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FFP ENT > Head and neck 2 > Flashcards

Head and neck 2 Flashcards

1
Q

Complications of DNSI

A

Airway compromise
Rupture
Mediastinitis
Lemierre’s syndrome
Carotid artery erosion

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2
Q

What can a rupture of DNSI lead to

A

Pneumonia, empyema, lung abscess

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3
Q

Symptoms and treatment of mediastinitis

A

SOB, chest pain, wide mediastinum

IV abx, surgery

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4
Q

What is Lemierre’s syndrome and its management

A

Internal Jugular Vein thrombosis and oropharynx infection

IV abx, heparin, excision?

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5
Q

What is carotid artery erosion

Presentation?

Management

A

Internal carotid artery most commonly eroded. Then external most likely, then common carotid.

Sentinel bleeds: mouth, nose, ear

Surgery

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6
Q

What is parotitis

Treatment

A

Can be mumps or bacterial parotitis

Mumps: children, bilateral ‘hamster face’. Watch for complications

Bacterial parotitis: occurs in elderly, debilitated and those with poor oral hygiene. Parotid swollen, tender, pus at duct opposite second upper molar. Treatment: PO/IV abx, rehydrate, oral care

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7
Q

Typical history of those with salivary gland stones

A

Pain after eating which settles an hour or so afterwards.

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8
Q

Symptoms of Sjogren’s syndrome

A

Dry eyes/mouth, arthralgia (joint pain)

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9
Q

Imaging for salivary stones

A

USS/ FNA/ Xray/ MRI

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10
Q

Difference between stertor and stridor

A

Stertor- noise breathing caused by partial obstruction of the airway above the larynx (tonsils, adenoids, tongue obstruction). Sounds like snoring

Stridor-NOisy breathing caused by partial obstruction of airway at or below the larynx

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11
Q

Signs of severe airway obstruction and what to do

A

Tracheal tug, recession, accessory muscle use, complete obstruction with quiet breathing, tachycardia, hypoxia, confusion

URGENT ent input

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12
Q

Causes of stridor

A

Supraglottitis/ epiglottitis
Malignancy
Vocal cord palsy
Angioedema
Foreign body

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13
Q

Causes of stertor

A

Tonsillitis
NAsal obstruction
Foreign body
Angioedema

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14
Q

Management of stridor

A

ABCDE
Resus
Anaesthetics
ENT

COnsider
Adrenaline nebuliser
Dexamethasons for inflammation
Theatre
Awake tracheostomy

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15
Q

If a sore throat looks unusual what is it

A

Tonsillitis

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16
Q

If a sore throat has a normal looking pharynx what is i

A

Supraglottitis

17
Q

What is supraglottitis

A

Infection of the supra glottis (larynx above the true cords)

18
Q

Management of supraglottitis

A

Consider airway compromise needing intubation or trache

Most settle with IV dexamethasone and IV abx

19
Q

Can adrenaline be given in supraglottitis?

IF so what should you be wary of

A

YEs. Nebulised adrenaline may buy time in extremis. But rebound tightening of airway is possible so if you need adrenaline you should consider securing the airway

20
Q

Symptoms of an impacted foreign body

A

Felt something stick at time of eating
Unable to finish meal
Unable to eat or drink since or swallow own saliva
Sharp pain
fever/surgical emphysema. abnormal physiology if progression

21
Q

Symptoms of an ingested foreign body which has just caused a scratch

A

OK at time of eating, pain later. Able to finish meal. Able to eat and drink subsequently. Able to swallow own saliva. Dull pain. Normal physiology

22
Q

Tests to do if ingested foreign body

A

Lateral neck xray. However not always seen.

CXR if think has gone down

ENT can do Flexi scope and remove it under anaesthetic. If no foreign body is seen, advise pt to return if worse/ persisting, fever or neck lump

23
Q

What does surgical emphysema indicate on a neck Xray

A

perforation

24
Q

how to manage a patient who has swallowed a large food bolus and presents with complete dysphagia

A

CXR and neck Xray to look for opaque bones as these won’t pass. Consider buscopan and diazepam to relax muscle. Oesophagoscopy and removal in ENT if doesn’t pass and food bolus is either pushed down or brought up

25
Q

What cancers arise from glands

A

Adenoid cystic carcinoma
Mucoepidermoid carcinoma

26
Q

What cancers arise from upper aerodigestive tract mucosa

A

squamous cell carcinoma

27
Q

Risk factors for H&N cancer

A

Tobacco and alcohol
HPV
Occupation: nickel refining, woodworking, exposure to textile fibres
Plummer-VInson syndrome: iron deficiency in older women. Develop hypo pharyngeal carcinoma

28
Q

Risk factors for H&N cancers in younger patients

A

HPV infevtion
Smokeless Tobacco
Marijauna

29
Q

How does head and neck cancer present

A

Visible lesions
Neck lump
Hoarse voice
Dysphagia
Referred otalgia

FFP ENT (9 decks)

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