General Board Prep Flashcards

1
Q

What nerve is associated with the first branchial arch?

A

CN V3

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2
Q

What nerve is associated with the second branchial arch?

A

CN VII

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3
Q

What nerve is associated with the third branchial arch?

A

CN IX

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4
Q

What nerve is associated with the fourth branchial arch?

A

Superior laryngeal nerve (CN X)

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5
Q

What artery is associated with the first branchial arch?

A

Maxillary

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6
Q

What artery is associated with the second branchial arch?

A

Stapedial

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7
Q

What artery is associated with the third branchial arch?

A

Common and internal carotid arteries

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8
Q

What artery is associated with the fourth branchial arch?

A

Subclavian on the right

Arch of the aorta on the left

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9
Q

What nerve is associated with the sixth branchial arch?

A

Recurrent laryngeal nerve (CN X)

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10
Q

What artery is associated with the sixth branchial arch?

A

Pulmonary artery on the right

Ductus arteriousus on the left

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11
Q

Are type 1 or 2 first branchial arch anomalies more common?

A

2: ectodermal AND mesodermal elements

Ends inferior to the EAC or into the bony cartilaginous junction

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12
Q

What is the most common type of branchial anomaly?

A

Second: external opening along the ant border of the SCM, internal opening in the tonsillar fossa
**penetrates the platysma

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13
Q

Which branchial anomaly runs between the ICE and the ECA?

A

Second

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14
Q

What is the 10 point grading system for aural atresia?

A

Jahrsdoerfer system: 2 pts for stapes, 1 for mastoid pneumatization, oval windo status, round window status, malleus, incus, facial nerve course, status of middle ear, external appearance

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15
Q

What structure from the nose?

A

Frontonasal process

Bilateral nasal placodes

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16
Q

What is the origin of the inferior turbinate?

A

Maxilloturbinal

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17
Q

What is the origin of the agger nasi cell or uncinate process?

A

First ethmoturbinal

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18
Q

What is the origin of middle turbinate?

A

second ethmoturbinal

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19
Q

What is the origin of superior turbinate?

A

third ethmoturbinal

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20
Q

What is the origin of the supreme turbinate?

A

Fourth ethmoturbinal

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21
Q

What is the Furstenburg test?

A

Expansion of a nasal mass with compression of the IVJs

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22
Q

What is the most common midline nasal mass?

A

Dermoid cyst

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23
Q

Where on the nost is a glimoa usually found?

A

Glabella

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24
Q

What is torticollis post-tonsillectomy concerning for?

A

Grisel’s syndrome: rare cause of torticollis that involves subluxation of atlanto-axial joint from inflammatory ligamentous laxity following an infectious process in the head and neck, usually a retropharyngeal abscess.

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25
Q

Croup like sx in a child <6 mo whould be concerning for possible:

A

Subglottic hemangioma

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26
Q

What are the 2 major criteria for chronic pediatric sinusitis

A

Nasal obstruction

Purulent nasal discharge

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27
Q

Chandler classification

A
I: Pre-septal cellulitis
II: Orbital cellulitis 
III: Sub-periosteal abscess
IV: Orbital abscess
V: Cavernous sinus thrombosis
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28
Q

What is the most common pattern of velopharyngeal closure?

A

Coronal

Followed by sagittal, circular, and circular with Passavant’s ridge

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29
Q

MCC of croup (laryngotracheitis)?

A

Parainfluenza

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30
Q

What does AP Xray show with Croup?

A

Steeple sign–subglottic narrowing

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31
Q

Rx croup:

A

Supportive care: humidification, racemic epi, steroids

NO intubation

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32
Q

AP xray finding with epiglottitis

A

Thumbprint sign

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33
Q

Rx for epiglottitis

A

OR intubation, extubate when air leak is present

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34
Q

What is the major blood supply of the adenoids?

A

Pharyngeal branch of the internal maxillary artery

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35
Q

What does inflammation do to the histopathological composition of the adenoids?

A

Increases squamous epithelium and decreases the respiratory proportion

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36
Q

What is the rule for tonsillectomy based on number of infections a year

A

7/yr for 1 yr
5/yr for 2 yr
3/yr for 3 yr

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37
Q

What is PFAPA syndrome

A
Periodic high fevers 
Aphthous stomatitis 
Pharyngitis 
Cervical adenitis
3-5 times per week for 6 mo
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38
Q

What microbe causes cat scratch fever?

