16.6.2013(ENT) 39 Flashcards
(439 cards)
0
Q
Use of appliances to bring cleft palate together before definitive Sx
A
Presurgical orthopaedics
1
Q
Pierre robin sequence
A
Micro/retrgnathia
Glossoptosis
Cleft palate
Ear anomalies
2
Q
Only indication for Sx of isolated cleft lip
A
Cosmetic
3
Q
Repair of cleft lip,rule of 10
A
10wks of age
Less than 10,000 WBC
more than 10pounds weight
More than 10g of Hb
4
Q
Type of speech in cleft palate
A
Rhinolalia aperta
5
Q
Indications of Sx in cleft palate
A
Rhinolalia aperta
Velopharyngeal incompetence(regurgitation)
Dental anomalies
Middle ear infection
6
Q
Repair of cleft palate,ideal age of repair
A
10-12months
7
Q
Races where orofacial clefting is common
A
North American Indians/Japanese
8
Q
Commonest type of orofacial clefting
A
Cleft lip with or without cleft palate
9
Q
U/L orofacial clefting is more common on
A
Left side
10
Q
Both Cleft lip and cleft palate common in
A
Males(2:1)
11
Q
Cleft palate alone is common in
A
Females(1:2)
12
Q
Bifid uvula
A
Submucosal cleft palate
13
Q
Orofacial clefting is least common in which race
A
Negroes
14
Q
Absolute contraindication for adenoidectomy
A
Submucosal cleft palate
Hypertrophied adenoid is preventing Velopharyngeal incompetence
15
Q
Second most common congenital anomaly
A
Orofacial Clefting
16
Q
Soft triangle
A
Part of nose lateral to tip of nose which doesn’t have support of cartilage
17
Q
Narrowest part of nasal cavity
A
Inner nasal valve at junction of upper and lower lateral nasal cartilage
18
Q
Number of cartilages in nose
A
Three paired and one unpaired
19
Q
Nerve supply of tip of nose
A
V1
20
Q
Nerve supply of angle of jaw
A
Great auricular nerve(C2,C3)
21
Q
Dangerous area of face
A
Lower part of nose with upper lip
22
Q
Tributaries of anterior facial vein
A
Superior labial vein
Angular vein
23
Q
Communication btw anterior facial vein and cavernous vein
A
Deep facial vein-pterygoid venous plexus- cavernous sinus
24
Commonest infection in danger area of face
Furuncle of nose
25
Dangerous area of nose
Olfactory area
26
Recurrent sinusitis and polyposis in a child <10yrs..
Cystic fibrosis
27
Olfactory acuity is maximum in
New borns
28
Decreased sense of smell with old age
Presbyosmia
29
Olfactory mucosa receptor
Neuroepithelial type of sensory receptor
Cell bodies lies at the surface
30
Shortest cranial nerve
Olfactory nerve
31
Cranial nerve without thalamic relay
Olfactory nerve
32
Quantitative assessment of olfaction
University of Pennsylvania smell identification test(UPSIT)
33
Respiratory epithelium
Pseudostratified ciliated columnar epithelium
Schneidarian membrane
34
Guard at the lower end of nasolacrimal duct
Hesner valve
35
In DCR nasolacrimal duct is opened into
Middle meatus
36
Drugs causing nasolacrimal duct obstruction
Local antiviral and anti glaucoma drugs
Anti cancer drugs(5FU)
Antihistamines
Diuretics
37
Mucocillary clearance time
5-20min
38
Abnormal mucocilliary clearance time
>1hour
39
Young syndrome
Kartagener - situs inversus
40
Turbinate which undergoes maximum hypertrophy
Inferior turbinate
41
Anterior rhinoscopy,turbinate not seen
Superior turbinate(seen only by posterior rhinoscopy or nasal endoscopy)
42
Concha bullosa is common in
Middle turbinate
43
Site of pathogenesis of sinusitis
Osteomeatal complex
44
Opening of sinuses in middle meatus,arrange in order
1. Frontal
2. Anterior ethmoidal
3. Maxillary
45
Parasympathetic supply of nose
Vidian nerve(greater superficial petrosal+deep petrosal nerve)
46
Sx for vasomotor rhinitis
Vidian neurectomy
47
Shape of nasopharynx
Oval in shape
48
Boundaries of nasopharynx
Superiorly(base of skull)
Inferiorly(soft palate or horizontal line along hard palate)
Posteriorly(C1)
Laterally(torus tubaris)
49
Apex of fossa of rosenmuller reaches
Carotid artery in carotid canal
50
Eustachian tube opens __________ cm behind posterior border of inferior turbinate
1.25
51
Free space above the upper border of superior constrictor
Sinus of morgagni
52
Structures coming into pharynx via sinus of morgagni
Levator palati
Ascending palatine artery
Eustachian tube
53
Passavant ridge is formed by
Palatopharyngeus
54
Other name of passavants ridge
Palatopharyngeal sphincter of willis
55
Hypertrophy of passavant ridge occurs in
Cleft palate
56
Maximum flow of air currents is through
Middle 3rd of nose
57
Sinuses are ventilated during
Expiration(turbulence or eddy currents)
58
Absence of scalloping
Mucocele of frontal sinus
59
Bone marrow is present in which wall of frontal bone
Anterior wall
| Osteomyelitis occurs only in anterior wall
