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Y2 ENT > Throat Conditions > Flashcards

Throat Conditions Flashcards

1
Q

how is neck trauma classified

A

zones 1-3

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2
Q

what are the investigations of a neck mass

A

US then FNA to determine tissue type +- MRI for nerve involvement

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3
Q

what is the cause of a laryngeal polyp

A

laryngeal mucosal reaction to trauma/stress/smoke on cords

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4
Q

what is the difference between a laryngeal polyp and nodule

A

polyp: unilateral, pedunculated
nodule: young women, bilateral

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5
Q

what is a squamous cell papilloma of the throat and what causes it

A

benign, HPV type 6 & 11 induce metaplasia of koliocyte cells

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6
Q

what is the presentation of a squamous cell papilloma of the throat

A

Persistent sore throat, neck mass

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7
Q

what is a paraganglionoma

A

neuroendocrine paraganglia tumour

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8
Q

what condition is associated with paragangliomas in people under 50yr

A

MEN2

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9
Q

what is the classification of paraganglionomas

A

chromaffin +ve or non-chromaffin

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10
Q

what type of paraganglionoma affects the nose/mouth/phayrnx

A

non-chromaffin

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11
Q

what is a sialolithiasis

A

salivary gland stone

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12
Q

what is a painful salivary gland in a young person a red flag for

A

mucoepidermoid carcinoma

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13
Q

what is the commonest salivary gland tumour

A

benign pleomorphic adenoma of the parotid

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14
Q

what is the management of a benign pleomorphic adenoma of the parotid

A

excise sine metaplasia risk

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15
Q

what is the pathophysiology of airway obstruction leading to death

A

resp distress > resp failure > resp arrest > cardiac arrest. Cardio failure > neuro failure

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16
Q

what is stridor

A

high pitch inspiratory noise due to turbulent airflow

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17
Q

what is the management of airway obstruction

A

ABC; O2, heliox, CCS, adrenaline

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18
Q

what is the management of burns causing airway obstruction

A

intubate asap

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19
Q

what investigation should be avoided in airway obstruction

A

tracheostomy

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20
Q

what are the types of patients who get oral squamous cell carcinoma

A

young: HPV type 16/18

old smoker/drinker

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21
Q

how does HPV cause squamous cell carcinoma

A

produce proteins disrupting p53 & RB

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22
Q

where do HPV induced squamous cell carcinomas of the throat occur

A

oropharynx: tongue base/tonsil

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23
Q

where do alcohol/smoking induced squamous cell carcinomas of the throat occur

A

vocal cord

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24
Q

what are the investigations of squamous cell carcinoma

A

biopsy for TNF staging

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25
Q

what is the presentation of HPV SCC

A

young, lymphadenopathy,

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26
Q

does HPV or alcohol/smoking SCC have a better response to chemotherapy and radiotherpay

A

HPV induced

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27
Q

what is the 1st step of the WHO pain ladder

A

non-opioid (e.g. NSAID) +- adjuvant

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28
Q

give examples of NSAIDs

A

paracetamol, aspirin, ibuprofen

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29
Q

what is an adjuvant analgesic

A

primary indication not for pain

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30
Q

give examples of adjuvant analgesics

A

gabapentin, pregabalin, amitriptyline

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31
Q

what is the 2nd step of the WHO pain ladder

A

mild opioid + non-opioid +- adjuvant

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32
Q

give examples of mild opioids

A

codeine, co-cocodamol, tramadol

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33
Q

what is the 3rd step of the WHO pain ladder

A

opioid +- non-opioid +- adjuvant

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34
Q

give examples of moderate-strong opioids

A

morphine, diamorphine, fentanyl, oxycodone

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35
Q

when should you refer a sore throat from primary care

A

dysphagia for longer than 3wk, red/white patch/ulcer for longer than 3wk, stridor

