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IPAP Senior ENT > Larynx > Flashcards

Larynx Flashcards

1
Q

Dysphonia

A

abnormality in speaking voice (hoarseness)

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2
Q

primary Sx of laryngeal disease

A

hoareness & stridor

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3
Q

Hoarseness

A

abnormal vocal quality caused by abnormal vibrations of vocal cords

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4
Q

Breathy Voice indicates what

A

unilateral vocal fold paralysis or vocal fold mass

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5
Q

Harsh voice indicates

A

laryngitis

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6
Q

Most common cause of hoarseness

A

Acute laryngitis

< 3 weeks

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7
Q

Tx of Acute laryngitis

A

avoid vigorous use of voice until Sx improve

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8
Q

Tx of Chronic Laryngitis

A

remove offending agent

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9
Q

Pt w/ rapidly developing sore throat, odynophagia out of proportion to exam & drooling

A

Suspect Epiglottitis or Supraglottitis

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10
Q

Dx of Epiglottitis or Supraglottitis

A

indirect larygoscopy safe in adults

Lateral neck soft tissue xray (Thumb sign)

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11
Q

Tx of Epiglottitis or Supraglottitis

A

Admit for IV ceftriaxone & IV dexamethasone

followed w/tapered corticosteroid & 10 day PO ABX

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12
Q

Laryngopharygeal Reflux (LPR) associated with

A

hoarseness, throat irritation, chronic cough

occur when upright & 1/2 dont experience heartburn

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13
Q

Dx of LPR made with

A

response to PPI ; omeprazole 40mg PO x 3 months

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14
Q

3months after initiating PPI therapy for LPR and Sx’s have improved what can be done

A

dose can be lowered as long as they remain asymptomatic

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15
Q

Prior to starting PPI’s to eval and Tx LPR what must be done

A

Laryngoscopy to r/o other causes of chronic hoarseness

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16
Q

common lesions of larynx & other sites where ciliated & squamous epithelia meet, almost always HPV 6 & 11

A

Respiratory Papllomatosis (Papillomas)

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17
Q

Most common Laryngeal Tumor in children

A

Respiratory Papillomatosis

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18
Q

Sx’s of Respiratory Papillomatosis

A

Hoarseness progress to stridor over weeks/months
Extension can occur in Trachea & lungs
multiple warty lesions on vocal cords

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19
Q

Tx of Papillomatosis

A

repeat laser vaporization / cord knife resection
cure not usually achieved
permit to develop voice / preserve structure, avoid trach

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20
Q

Prevention of Papillomatosis

A

Immunization w/Gardasil & Gardasil 9

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21
Q

What are considered manifestations of chronic vocal fold irritation

A

Vocal Cord Nodules &

Vocal Cord Polyps

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22
Q

common cause of hoarseness from abuse, w/smooth paired lesions @ junction of anterior 1/3 & posterior 2/3 of vocal folds

A

Vocal Fold Nodule

23
Q

Tx of Vocal Fold Nodule

A

modify voice habit
refer to speech therapist
Recalcitrant nodules may require surgical excision

24
Q

this is r/t truama (ie. smoking), unilat masses form w/in suerficial lamina propria of vocal fold

A

Vocal Fold Polyps

25
Q

Tx of Vocal Fold Polyps

A

small polyps- conservative measure (voice rest & corticosteroids)

Large polyps- irreversible require surgical removal to restore voice

26
Q

Form from mucous-secreting glands on inferior aspect of vocal fold, change in size from week-week, commonly cause hoarseness
(Can be True or Pseudo)

A

Vocal Fold Cyst

27
Q

vocal folds appear swollen & floppy may cause respiratory Sx’s in severe cases

A

Polypoid Corditis (Reinke’s edema)

28
Q

the changes in polypoid corditis (Reinke’s edema) are associated w/?

A

smoking
vocal abuse
chemical irritants
hypothyroidism

29
Q

Pt presentation of Polypoid corditis (Reinke’s edema)

A

Typically smoker, middle aged woman, w/ husky low-pitched voice

30
Q

Tx of Polypoid corditis(Reinke’s edema)

A

smoking cessation, acid reflux management, & voice therapy

31
Q

Tx of Polypoid corditis (Reinke’s edema) w/presence of stridor

A

surgical debulking/recontouring

32
Q

found in association w/ hoarseness in smokers, could be benign-malignant & what is needed

A

Laryngeal leukoplakia;

biopsy

33
Q

Tx of Laryngeal leukoplakia

A

smoking cessation
PPI’s (mainstay of Tx)
close follow w/laryngovideostroboscopy
serial resection & external radiation therapy

34
Q

essentials to Diagnosis of Squamous Cell Carcinoma of larynx

A 
new/persistent hoarseness
Persistent throat/ear pain especially w/swallowing
neck mass
Hemoptysis
Stridor / other compromised airway
35
Q

Most common Malignancy of Larynx

A

Squamous Cell Carcinoma

36
Q

Tx of early glottic & supraglottic cancer

A

SOC is radiation cure rate 95%

37
Q

Hoarseness > 2wks absence of acute respiratory infection Sx need to do what? (w/Hx of tobacco smoking)

A

complete ENT exam

38
Q

Most Common Cause of Vocal Cord Paralysis

A

Iatrogenic

39
Q

Pt’s voices w/ vocal cord paralysis sound

A

breathy dysphonia or “effortful voicing”

40
Q

what is damaged in vocal cord paralysis

A

either the vagus nerve or unilateral recurrent laryngeal nerve

41
Q

what surgeries may cause vocal cord paralysis

A

thyroid, esophageal, C-spine, thoracic

42
Q

What is required for a work up of vocal cord paralysis

A

Need thorough NC exam

CT w/ contrast

43
Q

what is required for Pt’s w/vocal cord paralysis & cranial neuropathy present

A

MRI

44
Q

When is early surgical medialization indicated in unilateral vocal cord paralysis?

A

severe Sx’s (aspiration pneumonia)
Disabling Breathy Disphonia
ineffective cough/disabling dyspnea
Mild Sx w/denervation on laryngeal elecrography

45
Q

Tx of mild unilateral vocal cord paralysis

A

voice/speech therapy

Get laryngeal electromyography

46
Q

Pt with mild unilateral vocal cord paralysis w/evidence of denervation/little activity on laryngeal electromyography

A

require referral for surgical medialization

47
Q

what is an acute/chronic syndrome w/ paradoxical vocal cord adduction?

A

Vocal Cord Dysfunction (VCD) or Paradoxical Vocal Fold Movement (PVFM)

48
Q

Triggers of VCD or PVFM?

A 
GERD
inhaled allergens
post nasal drip
excercise
neurological condition
psychosocial/stress
49
Q

Pt has dyspnea & wheezing that is not responding to bronchodilators, what is it?

A

Vocal Cord Disfunction (VCD)

50
Q

how to Diagnosis VCD?

A

direct visualization of Vocal cords showing adduction w/both inspiration & expiration

51
Q

Tx of VCD

A

stop any unnecessar Tx

1st line Tx speech therapy

52
Q

Acute Tx of VCD

A

CPAP & Breathing exercises

53
Q

Long term Tx of VCD

A

Speech therapy
Botox
severe- trach for relief

IPAP Senior ENT (7 decks)

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