Abo-oto Flashcards Preview

Inservice BV > Abo-oto > Flashcards

Flashcards in Abo-oto Deck (182):
1

Aminoglycosides and incidence of HL? which part of the cochlea does it effect? how soon after therapy do pt's start to experience HL?

-10% -basal and inner row of hair cells -3-4 days

2

Branchial Arches define?

A image thumb
3

Dermal filler for patients with AIDS

A image thumb
4

Treatment for anaphylaxis

0.3-0.5mg of 1:1000 epi every 15-20min. 

-repeat every 15-20min

-parenteral anti-histamine

5

Serum markers for anaphylaxis

-histamine have an immediate raise and lasts for 30-60min

-tryptase elevates 30-60min after and stays elevated up to 6 hrs

6

Innervation of the carotid sinus and/or carotid body tumor?

-Afferent CN IX: info about hypoxia, hypercap, acidosis

-Efferent: superior cervical plexus

 

7

Bacteriocidal antibiotics?

Bacteriostatic?

Very Finely Proficient At Cell Murder

-Vanco, Fluoroquinolones, Pens, Aminoglycosides, Cephs, Metro

ECSTaToC

-Erythro (macrolides)

-Clinda

-Sulfa

-Tetra

-Trimethoprim

-Chloramphenicol

8

PTC staging

A image thumb
9

Sunderland Classifications

A image thumb
10

Contributing vessels to Little's area

A image thumb
11

Growth pattern of hemangioma's of infancy

Rapid growth over first 6 mo's. 

50% resolve by 5 yo

70% resolve by 7 yo

12

Hemangioma of infancy subgottic risks

50% of subglottic will have cutaneous manifestations

60% of hemangiomas in the bearded area will be assc with subglottic ones

13

2nd most common region for otosclerosis?

Round window

14

Phases of wound healing

A image thumb
15

Friedman staging for UPPP and success?

A image thumb
16

What is the definition of surgical success and UPPP?

50% reduction or AHI < 20

17

Indication for RAI for follicular thyroid CA

-tumor > 4cm

-gross extracapsular extension

-extensive intravascular invasion

-elevated post op TG

-known or suspected metastatic disease. 

18

Only facial muscle not innervated by FN?

levator palpebrae superioris - innervated by CNIII

19

What kind of hearing loss do you get with quinine?

reversible at 4kHz

20

Contra-Indications for a partial laryngopharyngectomy?

- involvement of the pyriform

-extension to the post cricoid region

-ipsilateral TVC paralysis

-encroachment into the cricopharyngeus

21

Sequence of local anesthetic blockage

-Sympathetic fibers -> pain/temp -> touch/motor

22

Relationship between pH and pKa for local anesthetics

-the closer the pKa is to pH, the more likely the anesthetic will be in unprotonated/hydrophobic state and therefore faster onset of action

23

Dennie Lines

Assc with AR

-occur due to spasm of Mueller's muscles in chronic AR

A image thumb
24

Brow lift and facial nerve anatomy in relation

A image thumb
25

What is Galactomannan?

Polysaccharide found in aspergillous, elevated in invasive pulmonary aspergillosis. No utliity in mucor. 

 

26

T staging for supraglottic cancer

T1: Limited to one subsite

T2: Extends to adjacent subsite, still with vocal fold mobility

T3: Vocal cord paresis and/or invading inner cortex of thyroid cartilage, post cric, pre-epiglottic, paraglottic space. 

T4a: Invades beyond prior

T4b: Encases carotid, mediastinum or prevertebral invasion. 

27

What is Jessner's solution

salicylic acid, lactic acid, resorcinol, ethanol. 

28

What meds do you give for anaphalyxis of a pt experiencing anaphylaxis

antihistamines, steroid, glucagon (increases cardiac output/HR). 

29

semicircular canal dehiscence, what kind of hearing loss?

 

- CHL

30

How long abx for pott's puffy tumor

6-8 wks

31

When to consider SLNB in melanoma?

-T1b - T4, no gross nodal disease. 

32

Staging for melanoma?

A image thumb
33

how to treat methemoglobinemia?

1% meth blue 1mg/kilo total slow infusion

34

2nd MCC OC cancer?

adenocarcinoma

35

innervation of the ear canal?

A image thumb
36

MCC presenting sx of NPC?

- 75% neck mass

-73% nasal obstruction

37

What to do if AOM during CI?

SOM during CI?

