Oropharyngeal Flashcards

1
Q

what is also called canker sores and is the most common cause of oral ulcers?

A

aphthous ulcer

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2
Q

patient presents with a painful, localized, shallow, round to oval ulcer with a yellowish adherent exudate centrally. what are they experiencing?

A

aphthous ulcer

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3
Q

what is the course of an aphthous ulcer?

A

heals within 10-14 days without scarring

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4
Q

what are 3 treatments for an aphthous ulcer?

A
  1. kenalong orobase
  2. sucralfate suspension
  3. oragel
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5
Q

a disorder also called thrush that is a common infection in young infants, denture-wearers, and patients who are immunodeficient

A

candidiasis

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6
Q

what is the etiology of candidiasis?

A

fungus

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7
Q

what is the most common form of thrush that presents as white plaques on the buccal mucosa, palate, tongue, or oropharynx?

A

pseudomembranous

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8
Q

what is the form of candidiasis that is found under dentures and presents with erythema without plaques?

A

atrophic

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9
Q

a patient has a beefy red tongue and soreness, with angular cheilitis, a painful fissuring at the corners of the mouth, which is also seen in vitamin B deficiency. what are they experiencing?

A

candidiasis

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10
Q

how do diagnose a patient with candidiasis?

A

scrape white patches and do KOH prep

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11
Q

what does a KOH prep of scraped white patches show?

A

budding yeast

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12
Q

what 3 topical therapies are effective in non-immunosuppressed patients with candidiasis?

A
  1. clotrimazole troche
  2. miconazole tablets
  3. nystatin suspension
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13
Q

how long should a patient with candidiasis be treated with antibiotics?

A

7-14 days

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14
Q

what diagnostics should be done for a patient with recurrent or extensive candidiasis?

A

evaluate immune status and test for HIV

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15
Q

inflammation of a salivary gland due to an obstructive, infectious, or inflammatory etiology

A

sialadenitis

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16
Q

in which 2 salivary glands does sialadenitis mainly occur?

A
  1. parotid
  2. submandibular
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17
Q

what are 3 things that can lead to sialadenitis?

A
  1. dehydration
  2. chronic illness
  3. poor oral hygiene
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18
Q

what is the most common organism (etiology) of sialadenitis?

A

staph aureus

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19
Q

a patient presents with a tender, swollen gland that is exacerbated with meals, red ductal opening that may express pus, erythema/edema of overlying skin, trismus, may have a protruded auricle. what are they experiencing?

A

sialadenitis

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20
Q

if a patients auricle is protruding, what kind of sialadenitis do they have?

A

parotid sialadenitis

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21
Q

what 2 diagnostics can be ordered for a patient with sialadenitis?

A

CT or US

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22
Q

what should I do for a patient with sialadenitis?

A

refer to ENT

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23
Q

what are 5 ways to treat the underlying disorder that ENT can do for a patient with sialadenitis?

A
  1. rehydrate
  2. antibiotics
  3. sialagogues - sour drops
  4. massage
  5. I&D
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24
Q

a calculus (stone) formation in the salivary duct

A

sialolithiasis

25
Q

a patient presents with postprandial pain, local edema, and sometimes a palpable stone. what are they experiencing?

A

sialolithiasis

26
Q

how would ENT manage a patient with sialolithiasis? (2 steps)

A
  1. dilation of duct
  2. excision of duct and gland
27
Q

bilateral infection of the submandibular, sublingual, and submaxillary spaces that aggressively and rapidly spreads without lymphadenopathy

A

ludwig angina

28
Q

where does ludwig angina most commonly arise from?

A

infected 2nd or 3rd mandibular molar tooth

29
Q

a patient presents with edema, erythema of upper neck, displacement of tongue up and backwards, possible respiratory distress, fever, chills, malaise, mouth pain, stiff neck, drooling, dysphagia, and a muffled voice. what are they experiencing?

A

ludwig angina

30
Q

how serious is ludwig angina?

