Top Exam Pearls Flashcards
Which scan is best for temporal bone fracture
CT temporal bone without contrast
Best imaging for imaging the internal auditory canal (IAC) for acoustic neuroma?
MRI of the IAC with contrast
Best imaging for thyroid nodules
ultrasound
What is the most common pathogen of malignant otitis externa
Pseudomonas aeruginosa
Ludwig’s angina
- odontogenic infection of the subental and submandibular spaces
- causes progressive swelling of the floor of the mouth and upper airway obstruction
Infections of which 3 spaces can extend into the “danger space” allowing spread to the medistinum
- Parapharyngeal
- Prevertebral
- Retropharyngeal
Classic presentation of peritonsillar abscess (4)
- Deviation of the uvula
- Soft palate edema
- Trismus
- Muffled (“hot potato”) voice
First-line treatment for persistent idiopathic facial pain?
tricyclic antidepressants
4 types of papillae on the tongue
- Fungiform
- Filiform (only one that doesn’t contain taste buds)
- Folate
- Circumvalate
Which branchial cleft is the most common branchial cleft to develop an anomaly?
2nd branchial cleft
Does hypopharyngeal cancer carry a worse prognosis than laryngeal cancer?
Yes. hypopharyngeal has more frequent mucosal spread
Most common benign salivary gland tumor?
pleomorphic adenoma
Most common malignant salivary gland tumor?
mucoepidermoid carcinoma
Most common thyroid malignancy
Papillary carcinoma
Most common neoplasm of the thyroid?
Follicular adenoma
Name factors that increase risk of regional lymphatic involvement
- Tumor site
- Stage
- Presence of perineural and angiolymphatic invasion
- Thickness
- Differentiation
MC paraganglioma of the head and neck
carotid body tumor
- pulsatile mass
- Lyre’s sign (splaying of the external and internal carotid arteries)
What do you think a young male patient with unilateral nasal obstruction, epistaxis, and a bluish mass filling the nasal cavity might have?
JNA - juvenile nasopharyngeal angiofibroma
JNA radiolgraphic findings
- Bony destruction of the pterygoid process
- Widening of the spehopalatine and vidian foamina
- Expansion of the PPF on axial view (Holman-Miller sign)
Which cancer of the paranasal sinuses is associated with wood and leather dust exposure?
adenocarcinoma
Which cancer of the paranasal sinuses is associated with exposure to chromium, nickel, mustard gas, aflatoxin?
SCC
Which cranial nerves are present in cavernous sinus(4)?
- CN III
- CN IV
- CN V1, V2
- CN VI
Which cranial nerve in the cavernous sinus is most medial and most commonly injured?
CN VI (Abducens)
Chandler Classification is in regards to what?
Orbital infection
I- preseptal cellulitis II-orbital cellutiis III- subperiosteal abscess IV-orbital abscess V-cavernous sinus thrombosis
MC complication from a septal hematoma?
- septal perforation
- saddle nose deformity
What site is most commonly seen to have iatrogenic CSF leak during endoscopic sinus surgery?
lateral lamella of the cribriform
Top 4 causes of CHL?
- Cerumen impaction
- Otitis media with effusion
- TM perforation
- Otosclerosis
Top 3 causes of SNHL?
- Presbycusis
- Noise exposure
- Hereditary
Most common ototoxic drugs (4)?
- Aminoglycosides (ex. gentamycin)
- Loop diurectics (ex. furosemide)
- Platinum containing chemo drugs (ex. cisplatin)
- Salicylates (ex. aspirin, NSAIDS)
In a pediatric patient with SNHL, what is the most common radiographic finding?
Enlarged vestibular aqueduct
What is a pure-tone average?
Average air conduction hearing threshold at the frequencies associated with speech
- 500 Hz
- 1000 Hz
- 2000 Hz
How does peripheral nystagmus change when the patient gazes in the direction of the fast phase?
-peripheral nystagmus becomes faster and more apparent when patient looks in the direction of the fast phase
Ex. Right beating nystagmus worsens with rightward gaze
(“Alexander’s Law”)
3 types of cholesteatoma
- Congenital
- Primary acquired
- Secondary acquired
Superior semicircular canal dehiscence symptoms (4)
- Conductive hearing loss
- Autophony
- Vertigo (Tullio’s phenomenon)
- Ear fullness
CSF leak is common in temporal bone fractures. When does it usually stop?
Within 7 days
What do you think about in a infant patient presenting with respiratory distress and cyanosis at birth, worse with feeding and relieved by crying?
Bilateral choanal atresia
In a pediatric patient, what is the most common cause of stridorous breathing?
Laryngomalacia
Most common cause of subglottic stenosis
iatrogenic scarring related to endotrachial intubation
What is the most common tumor of infancy, of which the majority are found on the head and neck?
infantile hemangiomas
What distinguishes hemangiomas from vascular malformations?
GLUT-1 positivity
What is the first-line treatment of infantile hemangioma?
propranolol
Differential for pediatric midline nasal mass (3)
- glioma
- dermoid
- encephalocele
What is the MC cleft lip/palate configuration and what side does it occur on?
Left, cleft lip and palate
MC indication for tonsillectomy
- sleep disordered breathing
- recurrent tonsillitis
Layers of the eyelid, superficial to deep (7)
- skin
- orbicularis oculi
- orbital septum
- preaponeurotic fat
- levator aponeurosis
- Muller’s muscle
- Conjunctiva
Name of the skin peel formula containing 88% phenol, croton oil, septisol, and distilled water
Baker-Gordon formula
What is the main complication of phenol chemical peels?
cardiac toxicity
MC complication of a facelift surgery?
hematoma (occurs 10% of the time, MC in men)
What is the most commonly injured nerve in a facelift sugery?
Great auricular nerve (sensory, C2-C3)
How does botulinum toxin work?
prevents the release of acetylcholine from presynaptic nerves at the neuromuscular junction
In a patient with facial trauma, what is an early clinical finding suggesting injury to the optic nerve?
Loss of red color vision
MC site of mandible fracture?
angle of the mandible
Only abductor of the true vocal folds?
PCA - posterior cricoarytenoid muscle
Is fluid bright on T1 or T2 weighted MRI?
T2
What is the only laryngeal muscle not innervated by the recurrent laryngeal nerve?
cricothyroid
What is the cricothyroid innervated by?
superior laryngeal nerve
Your patient has vocal fold nodules from overuse. What treatment do you offer?
voice therapy
What is the name for the procedure to remove the central portion of the hyoid bone to prevent recurrence of thyroglossal duct cyst?
Sistrunk procedure
