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Respiratory Exam 1 > Upper Airway Diseases > Flashcards

Upper Airway Diseases Flashcards

1
Q

main fn of sinuses

A

filter, humidify, warm inspired air

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2
Q

3 cardinal sx of rhinosinusitis

A

purulent rhinorrhea, facial pain/pressure, nasal obstruction

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3
Q

differ acute, subacute, and chronic rhinosinusities

A

by timeline: acute up to 4 weeks w/ total resolution

subacute- more than 4, but less than 12 weeks w/ resolution

chronic- 12 weeks or more

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4
Q

Acute rhinosinusitis causes

A

mostly viral (rhinovirus, coronavirus, influenza)

more rarely bacterial- dx after 10 days of sx or improvement and then worsening
-strep pneumo and H flu and moraxella catarrhalis most common

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5
Q

Tx of ARS

A

Sx management usually

persistent/severe Sx tx w/ antibiotics

intranasal steroid

saline irrigations

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6
Q

2 mechanism of ARS complication

A

loss of anatomic border or hematologic spread

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7
Q

fundamental diff of CRS and ARS

A

12 weeks or more and considered more of an inflammatory disorder than infectious

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8
Q

Dx of CRS

A

Sx Dx unreliable, CT is gold standard

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9
Q

most common predisposing factor to CRS in adults

A

allergies, usually IgE mediated allergic rhinitis

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10
Q

genetic predisposition to CRS

A

primary ciliar dyskinesia and cystic fibrosis

associated w/ higher rates of surgery

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11
Q

describe primary ciliary dyskinesia

A

auto recessive, disorganized microtubules and absent dynein

chronic bronchitis, bronchiectasis, pneumonia, 50% have situs inversus,

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12
Q

3 strategies for CRS Tx

A

mechanical: saline irrigations

anti inflammatory: antihistamine, oral and topical steroids

antimicrobial: based on culture results, usually S aureus, anaerobes, G-, pseudo aeruginosa

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13
Q

2 systemic conditions that involve sinuses

A

granulomatosis w/ polyangitis (Wegeners)- idiopathic vasculitis in airways and kidneys

sarcoidosis

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14
Q

diff b/w allergic and invasive fungal sinusitis

A

allergic: CRS subset, Tx w/ surgery and post op medical
invasive: ENT emergency, usually immunocompromised, rapid necrosis, usually rhizopus, mucor, aspergillus, Tx w. debridement and IV antifungals

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15
Q

which Sx should raise concern for sinonasal tumor?

A

frequent, unexplained nosebleeds, discharge, sinus pain, unusual Sx like visual changes, tearing, neck nodes, hypoesthesia (numbness)

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16
Q

pharyngitis etiologies

A

mostly viral

less common bacterial: usually group A beta hemolytic strep pyogenes

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17
Q

physical exam for bacterial pharyngitis

A

swollen tonsils w/ exudate, maybe petechiae, bad breath

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18
Q

Tx for bacterial pharyngitis

A

pts are contagious, penicillin first line and can prevent complications like glomerulonephritis and ARF

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19
Q

Tx for infectious mono

A

rest, avoid contact sports

antivirals dont help, antibiotics for secondary bacterial infections

NO ampicillin or amoxicillin

steroids for upper airway obstruction

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20
Q

associations w/ peritonsillar abscess

A

trismus (lockjaw), muffled (hot potato) voice, drooling

21
Q

key Sx of retropharyngeal abscess

A

neck stiffness, odynophagia (painful swallowing)

22
Q

complications of retropharyngeal abscess

A

mediastinitis, airway obstruction, IJV thrombosis, sepsis

23
Q

where is danger space

A

b/w alar fascia and prevertebral fascia

24
Q

Ludwigs angina

A

inflammation and cellulitis of submandibular space

life threatening, requires tracheotemy typically

25
Q

abduction vs adduction in the larynx

A

abducted for breathing, adducted for sound production and swallowing

26
Q

when is dysphonia likely other than viral laryngitis

A

more than 2 weeks and other Sx like otalgia, dysphagia, difficulty breathing

27
Q

causes of hoarseness

A

neuro injury (think recurrent laryngeal nerve) or alterations of vocal cord lining (GERD and dehydration can do this)

28
Q

most common cause of vocal fold lesions

A

phonotrauma

29
Q

common benign vocal fold lesions

A

hemorrhage, polyp, cyst, reinke’s edema, granuloma

30
Q

what is the most common benign neoplasm in pediatric larynx? etiology?

A

recurrent respiratory papillomatosis, from HPV 6 and 11

31
Q

Tx of vocal fold lesions

A

combo of med Tx, speech therapy, surgery

32
Q

most common cause of unilateral vocal fold paralysis

A

iatrogenic injury

33
Q

risk factors for laryngeal carcinoma, type of cancer

A

smoking is main factor, EtOH is synergistic

usually sqamous cell carcinoma

34
Q

most common location for laryngeal carcinoma

A

glottic- in vocal folds

35
Q

Sx of laryngeal carcinoma

A

most common is hoarseness

dysphagia, hemoptysis, throat/ear pain, neck mass*

36
Q

diff b/w early and advanced Tx for laryngeal carcinoma

A

single modality early and combined modality w/ advanced (surgery followed by radiation)

37
Q

consequences of laryngectomy

A

cannot speak- require assistance w/ electrolarynx, esophageal speech (burping), tracheoesophageal speech

need to be intubated through the tracheal incision, cannot go through the nose/mouth

38
Q

most common cause of upper airway obstruction in kids

A

adenotonsillar hypertrophy

39
Q

stridor

A

high pitch breathing from turbulent airflow, more on inspiration but can be expiratory or biphasic

40
Q

stertor

A

noise from nose, nasopharynx, oropharynx

low pitched, snoring

41
Q

wheezing

A

high pitched, indicates lower airway disease, more commonly at end expiration

42
Q

signs of epiglottitis

A

thumb sign on saggital xray

airway emergency

43
Q

typical bacteria of epiglottitis

A

h flu type b, strep

44
Q

tx for epiglottitis

A

secure airway, flexible intubation, tracheotemy

avoid agitation

45
Q

characteristics of croup

epi, sx, risk, xray

A

common, viral, pediatric

barking cough, stridor, hoarse, difficulty breathing

swelling from inflammation leads to narrow airway

steeple sign in frontal xray

46
Q

laryngomalacia

A

congenital presents less than 2 mos old, floppy cartilage leads to collapse and inspiratory stridor

worse w/ feeding or supine

47
Q

laryngotracheal stenosis

A

narrowing of larynx or trachea

SOB, inspiratory stridor, no help w/ inhaler

can be progressive, often misdiagnosed as asthma or bronchitis

48
Q

risk of prolonged intubation

A

airway stenosis

Respiratory Exam 1 (14 decks)

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