A

Bartonella henselae

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39
Q

What is the most common pediatric salivary gland mass?

A

Hemangioma

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40
Q

What is the most common pediatric salivary gland neoplasm?

A

Pleomorphic adenoma

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41
Q

What is the most common pediatric salivary gland malignancy

A

Mucoepidermoid carcinoma

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42
Q

Are parotid gland neoplasms more commonly malignant in children vs adults?

A

Children 50%

Adults 20%

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43
Q

Three basic kinds of small blue cell malignancies of children?

A

Lymphoma
Sarcoma
Rhabdomyosarcoma

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44
Q

What is the most common site of rhabdomyosarcoma?

A

Orbit

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45
Q

What is the most common histopathology of rhabdomyosarcoma in infants and children?

A

Embryonal 75%: spindel shaped cells with eosinophilic cytoplasm, best prognosis

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46
Q

What is the most common histopathology of rhabdomyosarcoma in adolescents?

A

Alveolar: small round cells seperated by fibrous septae into alveolar groups

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47
Q

What syndrome is characterized by hemangioblastomas of the CNS and retina, renal cysts/carcinoma, pheochromocytoma, pancreatic cysts, and papillary cystadenomas of the epididymis

A

von Hippel Lindau syndrome

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48
Q

Classic triad of retrognathia, glossoptosis, and cleft palate

A

Pierre robin

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49
Q

What causes the cleft palate in Pierre robin sequence?

A

Retrognathia prevents descent of the tongue into the oral cavity, preventing palate fusion

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50
Q

MCC short limb dwarfism

A

Achondroplasia

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51
Q

What mutation causes achondroplasia?

A

AD mutation in FGFR-3

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52
Q

What is VATER syndrome? What is added in VACTERL?

A
Vertebral/vascular anomolies 
Anal atresia
Tracheal anomalies 
Esophageal anomalies 
Renal/radial bone anomalies 
**Cardiac anomalies 
**Limb anomalies
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53
Q

What are the AD syndromes?

A
WANTBCS
Waardenburg 
Apert 
Neurofibromatosis
Treacher Collins
Branchio-oto-renal
Crouzon
Stickler
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54
Q

What presents with pigmentary abnormalities, craniofacial anomalies, and unilateral or bilateral SNHL

A

Waardenburg

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55
Q

What is the key difference in phenotype between type I and type II Waardenburg syndrome?

A

Type I has dystopia canthorum

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56
Q

What is the key feature of type III and type IV Waardenburg syndromes?

A

III: skeletal dysplasias and muscular hypotonia
IV: Hirschsprung megacolon

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57
Q

What two syndromes are due to a mutation of the FGFR-2 gene?

A

Apert

Crouzon

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58
Q

What syndrome is similar to Apert’s syndrome but has digital broadening rather than syndactyly

A

Pffeiffer’s: associated with tracheal sleeve

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59
Q

Cafe au lait spots, Lisch nodules

A

Neurofibromatosis type I: mutation on chrom 17

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60
Q

Bilateral acoustic neuromas

A

Neurofibromatosis type II: mutation on chrom 22

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61
Q

Malformation of the 1st and 2nd branchial arches secondary to TCOF1 gene mutation on chrom 5

A

Treacher Collins: 50% have hearing impairment from EAC and/or middle ear malformations

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62
Q

Mutation in COL2A1 on chrom 12 (type II collagen) leadingto myopia with retinal detachment and cataracts, hypermobility with enlarged joints, early onset arthritis, SHNL in 80%

A

Stickler

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63
Q

Char by branchial cleft anomalies, otologic malformation, and renal dysplasia

A

Branchio-oto-renal

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64
Q

SNHL associated with iodine metabolism defect leading to euthyroid goiter, associated with Mondini’s dysplasia and enlarged vestibular aqueduct

A

Pendred

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65
Q

What was Pendred historically diagnose with?

A

Perchlorate discharge test: now test for the pendrin gene mutation

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66
Q

Hearing loss, vestibular deficits, ataxia, retinitis pigmentosa

A

Usher syndrome

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67
Q

What is the most common type of Usher syndrome?

