OTORHINOLARYNGOLOGY Flashcards

1
Q

Rinne (-), lateralisasi sakit (mendekat), memanjang, air-bone gap (+)

A

TULI KONDUKTIF

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2
Q

Rinne (+), lateralisasi sehat (menjauh), memendek, air-bone gap (-)

A

TULI SENSORINEURAL

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3
Q

Trauma, ekimosis, fluktuasi, darah (+), komp cauliflower ear

A

OTHEMATOMA

≤2cm (aspirasi), >2cm (insisi drainase), >1wk rujuk, profilaksis levofloxacin

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4
Q

Peradangan difus pinna, piercing, nyeri + inflamasi, p. aeruginosa

A

PERIKONDRITIS

Ciprofloxacin 2x 500mg / levofloxacin 1x 750 mg, abses = insisi drainase

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5
Q

Lubang abnormal belakang telinga, bisa keluar cairan

A

FISTULA PREAURIKULA

Observasi; Ab + kompres (infeksi), insisi drainase (abses)

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6
Q

Radang 1/3 luar folikel rambut, nyeri tekan/tarik, furunkel (+), MT bisa dinilai, s. aureus

A

OE SIRKUMSKRIPTA

Salep Ab topikal basitrasin/polimixin

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7
Q

Radang 2/3 dalam, nyeri tekan/tarik, MT edema sulit dinilai, p. aeruginosa

A

OE DIFUSA

Tampon Ab ofloxacin/polimixin/neomisin

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8
Q

OE difusa, nyeri hebat, MT edema, parese CN VII, p. aeruginosa

A

OE MALIGNA

Siprofloksasin 3x 400mg IV / levofloxacin 1x 750mg PO

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9
Q

Sangat gatal, newspaper app (aspergillus), cotton wool (candida), KOH 10% hifa bersepta

A

OTOMIKOSIS

Nystatin topikal 100,000 IU (candida), mikonazol 2% salep (aspergillus), ear toilet as asetat 2%

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10
Q

Tatalaksana Serumen
1. SERUMEN LUNAK
2. SERUMEN KERAS
3. SERUMEN REFRAKTER
4. SERUMEN DALAM

A
  1. Kapas dililit
  2. Hook/kuret
  3. Karbogliserin 10%/H2O2 3% 3d
  4. Spooling
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11
Q

Tatalaksana Benda Asing Telinga
1. CORPUS ALIENUM TELINGA LUNAK (kertas, kapas)
2. CORPUS ALIENUM TELINGA BULAT (biji, batu)
3. CORPUS ALIENUM TELINGA SERANGGA

A
  1. Aligator/bayonet forsep
  2. Ear loop (pengait)
  3. Karbogliserin hingga mati lalu aligator forsep
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12
Q

HL progresif bilateral, parakusis wilisi (+) ruang bising membaik, schwarte/pink flamingo sign (+)

A

OTOSKLEROSIS

Stapedektomi

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13
Q

Penebalan MT tapal kuda, HL konduktif

A

TIMPANOSKLEROSIS

ABD; pembedahan

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14
Q

Telinga penuh, glue ear (+), air bubble app (+), disfungsi tuba eustachius

A

OME

Etiologis, dekongestan; miringotomi

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15
Q

Infeksi telinga tengah, s. pneumoniae/h. influenzae, Telinga penuh, demam (-), MT retraksi suram

A

OMA STADIUM OKLUSI

Dekongestan topikal efedrin HCl 1% / oksimetazolin 0.05%

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16
Q

Infeksi telinga tengah, s. pneumoniae/h. influenzae, Otalgia, demam (+), MT hiperemis edema

A

OMA STADIUM HIPEREMIS

Amoksisilin 3x 500mg / eritromisin 4x 500mg / amoxiclav 3x 625mg PO, simtomatis

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17
Q

Infeksi telinga tengah, s. pneumoniae/h. influenzae, Otalgia berat, demam (+), MT buldging

A

OMA STADIUM SUPURASI

Amoksisilin 3x 500mg / eritromisin 4x 500mg / amoxiclav 3x 625mg PO, simtomatis; miringotomi

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18
Q

Infeksi telinga tengah, s. pneumoniae/h. influenzae, Sekret dari telinga, MT perforasi

A

OMA STADIUM PERFORASI

Ear toilet H2O2 3%, Ab oral/tetes

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19
Q

Infeksi telinga tengah, s. pneumoniae/h. influenzae, Sekret berkurang, MT mulai menutup

