Hoarseness of Voice

Question 1

_______________is defined as an altered

voice due to a laryngeal disorder

Answer 1

Hoarseness (dysphonia)

Question 2

Cut-off for acute versus chronic

Answer 2

The cut-off point between acute and chronic
hoarseness is three weeks duration, by which time most
self-limiting conditions have resolved

Question 3

Rarely, hoarseness
can be a functional or deliberate symptom referred
to as _____________-

Answer 3

‘hysterical aphonia’.

Question 4

In acute hoarseness the diagnosis is usually obvious from the history alone.

Examples include
1
2

Answer 4

acute upper respiratory tract infection (URTI) or

vocal overuse

Question 5

Think __________if unusual hoarseness develops

Answer 5

‘hypothyroidism’

Question 6

_________must be excluded if hoarseness

persists for longer than 3 weeks in an adult

Answer 6

Laryngeal cancer

Question 7

In cases of chronic hoarseness the larynx must be visualised for diagnosis but the following are common:
— children: _________
— adults—________________

Answer 7

—‘screamer’s nodules’

non-specific irritant laryngitis

Question 8

____________may develop as
a component of the life-threatening acute
angioedemic allergic response

Answer 8

Acute laryngeal oedema

Question 9

Elderly or debilitated patients may exhibit a shaky or soft ‘pseudohoarse’ voice due to a weakened respiratory effort. This is termed__________ or ___________

Answer 9

phonaesthenia or

presbyphonia

Question 10

Contact ulcers of the larynx occur on the ____________where the mucosa is thin.

Answer 10

posterior third of the vocal cords

Question 11

Most Sn Dxtic for assessment of hoarseness

Answer 11

Direct laryngoscopy with a flexible fibre-optic endoscope with possible biopsy

Question 12

MCC of hoarseness in children.

Examples of congenital

____________ (congenital
laryngeal stridor), which is particularly noticeable when the child is asleep;

_________________
(congenital laryngeal narrowing);

Answer 12

laryngomalacia

laryngeal stenosis

Question 13

_____________is the most common laryngeal abnormality in children (20% of cases) after laryngomalacia

Answer 13

Vocal cord paralysis/palsy

Question 14

In children with hoarseness, exclude the acute infections—

Answer 14

laryngotracheobronchitis (croup), tonsillitis and epiglottitis

Question 15

It is important to exclude a_________in a hoarse child

Answer 15

juvenile papilloma

Question 16

MC etiology of acute laryngitis

Answer 16

Most cases are caused by the respiratory viruses— rhinovirus, influenza, para-influenza, Coxsackie, adenovirus and respiratory syncytial virus, resulting
in vocal cord oedema

Question 17

This typically occurs in a heavy smoker who works in a heavy smoking environment, who is a heavy
drinker and continually talks or sings. It is a
combination of vocal abuse and chemical irritation

Answer 17

Chronic laryngitis: ‘barmaid

syndrome

Question 18

Chronic laryngitis due to laryngopharyngeal

reflux is treated with an _______

Answer 18

8–12 week empirical course

of proton-pump inhibitors as well as dietary and lifestyle modification.

Question 19

Examples of benign tumors of the vocal cords

Answer 19

nodules (most common)
polyps (number 2), cysts and papules.
Vocal cord nodules, including ‘singer’s nodules

Question 20

____________usually occurs in patients

with a history of chronic laryngitis, smoking and alcohol use

Answer 20

Squamous cell carcinoma

Question 21

What may preceed Squamous cell carcinoma

Answer 21

leucoplakia, which is treated by vocal cord stripping

under microsurgery

Question 22

If_______________is present with acute hoarseness, the airway is compromised. Be on stand-by for possible emergency intervention

Answer 22

stridor

Question 23

_____________may be associated with cancer of the lung and mediastinum, or diabetes, or may be idiopathic

Answer 23

Recurrent laryngeal nerve palsy