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Throat-ENT Flashcards

1
Q

tx acute tonsilitis

A
  • co-amox
  • analgesia +/- steroid bolus
  • rehydration/ bed rest
  • antipyretics
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2
Q

tx acute tonsilitis

A
  • co-amox
  • analgesia +/- steroid bolus
  • rehydration/ bed rest
  • antipyretics
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3
Q

viral vs. bacterial sore throat

A 
viral= milder, low grade adenopathy, 
bacterial= SEVERE> 48hrs
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4
Q

dx acute tonsilitis

A
  • fbc
  • MONOSPOT= Paul Bunnell
  • LFT
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5
Q

refer acute tonsilitis

A
  • severe sore throat
  • trsimus
  • hot potato
  • referred pain
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6
Q

causes of quinsy

A

S.aureus
S.pneumo
Bacteroides

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7
Q

Epiglottis in adults- location

A

SUPRAGLOTTIC

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8
Q

Tx epiglottitis

A

REFERRAL- ENT/anaesthesia/paeds

  • Oxygen
  • adnrealine neb
  • heliox
  • steroids
  • antibiotics– third gen cephalosporin
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9
Q

nasal facture– important to exclude

A

another max-fax fracture

CSF rhinorrhea

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10
Q

when to refer nasal fracture

A

obvious deformity- 5-7days; rhinoplasty

URGENTLY– septal haematoma

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11
Q

mgmt septal haematoma

A

incise
drain
tamponade

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12
Q

tx of orbital cellulitis

A

IB antibiotics
decongestants
analgesia
optic nerve damage= SURGICAL DECOMPRESSION

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13
Q

dx of orbital cellulitis

A

CT sinuses- exclude orbital abscess

urgent referral ENT/ OPTHO

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14
Q

epistaxis causes in kids

A
  • URTI

- digital trauma

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15
Q

epistaxis causes in adults

A
  • trauma
  • anterior bleed
  • posterior bleed
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16
Q

anterior bleed epistaxis in adults

A
  • little’s area

- recurrent self-limiting

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17
Q

posterior bleed epistaxis in adults

A
  • elderly
  • medical co-morbidities– anticoag, aspirin

MORE SEVERE–> ADMIT

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18
Q

bloody otorrhea tx– BASE OF SKULL FRACTURE

A

BATTLE SIGN: bruising over mastoid process, by extravasation of blood along path of posterior auricular artery

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19
Q

bloody otorrhea tx– BASE OF SKULL FRACTURE

A

BATTLE SIGN

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20
Q

viral vs. bacterial sore throat

A 
viral= milder, low grade adenopathy, 
bacterial= SEVERE> 48hrs
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21
Q

dx acute tonsilitis

A
  • fbc
  • MONOSPOT= Paul Bunnell
  • LFT
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22
Q

refer acute tonsilitis

A
  • severe sore throat
  • trsimus
  • hot potato
  • referred pain
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23
Q

causes of quinsy

A

S.aureus
S.pneumo
Bacteroides

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24
Q

Epiglottis in adults- location

A

SUPRAGLOTTIC

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25
Q

Tx epiglottitis

A

REFERRAL- ENT/anaesthesia/paeds

  • Oxygen
  • adnrealine neb
  • heliox
  • steroids
  • antibiotics– third gen cephalosporin
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26
Q

nasal facture– important to exclude

A

another max-fax fracture

CSF rhinorrhea

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27
Q

when to refer nasal fracture

A

obvious deformity- 5-7days; rhinoplasty

URGENTLY– septal haematoma

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28
Q

mgmt septal haematoma

A

incise
drain
tamponade

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29
Q

anterior ethmoidal artery

A

ophthalmic-ica-common carotid

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30
Q

sphenopalatine artery

A

terminal IMAX-ECA

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31
Q

greater palatine

A

IMAX-ECA

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32
Q

septal branch

A

superior labial-facial-IMAX-ECA

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33
Q

grade 1 chandlers

A

preseptal/ periorbital cellulitis

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34
Q

grade 2 chandlers

A

postseptal/ orbital cellulitis

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35
Q

grade 3 chandlers

A

subperiosteal abscess

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36
Q

grade 4 chandlers

A

intra-orbital abscess

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37
Q

grade 5 chandlers

A

cavernous sinus thrombosis

38
Q

tx of orbital cellulitis

A

IB antibiotics
decongestants
analgesia
optic nerve damage= SURGICAL DECOMPRESSION

