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ORL > 2 parcial > Flashcards

2 parcial Flashcards

1
Q

Acute Rhinosinusitis treatment

A

Saline irrigation
Nasal steroids
Antibiotics
Antihistamines (yellow)
NO systemic steroids or decongestants

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2
Q

Chronic Rhinosinusitis treatment

A

Saline irrigation
Nasal steroids
Antibiotics
Leukotriene antagonists
Antihistamines, monoclonal bodies, oral steroids(yellow)
NO antifungal
BEST: FESS

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3
Q

Antibiotics for rhinosinusitis

A

1st Amoxi + clavulanate
2 - quinolonas: Levofloxacino o moxifloxacino
x 14-21 días

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4
Q

Samter’s triad

A

Aspirin resistance, nasal polyps and asthma

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5
Q

What is the kartagener syndrome

A

Primary mucosa dyskinesia. Immotile cilia lead to chronic crusting from mucus stasis.

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6
Q

Gold standard for allergy testing in allergic rhinitis

A

SPT (Skin Prick Test)

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7
Q

Two phases of allergic rhinitis

A

Sensitization (dendritic cells –> T cells –> B cells –> memory)
Clinical disease (B cells -> IgE binds to mast cells –> histamine, humoral reaction 15 min –> quimiotaxis, symptoms, late-phase reaction 4-6 hrs)

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8
Q

Treatment for allergic rhinitis

A

1st - Antihistamines (diphenhydramine, chlorpheniramine, loratadine..)
Intranasal corticosteroids - most effective medication for overall control of symptoms (budesonide, triamcinolone)
Decongestants - phenylephrine, oxymetazoline

If nothing works: immunotherapy 3-5 years

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9
Q

3 types of viral adenotonsillar disease

A

Herpangina
Mononucleosis
Herpes

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10
Q

3 Bacterial acute pharyngotonsillitis

A

Acute streptococcal
STI (syphilis, gonorrhea)
Diphtheria

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11
Q

Centor criteria (5)

A

Temperature > 38ºC
Absence of cough
Swollen, tender cervical nodes
Tonsillar swelling or exudate
Age (3-14 +, 15-44 0, > 45 -)

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12
Q

CENTOR criteria score

A

1 - no more testing or atb
2 - 3 culture, atb if positive culture
4 or more - Empirically with atb and/or culture

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13
Q

If we have ulcers in the mouth we suspect a ___ infection

A

Viral infection

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14
Q

Best treatment for adenotonsillar disease by herpes

A

Acyclovir + NSAIDs (paracetamol) + steroids

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15
Q

10 yr old patient, with headache, odynophagia, fever, anorexia and ulcers in the palate

A

Herpangina

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16
Q

Agent responsible for each one
- herpangina ->
- Herpes ->
- Mononucleosis ->

A
  • herpangina -> coxsackie
  • Herpes -> herpes simple 1
  • Mononucleosis -> epstein-barr
17
Q

35 year old patient with high fever of 3 days, adenomegaly, hepatosplenomegaly, skin rash, malaise, and sore throat

A

Mononucleosis

18
Q

Most common group of strepts that cause pharyngotonsillitis

A

Group A of Beta hemolytic (pyogenes)

19
Q

Treatment for ACUTE STREPTOCOCCAL PHARYNGOTONSILLITIS

A

oral penicillin V: 10 days

20
Q

Union of nasal bones and cartilage

A

Keystone area

21
Q

Criteria for tonsillectomy

A

Episodes: At least 7 episodes in the previous year, 5 in the previous 2 years or 3 in the previous three years

Clinical: Sore throat + (fever >38.3, exudates, adenopathy >2cm, positive culture)

Treatment: previous antibiotics

22
Q

Agent responsible for each one
- Streptococcal ->
- Diphtheria ->
- STD ->

A
  • Streptococcal -> pyogenes
  • Diphtheria -> corynebacterium diphtheria
  • STD -> syphilis, gonorrhea, ulcers
23
Q

Treatment for diphtheria

A

Antitoxin + penicillin or erytromycin

24
Q

Most paranasal neoplasms come from what sinus

A

Maxillary sinus

25
Q

Most common benign neoplasm

A

Inverted papilloma

26
Q

Most common malignant tumor:

A

Squamous cell carcinoma (SCC)

27
Q

Clinical picture of paranasal sinus neoplasms (3)

A

mimic rhinosinusitis
* Nasal obstruction
* Rhinorrhea
* Sinus pressure

28
Q

Symptoms that suggest neoplastic process (7)

A
  • unilateral swelling
  • pain
  • epistaxis
  • Orbital symptoms (diplopia, proptosis, visual loss, epiphora)
  • Nasopharynx extension (obstruction of the eustachian tube → middle ear fullness, hearing loss)
  • Floor of the nasal cavity (hard palate, oral cavity mass with loose dentition)
    *Persistent nasal symptoms refractory to treatment may suggest neoplastic process

ORL (3 decks)

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