Corditis?

A

smokers/talkative/acid reflux

128
Q

What is key for vocal cord dysfunction?

A

correct diagnosis

129
Q

What kind of exercises for vocal cord dysfunction?

A

speech therapy

130
Q

What are the two treatments for Bells Palsy?

A

HIGH dose steroids

AND

anti-virals

131
Q

What type of testing IS WARRANTED during Bells Palsy?

A

audiometric

132
Q

What virus is associated with Ramsay Hunt Syndrome?

A

herpes zoster

133
Q

Is full recovery from Ramsay Hunt Syndrome likely?

A

no

134
Q

Is the hearing loss of Acoustic Schwannoma reversible or irreversible?

A

irreversible

135
Q

What is another name for Glomus tumor?

A

paragangliomas

136
Q

How does a Glomus Tumor present?

A

pulsatile tinnitus

137
Q

Which turbinate can obstruct airflow the most?

A

inferior turbinate

138
Q

What is more common, anterior or posterior epistaxis?

A

anterior

139
Q

Kesselbechs plexus is located along which septum?

A

anterior

140
Q

Is Kesselbechs plexus located anterior or posterior?

A

anterior

141
Q

Which vessels feed the nose?

A

external and internal carotid

142
Q

Which drug for nasal vestibulitis?

A

Bactroban

143
Q

Is silver nitrate a good choice for active rapid bleeding?

A

no

144
Q

How long is packing left in?

A

three days

145
Q

Who removes nose packing?

A

ENT

146
Q

Antibiotics for the coverage of what during nose packing?

A

staph

147
Q

Which is more severe, anterior or posterior epistaxis?

A

posterior

148
Q

Which artery can be ligated for POSTERIOR epistaxis?

A

anterior ethmoidal

149
Q

Does males or females get Juvenile Nasopharyngeal Angiofibroma?

A

males

150
Q

What imaging modality for the sinuses?

A

CT

151
Q

What imaging modality for the brain?

A

MRI

152
Q

What kind of metaplasia for Nasal Vestibulitis?

A

squamous

153
Q

Which turbinate is involved in Rhinitis Medicamentosa?

A

inferior

154
Q

What preceedes sinusitis?

A

rhinitis

155
Q

Does Chronic Rhinosinusitis have an increased white count?

A

no

156
Q

It is rare for an adult to have an ear infection w/o what other concurrent infection?

A

sinus infection

157
Q

Inflammation in the nose may lead to inflammation in what other area?

A

upper airway

158
Q

What is the main antibiotic for sinusitis?

A

amoxicillin-clavulanate

159
Q

What are the two nasal decongestants?

A

phenylephrine and oxymetazoline

160
Q

What process drives the formation of vocal cord polyps?

A

inflammation

161
Q

Two drugs for Traumatic Granuloma?

A

steroids and PPIs

162
Q

What definitevly treats a traumatic granuloma?

A

surgery

163
Q

What causes vocal cord nodules?

A

reflux

164
Q

Is laryngeal cancer very or not very treatable?

A

very

165
Q

Does laryngeal cancer metastisize early or late?

A

late

166
Q

What is the presentation of laryngeal cancer?

A

smokers with new onset hoarseness

167
Q

Does reflux laryngitis often or not often have signs of heartburn?

A

not often

168
Q

Does laryngomalacia have a relationship with reflux?

A

yes

169
Q

Which two months does LAryngomalacia present?

A

first to second

170
Q

What is the rate of incidence of Bells Palsy in comparing men to women?

A

equal

171
Q

What is the narrowest portion the facial nerve traverses?

A

internal genu

172
Q

What imaging for Bells Palsy?

A

MRI

173
Q

What can happen to the eye during Bells Palsy?

A

corneal abrasion

174
Q

According to Griffith, are most neck masses in the young adult benign or malignant? What is the top age of this group?

A

benign

40

175
Q

Where does masses in the Upper Jugular area come from?

A

nasopharynx

176
Q

Where does masses in the Lower Jugular area come from?

A

mediastinum

177
Q

Where two areas do submandibular masses come from?

A

anterior two thirds of tongue

floor of mouth

178
Q

Where do masses in the submental area come from?

A

Lip

179
Q

According to Griffith, what is the empirical treatment for a new onset neck mass?

A

two weeks of broad spectrum ABX

180
Q

According to Griffith, what is the standard of diagnosis for a neck mass?

A

fine needle aspiration

181
Q

Any conditions with symptoms of what disease always get an FNA?

A

lymphoma

182
Q

How many passes for an FNA?

A

four

183
Q

According to Griffith, what does CT distinguish regarding neck masses?

A

cystic vs. solid

184
Q

According to Griffith, what neck mass doesnt get contrast during a CT scan?

A

thyroid

185
Q

According to Griffith, radionucleotide scanning is used for identifying masses in which two areas?