39
Q

dx of orbital cellulitis

A

CT sinuses- exclude orbital abscess

urgent referral ENT/ OPTHO

40
Q

epistaxis causes in kids

A
  • URTI

- digital trauma

41
Q

epistaxis causes in adults

A
  • trauma
  • anterior bleed
  • posterior bleed
42
Q

anterior bleed epistaxis in adults

A
  • little’s area

- recurrent self-limiting

43
Q

posterior bleed epistaxis in adults

A
  • elderly
  • medical co-morbidities– anticoag, aspirin

MORE SEVERE–> ADMIT

44
Q

perichondral haematoma tx

A
  • IV abx
  • analgesia
  • refer–> incise and drain
45
Q

bloody otorrhea tx– BASE OF SKULL FRACTURE

A

BATTLE SIGN

46
Q

causes of bloody otorrhea

A
  • otitis– media/ externa
  • focal trauma
  • head injury
  • post-op
47
Q

mgmt bloody otorrhea

A

RADIOLOGY, PRIMARY/SECONDARY SURVEILLANCE

HEAD INJURY TEAM

48
Q

epistaxis tx

A
  1. Tilt head forward and apply nasal compression for 15 minutes
  2. Try againIf fails to resolve consider hospital admission
  3. Perform ABCD and correct any underlying pathology (HTN, bleeding disorder)
  4. Establish IV Line access
  5. Offer Nasal Decongestant (Oxymetazoline)
  6. Visualize and Cauterize the wound with silver nitrate
  7. Pack nose and give oral antibiotics
    Ribbon Gauze w/ BIPP, merocel (tampon), rapid rhino (balloon)
  8. Antibiotics to prevent: sinusitis, otitis media, cavernous sinus thrombosis
  9. if bleeding persists, consider surgical intervention
    Arterial ligation
    Radiological Embolization
49
Q

RR newborn

50
Q

RR toddler

51
Q

RR school

52
Q

RR adult

53
Q

indications for tracheostomy

A 
PELAPS
Prophylaxis
Edema- infective/trauma/burn
Long term ventilation
Airway obstruction
Pulmonar toilet-- aspiration
Sleep apnea
54
Q

do an open one, when there are contraindications to ventilation, such as…

A

OBESE
COAGULOPATHIC
PREVIOUS- Rtx/ Sx

55
Q

stridor neonate

A
  • laryngomalacia
  • congenital tumor
  • subglottic stenosis
  • vocal cord paralysis
56
Q

stridor children

A
  • croup
  • FB
  • epiglottitis
  • acute laryngitis
  • respiratory papillomatosis
57
Q

stridor adults

A
  • laryngeal cancer
  • laryngeal trauma
  • acute laryngitis
  • epiglottitis
58
Q

complications of tracheostomy

A
  1. death
  2. obstruction– from secretion since FB
  3. bleeding
  4. displacement
  5. subcutaneous emphysema
  6. pneumothorax
  7. fistula– TEF, tracheoinnominate
  8. RLN
59
Q

cuffed tube

A

can talk; seal for ventilation

change: ulcerates or RLN or aspiration or dysphasia

60
Q

double lumen tube

A

change: clean

61
Q

fenestrated tube

A

can talk;

change: granulations go through

62
Q

inflammatory causes of neck mass

A
  • cervical adenitis

- chronic sialadenitis

63
Q

infectious causes of neck mass

A
  • staph
  • strep
  • TB
  • HIV
  • Cat scratch
  • Toxo
  • EBV
  • Actinomycosis
64
Q

congenital causes of neck mass

A 
LATERAL= branchial cleft cyst
DIFFUSE= lymph/haemangioma
MIDLINE= 
- thyroglossal duct cyst
- dermoid cyst
65
Q

benign neoplastic causes of neck mass

A

benign:

  • lipoma
  • fibroma
  • neuroma
  • haemangioma
66
Q

malignant neoplastic causes of neck mass

A

malignant:

  • lymphoma
  • SCC
  • PTC
  • RCC or breast mets
67
Q

traumatic causes of neck mass

A

pseudoaneurysm

AV fistula

68
Q

idiopathic causes of neck mass

A

Sarcoidosis
Cattleman’s disease
Kimuras disease

69
Q

Kimuras disease=

A

chronic inflammation

70
Q

Castlemans disease=

A

benign lymphoproliferative

71
Q

side effects of gradualism vaccine

A

pain/ red at injection site
faint– 15 minutes after
v.rare= anaphylaxis

72
Q

presentation of SCC

A

= LATE, stages 3-4

73
Q

causes of leukoplakia

A
  • irritation– dentures, rough teeth, fillings, crowns
  • smoking
  • lip sun exposure
  • oral cancer
  • HIV
74
Q

PC HPV head and neck cancer

A
  • SOB
  • hoarseness
  • difficulty swallowing
  • painful swallowing
  • persistent pain
  • bleeding
  • ulceration– oral, skin
  • lump/ mass lesion
75
Q

other name for rodent ulcer

A

JACOBI ULCER

76
Q

two new names of aggressive BCC’s

A

cicatricial (morpheaform)

infiltrative

77
Q

superficial multicentric BCC

A

trunk/ erythematous patch

78
Q

merkel cell skin cancer a/w

A

POLYOMA VIRUS

79
Q

T size for SCC

80
Q

high risk features of SCC

A
  • ear or hair bearing lip
  • greater than 2cm
  • clark four– reticular dermal invasion
  • perineural invasion
  • poorly differentiated
  • chronic inflammation/ ulcer/ burn
81
Q

melanoma of extremities

82
Q

melanoma of trunk

83
Q

amelanotic melanoma

A

trunk, head and neck
presents in NORMAL SKIN
RAPID growth

84
Q

desmoplastic melanoma

A

HIGHLY AGGRESSIVE
NEURAL INVASION
SUNLIGHT EXPOSED areas

85
Q

in situ clarks

86
Q

stage 2 clarks

A

papillary dermis

87
Q

stage 3 clarks

A

papillary-reticular dermis

88
Q

stage 4 clarks

A

reticular dermis

89
Q

stage 5 clarks

A

subcutaneous fat

90
Q

GAMES for thyroid cancer

A 
G-grade
A-age-45yo
M-m stage- M0, M1
Extrathyroid extension
Size-4cm

ENT SC1 (8 decks)

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