A

Type I: most common, profound deafness with RP by the age of 10, absent vestibular response

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68
Q

Unilateral facial asymmetry, upper lid colobomata, otologic abnormalities, underdevelopment of the mandible

A

Goldenhar syndrome

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69
Q

Profound bilateral SNHL, cardiac defects, syncopal episodes

A

Jervell-Lange-Nielsen syndrome

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70
Q

X linked regressive syndromes

A

Alport
Norrie
Otopalatodigital
Wildervaank

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71
Q

X linked mutations in the NDP gene often leading to blindness, early onset SNHL

A

Norrie

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72
Q

Widely spaced first and second toes, CHL due to ossicular malformation, x linked recessive

A

Otopalatodigital

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73
Q

Klippel-Feil malformation (congenitally fused segment of the cervical spine), SNHL, CN VI paralysis (x linked recessive)

A

Wildervaank syndrome

74
Q

AD characterized by abnormal facies, VPI, and cardiac anomalies

A

Velocardiofacial: deletion of 22q11

75
Q

Medial displacement of the ICAs present in 25% of pt with this syndrome

A

Velocardiofacial

76
Q

Chars of DiGeorge syndrome

A
Cardiac anomolies (ToF)
Abnormal facies
Thymic aplasia
Cleft palate
Hypoparathyroidism
22q11 deletion
77
Q

Syndrome resulting from improper development of the 3rd and 4th branchial arches

A

DiGeorge syndrome: CATCH 22

78
Q

Central megaincisor, prosencephaly

A

Congenital pyriform aperture stenosis

79
Q

CHARGE syndrome

A
Coloboma
Heart disease 
Atresia, choanal
Retardation, growth
Genital defects 
Ear anomolies
80
Q

Cleft palate results from failure of fusion of:

A

Bilateral palatine shelves (from maxillary processes)

Developing nasal septum (frontonasal process and bilateral median nasal process

81
Q

Cleft lip results from failure of fusion of:

A

Maxillary swelling with medial nasal process

82
Q

Signs of a submucous cleft palate

A

Bifid uvula
Zona pellucida
Notched hard palate

83
Q

Why do pts with cleft palate almost always have chronic otitis media

A

Dehiscence of the palatal sling involving the levator veli palatini

84
Q

What % of clefts are unilateral? What side is more common?

A

80%

More common on the left

85
Q

Formula for ETT size in kids

A

(age + 16)/4

86
Q

ETT cuff pressures > ___ mmHg will exceed the capillary filling pressure and cause ischemic damage

A

20 mmHg

87
Q

At what spinal level is the pediatric larynx located at? Where does it descend to?

A

C2

C6

88
Q

What kind of stridor do supraglottic and glottic masses cause?

A

Inspiratory

89
Q

What kind of stridor does a subglottic mass cause?

A

Biphasic

90
Q

What kind of stridor does a fixed intrathoracic mass cause?

A

Expiratory

91
Q

Mneumonic for evaluation of stridor?

A
SPECSR
Subjective
Progression
Eating and feeding difficulties 
Cyanosis
Sleep disordered breathing
Radiography
92
Q

What are 4 pediatric airway abnormalities improved in the prone position?

A

Laryngomalacia
Pierre Robin sequence
Vascular compression
Mediastinal mass

93
Q

New onset biphasic stridor in an infant under 6 mo with no foreign body hx should raise suspicion for:

A

Subglottic hemangioma

94
Q

MCC of inspiratory stridor, worse when crying or lying supine

A

Laryngomalacia

95
Q

How many types of laryngeal clefts are there?

A

Type 1: supraglottic interarytenoid cleft above VF
Type 2: partial cricoid cleft, extends below VF
Type 3: total cricoid cleft w/o extension into cervical TE wall
Type 4: laryngotracheoesophageal cleft, almost universally fatal

96
Q

What is the grading system for subglottic stenosis?

A
Cotton-Myer
I: <50%
II: 51-70%
III: 71-99%
IV: No detectable lumen
97
Q

What is the cut-off for requiring trach and laryngotracheal reconstruction for subglottic stenosis?

A

Cotton-Myer grade III and above (>70%)

98
Q

What are the 4 classes of posterior glottic stenosis?

A

I: Interarytenoid adhesion: observe or lyse
II: Posterior commissure stenosis
III: Posterior commissure stenosis w/ unilat cricoarytenoid fixation
IV: Posterior commissure stenosis with bilat circoarytenoid fixation

99
Q

What is the most common type of TE fistula?