60
Nerve running over the roof of maxillary sinus
Infra orbital nerve
61
Other name for maxillary sinus
Antrum of highmore
62
Posterior most opening in middle meatus
Accessory Ostium
63
First step in FESS
Uncinectomy
64
Ostium visualised in routine nasal endoscopy
Accessory Ostium
65
Commonest site of oroantral fistula
First upper molar
66
Lamina papyracea
Medial wall of orbit and lateral wall of ethmoids
67
Weakest wall of orbits
Medial wall
68
Ethmoidal air cells in relation to orbital floor
Haller cells(surrounds maxillary sinus)
69
Ethmoid cell in relation to optic nerve
Onodi(sphenoethmoid cell)
70
Ethmoid cells bounding frontal sinus opening
Agger nasi cells
71
Sensory nerve supply of ethmoids
1. Anterior and posterior ethmoidal nerve
| 2. Branches of pterygopalatine ganglion
72
Roof of ethmoids
Fovea ethmoidalis
73
Thinnest part of anterior skull base
Junction between cribriform plate with fovea ethmoidalis
Also pierced by anterior ethmoidal artery
74
Bones forming paranasal sinuses
```
Unpaired
Frontal bone
Ethmoidal bone
Sphenoid bone
Paired
MAXILLA
```
75
Bones forming orbit
```
Lacrimal bone
Zygoma
Perpendicular plate of PALATINE bone
Frontal
sphenoid
Maxillary
Ethmoidal
```
76
Floor of orbit is formed by
Maxilla
Zygomatic
Palatine bone
77
Medial wall of orbit is formed by
Frontal pr of maxilla
Lacrimal bone
Ethmoid(lamina papyracea)
Body of sphenoid
78
Hyponasal voice
Rhinolalia clausa(any condition causing b/l nasal obstruction or nasopharyngeal obstruction)
79
Structures passing outside circle of zinn
Lacrimal
Frontal
Trochlear
LFT
80
Important function of sinuses
NO synthesis
| Richest source of nitric oxide in body
81
Aerocrine organs
Paranasal sinuses
82
Commonest x ray of sinuses
Water view(30 degree occipitomental view)
83
Occipitofrontal view is also known as
Caldwell view
84
Caldwell view is for
Frontal sinus
85
Water view is ideal for
Maxillary sinus
86
Importance of lateral view x ray skull
To see posterior limit of frontal and sphenoid sinus
| Lateral view of adenoids
87
Best x ray view for sella turcica
Lateral view
88
Anterior elongation of sella
J shaped sella
89
J shaped sella is produced by
```
Normal variant
Optic glioma
Hydrocephalus
MPS
achondroplasia
Neurofibromatosis
```
90
Ideal view for ethmoid sinus
Lateral oblique view
91
Ideal view for sphenoid sinus
Submentovertical or skull base view
92
Suprasellar calcification
Craniopharyngioma
Meningioma
Pitutary microadenoma
Aneurysm
93
Diagnosis of undisplaced # nasal bone
Clinical(crepitus)
| X-ray(medico legal)
94
X ray of choice for mandible pathologies
Orthopantamogram(OPG)
95
Investigation of choice for PNS
Coronal CT scan
96
Best CT for visualising frontal sinus drainage
sagittal CT
97
Axial CT of PNS advantages
Optic nerve and it's relation to sinuses
98
CT scan of PNS cannot differentiate
Exudate
Mucous thickening
Tumor
Polyp
99
Ground glass opacity in CT
Fibrous dysplasia
100
CT finding in fungal sinusitis
Double density sign
| Heterogenous densities
101
Radiologic appearance of ameloblastoma
Soap bubble appearance
102
Sinus present at birth
Maxillary
Rudimentary
Ethmoid
Sphenoid
103
Sinus absent at birth
Frontal
104
Most common congenital anomaly of nose
Choanal atresia
105
Choanal atresia is due to persistence of
Bucconasal membrane
106
Noncompressible mass over nasal Dorsum with or without nasal pit
Dermoid cyst/Dermoid sinus
107
Compressible mass over Dorsum of nose
Meningoencephalocele
108
Types of encephalocele in relation to nose
Internal(nasal Meningocele)
| External
109
Diff btw nasal glioma and Meningocele
Menigocele has intracranial communication
110
Increase in size of Meningocele on compression of IJV
Furstenberg sign
111
Investigation of choice for mass over Dorsum of nose
MRI
112
Choanal atresia is commonly
Bony(90%)
113
Choanal atresia is common in
Females(2:1)
114
Investigation of choice for Choanal atresia
HRCT
115
Most established risk factor for allergic rhinitis
Family history
116
Preformed mediators
Early mediators
Histamine
Eosinophilic Chemotactic factor A
PGD2,LTC4
117
Late mediators
```
Newly synthesised
PG
LT
PAF
TXA2
TNF
```
118
Dignostic sign of nasal allergy
Pale boggy turbinates
119
Signs in allergic rhinitis
```
Allergic salute
Allergic shiner
Pale boggy turbinate
Cobblestone of posterior pharyngeal wall
Dennie Morgan lines
Allergic gape
Conjunctival congestion
```
120
Investigation of choice in allergic rhinitis
Skin prick testing
121
RAST
Radio allergo sorbent test
Done when skin prick test is not practical
Like pt with dermatographism, for a child.