A

OMA STADIUM RESOLUSI

Observasi

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20
Q

Sekret telinga ≥3mo, MT perforasi sentral (pars tensa), tidak busuk, granulasi (-), kolesteatoma (-)

A

OMSK BENIGNA/AMAN

Ear toilet H2O2 3%, ofloxacin 3% topikal, amoksisilin 3x 500mg / ciprofloxacin 2x 500mg; miringo/timpanoplasti (refrakter)

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21
Q

Sekret telinga ≥3mo, MT perforasi atik/marginal (pars flasida), busuk, granulasi (+), kolesteatoma (+)

A

OMSK MALIGNA/BAHAYA

Mastoidektomi

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22
Q

Fase OMSK
1. Sekret (+)
2. Sekret (-)

A
  1. FASE AKTIF
  2. FASE TENANG
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23
Q

Inflamasi MT, bulla (+) serum/darah, s. pneumoniae

A

MIRINGITIS BULOSA

Amoksisilin 3x 500mg / eritromisin 4x 500mg / amoxiclav 3x 625mg PO, simtomatis

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24
Q

HL sensorineural progresif bilateral , usia tua, cocktail party deafness (+) ruang bising memburuk, ANM gangguan >2,000Hz

A

PRESBIAKUSIS

ABD

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25
Q

HL sensorineural bilateral, ANM gangguan 3,000-6,000 Hz terutama 4,000 Hz (noise notch), paparan bising

Batas bising - Waktu?

A

NIHL

ABD

85dB max 8 jam
+3dB waktu dibagi 2
E.g 88dB max 4 jam

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26
Q

HL mendadak akibat suara keras

A

TRAUMA AKUSTIK

ABD

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27
Q

HL, ANM gangguan >8,000Hz, rw aminoglikosida, cisplatin

A

OTOTOKSISITAS

Hentikan obat

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28
Q

INFLAMASI SALURAN THT
1. Rhinitis:
2. Sinusitis:
3. Tonsilitis:
4. Faringitis:
5. Laringitis:

A
  1. Rinore, hidung tersumbat, bersin, inflamasi rongga hidung
  2. Nyeri tekan sinus
  3. Inflamasi tonsil, odinofagia, halitosis
  4. Inflamasi faring, odinofagia
  5. Suara serak (disfonia)
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29
Q

Inflamasi rongga hidung, rinore, hidung tersumbat, Prodromal (+) lalu gejala rinitis, seromukus

A

RINITIS VIRUS

Self limiting, simtomatis

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30
Q

Inflamasi rongga hidung, rinore, hidung tersumbat, malaise demam (±), seromukus menjadi mukopurulen

A

RINITIS BAKTERIAL

Simtomatis; amoksisilin 3x 500mg, eritromisin 4x 500mg (refrakter)

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31
Q

Inflamasi rongga hidung, rinore, hidung tersumbat, rinitis berulang, konka dan faring bengkak, fenilefrin konka mengempis, sekret mukoid

A

RINITIS KRONIS SIMPLEKS

Cuci hidung, simtomatis

32
Q

Inflamasi rongga hidung, rinore, hidung tersumbat, rinitis berulang, konka hipertrofi dan benjol benjol, fenilefrin konka tidak mengempis

A

RINITIS HIPERTROFI

Etiologis, konkotomi

33
Q

Inflamasi rongga hidung, rinore, hidung tersumbat, Infeksi kronis, hidung bau busuk, sekret purulen bau busuk, krusta (+)

A

RINITIS ATROFI/OZENA

Cuci hidung, Ab kuinolon; pembedahan young (refrakter)

34
Q

Inflamasi rongga hidung, rinore, hidung tersumbat, udara panas/kering, krusta 1/3 anterior septum nasi yang mudah berdarah

A

RINITIS SICCA

Cuci hidung

35
Q

Inflamasi rongga hidung, rinore, hidung tersumbat, Rw alergi, paparan alergen, sekret serosa, allergic shinner (kantong mata), allergic salute (manuever gosok hidung), allergic crease (garis hidung), cobblestone faring, IgE (+), eosinofil tinggi

A

RINITIS ALERGI

Cetirizine/loratadine 1x 10mg PO (int. ringan); + pseudoefedrine 2x 60mg PO / flutikason/mometason spray (int. sedang-berat/per. ringan); flutikason/mometasone spray SAJA (per. berat)

36
Q

Inflamasi rongga hidung, rinore, hidung tersumbat, Suhu/stres/asap, hidung tersumbat gantian, konka gelap hipertrofi, gangg. regulasi nasal

