Otolaryngology

Question 0

Midline mass at level of hyoid
Connected to tongue
Tx?

Answer 0

Thyroglossal duct cyst

Removal of cyst, middle of hyoid, tract to base of tongue

Question 1

Difference in presentation between inflammatory and neoplastic neck masses

Answer 1

Inflammatory: timetable measured in days or weeks
Neoplastic: several months of consistent growth

Question 2

Mass on anterior edge of sternocleidomastoid
Several cm
Small opening in skin overlying

Answer 2

Branchial cleft cyst

Question 3

Large, mushy, ill-defined mass overlying supraclavicular area
Often extend into mediastinum
Dx, Tx?

Answer 3

Cystic hygroma
CT scan
Surgical removal

Question 4

Pt with enlarged lymph node

Whats is diagnostic approach

Answer 4

< 1 month probably inflammatory, follow

> 1 month probably inflammatory, but workup for neoplasia

Question 5

Multiple enlarged lymph nodes
Low grade fever, night sweats
Dx, tx?

Answer 5

Lymphoma
FNA, but node removal necessary for typing
Chemotherapy

Question 6

Supraclavicular node tumor

Answer 6

Metastatic tumor from lung or abdomen

Question 7

Risk factors for squamous cell carcinoma of head and neck mucosa

Answer 7

Age
Smoking
Alcohol
Poor dental hygiene
AIDS

Question 8

Dx, tx of squamous cell carcinoma of head and neck mucosa

Answer 8

Triple endoscopy, biopsy
FNA enlarged neck nodes, no open biopsy!

Resection and radical neck dissection
Radiotherapy, platinum based chemo

Question 9

Persistent hoarseness
Persistent painless ulcer on floor of mouth
Persistent unilateral earache

Answer 9

Squamous cell carcinoma of mucosa

Question 10

Sensory hearing loss in one ear

Dx?

Answer 10

Acoustic neuroma

MRI

Question 11

Gradual unilateral facial nerve paralysis
Both forehead and face
Dx?

Answer 11

Facial nerve tumor

Gadolinium enhanced MRI

Question 12

Sudden unilateral facial nerve paralysis

Forehead and face

Answer 12

Bell’s palsy

Question 13

Most common parotid tumor

Answer 13

Pleomorphic adenoma

Painless, no facial n involvement

Question 14

Tx for parotid tumor

Answer 14

Superficial parotidectomy

Sacrifice facial nerve if malignant

Question 15

Unilateral ENT problem in toddlers

Tx?

Answer 15

Foreign body

Endoscopic removal

Question 16

Abscess in floor of mouth
Poor dental hygiene
Tx?

Answer 16

Ludwig angina

I&D, intubation and tracheostomy if airway threatened

Question 17

Tx for Bell’s palsy

Answer 17

Antivirals, steroids

Question 18

Cause of late onset facial nerve paralysis after trauma

Answer 18

Swelling

Nerve injuries cause paralysis immediately

Question 19

New onset diplopia in pt with frontal or ethmoid sinusitis

Dx, tx?

Answer 19

Cavernous sinus thrombosis
CT scan
IV antibiotics, drainage of affected sinus

Question 20

Tx for epistaxis in children

Cause?

Answer 20

Local pressure
Epinephrine spray

Nosepicking

Question 21

Tx for epistaxis in teenager

Cause?

Answer 21

Posterior packing- cocaine

Resection- juvenile nasopharyngeal fibroma

Question 22

Tx for epistaxis in elderly

Answer 22

Control BP
Posterior packing
Ligation of feeding vessels

Question 23

Dizziness
Room perceived to be spinning
Tx?

Answer 23

Inner ear dizziness

Meclizine, phenergan, diazepam

Question 24

Dizziness

Room perceived to be stable, patient feels unstable

Answer 24

Brain related dizziness

Do neuro workup