ENT

Question 1

Symptoms of episodic paradoxical vocal fold dysfunction (PVFD). (aka vocal cord dysfunction) vs. asthma

Answer 1

Usually exercise induced. Abrupt onset and resolution. Other symptoms that may help differentiate PVFD from asthma include stridor as opposed to wheezing, difficulty in inspiration as opposed to expiration, throat tightness as opposed to chest tightness, and onset of symptoms early during physical activity as opposed to late or after completion. Vocal quality or pitch may change because of narrowing of the glottis.

Question 2

Paradoxical Vocal Fold Dysfunction definition

Answer 2

adduction of the vocal cords during inspiration, or during inspiration and expiration, with preservation of a posterior region of glottic opening known as a “posterior glottic chink.”

Question 3

Severe odynophagia, no TM findings, + papule of gum, ipsilateral cervical LAD, think ____

Answer 3

dental abscess

Question 4

Viruses associated with parotidis aside from mumps

Answer 4

CMV, enterovirus, EBV, influenza, parainfluenza, HIV

Question 5

Painless preauricular swelling that persists over time, think ___

Answer 5

malignancy

Question 6

Diagnosis of acute bacterial sinusitis

Answer 6

1. Persistence of sx beyond 10 days without improvement
2. Worsening of symptoms or new onset of symptoms after initial improvement
3. Severe symptoms at onset lasting for 3 consecutive days

Question 7

Diagnosis of acute bacterial sinusitis

Answer 7

1. Persistence of sx beyond 10 days without improvement
2. Worsening of symptoms or new onset of symptoms after initial improvement
3. Severe symptoms at onset lasting for 3 consecutive days

Question 8

Pathogen most likely to be culprit in acute otitis media and acute mastoiditis

Answer 8

strep pneumo

Question 9

Protruding erythematous masses after facial trauma and epistaxis. Dx and what would you do next?

Answer 9

septal hamatomas
ENT consult for rhinoscopy and emergent drainage

Question 10

Consequence of not draining septal hematoma within 72-96 hrs

Answer 10

necrosis of nasal septum (obstruction of blood flow from mucoperichordium to cartilage)
–> permanent deformity (saddle-nose)

Question 11

MEN 2B

Answer 11

Marfanoid
Medullary thyroid carcinoma (100% of people)
Pheochromocytoma (late onset)

+ mucosal neuromas

Question 12

Optic glioma is associated with what disease

Answer 12

NF1

Question 13

MEN 2A and 2B gene mutation

Answer 13

RET proto-oncogene
Autosomal dominant, but most 2B are de novo

Question 14

Most common midline neck mass and how to diagnose it, tx?

Answer 14

thyroglossal duct cyst
Ultrasound
Surgical removal

Question 15

When should we repeat a hearing test if a neonate fails?

Answer 15

3 mo

Question 16

Myringosclerosis

Answer 16

calcium and phosphate crystal deposits within the tympanic membrane that appear as whitish plaques on otoscopy and may demonstrate decreased mobility on pneumatic otoscopy.

Question 17

chronic suppurative otitis media (CSOM) timing n tx

Answer 17

greater than 6 weeks of ear drainage from a perforation in her tympanic membrane

Ofloxacin ear drops

Question 18

Implants appropriate for sensorineural hearing loss by age

Answer 18

2mo: behind the ear
5 yo: bone-anchored
Cochlear implant if nothing works
Brainstem implant on very special occasions

Question 19

Most common pathogen associated with retropharyngeal abscess

Answer 19

Strep pyo

Question 20

Cleft lip, Palate repair age and why

Answer 20

cleft lip can be repaired between 2 to 6 months of age. Palate repair often takes place between 9 to 19 months of age; repair before 7 months of age is associated with an increased risk of midface hypoplasia. A maxillary bone graft to fill the alveolar cleft is often needed between 6 to 8 years of age.

Question 21

Criteria for getting myryngotomy tube placement

Answer 21

Otitis effusion for 3mo or more with conductive hearing loss, OR 3 mo or more with risks of speech language development difficulties

OR 3 mo with middle or tmpanic membrane damage

Question 22

Antibiotic and aftercare for for tooth avulsion replacement

Answer 22

Chlorhexidine 0.1% solution rinses bid for 1 week
Doxy bid for 7 days
OR amox

Question 23

Up to 35% of children with meningitis from S. pneumo will develop ____

Answer 23

hearing loss

Should have hearing evaluation at dx, 4-8 weeks, 6 mo, and 12 mo after discharge

Question 24

Normal ability of hearing in decibels

Answer 24

0-15

Question 25

Minimal to severe hearing loss in decibles

Answer 25

Minimal 16-25
Mild 26-40
Moderate 41-55
Severe 71-90
Profound >90 dB

Question 26

If hearing screen is abnormal, what do you use for repeat

Answer 26

automated auditory brainstem response

Question 27

Most common cause of bacterial CONJUNCTIVITIS and acute otitis media in young todds (12mo-18 mo)

Answer 27

nontypable h. flu

Question 28

Young child with URI sx, developed otorrhea, no pain of external ear. Dx and treatment?

Answer 28

Acute otitis media with TM rupture (NOT otitis externa)

Oral amox