122
Effective Rx of allergy
Avoidance of allergen
Hincherton hay-fever helmet
123
Rx of choice for allergic rhinitis
Intranasal corticosteroid spray
124
Most specific Rx for allergic rhinitis
Allergen immunotherapy
Best for insect bite allergy
125
Best Intranasal corticosteroid spray
1. momentasone
| 2. Fluticasone
126
Commonest side effect of antihistamines
Sedation
127
Only truly non sedating antihistaminic
Fexofenodine
128
Antihistamines definitely causing TDP
Terfinadine
Astemazole
Diphenhydramine
129
Least chance of TDP in which antihistamines
1. Cetrizine
1. Levocetrizine
Fexofenadine
Desloratidine
130
Longest acting antihistaminic
Astemazole
131
Shortest acting antihistamines
Acrivastine
132
Local antihistamine spray
Azelastine
133
Most important sequel of allergic rhinitis
Bronchial asthma
80% of asthmatics have allergic rhinitis
30% of allergic rhinitis pts have BA
134
Mast cell stabiliser
Local-disodium cromoglycate
| Systemic- ketotifen
135
Inheritance of kallman syndrome
Autosomal dominant
136
Kallman syndrome
```
Cong.hypogonadotrophic hypogonadism+anosmia
Cryptorchidism
Renal agenesis
Cardiac anomalies
SNHL
Cleft lip/palate
```
137
Intracranial tumor causing anosmia
Frontal lobe tumors
138
Temporal lobe tumors cause
Olfactory hallucinations
139
Other name for olfactory hallucinations
Phantosmia
140
Commonest cause of anosmia
1.Viral infection
2.# of anterior cranial fossa
3.Frontal lobe tumors
olfactory neuroblastoma
Atrophic rhinitis(merciful anosmia)
141
Perverted sense of smell
Parosmia
142
Cause of parosmia
1.recovery phase of post viral anosmia
| Streptomycin
143
Hyperosmia
1.Hunger
Pregnancy
Aura of migrane or epilepsy
144
Eosinophilia in vasomotor rhinitis
NARES
Non Allergic Rhinitis with Eosinophilia Syndrome
May present with polyps
145
Appearance of vasomotor rhinitis in anterior rhinoscopy
Congested boggy turbinates
146
Vidian neurectomy indication
Vasomotor rhinitis with rhinorhea
147
Topical Rx for vasomotor rhinitis
Ipratropium
148
Sx done for vasomotor rhinitis with obstruction
```
Turbinate reduction
Submucosal resection
Submucous diathermy
Turbinectomy
Cryo
LASER
```
149
Nasal esophilia is seen in
Nasal allergy
NARES
aspirin sensitivity
Allergic fungal rhinosinusitis
Predispose to polyps also
150
Rebound nasal obstruction due to tachyphylaxis
Rhinitis medicamentosa
151
U/L foul smelling,often blood stained discharge in children
Foreign body
152
Most common cause of U/L foreign body obstruction in children
Foreign body
Not Choanal atresia
153
GA is indicated in foreign body in which site
Ear
154
Cause of nasal obstruction(despite roomy nose) in atrophic rhinitis
Decreased sensation of nasal airflow due to atrophy of free nerve endings in nasal mucosa
155
Nasal drops used in atrophic rhinitis
25% in glucose and glycerine
Alkaline douche
Local estradiol in oil
Gentamycin in saline
Chloramphenicol, estradiol, vit D2(kemicetine anti ozaenea solution)
156
Primary atrophic rhinitis is common in
Females
157
Causes of secondary atrophic rhinitis
```
TB
syphilis
Leprosy
Wegener
Lupus vulgaris
```
Any chronic Granulomatous disorder of nose
158
Sx of atrophic rhinitis
Modified young operation(partial closure)
Narrowing of nose by insertion of bone, Teflon strip, cartilage under bone)
Sub mucosal placental extract
Stellate ganglion block
Laurenslager operation
159
Young operation,disadvantage
OSA
160
Cause of death in myiasis
1. Meningitis
| 2. Erosion of vessels
161
Maggots don't occurs in normal nasal cavity because of
Intact sneeze reflex
162
Rx of myiasis
25% ether
| Chloroform
163
Glandular hypertrophy of tip of nose
Potato nose
| Rhinophyma
164
Potato tumor
Carotid body tumor
165
Hot potato voice
Peritonsillar abscess
166
Rx of choice for rhinophyma
CO2 LASER
167
Other name for klebsiella rhinoscleromatis
Frisch bacillus
168
Stages of rhinoscleroma
1. Atrophic
2. Nodular
3. Cicatrising
169
Transformed plasma cell in rhinoscleroma
Russell body
170
Foam cell with vacuolated cytoplasm and eccentric nucleus in rhinoscleroma
Miculicz cell
171