A

Esophageal atresia with disteal TEF

100
Q

Acidic ingestion leads to _____ necrosis

Alkaline ingestion leads to _____ necrosis

A

Acidic: coagulative (superficial)
Alkaline: liquefactive (deep)

101
Q

When should esophagoscopy be done following acidic or alkaline ingestion?

A

24-72 hr (increased risk of iatrogenic perforation after 72 hr)

102
Q

What are 4 structures that compress the esophagus and are likely spots for foreign bodies to get caught?

A

Cricopharyngeus
Aortic arch
Left mainstem bronchus
Lower esophageal sphincter

103
Q

What is the characteristic sign of ingested button batteries on xray?

A

Double halo sign

104
Q

How many episodes of recurrent AOM are required prior to replacing tube

A

> 3 in 6 mo

>4 in 12 mo

105
Q

Indications for tube placement in the setting of COME?

A

Bilateral COME >3 mo
Unilateral COME >6 mo
Earlier for significant speech delay, severe retraction pocket, disequilibrium, tinnitus

106
Q

What type of auditory testing can be completed from 6 mo to 2 yr?

A

Visual reinforcement audiometry

Followed by conditioned play

107
Q

When mutation is present in 30% of nonsyndromic congenital hearing loss?

A

Connexin 26

108
Q

What is the name for complete bony and membranous labyrinthine aplasia?

A

Michel aplasia

109
Q

What is the most common type of membranous inner ear malformation?

A

Schiebe (cochleosaccular aplasia)

110
Q

In what malformation is the following seen?

  1. only 1.5 turns (instead of the normal 2.5 turns)
  2. Enlarged vestibule with normal semicircular canals
  3. Enlarged vestibular aqueduct containing a dilated endolymphatic sac
  4. Loss of normal partitions
A

Mondini malformation

111
Q

Which SCC develops last and is most commonly affected in labyrinthine abnormalities

A

Lateral

112
Q

What classifies an enlarged vestibular aqueduct?

Enlarged cochlear aqueduct?

A

> 1.5 mm in diameter

3-4 mm in diameter

113
Q
Narrowed IAC (<3mm) associated with \_\_\_\_
Widened IAC (>10mm) associated with \_\_\_\_
A

Absent or hypoplastic CN VIII

Stapes gusher

114
Q

What is the appearance of dried secretions vs polyps on T1 vs T2?

A

Dried secretions: hyper T1, hypo T2

Polyps: hypo T1, hyper T2

115
Q

What bacteria causes rhinoscleroma?

What does histopath show?

A
Klebsiella rhinoscleromatis 
Mikulicz cells (macrophages containing pathogen) and Russel bodies (plasma cells)
116
Q

In what meatus is the nasolacrimal duct opening?

A
Inferior meatus (inferior to the inferior turb)
Valve of hasner
117
Q

Where is the semilunar hiatus located? What does is receive drainage from?

A

Middle meatus

Ethmoid infundibulum, which receives drainage from the maxillary, anterior ethmoid, and frontal sinuses

118
Q

Where is the opening to the posterior ethomoid sinuses located?

A

Superior meatus

119
Q

Where is the sphenoethmoidal recess located in relation to the superior turbinate?

A

Posteriorosuperior to the superior turbinate

120
Q

What plexus is located at the posterior portion of the inferior meatus and nasopharynx, and is the junction of the posterior nasal, sphenopalatine, and ascending pharyngeal veins

A

Woodruffs

121
Q

What are the two periods of growth of the maxillary sinuses?

A

3 yo and 7-12 yo

Cooresponds with growth of dentition

122
Q

What separates the anterior and posterior ethmoids?

A

basal lamella of the middle turbinate

123
Q

What classification system compares the height of the cribriform plate with the fovea ethmoidalis?

A

Keros classification:
I: Cribriform plate 1-3 mm inferior
II: 5-7 inferior
III: 8-16 inferior

124
Q

What is an agger nasi?

A

Most anterior ethmoid air cell caused by pneumatization of the lacrimal bone, can block the frontal recess

125
Q

What is a infraorbital ethmoid cell pneumatizating into the maxillary sinus that can block the maxillary sinus osteum?

A

Haller cell

126
Q

What is a posterior ethmoid cell located superolateral to the sphenoid sinus, may interface with the internal carotid or optic nerve

A

Onodi cell

127
Q

What is the difference between the semilunar hiatus and the infundibulum?

