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ENT > Oropharynx > Flashcards

Oropharynx Flashcards

1
Q

What are the types of Acute tonsillitis?

A

Acute catarrhal/superficial tonsillitis
Acute follicular tonsillitis
Acute membranous tonsillitis
Acute parenchymatous tonsillitis

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2
Q

Acute tonsillitis is common in _____________ and is caused by ___________

A

school going children
hemolytic streptococcus

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3
Q

What are the symptoms of tonsillitis?

A

Sore throat
Ear ache
Difficulty in swallowing
Fever, malaise

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4
Q

What are the signs of tonsillitis?

A

Bad breath
Coasted tongue
Follicles
Hyperemia of the tonsils
A membrane that can be easily wiped
Tonsils that meet each other (parenchymatous)
Enlarged JD nodes

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5
Q

What is the treatment for tonsillitis

A

Fluids
Aspirin or paracetamol
Penicillin or erythromycin for 7-10 days

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6
Q

What are the complications of tonsillitis?

A

Chronic tonsillitis
Peritonsillar abscess
Parapharyngeal abscess
Cervical abscess
Rheumatic fever
Acute glomerulonephritis
Subacute bacterial endocarditis
Acute otitis media

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7
Q

Distinguishing features of Diphtheria

A

Slow onset
Membrane is dirty grey in color
Extends onto tonsils, soft palate
Removing it leaves a bleeding surface
Urine shows albumin

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8
Q

Distinguishing features of vincent angina

A

Removing the membrane will reveal irregular ulcers on tonsil

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9
Q

Distinguishing features of IMN

A

Young adults
Splenomegaly
Failure of the antibiotic treatment
Lymphocytes on CBC
Paul Bunnell test (mono test)

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10
Q

What is the Paul Bunnell test done for?

A

Infectious mononucleosis

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11
Q

What do we find in the Paul Bunnell test?

A

High titre of heterophil antibody

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12
Q

D/Ds of acute tonsillitis

A

Diphtheria
Vincent Angina
IMN
Agranulocytosis
Leukemia
Aphthous ulcer
Malignant tonsils
Traumatic ulcer
Candida

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13
Q

What are the types of chronic tonsillitis?

A

Chronic follicular
Chronic parenchymatous
Chronic fibroid

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14
Q

WHat type of chronic tonsillitis is associated with sleep apnea and risk of cor pulmonale?

A

Chronic parenchymatous

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15
Q

WHat type of chronic tonsillitis is associated with recurrent sore throat?

A

CHronic fibroid tonsillitis

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16
Q

Important sign of chronic tonsillits

A

Flushing of Anterior pillars

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17
Q

What are the indications of tonsillectomy

A

Speech
Deglutition
Respiration
Recurrent attacks

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18
Q

What are the complications of chronic tonsillitis?

A

Peritonsillar abscess
Parapharyngeal abscess
Intratonsillar abscess
Tonsilloliths
Tonsillar cyst
Other systematic infections

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19
Q

What is ludwig Angina

A

Infection of the submandibular space

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20
Q

Explain the anatomy of the submandibular space

A

Above the mylohyoid, we got the sublingual space
Below it, we have submaxillary and submental space

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21
Q

WHat are the causes of ludwigs angina

A

Dental infection
Submandibular sialadenitis
Injury to oral mucosa
Fractures of mandibule

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22
Q

What afre the bacteria involved in ludwigs angina

A

Mixed
Streptococci
Staphylococci
Bacteroides

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23
Q

Features of ludwig angina

A

Odonyphagia
Trismus
Tongue pushed up
Woody hard feel
Laryngeal edema

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24
Q

Complications of LA

A

SPread of infection
Airway obstruction
Septicemia
Aspiration pneumonia

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25
Q

Treatment of LA

A

Systemic antibiotics
I/D intraoral if sublingual
I/D external if submaxillary
Tracheostomy

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26
Q

What is peritonsillar abscess

A

Collection of pus in the space between capsule of tonsils and superior constrictor muscle

27
Q

What is the cause of peritonsillar abscess

A

Acute tonsillits
De novo

28
Q

Features of Peritonsillar abscess

A

Constitutional symptoms
Odonyphagia is so severe that it causes dehydration
Hot potato voice
Foul breath
Earache
Trismus

29
Q

Peritonsillar abscess mostly affects ________ and is _________ (unilateral/bilateral)

A

adults
unilateral

30
Q

WHat are the signs of peritonsillar abscess

A

Uvula bulged to opposite site
Torticollis to the side of abscess

31
Q

Tx of Peritonsillar abscess

A

Hospitalization
IVF
A/A
I/D
Interval tonsillectomy
Abscess or hot tonsillectomy

32
Q

Complications of Peritonsillar Abscess

A

Parapharyngeal abscess
Laryngeal Edema
Septicemia
Pneumonia
Jugular Vein thrombosis
SPontanoeus hemorrhage

