Top 100 Pearls Flashcards
Ludwig’s angina occurs in which area
Submental and Submandibular
Swelling of FOM, Upper airway
Histopathology of IFS
Fungal invasion into submucosal tissues and vessels, associated necrosis
Classic symptoms of PTA
Trismus, uvular deviation, muffled voice, soft palate edema
Elevated RF for OSA
>65 BMI >30 kg/m2 Post-menopause AA or Asian Male Neck >17 (m) >16 (f)
Mucor pathology
Non-septate, wide angle br
Aspergillus path
Septate, 45 br
Most common HA
Tension HA
Treatment persistent idiopathic facial pain
TCAs
Tongue papillae
Fungiform
Foliate (sides)
Circumvallate
Filiform (no buds)
Why hypopharyngeal cancer is worse than laryngeal
Frequent submucosal spread
Most common malignancy and neoplasm of thyroid
M: Papillary
N: Follicular adenoma
Most common H/N paraganglioma
Carotid body tumor
JNA classic presentation
Nasal obstruction, epistaxis, bluish mass
Expansion of PPF on axial view, widening of sphenopalatine and vidian foramina, bony destruction pterygoid process
Exposure risks for adenocarcinoma and SCC of sinuses
A: Wood, leather dust
S: chromium, nickel, mustard gas, aflatoxin
Ohngrens line
Medial canthus to angle of mandible, maxillary sinus tumors worse above line
Most common nerve affected in cavernous sinus
VI (most medial)
CSF production per hour
20 ml
Chandler classification
I- preseptal cellulitis II- orbital cellulitis III- subperiosteal abscess IV- orbital abscess V- cavernous sinus thrombosis
Major tip support
Attachments between septum, Lower lats, upper lats
Minor tip support
Interdomal lig, dorsal septum, membranous septum, sesamoid complex, skin and SQ tissue of tip, maxillary spine
Nose changes u/l cleft
I/l LLC inf/Post/lat
Tip, caudal septum, columella towards non cleft side
Bony septum toward cleft
Most common complications of septal hematoma
Septal perforation, saddle nose
Symptoms of TSS
S Aureus
High T, low P, multiorgan failure
Rash, vomit, diarrhea
IV ABx
Keros Olfactory Fossa Depth
I: 1-3mm
II: 4-7mm
III: 8mm +
Most common iatrogenic CSF leak during FESS
Lateral lamella cribiform
Cochlear tonotopy
Basilar membrane thick, stiff, narrow (higher f)
Apex thin, flexible, wide (lower f)
4 most common causes CHL
Cerumen impaction
OME (#1 in kids)
TM perf
Otosclerosis
3 most common causes SNHL
Presbycusis
Noise
Hereditary
Most common ototoxic meds
Aminoglycosides
Cisplatin
Loop D
Salicylates
Pure Tone Average
Air conduction 500, 1000, 2000 (speech)
Alexander’s Law (Nystagmus)
Worse when gaze in direction of fast phase (right beating worsens on right gaze)
4 components of hearing aid
Microphone, amplifier, receiver, battery
Percentage of AOM bacteria susceptible to Amoxicillin
80% (if concurrent bact conj then most likely H Flu and resistant to amoxicillin)
When to do CWD mastoidectomy
SCC fistula, posterior canal wall damage due to cholesteatoma, sclerotic mastoid prevents visualization, unable to follow up or get more surgeries
Otosclerosis presentation and CT
20-40 progressive CHL (rare SNHL), FHx
Remodel otic capsule, lose piston Action
Otospongiosis, lucent temporal focus
Mechanism of passive upper eyelid closure
Relaxation of LPS
Most susceptible CN7 segment to entrapment neuropathy
Labyrinthine segment (narrowest portion of fallopian canal)
Symptoms of SCC dehiscence
CHL, aural fullness, vertigo, autophony
Portions of canal numb with acoustic neuroma compression
Posterior, Superior, Medial
Hitzelberger Sign
How long does it take for CSF leak to typically stop after T-bone fx
7 days
2 most common causes strider in children
Laryngomalacia
U/l VC paralysis (iatrogenic usually)
Lab test to distinguish hemangioma from vascular malformation
GLUT-1 positive hemang
Post-adenoidectomy VPI
Resolves 4-6 wk usually
If 2 mo persistent…pharyngeal flap
Bronchial cleft anomalies location relative to arch
Deep to own arch, superficial to subsequent arch
Cleft percentages
50% lip and palate
35% palate alone
15% lip alone
Most common left unilateral
Internal nasal valve
Upper lats, septum, floor
Pollybeak deformity
Supratip fullness post-rhinoplasty due to loss of tip support, supratip scar tissue
Layers of eyelid A-P
Skin Orb Oc Septum Pre-aponeurotic fat Levator aponeurosis Muller’s muscle Conjunctiva
Toxicity of phenol chemical peels
Cardiac
Apply to individual facial subunits in 15 min intervals
Facelift common complication and nerve injuries
Hematoma
10%, more common in men
GA, Marg
Botox mechanism
Presynaptic NMJ
Prevent Ach release
Advantages of FTSG
Limits contraction
Better texture and color match
First color to lose (vision)
Red
Most common facial bone fx, site of jaw fx
Nasal
Angle
VC abductor
Post CA
Innervation of cricothyroid and interarytenoid
SLN
Bilateral RLN
HPV types causing RRP
6, 11
Primary management of VC nodules
Voice therapy
Laryngeal EMG signs of denervation and reinnervation
De: fibrillation potentials, positive waves
Re: polyphasic motor units
7 steps to handle airway fire
O2 off Saline (douse) Remove damaged tube Re-intubate IV steroids, ABx Bronch Delayed extubation, repeat bronchs
Pendred syndrome mutation
SLC26A4
Hearing loss, enlarged vestibular aqueduct, euthymic goiter
Sistrunk procedure key
Central hyoid resection
Resect tongue mm between hyoid and foramen cecum
C Diff antibiotics
Clindamycin
Fluoro
Cephalosporin
Carbapenem
How to manage posterior nasal packing patient
Admit, telemetry, pulse ox
How long to wait for scar revision
At least 6-12 months (unless obvious concern not expected to improve)
Usually improve spontaneously after 1-3 yr