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36
Q

how to decide when to give antibiotics for a sore throat

A

centor criteria

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37
Q

what type of bacteria is diphtheria

A

cornyebacterium

38
Q

what is the presentation of diphtheria

A

very sore throat, grey white membrane on posterior pharynx

39
Q

what is the treatment of diphtheria

A

antitoxin + penicillin/erythromycin

40
Q

what type of vaccine is the diphtheria vaccine

41
Q

what is a risk factor for oral thrush

A

CCS inhaler

42
Q

what is the infecting organism in oral thrush

A

candida albicans

43
Q

what is the treatment of oral thrush

44
Q

what is paramyoxovirus

A

mumps; bilateral parotid salivary gland infection

45
Q

what are complications of mumps

A

meningitis, male infertility

46
Q

what is the infecting organism in primary syphilis

A

treponema pallidum

47
Q

what is an aphthous ulcer

A

round recurrent self limiting mouth ulcers without infection/systemic disease

48
Q

what virus causes hand foot and mouth

A

coxsackie enterovirus

49
Q

what is the presentation of hand foot and mouth disease

A

pyrexic, anorexia, leg ache, itchy papules on hand, foot and mouth

50
Q

what is the transmission of hand, foot and mouth

A

faecal-oral

51
Q

how is hand, foot and mouth diagnosed

A

clinical Dx or swab in viral transport medium for pcr

52
Q

what is the management of hand, foot and mouth

A

self limiting, fluids, NSAID, hand-washing

53
Q

what is the infecting organism in herpangina

A

enterovirus coxsackie

54
Q

what is the presentation of herpangina

A

ulcers on the soft palate of a child

55
Q

what is the management of herpangina

A

self-limiting

56
Q

what is herpetic whitlow

A

herpes simplex infection on finger, often dentist/ anaesthetist

57
Q

how is HSV1 transmissed

58
Q

how is HSV1 infection diagnosed

A

clinical or swab virus in transport medium for viral DNA PCR

59
Q

what is the management of active HSV1 infection

60
Q

what is a complication of HSV1

A

encephalitis

61
Q

what type of herpes causes oral lesions

A

type 1 (i think?)

62
Q

what is primary gingivostomatitis

A

primary HSV1 infection in young child causing ulcer plus systemic upset

63
Q

what are the commonest infecting organisms in tonsillitis

A

viruses: rhinovirus / influenza / enterovirus / adenovirus. rarely EBV

64
Q

which bacteria can cause tonsillitis

A

h. influenzae, s. pyogenes, s. aureus, s. pneumoniae

65
Q

which tonsil inflam will cause AOM

A

pharyngeal

66
Q

what is the difference in the presentation of viral and bacterial tonsillitis

A

viral no fever
bacterial lymphadenopathy
bacterial odynophagia & halitosis
bacterial lasts longer

67
Q

what is the commonest bacteria causing tonsillits

A

s. pyogenes

68
Q

what are the complications of s. pyogenes tonsillits

A

rheumatic fever, glomerulonephritis

69
Q

what are the infection control precautions for s. pyogenes tonsillits

A

SICPS+ contact +- droplet precautions

70
Q

how to decide whether to give antibiotics for tonsillits

A

centor criteria

71
Q

how to do the centor criteria

A 
one point for:
fever
no cough
tonsillar exudate
tender anterior cervical LN
<15yr
- one point if >45yr
72
Q

do you give antibiotics for a centor criteria score of 0-1

73
Q

do you give antibiotics for a centor criteria score of 2-3

A

if symptoms progress

74
Q

do you give antibiotics for a centor criteria score of 4-5

A

start empirical ABx

75
Q

what antibiotics can be prescribed for tonsillitis

A

1st penicillin

2nd clarithromycin

76
Q

when is surgery indicated for tonsillitis

A

episodes prevent ADL + 5+ in past 2yr given ABx OR 3 in past 1yr given ABx

77
Q

what is the commonest complication of tonsillitis

78
Q

what is quinsy

A

unilateral peritonsillar abscess

79
Q

what is the presentation of quinsy

A

odynophagia, trismus, tonsil/uvula medial displacement

80
Q

what is the management of quinsy

A

aspirate + ABx

81
Q

what is the infecting organism in glandular fever aka infectious mononucleosis

A

epstein barr virus

82
Q

what is seen on examination in glandular fever

A

enlarged tonsils + exudate, cervical lymphadenopathy, +- jaundice, +- rash, +- palatal petechiae, +- hepatosplenomegaly

83
Q

what would the patient complain of in glandular fever

A

fever, sore throat, malaise

84
Q

what is diagnostic of glandular fever

A

EBV IgM (not IgG since could have had childhood infection)

85
Q

what investigations can be done for glandular fever

A

FBC, LFT, serology, blood film, Paul Bunnel, Monospot heterophile Ab, CRP

86
Q

what is seen on a blood film in glandular fever

A

large atypical lymphocytes plus leukocytosis

87
Q

what is the management of glandular fever

A

self limiting over 2-4weeks

88
Q

what drug shouldn’t be prescribed for glandular fever and why

A

amoxicillin causes macular rash

89
Q

what is the management of glandular fever if its causing anaemia or tonsillitis

90
Q

what are complications of glandular fever

A

anaemia, spleen rupture, lymphoma, thrombocytopaenia

Y2 ENT (12 decks)

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