A

salivary and thyroid

186
Q

What is the most common type of carcninoma in adult head and neck masses?

A

squamous cell

187
Q

According to Griffith, what is the most common neck mass?

A

thyroid

188
Q

Are thyroid masses more often malignant in children or adults?

A

children

189
Q

Are thyroid masses more common in males or females?

A

males

190
Q

According to Griffith, is lymphoma more common in younger or older poeple?

A

younger

191
Q

Do lipomas affect the young or the old more often?

A

old

192
Q

What two vessels is a Type Two Branchial Cleft Cyst most often located between?

A

internal and external carotid

193
Q

According to Griffith, which Type of branchial cleft cyst involves the facial nerve?

A

Type One

194
Q

According to Griffith, branchial Cleft Cysts present often after which type of infection?

A

upper respiratory infection

195
Q

According to Griffith, which resolves spontaneously, hemangiomas or lymphangiomas?

A

hemangioma

196
Q

According to Griffith, how are lymphangiomas treated?

A

surgical excision

197
Q

What is the most common type of head and neck cancer?

A

squamous cell

198
Q

What percent of Erythroplakia progress into carcinoma?

A

20-30%

199
Q

What has to be present for ABX for Acute Pharyngitis?

A

positive culture

200
Q

What bacteria is the most common agent of tonsilitis?

A

Group A beta-hemolytic strep

201
Q

According to Griffith, which antibiotic for tonsillitis? How long?

A

penicillin

5-10 days

202
Q

What type of rash for mono?

A

macular

203
Q

Where in the oral cavity does mono present a rash?

A

junction or hard and soft palate

204
Q

What drug for mono?

A

prednisone

205
Q

Mono can cause what nerve dysfunction?

A

GBS

206
Q

According to Griffith, an infection of the tonsil can precede what severe infection?

A

peritonsillar abscess

207
Q

Where can a peritonsillar abscess refer pain?

A

EAR

208
Q

According to Griffith, what infection can cause trismus?

A

peritonsillar abscess

209
Q

According to Griffith, palpation can differentiate a peritonsillar abscess from what?

A

cellulitis

210
Q

According to Griffith, are throat cultures effective for a peritonsillar abscess?

A

no

211
Q

According to Griffith, what two things are needed to treat a peritonsillar abscess?

A

incision and drainage

212
Q

Does peritonsillar cellulitis have pus? Does abscess?

A

cellulitis = no pus

abscess = pus

213
Q

What does a Retropharyngeal Abscess span?

A

entire length of neck

214
Q

Do people hold their neck stiff during a peritonsillar abscess or retropharyngeal abscess?

A

retropharyngeal abscess

215
Q

Do people have NUCHAL RIGIDITY during a peritonsillar abscess or retropharyngeal abscess?

A

retropharyngeal abscess

216
Q

Do people have voice changes more often during a peritonsillar abscess or retropharyngeal abscess?

A

peritonsillar

217
Q

What is the most common post-operative complication following tonsillectomy?

A

bleeding

218
Q

Which vessel could lacerate leading to severe outcomes following tonsilectomy?

A

internal carotid

219
Q

What canal does otoconia establish themselves in during BPPV?

A

posterior

220
Q

Is vertigo made better or worsened by head movement during vestibular neuritis?

A

worsened

221
Q

After what type of infection can vestibular neuritis present?

A

respiratory infection

222
Q

Does vestibular neuritis have acute or slowed onset?

A

acute

223
Q

Does vestibular neuritis increase when looking toward healthy or non-healthy ear?

A

healthy

224
Q

What is the triad of Menieres Disease?

A

tinnitus

vertigo

hearing loss

225
Q

Is meniere’s episodic or non-episodic?

A

episodic

226
Q

What diet for Meniere’s?

A

low sodium

227
Q

What drugs for Meniere’s?

A

diuretics

228
Q

What causes a Perilymphatic Fistula?

A

trauma

229
Q

What is the main cause of central vertigo?

A

infarct

230
Q

What type of nystagmus is present during central vertigo?

A

vertical

231
Q

According to Griffith, which two vessels can contribute to a central vertigo?

A

PICA or vertebral

232
Q

Can MS produce dizziness?

A

yes

233
Q

Is the vertigo in MS constant or does it change?

A

changes

234
Q

What type of nystagmus is present during peripheral vertigo?

A

horizontal

235
Q

Does central or peripheral vertigo last longer?

A

peripheral

236
Q

Does peripheral or central nystagmus close their eyes?

A

central

237
Q

Does vertigo need lab testing?

A

no

238
Q

Which groups of drug are the best for suppressing Acute Vertigo?

A

benzo

239
Q

What two things does the high epiglottis allow children to do?

A

eat ad breath

obligate nasal breathers

240
Q

Does laryngomalacia spontaneously resolve?

A

yes

241
Q

What is fibromatosis coli?

