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ENT > Laryngology > Flashcards

Laryngology Flashcards

1
Q

Most common pathogen in viral laryngitis

A

Rhinovirus

Can also see parainfluenza, RSV, adenovirus, flu, pertussis

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2
Q

What are the clinical tools used to assess for LPR?

A

Reflux Symptom Index (RSI)

Reflux Finding Score (RFS)

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3
Q

Where is tuberculous laryngitis typically located?

A

Posterior glottis (interarytenoids)

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4
Q

Forms of chronic infectious laryngitis

A

Tuberculous laryngitis
Syphilitic laryngitis
Rhinoscleroma of larynx
Leprosy

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5
Q

What can cause laryngeal chondritis?

A

Relapsing polychondritis (50% of RP pts)
Radiation
Infectious (TB, syphilis, septic laryngitis)

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6
Q

What is the most commonly involved laryngeal cartilage involved in laryngeal chondritis?

A

Thyroid cartilage

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7
Q

How do the various fungal laryngitis bugs look?

A

Candida: White plaques
Histo/Blasto: Ulceration
Coccidio: Nodule

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8
Q

What are the benign laryngeal tumors?

A

Chondroma
Granular cell tumor
Recurrent respiratory papillomatosis

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9
Q

Most common site in the larynx for a chondroma

A

Posterior cricoid cartilage (hyaline)

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10
Q

Where do laryngeal granular cell tumors arise from?

A

Schwann cells in the posterior true vocal fold or arytenoids

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11
Q

What is seen on histology of laryngeal granular cell tumors?

A 
Pseudoepitheliomatous hyperplasia
(often confused for SCCa)
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12
Q

Presentation of laryngeal sarcoid

A

Supraglottic submucosal mass

epiglottis most common

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13
Q

Presentation of laryngeal GPA

A

Mucosal ulcerations

Subglottic mass/stenosis

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14
Q

Presentation of laryngeal amyloidosis

A

Supraglottic mass covered by mucosa

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15
Q

Which laryngeal joint is most commonly affected by RA?

A

Cricoarytenoid

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16
Q

What laryngeal sites are involved in wegener’s, sarcoid, and amyloid?

A

Sarcoid: Supraglottis
Amyloid: Supraglottis
Wegener’s: Subglottis

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17
Q

What should you have patients say if you believe them to have ADductor spasmodic dysphonia?
ABductor?

A

ADductor: 80-89
ABductor: 60-69

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18
Q

Treatment for ADductor spasmodic dysphonia

A

Botox injection into the thyroarytenoid muscle

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19
Q

How does a person’s voice change in response to hearing loss?

A

SNHL: Louder
CHL: Louder or sometimes quieter

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20
Q

What causes diplophonia?

A

Recruitment of false cords or asymmetric mass

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21
Q

What is seen on laryngoscopy in VCD?

A

Posterior glottic chink

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22
Q

What type of stridor is heard with supraglottic obstruction?

A

Inspiratory

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23
Q

What type of stridor is heard with glottic obstruction?

A

Inspiratory or biphasic

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24
Q

What type of stridor is heard with subglottic obstruction?

A

Biphasic

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25
Q

What type of stridor is heard with intrathoracic obstruction?

A

Expiratory

26
Q

What is the maximum trach tube cuff pressure?

A

25 mmHg

Any higher will exceed capillary hydrostatic pressure.

27
Q

What is the most common pathogen in laryngitis?

A

Rhinovirus

28
Q

What is seen on FFL in tuberculous laryngitis?

A

Granulation and ulcerative tissue in posterior glottis. Typically interarytenoid.

29
Q

What non-classical infectious pathogens can infect the larynx?

A 
H. flu (epiglottitis)
Syphilis
TB
Leprosy
Klebsiella rhinoscleromatis
Candida, Aspergillus, endemic fungi
30
Q

What is the most commonly involved cartilage in laryngeal chondritis?

A

Thyroid cartilage

31
Q

What is seen on endoscopy in laryngeal chondritis?

A

Pale laryngeal mucosa

32
Q

What are the benign neoplasms of the larynx?

A

Chondroma
Granular cell tumor
RRP
Vascular tumors (hemangioma, paraganglioma)

33
Q

Where is the most common site of laryngeal chondroma?

A

Posterior cricoid cartilage

34
Q

Where do laryngeal granular cell tumors arise?

A

Posterior portion of true cords; arytenoids

35
Q

From what do laryngeal granular cell tumors arise?

A

Schwann cells

36
Q

What is the risk of malignant degeneration in laryngeal granular cell tumor?

A

3%

37
Q

Why are laryngeal granular cell tumors sometimes confused with SCC?

A

They can induce pseudoepitheliomatous hyperplasia around their borders

38
Q

Where in the larynx can amyloidosis deposit?

A

Glottis & subglottis

39
Q

What causes hereditary angioedema?

A

C1 esterase inhibitor deficiency

40
Q

Acute treatment of hereditary angioedema

A

FFP
C1 or kallikrein inhibitors
Bradykinin receptor antagonist

41
Q

What are the causes of Reinke’s edema?

A 
LPR
Smoking
Hypothyroidism
Vocal abuse
Cough/throat clearing
42
Q

Where are laryngeal mucus retention cysts found?

A

Supraglottis

43
Q

What can cause a subglottic cyst?

A

ETT can obstruct a mucus gland

Consider if stridulous after short, non-traumatic intubation

44
Q

What is seen on FFL in presbylaryngis?

A

VC bowing

45
Q

Where do vocal fold granulomas form?

A

Medial arytenoid near the vocal process

Caused by vocal abuse

46
Q

Where do vocal fold nodules form?

A

Anterior-middle junction of TVF

Bilateral by definition

47
Q

What are the types of vocal fold polyps?

A

Mucoid

Angiomatous

48
Q

What should be suspected if voice worse than FFL suggests in a vocal abuser?

A

Sulcus vocalis

49
Q

What is the PPP rule?

A

In unilateral SLN injury, the Posterior commisure Points to the Paralyzed side

50
Q

On laryngeal EMG, what indicates good potential for recovery?

A

Polyphasic potentials

51
Q

On laryngeal EMG, what indicates poor potential for recovery?

A

Fibrillation potentials

52
Q

What is seen on FFL with SLN paralysis?

A

Bowing deformity

Cricothyroid responsible for VF tension

53
Q

What is seen on FFL with RLN paralysis?

A

Paramedian VF

54
Q

What infectious processes can cause VF immobility?

A 
Lyme disease
Syphilis
EBV
TB
Viral
55
Q

How long does gelfoam last after injection medialization?

A

4-6w

Must do 30% overcorrection for saline resorption

56
Q

How long does fat last after injection medialization?

A

6mo-1y

57
Q

How long does collagen last after injection medialization?

A

4-9mo

58
Q

How long does calcium hydroxyapatite (Radiesses voice) last after injection medialization?

A

Permanently

59
Q

How long does Radiesses voice gel last after injection medialization?

A

1-2mo

Carrier only, no hydroxyapatite

60
Q

How long does Hyaluronic acid last after injection medialization?

A

6mo

61
Q

How long does micronized alloderm last after injection medialization?

A

6mo

ENT (10 decks)

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