Rx of rhinoscleroma
Tetracycline
Rifampicin
Ciprofloxacin
streptomycin
172
Primary host of rhinosporidiosis
Cattle
173
Risk factor for rhinosporidiosis
Bath in stagnating water
174
Rx of rhinosporidiosis
1. Endoscopic excision with LASER
| 2. Excision and cauterisation of base
175
Role of dapsone in rhinosporidiosis
Prevention of recurrence after surgery
| Prevention of bleeding in recurrent rhinosporidiosis
176
Latest theory about rhinosporium
Mesomycetozoa
| Aquatic parasite
177
Catarrhal rhinitis during 1st 3 months of life
Snuffles
178
Bony septal perforation with dorsal saddling
Late congenital syphilis
| Tertiary syphilis
179
Rx of wegener
Cyclophosphamide
| Azathioprine with steroids
180
Midline Lethal granuloma
Stewart's granuloma
181
Stewart's granuloma is
Non Hodgkin lymphoma of nose
| T/NK cell tumor
182
Reddish firm nodules over the skin and mucocutaneous jn
Apple jelly nodules
183
Strawberry skin appearance of nasal mucosa
Sarcoidosis
184
Violaceous affection of nasal tip and external surface in sarcoidosis
Lupus pernio
185
Most common organism in acute bacterial sinusitis
1.S.pneumoniae
2.H.influenzae
3.Morexella catarhhalis
S.aureus
186
Chronic sinusitis
Gram positive and gram negative organisms
Anaerobes if source of infection is tooth
187
Commonest cause of acute bacterial sinusitis
Viral rhinitis
188
Predominant symptom of sinusitis
Head ache
189
Only sinusitis that presents as headache
Sphenoid sinusitis
190
Antibiotic of choice for acute bacterial sinusitis
Amoxicillin+clavulinic acid
191
Commonest sinusitis in children
Ethmoid sinusitis
192
Major criteria for diagnosis of bacterial rhinosinusitis
```
Facial pain
Pressure
Congestion
Nasal obstruction
Nasal discharge
Hyposmia
Fever
```
193
Most diagnostic sign of sinusitis
Mucopus in middle meatus
194
Least diagnostic sign of sinusitis
Sinus tenderness
195
Mucopus above the middle meatus
Posterior ethmoiditis or sphenoiditis
196
Radiological investigation of choice in sinusitis
CT scan
197
Investigation of choice in sinusitis
Endoscopy with directed cultures from middle meatus
198
Most common cause of unilateral proptosis in children
Ethmoiditis
199
Common cause of B/L proptosis in children
Rhabdomyosarcoma
AML
Neuroblastoma
200
Commonest cause of both U/L and B/L proptosis
Thyroid ophthalmopathy
201
Commonest presentation of allergic fungal rhinosinusitis
Nasal polyps
202
Criteria for allergic fungal rhinosinusitis
Brent Kuhn criteria
203
Brent Kuhn criteria
```
Nasal polyposis
Eosinophilic mucin(no fungal invasion)
Characteristic radiology(double density sign)
Demonstrate Type I hypersensitivity
Positive fungal stain
```
204
Types of hypersensitivity in AFRS
Type I and III
205
Commonest organism in invasive fungal sinusitis
A.fumigatus and flavus
206
Characteristic of aspergillosis
```
Septate hyphae
Dichotomous branching(45 degree)
```
207
Mucormycosis organism characteristic
Aseptate
| Branch at right angles
208
Investigation of choice in mucormycosis
Biopsy
| Radiological - MRI
209
Non invasive fungal sinusitis
```
AFRS
Fungal ball(aspergilloma)
```
210
Rx of aspergilloma
FESS+ steroids
211
Rx of invasive fungal sinusitis due to mucormycosis
Debridement+ AmphotericinB + heparinisation and hyperbaric oxygen
212
Rx of invasive fungal sinusitis due to aspergillosis
Voriconazole
213
Sx treatment of choice in fungal sinusitis
FESS
214
Orbital complications of FESS are common in
Ethmoid
Maxillary
Frontal sinus surgeries
215
Orbital complications of FESS
Emphysema
Hematoma
Medial rectus injury
216
Optic nerve injury is common in FESS done for
Posterior ethmoid
| Sphenoid sinus
217
Intracranial complications of FESS
```
CSF leak
Meningitis
Brain injury
Pneumocephalus
Internal carotid artery injury
Cranial nerve palsy
```
218
Pneumoencephalus is common in FESS done for
Frontal sinus
219
Intracranial complications are common in FESS done for
Ethmoid
Frontal
Sphenoid sinuses
220
Internal carotid artery injury and cranial nerve palsy are common in FESS done for
Sphenoid sinus
221
Nasal complications of FESS