A

Semilunar hiatus: 2D gap between the uncinate and the ethmoid bulla
Infundibulum: 3D space bounded by the uncinate medially, lamina papyracea laterally, and frontal process of the maxilla anterosuperiorly **route to drainage of the maxillary, anterior ethmoid, and frontal sinuses

128
Q

What is the name of the functional drainage pathway for the maxillary, anterior ethmoid, and frontal sinuses (including middle turbinate, uncinate, semilunar hiatus, ethmoid bulla, and infundibulum)?

A

Ostiomeatal complex

129
Q

The drainage pattern of the frontal sinus is determined by the position of attachment of the:

A

Uncinate process

130
Q

What is the most common attachment site of the UP and subsequent drainage pattern of the frontal sinus?
Other options?

A

Attached to the laminal papyracea-> drains medial to the UP

Attaches to skull base or middle turbinate -> lateral to the UP

131
Q

What are the 4 types of frontal cells?

A

I: Cell above the agger nasi
II: Two or more cells above the agger nasi
III: Single cell extending from the agger nasi superiorly into the frontal sinus
IV: Isolated cells within the frontal sinus

132
Q

Where is olfactory epithelium located?

A

Upper 1/3 of the septum
Medial superior/supreme tubrinates
Roof of the nasal cavity

133
Q

Unilateral anosmia, optic atrophy, and papilledema due to a frontal lobe mass

A

Foster Kennedy Syndrome

134
Q

Hypogonadotropic hypogonadism and anosmia (failure of the hypothalamus to secrete GnRH)

A

Kallman’s syndrome

135
Q

Nasal airflow accounts for __% of the airway resistance

A

50%

136
Q

What are the limits of the internal nasal valve?

A

Nasal septum
Upper lateral cartilage
Head of the inferior turbinate
Nasal floor

137
Q

What is the Holman Miller sign?

A

Anterior bowing of the posterior maxillary sinus wall–seen in JNA

138
Q

What finding in the sinuses shows a ground glass appearance on CT and is hypointense on T2?

A

Fibrous dysplasia

139
Q

What is a eukaryotic parasitic pathogen that can cause unitlateral nasal obstruction, epistaxis, and friable polyps

A

Rhinosporidium seeberi (causes Rhinosporidiosis)

140
Q

What are the three stages of Rhinoscleroma?

A

Catarrhal (nonspecific crusting)
Granulomatous (epistaxis, friable mucosa, nodules through the respiratory tract)
Sclerotic (sclerosis and fibrosis)

141
Q

Broad based ribbon-like nonseptate hypae with 90 degree branching

A

Mucor

142
Q

Narrow septate hyphae with branching at 45 degrees

A

Aspergillus

143
Q

What is the difference in timing between acute, subacute, and chronic rhinosinusitis

A

Acute: <4 weeks
Subacute: 4-12 weeks
Chronic: >12 weeks

144
Q

What are the two most common viruses to cause acute rhinosinusitis?

A

Rhinovirus

Coronavirus

145
Q

Chandler classification for orbital complications of sinusitis

A
Preseptal cellulitis 
Orbital cellulitis 
Subperiosteal abscess 
Orbital abscess 
Cavernous sinus thrombosis
146
Q

What structures pass through the cavernous sinus?

A
O TOM CAT
Opthalmic (V1)
Oculomotor (III)
Trochlear (IV)
Maxillary (V2)
Carotid (internal)
Abducens (VI)
147
Q

Osteomyelitis of the anterior table of the frontal sinus

A

Potts Puffy Tumor: infection transmitted via diploic veins, swelling of forehead soft tissue

148
Q

What is the difference between superior orbital fissue syndrome and orbital apex syndrome?

A

SOF syndrome: III, IV, V1, VI, opthalmic vien

+ CN II

149
Q

What is the defect in primary ciliary dyskinesia

A

AR defect in the dynein arms of cilia leading to URIs, otitis media, and infertility

150
Q

PCD with situs inversus and bronchiectasis

A

Kartagener’s syndrome

151
Q

What is Samter’s triad?