33
Q

Explain retropharyngeal space

A

The space between bucopharyngeal fascia (covering the pharyngeal constrictors) and prevertebral fascia

34
Q

Explain prevertebral space

A

Space between the prevertebral fascia and the vertebral bodies

35
Q

Acute retropharyngeal abscess is in _____________

A

Retropharyngeal space

36
Q

Chronic Retropharyngeal abscess is in _______________

A

prevertebral space

37
Q

Etiology of Acute RP Abscess

A

Secondary infections of surrounding structures in children
Injury in adults

38
Q

Dx of Acute RP abscess

A

Stridor
Croupy cough
Torticollis
Dysphagia
Bulge in the posterior pharyngeal abscess
Widening of prevertebral shadow and presence of gas

39
Q

Chronic RP Abscess is caused by _____________

A

tuberculosis (on one side of the midline)
caries of the cervical spine (centrally)

40
Q

Quinsy is AKA as _____________

A

Peritonsillar Abscess

41
Q

Explain the parapharyngeal space anatomy

A

The space lateral to the pharynx. It is divided into Anterior compartment and posterior compartment

42
Q

What are the important structures that pass through the posterior compartment of parapharyngeal space?

A

Carotid artery
Jugular Vein
9, 10, 11 and 12 CN
Sympathetic trunk
Deep cervical nodes

43
Q

What are the features of Anterior compartment infection of the parapharyngeal space?

A

prolapse of tonsil and fossa
trismus
swelling behind the angle of the jaw

44
Q

What are the features of posterior compartment infection of the parapharyngeal space?

A

Bulge of pharynx behind the posterior pillar
Paralysis of CNs and sympathetic chain
Swelling of the parotid region

45
Q

Complications of Parapharyngeal abscess

A

Edema of larynx
Thrombophlebitis
Spread of infection
Mycotic aneurysm of carotid artery
Carotid blow

46
Q

Pleomorphic adenoma is most commonly found on _____________

A

hard or soft palate

47
Q

Mucus cyst is usually seen in _________

A

vallecula

48
Q

Common sites of malignant tumors in the oropharynx

A

Posterior 1/3 or base of the tongue
Tonsils and fossa
Faucial palatine arch
Posterior and lateral pharyngeal wall

49
Q

Hot potato voice is seen in ___________ and _____________

A

Peritonsillar abscess
Base of the tongue CA

50
Q

____________ CA is the most common in oropharynx

A

Squamous cell carcinoma

51
Q

What is styalgia?

A

Pain in tonsillar fossa
Aggravated on swallowing
Dx - Palpation of styloid process and Xray lateral or open mouth

52
Q

Styalgia is AKA ___________

A

Eagle Syndrome (elongation of styloid process or calcification of stylohyoid ligament)

53
Q

Sleep Apnea means ___________

A

No breathing during sleep

54
Q

Types of sleep apnea

A

Obstructive sleep apnea
Central Sleep Apnea
Mixed

55
Q

Pathophysiology of sleep apnea

A

Hypoxia - CO2 retention - pulmonary vasoconstriction - CHF, ↓ HR, MI leaft heart failure, cardiac arrhythmias and sudden death

56
Q

Symptoms of sleep apnea

A

Sleep fragmentation
Day time sleepiness
Snoring
Gasping and choking
Morning headaches
Memory loss
Impotency

57
Q

Excessive daytime sleepiness is measured by ______________

A

Epworth sleepiness scale

58
Q

The collar size should not exceed ____ cm in males and ____ cm in females

A

> 42 cm in males
37.5 cm in females

59
Q

Muller maneuver is used for __________

A

sleep apnea

60
Q

Examination of patients with sleep apnea include

A

BMI
Collar size
Head and neck examination
Muller Maneuver
Systemic examination
Cephalometric radiographs
Polysomnography
Split-night polysomnography

61
Q

What is the gold standard test for sleep apnea?

A

Polysomnography

62
Q

Nonsurgical treatment of sleep apnea

A

Positional therapy (sleep on his/her side)
Intraoral devices (Mandible advancement device; MAD or Tongue retaining device TRD)
CPAP (continuous positive airway pressure)

63
Q

Surgical treatment of sleep apnea

A

Permanent tracheostomy is the gold standard
Tonsillectomy/ Adenoidectomy
Nasal surgery
Oropharyngeal surgery
Advancement genioplasty with hyoid suspension
Tongue base radiofrequency
Maxillomandibular advancement osteotomy

ENT (12 decks)

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