A

RINITIS VASOMOTOR

Hindari stimulus, simtomatis; neurektomi n. vidianus

37
Q

Inflamasi rongga hidung, rinore, hidung tersumbat, Penggunaan efedrin/oksimetazolin berlebih

A

RINITIS MEDIKAMENTOSA

Hentikan dekongestan nasal, intranasal CS

38
Q

<12wk, ≥2 (kongesti hidung, sekret hidung/faring, nyeri wajah, hiposmia)

A

RINOSINUSITIS AKUT

Simtomatis; intranasal CS ± Ab (refrakter 5d)

39
Q

≥12wk, ≥2 (kongesti hidung, sekret hidung/faring, nyeri wajah, hiposmia), ≥1 (polip nasi, mukopurulensi, obstruksi meatus media), rontgen waters/CT paranasal penebalan mukosa, air-fluid level

A

RINOSINUSITIS KRONIS

Cuci hidung, flutikason/mometason spray, Ab (infeksi); FESS (refrakter)

40
Q

Pendarahan hidung, trauma, plexus kiesselbach/little area/a. ethmoidalis ant.

A

EPISTAKSIS ANTERIOR

Trotter’s method (tekan hidung 15m); tampon anterior dengan lidocaine 2% + 1/1000 0.2 mL epinefrin (15m); kauterisasi AgNO3 15-25%, tampon anterior vaselin + Ab (2x 24h)

41
Q

Pendarahan hidung, penyakit sistemik, plexus woodruff/a. sfenopalatina/a. ethmoidalis post.

A

EPISTAXIS POSTERIOR

Tampon posterior/bellocq

42
Q

Massa hidung bertungkai licin putih-abu-merah

A

POLIP NASI

Intranasal CS; polipektomi (refrakter)

43
Q

Tatalaksana Benda Asing Hidung
1. CORPUS ALIENUM HIDUNG GRASPABLE
2. CORPUS ALIENUM HIDUNG FRIABEL
3. CORPUS ALIENUM HIDUNG SOLID

A
  1. Aligator forsep
  2. Suction/irigasi
  3. Hook/kuret; lasso; superglue
44
Q

Rw ingesti benda, asimtomatis, bronkus kanan»

A

CORPUS ALIENUM BRONKUS

Bronkoskopi

45
Q

Rw ingesti benda, audible slap, palpatory thud, asthmatoid wheeze

A

CORPUS ALIENUM TRAKEA

Bronkoskopi

46
Q

Rw ingesti benda, odinofagia, benda tervisualisasi
1. Suara parau, disfonia:
2. Afonia, apneu, sianosis:

A

CORPUS ALIENUM LARING
1. SUBTOTAL/PARSIAL
2. TOTAL

Heimlich/back blow (total), laringoskopi (subtotal)

47
Q

Rw ingesti benda, odinofagia saja

A

CORPUS ALIENUM HIPOFARING/OROFARING

Ekstraksi pinset corpal

48
Q

Rw trauma, hidung tersumbat, cavum nasi asimetris

A

DEVIASI SEPTUM

Septoplasti

49
Q

Rw trauma, hidung tersumbat bengkak, darah (+)

A

HEMATOMA SEPTUM

Insisi drainase, Ab IV

50
Q

Demam, odinofagia, nyeri, detritus non konfluen (folikularis)/konfluen (lakunaris), tonsil bengkak hiperemis

A

TONSILITIS AKUT

Simtomatis, benzatin penisilin G 50,000U/kg / 600,000-1,200,000U SD IM / amoxicillin 50mg/kg 10d / eritromisin 4x 500mg 10d (GAS)

51
Q

Rasa ganjal tenggorokan, halitosis, kripte melebar isi detritus, jaringan parut (+), tonsil membesar berdungkul

A

TONSILITIS KRONIS

Tonsilektomi

52
Q

Demam, pseudomembran mudah berdarah, bullneck, c. diphteriae (gram (+) bentuk drumstik), kultur blood tellurite (+)

A

TONSILITIS DIFTERI

Anti difteri serum 20,000-100,000 IU, Ab eritromisin / penisilin

53
Q

Demam, odinofagia, faring hiperemis, swab/kultur (+), GAS
1. Sekret jernih
2. Demam tinggi, eksudat
3. Bercak putih

A

FARINGITIS AKUT
1. VIRAL
2. BAKTERIAL
3. FUNGAL

Simtomatis (viral), benzatin penisilin G 50,000U/kg / 600,000-1,200,000U SD IM / amoxicillin 50mg/kg 10d / eritromisin 4x 500mg 10d (bakterial), nystatin drop 2-3x 100,000-400,000 IU (fungal)