Nasal bleeding
| Nasolacrimal duct injury
222
Other surgeries that can be done with nasal endoscopy
```
Orbital decompression
Optic nerve decompression
Endoscopic DCR
transsphenoidal hypophysectomy
CSF rhinorrhea closure
Meningocele closure
```
223
Role of Caldwell luc surgery
1. Recurrent antrochoanal polyp in adults
| 2. maxillary sinusitis of dental origin
224
Balloon sinuplasty
Rx of acute sinusitis
225
Diff btw preseptal cellulitis and orbital cellulitis
Unilateral Chemosis of conjunctiva
Exophthalmos
ophthalmoplegia
Seen in orbital cellulitis
226
Orbital apex syndrome
3,4,6
V1
V2
Optic nerve
227
Diff btw cavernous sinus thrombosis and orbital apex syndrome
U/L orbital symptoms becoming B/L
Dramatic onset with fever,rigor and chills
Patchy involvement of cranial nerves esp abducent affected first
Fixed Dilated pupil(irritation of sympathetics around carotids)
Dimness of vision(optic nerve)
Retinal vessel engorgement
Are seen in cavernous sinus thrombosis
228
Superior orbital fissure syndrome
3,4,6
| V1
229
Commonest intracranial abscess after sinusitis
Frontal abscess
230
Commonest intracranial complication of sinusitis
Meningitis
231
Commonest intracranial complication of CSOM
Brain abscess
232
Commonest site of brain abscess in CSOM
Temporal lobe
233
Orbital swelling with proptosis and eggshell crackling
Mucocele
234
Proptosis in frontal mucocele
Pushed downwards and outwards
235
Proptosis in ethmoidal mucocele
Laterally
236
Mucormycosis occurs in
Diabetics
| Desferroximine therapy
237
Inheritance of osler weber rendu disease
AD
238
Hereditary hemorrhagic telangiectasia
Spontaneous recurrent epistaxis
Telangiectasias in lips,oral cavity,nose
Visceral AVM(GIT,pulmonary,cerebral)
239
CHARGE association
```
Colobamatous blindness
Heart disease
Atresia of choana
Retarded growth(CNS)
Genital hypoplasia(in males)
Ear deformities with deafness
```
240
Investigation of choice for Choanal atresia
HRCT
241
Investigations in Choanal atresia
Cold spatula test
Choanogram
Nasal endoscopy
Catheter
242
Drug used to prevent restenosis after Sx for Choanal atresia
Mitomycin C
243
Upper lip swelling lateral to midline raising the ala of nose
Nasolabial cyst
244
Nasolabial cyst is a derivative of
medial nasal or
lateral nasal or
Maxillary process or
Nasolacrimal duct
245
Nasolabial cyst commonly occurs in
30-40yrs
| Female(1:3)
246
Nasolabial cyst U/L or B/L
U/L in 90%
247
Rx of nasolabial cyst
Sublabial excision
248
Parts of nasal septum
```
Vomer
Perpendicular plate of ethmoid
Nasal spine of frontal bone
Maxilla
Rostrum of Sphenoid
Palatine
Nasal bone
```
249
Commonest cause of septal deviation
Trauma
250
Prevalence of Septal deviation
60%
251
Pain in DNS,site
Pain radiates from root of nose to superciliary ridges
252
Commonest site of septal spur
Chondro vomeral junction
253
Sluder neuralgia
Anterior ethmoidal nerve syndrome
254
Sx of choice in septal deviation
Septoplasty
255
Specific indications of septoplasty
- Anterior dislocation
- Children
- Along with rhinoplasty
256
Incision for septal surgeries
Freer(septoplasty)
| Killian(SMR)
257
Role of conservative Rx in septal hematoma
No role
| Immediate Sx needed
258
Trigeminal neuralgia affects
Older individuals
| >40-60 yrs
259
Commonest trigger point for Trigeminal neuralgia
Nasolabial fold
260
Motor and sensory functions in Trigeminal neuralgia
Normal
261
DD for Trigeminal neuralgia
Acoustic neuroma
Apex petrositis
Nasopharyngeal carcinoma
Multiple sclerosis
262
Sx for Trigeminal neuralgia
Stereotactic thermoablation
| Injection of alcohol into gasserian ganglion
263
Dysfunction of TMJ joint producing pain
Costen syndrome
264
Nerve involved in Costen syndrome
Auriculotemporal nerve
265
Commonest cause of headache
Tension type headache
266
Tension type headache is common in
Females
267
TMJ dysfunction is associated with
Bruxism
268
Rx of choice for tension headache
Amitryptiline
269
Rx in chronic tension type of headache
Botox injection
270
Suicide headache
Cluster headache
271
Alarm clock headache
