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Respiratory Week 1 > Upper Airway Disorders > Flashcards

Upper Airway Disorders Flashcards

1
Q

what two antibodies are in sinus secretions

A

IgG and IgA

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2
Q

what type of epithelium lines the mucosal areas

A

psuedostratified columnar ciliated epithelium

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3
Q

3 cardinal symptoms of rhinosinusitis

A

facial pressure
nasal obstruction
purulent rhinorrhea

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4
Q

two main types of rhinosinusitis

A

acute and chronic

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5
Q

how long does chronic rhinosinusitis have to be

A

longer than 12 weeks

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6
Q

what is the usual pathogenic cause of acute rhinosinusitis

A

viral

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7
Q

name the three most common bacteria that cause acute rhinosinusitis

A

strep pneumo
haemophilus
Moraxella catrrhalis

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8
Q

while acute rhinosinusitis is considered to be infectious…what is chronic considered?

A

more inflammatory in nature

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9
Q

what is the gold standard for chronic sinusitis imaging

A

CT

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10
Q

what is the most common predisposing factor leading to chronic rhinosinusitis

A

allergies

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11
Q

name the two genetic predispositions to chronic sinusitis

A

primary ciliary dyskinesia

CF

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12
Q

what is mode of inheritance for primary ciliary

dyskinesia

A

autosomal recessive

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13
Q

name the four different treatment or symptom improving drugs for acute rhinosinusitis

A

antibiotics
steroids
saline irrigation
nasal decongestant

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14
Q

what is an autonomic drug used for rhinosinusitis?

A

phenylephrine…because it decreases edema and mucos

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15
Q

what is potts puffy tumor? what is it associated with?

A

it is a frontal bone osteomyelitis and is associated with adverse outcome of acute rhinosinusitis

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16
Q

what are the broad categories that can contribute to development of chronic rhinosinusitis? (5)

A 
systemic-immuno/genetic
local-obstructions/dysfunction
microorganisms
pollutants
medications
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17
Q

what is rhinitis medicamentosa?

A

when you take too much nasal decongestant you can get chronis rhinosinusitis

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18
Q

name the five treatment drug options for chronic rhinosinusitis

A

mechanical like saline rinse and mucolytics
antihistamines
steroids..oral and topical
antibiotics

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19
Q

name two systemic diseases that can cause sinus blockage

A

granulomatosis with polyangitis (wegeners)

Sarcoidosis

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20
Q

what is Granulomatosis with polyangitis?

A

idiopathic autoimmune disorder that leads to necrotiing granulomas and can involve the upper airways

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21
Q

what are the two types of fungal sinusitis?

A

allergic and invasive

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22
Q

what is the treatment for allergic fungal sinusitis?

A

mainly surgical clearance

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23
Q

what bugs are usually responsible for invasive fungal sinusitis?

A

mucor, rhizopus, and aspergillus

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24
Q

what is the treatment for invasive fungal sinusitis?

A

surgical followed by IV antifungals

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25
Q

what type of person usually suffers from invasive fungal sinusitis?

A

an immunocompromised patient

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26
Q

what are three common symptoms that are signs of potential sinonasal tumors?

A

unexplained nosebleeds..often one sided
sinonasal discharge
sinus pain

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27
Q

name the common sinonasal tumor..what group suffers from this?

A

juvenile nasopharyngeal angiofibroma…mainly in young males

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28
Q

what is the most common cause of bacterial pharyngitis in adults?

A

group A beta hemolytic streptococcus pyogenes

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29
Q

is the usual cause of a sore throat bacterial or viral?

A

most are viral…but bacteria does have bigger presence in kids compared to adults

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30
Q

what is treatment for bacterial pharyngitis?

A

antibiotics…amoxicillin/penicillin…macrolides if allergic to penicillin

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31
Q

what is the structure of the EBV?

A

double stranded DNA virus

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32
Q

describe treatment for MONO

A

supportive care, antipyretics…NO amoxicillin or antibiotics in general unless there is secondary bacterial infection

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33
Q

what is a peritonsillar abscess?

A

an abscess between the capsule of the tonsils and the pharyngeal constrictors

34
Q

name three symptoms associated with peritonsillar abscess?

A

trismus (lock jaw), hot potato voice (muffled voice), drooling

35
Q

how do you treat a peritonsillar abscess?

A

drain it and give anitbiotics

36
Q

what is a retropharyngeal abscess?

A

this is an abscess in the retropharyngeal space that is between the buccopharyngeal outpouch of the pretracheal layer and the alar fascia

37
Q

what is the usual cause of the retropharyngeal abscess?

A

polymicrobial…can be aerobic..anaerobic and gram negative

38
Q

how to treat retropharyngeal abscess?

A

incision and drainage then antibiotics

39
Q

name the five common symptoms of a retripharyngeal abscess

A 
fever 
sore throat
shortness of breath
neck stiffness
painful swallowing
40
Q

name five complications of a retropharyngeal abscess

A 
internal jugular vein thrombosis
necrotizing fascitis
sepsis
mediatinitis
airway obstruction
41
Q

describe how Ludwigs angina occurs?

