pestana: skin, optho, ENT Flashcards
basal cell carcinoma presentation
upper face
timetable measured in years
does not metastasize- locally invades
what size margins when excising basal cell carc?
1 mm margins
squamous cell carc presentation
lower lip, and body
timetable measured in months
metastasizes to lymph nodes
what size margins when excising squamous cell carc presentation
0.5-2 cm
melanomas less than how many mm only require local excision?
1 mm
best chance at treating the unpredictable melanoma mets
interferon
targeted therapy- dacarbazine, pembrolizumab
amblyopia cause (lazy eye)
interference of brain processing images during first 6-7 years of life
faced with two overlapping images –> brain suppresses one of them –> strabismus
what will happen if amblyopia not corrected early on
permanent cortical blindness of suppressed eye
if strabismus (cross eye) develops later in infancy, what is the cause of the problem
refraction difficulties- get corrective glasses
not a true strabismus
white pupil in baby means
optho emergency! like retinoblastoma!
even tho could be congenital cataract
acute angle closure glaucoma presentation
severe eye pain, frontal HA
starting in evening when pupils dilated
female asian- halos around lights
acute angle closure glaucoma on physical exam
mid dilated, doesnt react to light
cornea cloudy, green ish hue
eye feels hard as a rock
treat acute angle closure glaucoma
surgery- drain fluid
meds: CA inhibitors, topical beta blockers, alpha 2 agonists
what is this: eye lids hot tender, red, swollen. patient is febrile. When eyelids pried open, pupil is dilated and fixed with limited motion
orbital cellulitis
diagnose and treat orbital cellulitis
emergency CT and drainage
retinal detachment presentation
flashes of lights and “floaters” in the eye (the more floaters, the worse it is)
retinal detachment treatment
emergency- laser “spot welding”
embolic occlusion of retinal artery presentation
elderly
sudden loss of vision from one eye
in how many minutes will damage be irreversible in embolic occlusion of retinal artery
30 minutes! emergency!
thyroglossal duct cyst location and size
midline, level of hyoid, connected to tongue
1-2 cm
branchial cleft cysts location
along anterior edge of sternocleidomastoid
cystic hygroma location
base of neck
occupies entrire supraclavicular area and extends deeply
when should you start workup of enlarged lymph nodes
history of >4 weeks
lymphoma presentation- age and symptoms
young people
multiple enlarged nodes
fever, night sweats
which primary tumor usually produces mets to supraclavicular node?
lung, intraabdominal
squamous cell carc of mucosa of head/neck population
old men who smoke, drink, rotten teeth
AIDS
squamous cell carc of mucosa of head/neck presentation
persistent hoarseness
persistent painless ulcer in floor of mouth
persistent unilateral earache
squamous cell carc of mucosa of head/neck workup
triple endoscopy- look for primary tumors
biopsy
CT to show extent
squamous cell carc of mucosa of head/neck treatment
resection
radial neck dissection
platinum chemo, RT
what should you suspect in an adult who has sensory hearing loss in one ear but not the other? and what testing to do?
acoustic nerve neuroma
MRI
what shoud you suspect with GRADUAL vs SUDDEN ONSET unilateral facial nerve paralysis (upper and lower)
gradual: facial nerve tumor
sudden: bell’s palsy
most common parotid tumor
pleomorphic adenomas- benign but capable of malignancy
benign or malignant parotid tumor? painful and hard
malignant
what is contraindicated for imaging for parotid tumor?
FNA
treat parotid tumor
formal superficial parotidectomy
in malignant: nerve sacrificed, graft done
whats most common cause of unilateral ENT problems in toddlers?
foreign bodies
ludwig angina
abscess of floor of mouth (result of bad tooth inf)
treating bell’s palsy
antivirals- early!
steroids
what is this: diplopia, facial pain, high fever in patient with frontal or ethmoid sinusitis
cavernous sinus thrombosis- emergency!
treating cavernous sinus thrombosis
IV abx for 3-4 weeks
drain
prime suspects for 18 year old with nose bleed
cocaine abuse- septal perf
juvenile nasopharyngeal angiofibroma