A

Sinonasal polyps
Astma
Aspirin sensitivity

152
Q

What is the mechanism of ASA hypersensitivity

A

ASA inhibits COX metabolism of AA
Substrate into 5 lipo-oxygenase and leukotrienes
Asthma and allergy

153
Q

What is the MC benign sinonasal lesion

A

Osteoma

154
Q

Skull osteomas
Colonic polyps
Soft tissue tumors

A

Gardner syndrome

155
Q

McCune-Albright syndrome

A

Polyostotic lesions (fibrous dysplasia)
Precocious puberty
Pigmented skin lesions

156
Q

Solitary encapsulated slow growing monostotic tumor, CT shows central lucency with an eggshell rim

A

Ossifying fibroma

157
Q

What are the 4 lamella encountered during FESS anterior to posterior

A

Uncinate
Ethmoid bulla
Vertical portion of the middle turbinate basal lamella
Vertical portion of the superior turbinate basal lamella

158
Q

Draf I

A

Removal of anterior ethmoid cells
Removal of uncinate
Obstructing frontal cells removed
**no instrumentation of the frontal sinus ostium

159
Q

Draf IIa:

A

Draf I with widening of the frontal sinus ostium

Resection of the floor of the frontal sinus from the lamina to the insertion of the middle turbinate

160
Q

Draf IIb:

A

Draf IIa + resection of the middle turbinate to the skull base
Widening of the frontal sinus medially to the septum

161
Q

Draf III (modified lothrop)

A

Draf II with removal of the intrasinus septum and connecting the bilateral frontal sinuses into one with a common drainage pathway

162
Q

What is the most common site of CSF leak in FESS

A

Lateral lamella of the ethmoid roof

163
Q

With allergy testing, wheal of greater than __ mm is positive

A

3

164
Q

Contents of eosinophils

A
Peroxidase
Neurotoxin
Cationic protein
Charcot Leyden crystals
Major basic protein
165
Q

Which cytokines induce B cells and mast cells to increase IgE production

A

IL 4 and IL 13

166
Q

Which cytokine is involved in the activation and maturation of eosinophils

A

IL 5

167
Q

Which complement pathway uses the C1 complex?

A

Classical pathway

**Lectin pathway similar but uses mannose binding lectin

168
Q

What does major basic protein in eosinophils induce the release of?

A

Histamine from mast cells, leads to damage to epithelial cells

169
Q

What kind of hypersensitivity reaction is hemolytic anemia, transfusion reactions, Goodpasture, MG

A

Type II : antibodies directed against cell antigens, destruction via complement interaction

170
Q

Examples of type III hypersensitivity

A

Serum sickness
PSGN
Angioedema
***antigen-antibody deposition leading to massive PMN infiltration

171
Q

What is the MC granumolatous disease to affect the upper airway?

A

Wegener’s granulomatosis: necrotizing granulomas, small and medium vessel vasculitis

172
Q

Relapsing and remitting AI disease with a triad of oral or genital ulcers, irititis/uveitis, and progressive SNHL

A

Behcet’s syndrome

173
Q

Which two syndromes display genetic imprinting on chromosome 15?

A
Angelman syndrome (lacks maternal copy)
Prader-Willi syndrome (lacks paternal copy)
174
Q

What is the function of p53?

A

Tumor supressor gene involved in cell cycle regulation and apoptosis
Binds CDK and arrests cell replication in G1
**mutations in 50-66% of H&N SCC

175
Q

What is the function of p16 and p21?

A

Tumore suppressor proteins, bind cyclin and CDK

176
Q

What is an oncogene that inhibits apotosis and counteracts p53

A

bcl-2

177
Q

Cell surface tyrosine kinase receptor proto-oncogene, associated with MEN IIa and IIb

A

RET

178
Q

What is another name for Osler Weber Rendu syndrome?

A

Hereditary hemorrhagic telangiectasia

179
Q

What is the diagnostic criteria for Kawasaki disease?

A

Fever > 5 days and 4-5 of the following:

1) Acute cervical lymphadenopathy > 1.5 cm
2) Desquamative rash of the palms and soles
3) Truncal rash
4) Bilateral painless conjunctivitis
5) Erythema of the tongue (strawberry tongue)

180
Q

What is the tx for Kawasaki disease?

A

High dose aspirin

Immunoglobulin

181
Q

What arteries does giant cell arteritis typically affect?

A

Large vessel vasculitis

Temporal and opthalmic arteries

182
Q

Non-syphillitic interstitial keratitis and vestibuloauditory symptoms–Meniere-like hearing loss and vestibular symptoms

A

Cogan’s syndrome