- place tubes, implant once clear of infection for min 2 wks

- irrigate, topical gtts, post op ceftriaxone

38

Meds that increase T4 catabolism?

phenytoin, carbamazepine, phenobarbital, rifampin

39

Vessels of Woodruff's plexus

SPA, ascending pharyngeal

40

Cidofovir?

inhibits DNA polymerase, used in respiratory papillomatosis

41

What meds are used in respiratory papillomatosis?

Cidofovir, avastin

42

43

organisms in ARS most likely to self resolve?

moraxella catarrhalis, sometimes haemophilus. 

S pneumo will not self resolve. 

44

how many dB do you need to double the sound

3 dB

A image thumb
45

Sx of Churg Strauss?

-Granulomatis nasal lesions but no epistaxis

-> 10% serum eosinophilia

- allergic rhinosinusitis

-granulomatous lesions of lungs

- asthma

- vasculitis w extravascular eosinophils

- mononeuritis multiplex

46

what is the risk for cervical mets in lip SCCa?

10%

47

most common dental cysts?

Radicular cysts > dentigerous cysts

48

Gorlin syndrome?

-mulitiple basal cells

-odontogenic keratocysts

 

49

What is the chance for malignancy in a cold nodule in Graves?

45%

they also tend to be more aggressive in Graves patients

50

Vestibular neuritis typically effects which vestibular nerve?

How to test for laterality?

Superior 

-fast phase away from the affected side

-symptoms worse with head movements

51

Dedo classifications

Class 1: minimal defects, no surgery

Class 2: lax skin, rhitidectomy

3: submental/submandibular adiposity: liposuction and consider anterior platysmoplasty

4: anterior banding of platysmal banding -

5: microgenia/micrognathia

6: inferior positioned hyoid: division of suprahyoid muscles, suturing of anterior diagstric muscles, chin augment

52

Blood supply to the temporalis muscles?

Ant/Posterior branches of the deep temporal artery which are branches from the IMAX

53

Nerves involved with orbital apex syndrome?

- CN 2, 3, 4, 6, nasociliary/frontal nerves, superior ophthalmic vein. 

54

MCC reason for b/l facial paralysis

Lymes 

55

Positive hitsilberger sign is what? and what does it signify

- Posterior superior concha numbness

-space occupying lesion of the IAC compressing facial nerve. 

56

Path of foamy histiocytes and bloated plasma cells?

foamy histiocytes -> mikulicz cells

bloated plasma cells -> Russell bodies

sign of rhinoscleroma caused by klebsiella rhinoscleromatis. 

57

Serum Ig changes with immunotherapy?

- 1st: there's a spike in specific IgE: total IgE levels (up to 16)

-2nd: then's it will drop to below pre therapy levels. 

-3rd: get a rise in IgA and IgG4

58

Innervation of taste of the soft palate?

Posterior tongue?

Greater superficial petrosal nerve. 

lingual branch of glosspharyngeal n.

59

Diplacusis?

Rollover?

Parascusis of Willis?

 

Diplacusis: subjective perception of more than one pitch when 1 tone is presented. Sign of cochlear dysfunction. 

Rollover: Speech reception scores drop with increasing loudness

Paracusis of Willisii: phenomenom where people with CHL can have an enhanced ability to hear in noisy environment. 

60

When to treat with Augmentin/fluoroquinolone in sinusitis?

If failed abx therapy or treated w abx in last 6 wks

61

Which HPV with RRP?

6, 11 (11 has worse course)

62

Which HPV for cancer?

16 and 18

63

64

Define level III neck radiographically?

 

inferior cricoid to inferior hyoid. 

65

Most sensitive test for central vestibular dysfunction?

Smooth pursuit tracking. 

If impaired, suggests unilateral or posterior fossa lesion. 

66

Head shake test and nystagmus?

 

horizontal nystagmus will beat away from affected side. 

If vertical/rotarary -> suggestive of cns disorder. 

67

MOA of mitomycin C?

DNA crosslinking to prevent cell replication

68

Criteria for anterior cricoid split?

- failed 2 extubations

->1500g weight

-no assisted ventilation for 10 days

-otherwise healthy

69

What is the definition of sleep hypoventilation?

 

increase paCo2 to 10mmhg

70

Treatment of Ramsay Hunt?

-Valcyclovir for 14 days

-or Famcyclovir for 10 days 

both w steroids

71

Describe normal occlusion?

Mesiobuccal cusp of the 1st maxillary molar is aligned with the buccal groove of the mandibular 1st molar. 

72

two MCC viruses that cause rhinitis?

rhinovirus > coronavirus

73

Proper sequence to treat cleft palate/lip kids?