54
Q

Rasa kering di tenggorokan, rasa mengganjal
1. Faring cobblestone
2. Udara kering, halitosis, lendir kental faring
3. Bercak keputihan, gumma, sifilis
4. Granuloma perkejuan, TB

A

FARINGITIS KRONIS
1. HIPERTROFIK
2. ATROFI
3. LUETIKA
4. TUBERKULOSA

Obat kumur, AgNO3 (hipertrofik)
Obat kumur, Ab kuinolon (atrofi)
Obat sifilis (luetika)
obat TB (tuberkulosa)

55
Q

Demam, ISPA, disfagia, odinofagia, disfonia, mengganjal dan berdehem (kronis), x-ray thorax steeple sign (+)

A

LARINGITIS

Simtomatis

56
Q

Penyanyi/instruktur, disfonia, nodul kacang hijau putih pita suara bilateral

A

SINGER’S NODE

Istirahat bicara, voice therapy; bedah mikrolaringoskop

57
Q

Alergi/rokok, disfonia, massa unilateral bertangkai mobile

A

POLIP PITA SUARA

Voice therapy; bedah mikrolaringoskop

58
Q

GERD, ulkus unilateral/bilateral aritenoid

A

GRANULOMA

PPI, voice therapy

59
Q

besitas, mengorok dan episode terbangun, polisomnografi abnormal

A

OSA

Turunkan BB, CPAP

60
Q

Hidung tersumbat, OSA, adenoid facies, nafas mulut, RAN ≥0,52

A

HIPERTROFI ADENOID

Adenoidektomi

61
Q

Abses, Tonsilitis komplikata, hot potato voice (+), uvula terdotong kontralateral, palatum fluktuasi (+)

A

ABSES PERITONSILAR/QUINCY

Ab IV, insisi drainase

62
Q

Abses, Tonsilitis/faringitis komplikata, trismus (+), faring terdorong kontralateral

A

ABSES PARAFARING

Ab IV, insisi drainase

63
Q

Abses, Tonsilitis/faringitis komplikata, trismus (-), benjolan faring

A

ABSES RETROFARING

Ab IV, insisi drainase

64
Q

Abses, OMA/OMSK komplikata, temporo-oksipital edema, fluktuasi (+)

A

ABSES CITELI

Ab IV, insisi drainase

65
Q

Abses, OMA/OMSK komplikata, temporo-zygomatik edema, fluktuasi (+)

A

ABSES LUC

Ab IV, insisi drainase

66
Q

Abses, OMA/OMSK komplikata, m. sternocleidomastoideus/digastrik, edema, fluktuasi (+)

A

ABSES BEZOLD

Ab IV, insisi drainase

67
Q

Abses, Infeksi gigi, edema submandibula bilateral, lidah terangkat, keras seperti papan

A

ANGINA LUDWIG

Ab IV, insisi drainase

68
Q

Rw EBV, perokok, gejala THT + mata, massa fossa rossenmuller, fenomena palatum mole (-), biopsi histo PA (+) maligna

A

CA NASOFARING

Radiasi (S I), kemoradiasi (S II-IV)

69
Q

Massa sinus, industri kimia, gejala H + mata, fasial

A

CA SINONASAL

Pembedahan

70
Q

Laki remaja, epistaxis berulang, massa kenyal medah berdarah, CT (+) holman miller sign, angiografi (+)

A

JUVENILE NASOPHARYNGEAL ANGIOFIBROMA

Pembedahan

71
Q

Massa Os hyoid, ikut naik turun saat menelan

A

KISTA DUKTUS TIROGLOSSUS

Metode sistrunk

72
Q

Massa Anterior m. sternocleidomastoideus, lunak, tidak nyeri, fluktuasi (+)

A

BRANCHIAL CLEFT CYST

Eksisi komplit

73
Q

Massa Posterior triangle, transiluminasi (+)

A

HIGROMA KISTIK

Aspirasi

74
Q

Kepala miring ke satu sisi sejak lahir

A

TORTIKOLIS KONGENITAL

Fisioterapi; operasi

75
Q

Metode Imaging:
1. Sinus maksilaris, arkus zygomatikus, cavum nasi
2. Posterior sinus maksilaris, posterior fossa
3. Sinus frontalis
4. Semua sinus
5. Kanal dan foramen optik
6. Mastoid lateral (air cells)
7. Seluruh mastoid, temporal

A
  1. WATERS
  2. TOWNE
  3. CALDWELL
  4. SCHEDEL
  5. RHESE
  6. SCHULLER
  7. STENVER