Cluster headache
272
Cluster headache,synonyms
Reader's syndrome
| Sphenopalatine neuralgia
273
Rx of acute cluster attack
100% oxygen
274
Prophylaxis of cluster
Li
Verapamil
Steroid
275
Commonest aura in migrane
Visual
276
Common type of migrane
Migrane without aura
277
Commonest cranial nerve involved in opthalmoplegic migrane
Oculomotor
278
Ophthalmoplegic migrane is common in
Children
279
Cause of opthalmoplegic migrane
Post viral demyelination
| Thickening of 3 rd cranial nerve
280
Abdominal migrane is common in
Children
281
Theory explaining migrane
Neurovascular theory
282
Triptans act on
5HT1 B,D,H
283
Contraindications of Triptans
CAD
284
Most effective triptan
Rizatriptan
| Almotriptan
285
Rx of choice for prophylaxis of migrane
Betablockers
286
Benign intracranial hypertension is common in
Obese middle aged female
287
Common cause of pseudotumor cerebri
Cranial venous sinus thrombosis
288
IOC for pseudotumor cerebri
MR angiogram
289
Rx of pseudotumor cerebri
Mannitol
Acetazolamide
Steroids
Shunt surgeries
290
DD for acute severe headache
SAH
meningitis
Other intracranial hemorrhages
Glaucoma
291
Headaches common in males
Cluster headache
Cough headache
Coital headache
292
CSF rhinorhea can occur due to # of
Anterior cranial fossa
| Also middle and posterior cranial fossa(though sphenoid or temporal bone)
293
Cause of spontaneous CSF rhinorhea
Benign IHT
294
Pathogenesis of spontaneous rhinorhea
```
Benign IHT
Hydrostatic pressure at weak areas of skull
Dural herniation to sella turcica
Spontaneous CSF leak
Associated meningoencephalocele
```
295
Halo sign is seen in
Traumatic CSF leaks
296
Halo sign,synonyms
Ring sign
Double ring sign
Target sign
297
Sugar values in CSF rhinorhea
Normal mucosal fluid sugar(<10%)
More than 30% in CSF rhinorhhea
298
Investigation of choice in CSF rhinorhea
Beta 2 transferrin
299
False positive beta 2 transferrin in seen in
Glycogen storage disease
Liver disease
Ca rectum
neuropsychiatric disease
300
Substance other than beta2 transferrin used for Dx of CSF rhinorhea
Beta trace protein
301
Site of leak in CSF rhinorrhea(bone defect) is best detected by
HRCT
302
Investigation of choice in CSF rhinorrhea due to encephalocele/tumors
MRI(T2)
303
Exception to rule of conservative treatment in CSF rhinorhea
Peroperative iatrogenic leak
304
Risk in CSF rhinorrhea
Recurrent meningitis
305
Recurrent pneumococcal meningitis is seen in
CSF rhinorrhea
306
Antibiotics against which organisms should be given in CSF rhinorhea
All cases(pneumococci)
Infants and children(H.influenza,E.coli)
Trauma(staphylococcus)
307
Artery not involved in kisselbach plexus
Posterior ethmoidal artery
308
Woodruff plexus is found in
Lateral wall of nasal cavity
309
Brown area is found in
Posterioinferior part of nasal septum
310
Epistaxis presenting as hematemesis
Posterior epistaxis
311
Site of bleeding following nasal picking
Retrocolumellar vein
312
Rx of choice for epistaxis
Endoscopic cautery
313
Cardiac complication of postnasal packing
Cor pulmonale
314
Arterial ligation method of choice in epistaxis
Endoscopic sphenopalatine artery ligation
315
Rx of choice for intractable bleeding following # of nasal bone
Anterior ethmoidal artery ligation
316
Vascular cause of epistaxis
Digital subtraction angiography followed by embolisation
317
Indication of embolisation in nasopharyngeal angiofibromas
Preoperatively to reduce vascularity
Sx should be done within 24-48hrs
318
Trotters method
Induced hypotension for Rx of epistaxis
319
Temporal arteritis on exposure to
Cold
320
Commonest # of faciomaxillary skeleton
Nasal bone
321
Best time to reduce # nasal bone
Immediately
Or after Edema subsides(5-7 days)
Beyond 3 weeks, open rhinoplasty approach may be required
322
Treatment of nasal bone # when pts presents after 6 weeks
Rhinoplasty
323
Nasoethmoid # results in
Pig-snout deformity
324
Fracture of nasal septum
Chevallet#(vertical)
| Jarjaway#(horizontal)
325
Instrument used to reduce nasal bone fracture
Walsham
326
Forceps used to reduce nasal septum
Asch forceps
