Oral, Pharyngeal, & Laryngeal Disorders

Question 1

diminished taste to 1 or more tastants

Answer 1

hypogeusia

Question 2

absent taste fxn

Answer 2

ageusea

Question 3

persistent sweet, sour, salty, bitter or metallic taste

Answer 3

dysgeusia

Question 4

unpleasant taste of food or drink that is usually pleasant

Answer 4

allegeusia

Question 5

unpleasant taste produced indigenously due to gustatory hallucination

Answer 5

phantogeusia

Question 6

meds used to treat dysgeusia

Answer 6

clonazepam (Klonopin) or TCAs

Question 7

define tonsilloliths

Answer 7

bacteria in the crypts of the tonsils and are foul smelling

Question 8

fancy word for mouth pain

Answer 8

Odynophagia

Question 9

fancy word for inflammatory conditions of the mouth

Answer 9

Stomatitis

Question 10

Painful mucocutaneous ulceration is one of the most distinctive manifestations of what disease?

Answer 10

HIV

Question 11

Symptomatic tx for stomatitis

Answer 11

Triamcinolone acetonide in Orabase gel, oragel, anbesol, magic mouthwash, acyclovir

Question 12

Tx for more severe stomatitis

Answer 12

Chemical cautery w/ silver nitrate or sulfuric acid. intralesional or oral cortisone

Question 13

What is laryngitis associated with?

Answer 13

URI (usually viral)

Question 14

Define polypoid corditis (Reinke’s edema)

Answer 14

Isolated edema of the mucosal edge of the vocal fold

Question 15

Most common etiology of polypoid coriditis

Answer 15

smoking

Question 16

Tx of vocal nodules/polyps

Answer 16

excision.

Question 17

Difference between vocal polyps and nodules

Answer 17

polyps are unilateral, sessile/pedunculated lesions whereas nodules are bilateral, thickened areas on the vocal cord

Question 18

Most common type of laryngeal cancer

Answer 18

squamous cell

Question 19

5 year cure rate for small, early stage laryngeal cancer lesions

Answer 19

90%

Question 20

What cranial nerves are responsible for the pharyngeal phase?

Answer 20

CN V, X, XI, XII

Question 21

Why is group A beta-hemolytic strep concerning cause of pharyngitis?

Answer 21

can lead to rheumatic heart disease and glomerulonephritis

Question 22

what condition is characterized by sx immediately after swallowing, point to cervical region where food sticks, weight loss, aspiration

Answer 22

oropharyngeal dysphagia

Question 23

What is one the major causes of antibiotic abuse?

Answer 23

Over treatment of acute pharyngitis

Question 24

What percent of pharyngitis has a viral etiology?

Answer 24

90% in adults and 60-75% in children

Question 25

Age popn with highest incidence of GABHS

Answer 25

6-15 years of age (25-40% of pharyngitis cases)

Question 26

Seasonal features of GABHS

Answer 26

late winter and spring (Jan-Apr), uncommon in summer

Question 27

What is absent in GABHS?

Answer 27

other URI symptoms (rhinorrhea, conjunctivitis, diarrhea or cough)

Question 28

Classic physical signs of GABHS

Answer 28

Exudative pharyngeal erythema. Palatal petechiae. Tender anterior cervical adenopathy. Fever (>101F or 38.3C)

Question 29

Tx of choice for GABHS

Answer 29

Oral penicillin TID for 10 days. If allergic azithromycin

Question 30

What is the latest therapy for GABHS can be initiated?

Answer 30

9 days after onset of symptoms

Question 31

When are patients with GABHS considered non-contagious?

Answer 31

24 hours after starting antibiotic

Question 32

Common organism responsible for bacterial tonsillitis

Answer 32

Group A beta-hemolytic Streptococcus

Question 33

what illness is characterized by Fever, sore throat, foul breath, dysphagia, odynophagia, and tender cervical lymph nodes?

Answer 33

tonsillitis

Question 34

how many episodes of tonsillitis do you need before it's considered recurrent?

Answer 34

7 episodes in 1 year, 5 infections in 2 consecutive years, or 3 infections each year for 3 years consecutively

Question 35

On physical exam noted Unilateral bulging above and lateral to one of the tonsils causing displacement of uvula and tender cervical adenopathy describes what illness?

Answer 35

Peritonsillar abscess

Question 36

Tx of peritonsillar abscess

Answer 36

I & D by ENT, then start on antibiotics—sometimes IV. Occasionally need immediate tonsillectomy

Question 37

Common cause of Vincen'ts angina (trench mouth)

Answer 37

mixed bacterial-spirochetal infection

Question 38

Illness characterized by Severe throat pain, often radiating to the ears, halitosis, bad taste?

Answer 38

Vincent’s Angina (Trench mouth)

Question 39

Why is Ludwig's angina considered an emergency?

Answer 39

Can cause airway compromise because of the swelling in the floor of the mouth and neck. 10% mortality

Question 40

Organisms responsible for epiglottitis

Answer 40

H. flu***, strep pneumo, staph, GAS

Question 41

Illness characterized by hot potato voice/drooling, fever, sore throat, and pt is anxious w/ muffled speech and posturing

Answer 41

epiglottitis

Question 42

Pathognomic CXR for epiglottitis

Answer 42

thumbprint sign

Question 43

First step in tx of epiglottitis

Answer 43

secure airway- usually need to trach

Question 44

Abx for epiglottitis

Answer 44

third-generation cephalosporin ( ceftriaxone or cefotaxime) AND an antistaphylococcal agent active against MRSA ( clindamycin, vancomycin)

Question 45

Three things you should not do to a patient with epiglottitis

Answer 45

DO NOT move patient, put in supine position, send to x-ray

Question 46

Virus that causes croup (Laryngotracheitis)

Answer 46

Parainfluenza 1

Question 47

Most common age grp for croup

Answer 47

children 6-36 mo

Question 48

Tx of croup

Answer 48

humidified air, IV fluids, steroids, nebulized epi

Question 49

Most common complications of diptheria

Answer 49

myocarditis and neuritis

Question 50

Pathgnomic finding of diptheria

Answer 50

gray pseudomembrane that adheres tightly to the underlying tissue and bleeds with scraping.

Question 51

Tx of diptheria

Answer 51

erythromycin or pcn G. if severe, diptheria antitoxin

Question 52

Other monitoring needed for diptheria

Answer 52

serial EKGs and cardiac enzymes. neurologic status monitored