A

fibroma in SCM

242
Q

What are the two landmarks for a Branchial Cleft Cyst?

A

cricoid

anterior to SCM

243
Q

Which bacteria is increasing in the incidence of otitis media?

A

non-typeable H. flu

244
Q

Can blood flow through the lacrimal duct?

A

yes

245
Q

Which nasal ointment for Nasal Vestibulitis?

A

Mupirocin

246
Q

What is the treatment of vocal cord nodules?

A

voice hygiene and NOT SURGICAL

247
Q

What is the treatment for childhood dysphonia?

A

reflux control

248
Q

Rotation of the neck aids in examination of which neck triangle?

A

posterior

249
Q

Greater than what size of growth above the supraclavicular area requires FNA?

A

3 cm

250
Q

What two areas of the head and neck is MRI a better imaging modality for?

A

upper neck

base of skull

251
Q

What two TISSUES can radionucleotide scanning differentiate? Two locations?

A

salivary and thyroid

glandular vs. non-glandular

252
Q

What meatus do the lacrimal ducts drain into?

A

inferior

253
Q

At what anatomical level of the airway is Subglottic Stenosis?

A

cricoid

254
Q

How does Subglottic Hemangioma present?

A

biphasic stridor by six months

255
Q

What is another name for a Type Three Branchial Cleft Cyst?

A

Pyriform Sinus Fistula

256
Q

Does Cat Scratch spontaneously resolve?

A

yes

257
Q

What type of cyst does a dermoid cyst often get confused with?

A

thyroglossal duct cyst

258
Q

What percent of pediatric neck masses are Lymphomas?

A

50%

259
Q

Which turbinate runs the length of the nose?

A

inferior

260
Q

Which procedure to get a patient off afrin?

A

Turbinoplasty

261
Q

What does long term afrin use do to the nose?

A

rebound vasodilation

262
Q

How are vocal polyps treated?

A

surgery

263
Q

Are vocal cord nodules unilateral or bilateral?

A

bilateral

264
Q

Are vocal cord polyps unilateral or bilateral?

A

unilateral

265
Q

What causes Childhood Dysphonia?

A

reflux

266
Q

Are acoustic neuromas more often unilateral or bilateral?

A

unilateral

267
Q

Are acoustic neuromas more often hereditary or non-hereditary?

A

non-hereditary

268
Q

Do thyroid masses more often present in males or females during adulthood?

A

females

269
Q

What is the preferred diagnostic MODALITY for a head ad neck mass that may involve a vascular tumor?

A

MRI

270
Q

Which two diagnostic imaging modalities for a carotid tumor?

A

CT or angiogram

271
Q

According to Griffith, where do Schwannomas most often present in the head and neck?

A

angle of mandible

272
Q

According to Griffith, what is the most common congenital neck mass?

A

thyroglossal duct cyst

273
Q

Does the utricle contain perilymph or endolymph?

A

endolymph

274
Q

Which structure represents the inner surface of the cricoid?

A

subglottis

275
Q

Where does Croup cause obstruction?

A

most of airway

276
Q

What is the most common cause of acute onset lateral neck mass?

A

acute viral lymphadenitis

277
Q

According to Young, what is needed before excision of a thyroglossal duct cyst?

A

confirmation of thyroid tissue

278
Q

According to Young, a mass with fever/night sweats in kids will most often arise in what triangle?

A

posterior triangle

279
Q

According to Young, what needs to be overcome regarding hearing?

A

impedance

280
Q

What is the only device that can measure the sensory experience of hearing?

A

audiogram

281
Q

What can hearing loss not be described as?

A

percentage loss

282
Q

Are the majorities of anosmia idiopathic?

A

yes

283
Q

What drug can treat Rhinitis Medicamentosa?

A

nasal steroids

284
Q

What is the imaging modality for an Acoustic Neuroma?

A

MRI with gadolinium

285
Q

Which mass of the head and neck with get a full body CT?

A

lymphoma

286
Q

According to Griffith, what is the preferred diagnostic test for a salivary gland tumor?

A

open excisioal biopsy

287
Q

Which blood abnormality can a hemangioma present with?

A

thrombocytopenia

288
Q

Which two viruses are associated with long-term vestibular neuritis?

A

measles and mumps

289
Q

Is a perilymphatic fistula self-limiting?

A

yes

290
Q

What is the most deadly nasal structure?

A

choanal atresia

291
Q

What is the most common cause pediatric stridor?

A

laryngomalacia

292
Q

Relieved with crying, where is the lesion?

A

nose

293
Q

Do vocal cord papillomas more often occur as a single or multiple lesions in kids?

A

single = adults

multiple = kids

294
Q

Which direction are carotid body tumors NOT movable?

A

vertical

295
Q

Angular chelitis is associated with what?

A

candidiasis

Specialty Medicine (3 decks)

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