327
Tripod #
Zygoma #
Infra orbital
Zygomaticofrontal
Zygomaticotemporal
328
Commonest orbital structure getting entrapped in blowout #
Inferior rectus
329
Features of blowout #
Infra orbital anesthesia
Enophthalmos
Restricted elevation of eyeball
330
X ray feature of blowout #
Tear drop sign
331
Gelle operation is done in
of zygomatic arch
332
LE forte #
Le fort 1(guerin)
Le fort 2(pyramidal)
Le fort 3(craniofacial dysjunction)
333
Le fort # doesn't involve
Mandible
334
Le frot # associated with CSF rhinorrhea
Le fort 2 and 3
335
Commonest site of mandibular#
Beneath condyle of mandible
336
Best management for severe maxilla facial trauma with bleeding
Tracheostomy
337
Pneumocephalus is associated with # of
Posterior wall of frontal sinus
338
Nasal polyps are associated with
```
Allergy
H.influenza infection
NARE
Bernoulli phenomenon
Polysaccharide change
```
339
Associations with nasal polyps
```
Aspirin hypersensitivity
Asthma
CF
AFRS
kartagener
Young
Chung Strauss
Nasal mastocytosis
```
340
U/L ethmoidal polyp in elderly may masquerade
Malignancies
341
Sampter triad is _________ form of nasal polyp
Severest
| Recurrence common
342
Frog face deformity
Nasopharyngeal angiofibroma
| B/L ethmoidal polyp
343
Rx of ethmoidal polyps is
Essentially medical(allergic polyp)
344
Medical polypectomy
Systemic steroids for polyps
345
Rx of recurrent antrochoanal polyp in adults
Caldwell luc Sx
346
U/L fleshy polypoidal masses
Inverted papilloma
347
Most common cause of ciliary dyskinesia
Common cold
348
Commonest malignancy of nasal skin
BCC
349
Commonest variety of BCC
Nodular
350
Commonest site of BCC
Inner canthus
351
Investigation of choice in BCC
Wedge biopsy
352
HPE of BCC
Dermal nests,cords or islands with peripheral palisading
353
Minimal margin of clearance for BCC less than 2 cm
4mm margin
354
Rx of choice for BCC
Wide surgical excision
355
In Moh microsurgery,tissues are evaluated
Horizontally
356
Treatment options in BCC
```
Wide excision
Moh
Curettage
Electro dissection
Cryosurgery/CO2 LASER
topical 5FU
RT
interferon
Immunotherapy
Vismodegib
```
357
Commonest benign tumor of nose
Capillary hemangioma
358
Bleeding polypus of septum
Capillary hemangioma
359
Common site of hemangioma of nose
Septum
360
Commonest benign tumor of paranasal sinuses
Osteoma
361
Commonest site of paranasal sinus osteoma
Frontal bone
362
Commonest tumor arising from ringertz tumor
SCC
363
Ringertz papilloma,synonyms
Schnederian papilloma
| Transitional cell papilloma
364
Inverted papilloma is U/L or B/L
U/L
365
Rx of inverted papilloma
Lateral rhinotomy
| Endoscopic
366
Incision for lateral rhinotomy
Moure's incision
367
Wood workers carcinoma
Adenocarcinoma of ethmoid(African mahogany)
368
Commonest malignancy of sinuses
SCC
369
Commonest site of PNS malignancy
Maxilla
370
Olfactory neuroblastoma
Esthesioneuroblastoma
371
Rx of olfactory neuroblastoma
Anterior Craniofacial resection
372
Warning signs of Ca maxilla
```
floor involved
Recent loosening of teeth in old man
IlL fitting dentures
Roof involved
Numbness over face
Neuralgia
Unilateral epistaxis
```
373
Incision for radical maxillectomy
Weber ferguson incision
374
Radical maxillectomy
Removal of maxilla along with orbit
375
Rx of Ca maxilla
Sx+ radiotherapy
376
Commonest lymphoma affecting orbit
B cell lymphoma
377
Commonest malignant tumor of orbit
Lymphoma(adults)
| Rhabdomyosarcoma(children)
378
Commonest benign tumor in orbit
```
Cavernous hemangioma (adult)
Dermoid(children)
```
379
Nasopharyngeal mass at birth
Meningocele/encephalocele
Adenoids are poorly developed at birth
Presence of nasopharyngeal soft tissue in newborns rules out presence of meningocoele/encephalocoele
380
Adenoid not visible by 4-6 months
Primary immunodeficiencies
381
B/L nasal obstruction in adenoid hypertrophy
```
Rhinolalia clausa
Mouth breathing
OSA
snoring
Recurrent rhinosinusitis
```
382
Adenoid Facies
```
Short upper lip
High arched palate
Hypoplastic maxilla
Pinched nose
Widening of intercanthal distance
Crowding of teeth
```
383