- determine syndromic, feeding issues, evaluate ears, speech eval

3 mo's: tip rhino, cleft lip, tubes

1yr: palate

5yrs: columellar lengthening

8-16: orthodontics

10 yrs: alveolar grafts

14 yrs: definitive rhino

74

Closing eye lid defects?

up to a third: primary 

1/3-2/3: lateral canthotomy, semicircular advancement flap

50-100%: Hughes tarsoconj flap

75

What is in Baker's solution?

 

phenol, septisol, croton oil, distilled h2o

-croton oil is the key ingredient for depth of chemical peel

76

Correct auriculocephalic angle?

How far apart should mustarde stitches be placed?

25-35 degrees.

at least 16mm, place at least 3

77

Pendred Syndrome?

AR

goiter, enlarged vestibular aqueduct, cochlear hypoplasia, mondini malformation. 

-defective pendrid protein affecting chloride and iodide transport 

78

Appropriate MRD-1/2?

 

4-5mm

5-5.5mm respectively

79

Goldenhar Syndrome?

AD

hemifacial microsomia (1/2nd branchial arch defect)

80

Mobius Syndrome?

congential FN paralysis

81

5 ethmoturbinals?

1) agger/uncinate

2) MT

3) superior turb

4/5) supreme

82

Early signs of lidocaine tox?

metallic taste, tinnitus, numbness around mouth. 

83

What immunodeficiency cannot surmount a host response to encapsulated bacteria?

IgG2 defiency. 

Encapsulated bacteria would include H influenzae

84

MCC immunodeficiency in adults?

IgG3 

-more susceptible to URIs, AR, asthma

85

How much bone can you harvest for a fib flap?

 

25cm

86

Histology of schwannoma?

 

Spindle cells arranged in Antoni type A/B patterns

-A: densely packed spindle cells w aligned or palisading nuclei

-B: loosly arranged myxoid stroma

87

MOA of 5 fluorouracil?

Binds to thymidylate synthetase

88

MOA of methotrexate?

binds to dihydrofolate reductase

89

When do frontal sinuses appear in development?

5-6 yrs

90

Alexander's law

Nystagmus is worse in the direction of the healthy ear

91

How is central vertigo different from peripheral?

-does not improve w fixation

-does not improve with repeated stimulation

-multidirectional nystagmus

92

What congenital condition is assc w endolymphatic sac tumors?

Von hippa lindau

-hemangioblastomas of retina and CNS

-endolymphatic sac tumors

-clear cell renal ca

-pheochromocytoma

93

Pedicle artery for ALT flap?

-Descending branch of lateral circumflex femoral  

94

MCC  benign sinonasal tumors?

1. osteoma

2. IP

95

MCC affected sites for IP?

Lateral nasal wall > max 

96

What anatomically is the greatest predictor OSA?

Man neck circ > 17cm

Woman neck circ > 15cm

97

Dosing for propanolol for infantile hemangioma?

Propranolol dose for infantile hemangioma

2-3mg/kg per day

98

Wound tensile strength by time?

3% at 1 wk

20% at 3 wks

80% at 3 mo's

99

What is the inheritance pattern of Osler Weber Rendu?

AD

100

Medication and diet stoppage prior to RAI?

Cytomel stoppage 2 wks prior, synthroid 6 wks prior

amiodarone 9 mo's prior

low iodine diet 2 wks prior

101

For adductor vs abductor dysphonia, which #'s would they have difficulty saying?

 

adductor -> 80-89

abductor -> 60-69

102

How to diagnose and monitor malignant OE?

 

Tc99 scan for dx

then follow w Gallum 67 scan every 4 wks 

tx usually 2-4 mos

103

Inheritance of otosclerosis?

AD

104

Mean sleep latency of people w OSA?

5 min

105

MCC cardiac arrhythmia of those w OSA?

sinus brady

106

Inflammatory marker assc w OSA?

CRP

107

Most prominent pharyngeal dilators 

Genioglossus and tensor palitini

108

Esthesio and Kadish staging?

A image thumb
109

What % of hyperparathyroidism is due to adenoma? hyperplasia? lithium? carcinoma?

- 70% single adenoma

-26% double adenoma

-1.5% hyperplasia

-1.5% lithium

-1% carcinoma

110

cervical vestibular evoked myogenic potentials pathway?

stimulation of saccule -> inferior vestibular n -> vestibulospinal tract -> SCM

oVEMPs stimulates utricle -> superior nerve. 

111

Markers for B cells? T cells? NK cells? Eosinophils?

B: CD19, 20, 22

T: CD2,3,4,8

NK: CD56,16

Eosinophils: CD69

112

Histo for Warthin's?

Cyst surrounded by double epithelium, papillary fronds with lymphoid stroma

113

How long is re-epithelization after dermaabrasion?