A

medical emergency due to potential for airway obstruction

31
Q

what would the ER do for a patient with ludwig angina?

A
  1. CT
  2. IV antibiotics empirically, with MRSA coverage
32
Q

a patient presents with change in voice quality (hoarseness), sometimes with rhinorrhea, cough, and mild sore throat. what are they experiencing?

A

acute laryngitis

33
Q

a common, self-limited inflammation of the vocal cords that lasts less then 3 weeks

A

acute laryngitis

34
Q

what is the most common etiology of acute laryngitis?

A

viral URI

35
Q

what is the treatment for a patient with acute laryngitis that does not need to use their voice?

A

voice rest, hydration, humidification, antibiotics if bacterial, and manage reflux

36
Q

what antibiotic can I use for a patient with acute laryngitis from a bacterial URI?

A

macrolide

37
Q

what is the treatment for a patient with acute laryngitis that needs to use their voice?

A

oral steroids

38
Q

what to do for a patient with acute laryngitis that has had hoarseness for over 2 weeks?

A

ENT should do laryngoscopy

39
Q

what is the most common etiology of pharyngitis?

A

respiratory virus

40
Q

what is the etiology of bacterial pharyngitis?

A

group A strep

41
Q

a patient presents with URI symptoms, ear pain, rhinorrhea, hoarseness, and minimal exudate except with mono. what are they experiencing?

A

viral pharyngitis

42
Q

a patient presents with fever, dysphagia, odynophagia, anterior cervical lymphadenopathy, patchy tonsillar exudate, palatial petechiae, and strawberry tongue. what are they experiencing?

A

bacterial pharyngitis

43
Q

what is the main goal in evaluating a patient with pharyngitis?

A

ensure they do not lose their airway

44
Q

what are 2 things to do to identify pharyngitis as group A strep?

A
  1. sensitive rapid antigen test
  2. culture
45
Q

what is the supportive treatment for viral pharyngitis?

A
  1. fever reducer
  2. rest
  3. hydration
  4. soft diet
46
Q

what is the supportive treatment for bacterial pharyngitis?

A

same as viral + antibiotics

47
Q

what is the antibiotic treatment for adults with bacterial pharyngitis?

A

oral penicillin for 10 days

48
Q

what is the antibiotic treatment for children with bacterial pharyngitis?

A

oral penicillin or amoxicillin

49
Q

what is the treatment for a patient with bacterial pharyngitis who is allergic to penicillin?

A

cephalosporin, clindamycin, and macrolides

50
Q

what are 5 indications of urgent pharyngitis?

A
  1. hot potato voice
  2. drooling
  3. stridor
  4. sniffing or tripod position
  5. crepitus
51
Q

when should a patient with strep pharyngitis be referred to an ENT?

A

5-7 episodes of strep pharyngitis in one year

51
Q

what is the first goal in a patient with peritonsillar abscess?

A

assess upper airway

52
Q

an infection and collection of pus in the tonsillar fossa that is preceded by tonsilitis or pharyngitis and progresses from cellulitis to abscess

A

peritonsillar abscess

53
Q

a patient presents with severe, unilateral sore throat, fever, hot potato voice. drooling, trismus, ipsilateral ear pain, and extremely swollen tonsil with deviation of the uvula to the opposite side. what are they experiencing?

A

peritonsillar abscess

54
Q

what are 4 diagnostics the ER would do in a patient with peritonsillar abscess during their evaluation?

A
  1. CBC
  2. serum electrolytes
  3. rapid strep
  4. culture
55
Q

what can help distinguish peritonsillar abscess from cellulitis and guide a needle for aspiration?

A

intraoral or submandibular US

56
Q

how would an ENT treat a patient with peritonsillar abscess? (2)

A
  1. needle aspiration with culture
  2. antibiotics
57
Q

what antibiotics would an ENT use for a patient with peritonsillar abscess? (2)

A
  1. augmentin
  2. clindamycin, if augmentin does not work