A

usually dental in nature…inflammation and cellulitis of the submandibular space that spreads to the sublingual space

42
Q

what is the most common issue encountered with ludwig angina?

A

tongue gets displaced due to swelling under it and will block the airway

43
Q

what is the treatment for ludwigs angina?

A

give IV antibiotics, incision and drain, maintain airway

44
Q

what are the common symptoms (4) for ludwigs angina?

A

shortness of breath, submandibular mass, drooling, trismus

45
Q

what is the most common cause of long term dysphonia or hoarseness

A

iatrogenic injury to the recurrent laryngeal nerve

46
Q

name three causes of neurological injury that can leads to hoarseness

A

neoplasm
viral neuropathy
idiopathic injury

47
Q

four symptoms of unilateral vocal fold paralysis

A

breathy, weak dysphonia, poor cough, dysphagia

48
Q

what type of imaging to use to see the recurrent laryngeal nerve?

A

CT scan

49
Q

what is the pancoast tumor?

A

a tumor in the apex of the lung that can cause compression on the recurrent laryngeal and lead to hoarseness

50
Q

what is the cause of most benign vocal fold lesions?

A

phonotrauma

51
Q

what cell layers of vocal cords are usually involved in vocal cord lesions?

A

superficial lamina propria and epithelial cover

52
Q

what is recurrent respiratory papillomatosis? how to treat it?

A

from the HPV 6 and 11 strands and causes lesions on the airways…often a cause of vocal cord lesions

surgery…not a cure

53
Q

what age does recurrent respiratory papillomatosis affect mainly?

A

most common benign neoplasm in children…if get in childhood it is likely linked to mother

54
Q

how does laryngeal cancer present?

A

hoaresness, neck masses, hemptysis, throat and ear pain, will see some masses on laryngoscopy, lymphadenopathy

55
Q

how to treat early stage laryngeal cancer?

A

surgery or radiation therapy

56
Q

how to treat late stage laryngeal cancer?

A

combined surgery and radiation therapy

57
Q

what is a total laryngectomy?

A

complete disconnect of the respiratory tract and esophagus…trachea now comes out at the throat…breath through neck hole

58
Q

how does tracheoesophageal speech work following a total laryngectomy?

A

have a fistula placed in the new trachea and it makes vibrations as air moves up and then the vibrations travel out of the mouth as speech

59
Q

what is pediatric OSA? what are the signs of it?

A

obstructive sleep apnea

mouth breathing, snoring, snorting, gasping, dysphagia and choking signal tonsils, nasal voice signals adenoids

60
Q

what four problems can kids with OSA have?

A

failure to thrive, learning disability, behavorial issues, ADHD

61
Q

how to treat pediatric OSA?

A

most common cause is adenotonsillar hypertrophy so remove them

62
Q

define stridor

A

high pitch breathing on inspiration, expiration or biphasic from narrowed trachea or larynx

63
Q

define stertor

A

airway noise from nose or naso/oropharynx…low pitch

64
Q

define wheezing

A

high pitched sound at end expiratory…signal lower respiration problem

65
Q

with inspiratory stridor, where is the blockage?

A

supraglottis/glottis

66
Q

with biphasic stridor where is the blockage?

A

subglottis

67
Q

with expiratory stridor, where is the blockage?

A

trachea

68
Q

what is epiglottitis?

A

bacterial infection of the epiglottis

69
Q

what two organisms commonly cause epiglottitis?

A

haemophilus and streptococcus species

70
Q

treatment for epiglottitis

A

secure airway, give antibiotics and steroids

71
Q

what is the croup?

A

laryngotracheobronchitis…viral infection in pediatrics leads to inflammation and airway blockage

commonly have barking cough and stridor

72
Q

what is the sign associated with epiglottitis?

A

thumb sign

73
Q

what is the sign associated with croup?

A

steeple sign

74
Q

what is a positional sign for epiglottitis?

A

they sit in a tripod position

75
Q

do you have difficulty swallowing in epiglottitis and croup?

A

yes for epiglottitis and NO for croup

76
Q

what is laryngomalacia? what age does it effect?

A

congenital abnormality of the laryngeal cartilage leads to collapse and inspiratory stridor

mainly infants

77
Q

what is laryngotracheal stenosis

A

stenosis of the trachea and larynx that leads to narrowing of the airways

78
Q

name the six classes of causes for laryngotracheal stenosis

A 
idiopathic
trauma
neoplasms
congenital 
collagen vascular disease
chronic inflammatory disease
79
Q

name a common traumatic cause of laryngotracheal stenosis

A

endotracheal tube placement for too long…more than 7-10 days

80
Q

four symptoms of laryngotracheal stenosis

A

shortness of breath
inspiratory stridor
no aid with inhalers
tight throat

Respiratory Week 1 (18 decks)

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