Any child with B/L conductive hearing loss
Secretory otitis media following adenoid hypertrophy
384
Commonest cause of bleeding during adenoidectomy
adenoid remnants
385
Torrential bleeding during adenoidectomy
Aberrant ICA
386
Preferred method of adenoidectomy
Endoscopic adenoidectomy
387
Griessel syndrome
Atlanto axial subluxation after adenoidectomy due to exposure of anterior spinal ligament
388
Child presenting 2-3wks after adenoidectomy with torticollis
Griesel syndrome
389
Size of adenoids is assessed by
Lateral x ray skull
390
Apnea
Cessation of respiration at nose lasting for 10 seconds
391
Apneic index
Number of Apneic episodes per hour
392
OSA
More than 30 episodes of apnea during 7 hours of sleep
| Apnea index of more than 5
393
Hallmark of OSA
1. Snoring(heroic snoring)
| 2. Daytime somnolence
394
Investigation of choice for OSA
Nocturnal polysomnogram
395
OSA is common in
Males(young)
| Females(old)
396
Rx of obstructive sleep apnea due to obstruction at oro pharynx
Uvulopalatopharyngoplasty
397
Commonest benign tumor of nasopharynx
Nasopharyngeal angiofibroma
398
Nasopharyngeal angiofibroma is dependant on which hormone
Androgen
399
Nasopharyngeal angiofibroma is common in
Adolescent males
400
Finding in nasopharyngeal angiofibroma
Pinkish mass
401
Site of origin of JNA
Sphenopalatine foramen
402
Bowing of posterior wall of maxillary Antrum on lateral x ray
Antral sign or Holman miller sign
403
IOC choice for JNA
CT scan
| Erosion of sphenopalatine foramen can be seen
404
Major feeding vessel of JNA
Internal maxillary artery
405
Sx in JNA
```
Transpalatal(Wilson)
Medial maxillectomy
Mid facial degloving
Craniofacial resection
Endoscopic laser(recent)
```
406
Rx for JNA with intracranial spread
Radiotherapy
407
Radiotherapy for JNA is associated with
Sarcomatous change
408
Drug used for Rx of JNA
Flutamide
409
Sx treatment of choice in JNA
Mid facial degloving
410
Fossa of rosenmuller is also known as
Pharyngeal recesses
| Lateral recesses
411
Nasopharyngeal Ca is high in
Southern Chinese
412
Ca nasopharynx age of occurrence in India
Bimodal distribution
413
Presentation of Ca nasopharynx
Neck node enlargement
Epistaxis
U/L secretory otitis media
Cranial nerve palsies
414
Commonest malignancy that presents as U/L or B/L neck node
Ca nasopharynx
415
Common cause of malignancy with unknown primary
Ca nasopharynx
416
Commonest cranial nerve involved in Ca nasopharynx
5th nerve
| Trigeminal neuralgia
417
Cranial nerves affected in Ca nasopharynx
3,4,5,6,9,10,11,12
418
Trotter triad also known as
Sinus of morgagni syndrome
419
Trotter triad
Trigeminal neuralgia
Secretory otitis media
Palatal palsy
420
Commonest type of Ca nasopharynx
Undiffentiated
421
Rx of choice for Ca nasopharynx
Radiotherapy(early)
| Chemoradiation(late)
422
Cause of deafness in Ca nasopharynx
Eustachain tube dysfunction
| RT
423
Frontal sinusitis Headache
Office headache, more in the morning
424
Maxillary headache
More in the evening
425
Liposomal amphotericin B
Drug attached to liposomes, so it does not reach the liver and kidney hence decreasing complications
426
Steps in FESS
```
Uncinectomy
Anterior ethmoidectomy
Middle meatal antrostomy
Posterior ethmoidectomy
Sphenoidectomy
Frontal recess clearance
```
427
Bony septal perforation is seen in
Syphilis
| Others cause cartilaginous perforation
428
Beta2 transferrin is also seen normally in
Perilymph
| Vitreous humor
429
Artery of epistaxis
Long sphenopalatine artery
430
Radical tonsillectomy
Uvulopalatopharygoplasty
431
Ohngrens line
Medial canthus to the angle of mandible
| Tumours above have bad prognosis
432
Earliest LN spread of maxillary Ca
Retro pharyngeal nodes
| Commonest is submandibular
433
Appearance of JNA in MRI
Bag of worms appearance
434
Medical treatment of JNA
Flutamide
435
Commonest type of NPCa
Undifferentiated Ca
436
Foramina of breschet
Venous drainage channels located in the posterior wall of frontal sinus
437
Most common congenital anomaly
CTEV
438
Mechanism of action of vismodegib
Hedgehog pathway inhibitor
