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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
Tx of Vocal Fold Polyps
small polyps- conservative measure (voice rest & corticosteroids) Large polyps- irreversible require surgical removal to restore voice
26
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)
Vocal Fold Cyst
27
vocal folds appear swollen & floppy may cause respiratory Sx's in severe cases
Polypoid Corditis (Reinke's edema)
28
the changes in polypoid corditis (Reinke's edema) are associated w/?
smoking vocal abuse chemical irritants hypothyroidism
29
Pt presentation of Polypoid corditis (Reinke's edema)
Typically smoker, middle aged woman, w/ husky low-pitched voice
30
Tx of Polypoid corditis(Reinke's edema)
smoking cessation, acid reflux management, & voice therapy
31
Tx of Polypoid corditis (Reinke's edema) w/presence of stridor
surgical debulking/recontouring
32
found in association w/ hoarseness in smokers, could be benign-malignant & what is needed
Laryngeal leukoplakia; | biopsy
33
Tx of Laryngeal leukoplakia
smoking cessation *PPI's (mainstay of Tx)* close follow w/laryngovideostroboscopy serial resection & external radiation therapy
34
essentials to Diagnosis of Squamous Cell Carcinoma of larynx
``` new/persistent hoarseness Persistent throat/ear pain especially w/swallowing neck mass Hemoptysis Stridor / other compromised airway ```
35
Most common Malignancy of Larynx
Squamous Cell Carcinoma
36
Tx of early glottic & supraglottic cancer
SOC is radiation cure rate 95%
37
Hoarseness > 2wks absence of acute respiratory infection Sx need to do what? (w/Hx of tobacco smoking)
complete ENT exam
38
Most Common Cause of Vocal Cord Paralysis
Iatrogenic
39
Pt's voices w/ vocal cord paralysis sound
breathy dysphonia or "effortful voicing"
40
what is damaged in vocal cord paralysis
either the vagus nerve or unilateral recurrent laryngeal nerve
41
what surgeries may cause vocal cord paralysis
thyroid, esophageal, C-spine, thoracic
42
What is required for a work up of vocal cord paralysis
Need thorough NC exam | CT w/ contrast
43
what is required for Pt's w/vocal cord paralysis & cranial neuropathy present
MRI
44
When is early surgical medialization indicated in unilateral vocal cord paralysis?
severe Sx's (aspiration pneumonia) Disabling Breathy Disphonia ineffective cough/disabling dyspnea Mild Sx w/denervation on laryngeal elecrography
45
Tx of mild unilateral vocal cord paralysis
voice/speech therapy | Get laryngeal electromyography
46
Pt with mild unilateral vocal cord paralysis w/evidence of denervation/little activity on laryngeal electromyography
require referral for surgical medialization
47
what is an acute/chronic syndrome w/ paradoxical vocal cord adduction?
Vocal Cord Dysfunction (VCD) or Paradoxical Vocal Fold Movement (PVFM)
48
Triggers of VCD or PVFM?
``` GERD inhaled allergens post nasal drip excercise neurological condition psychosocial/stress ```
49
Pt has dyspnea & wheezing that is not responding to bronchodilators, what is it?
Vocal Cord Disfunction (VCD)
50
how to Diagnosis VCD?
direct visualization of Vocal cords showing adduction w/both inspiration & expiration
51
Tx of VCD
stop any unnecessar Tx | 1st line Tx speech therapy
52
Acute Tx of VCD
CPAP & Breathing exercises
53
Long term Tx of VCD
Speech therapy Botox severe- trach for relief

IPAP Senior ENT (7 decks)

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