5-7 days

114

Neutrophil count below what number is ominious in mucor?

below 1000

115

Which antithyroid med is ok during 1st trimester?

PTU

116

In the scalp, how large should the tissue expander be? When should inflation occur after placement? How often?

2.5x the size of the defect

2 wks after

1-2 times/wk

117

Abx treatment for Lemierre's syndrome?

What bug?

What location is the source?

Metronidozole

Fusobacterium necrophorum

Peritonsillar region

118

Nerve contributions to pterygopalatine ganglion

deep petrosal

GSPN

Max nerve

nerve of pterygoid canal

119

Wiskot Aldrich syndrome?

- X linked

- Eczema

-elevated IgE/A but decreased IgM

-thrombocytopenia

120

Bruton's agammaglobinemia?

-defect in tyrosine kinase therefore B cells cannot mature and have decreased amounts of Ig's across the board

-Infections start at 6mo's once they lose mothers Igs

-Inheritance X linked

121

IgA deficiency, what do you have to watch out for?

anaphylaxis during blood transfusion

122

Describe segments of ICA?

A image thumb
123

Godtfredson's syndrome?

Abducens and hypoglossal nerve palsy

Due to tumor of clivus or NPC

124

Hering's Law

Equivalent innervation of matched muscles may cause non physiological overactivity of the normal side while compensating for the weak side. 

To pre-op test, manually elevate the ptoticl lid, the opposite normal lid will then become ptotic

125

Furnas technique?

Conchal setback: suture technique tacking concha to mastoid periosteum

126

What % of Downs have atlanto-axial instability?

What do you look for on scan?

10-20%

>4mm from dens to anterior edge of atlas. 

127

Jugal point?

point at the anteror end of the upper border of the zygomatic arch where the masseteric and maxillary edges meet at an angle. 

128

Syndrome: FAP, sinonasal osteomas, supranumery teeth?

Gardner syndrome

129

Associated features along with pyriform aperture stenosis?

premaxillary dysgenesis, central mega incisor, flat nasal bridge, hypertelorism, holoproencephaly

130

What deficiency is RLS assc with?

Assc with what medication use?

Tx?

Associated pathology?

-Deficient in CNS iron

-SSRIs, SNRIs, TCAs, lithium, antiemetics, dopamine antagonists

-Tx: pramipexole, ropinirole

-loss of dopaminergic cells in substantia nigra

131

What pyriform apex tumors can you avoid a TL?

< 2cm in size

1.5cm above the pyriform apex

no cord fixation

no invasion

appropriate PFTs

132

How does frontal sinusitis track to the cavernous sinus?

 

superior ophthalmic vein

133

When to perform Laryngeal EMG in setting of RLN injury?

3-6 mo's after injury

134

pathphysio for DKA being susceptible to mucor?

-altered transferring binding which leads to increased serum iron which enhances fungal growth

135

What is Kasabach Merrit phenomenom?

It's a consumptive coagulopathy associated w tufted angiomas

136

Sturge Weber syndrome

V1 capillary malformation, leptomeningeal angiomas, intellectual instability, glaucoma

137

What pt features correlate w worse prognosis in PTC?

Males > 41yo; Females > 51yo

nodule > 5cm

138

How far prior to RAI does levothyroxine have to be stopped? Liotyronine?

6 wks

2 wks

139

Management of sialocele after face lift?

 

Pressure dressing, glycopyrrolate, botox, transdermal scopalamine

consider drain placement. 

140

Cidofovir MOA? What is it used for?

 

inhibits DNA polymerasae

used for RRP but off label

141

How does a vestibular schwannoma appear on MRI?

 

T1 hypointense, T2 heterogenous, T1 enhancement w gad

142

What does Ristocetin test test for?

vWF deficiency

143

What is the ultimobranchial body and what does it test for?

 

part of the 4th branchial pouch and gives rise to calcitonin producing parafollicular cells. 

144

For cutaneous squam, level neck dissection per subsite?

face: 1-3

anterior scalp: 2-3

ear: 2-3

posterior scalp: 2-5

145

Abx tx for nec fasc?

A image thumb
146

boundaries of pre-epiglottic space?

hyoid, thyrohyoid membrane, epiglottis, thyroepiglottic ligament, hyoepiglottic ligament

147

avg palpebral fissure diameter?

9mm

148

number of cartilage in larynx?

cric, thyroi, epig, cuneiform, corniculate, arytenoids

149

Where is the toxicity to the ear in platin medications?

Cisplatin: changes to stria vascularis, spiral ganglion, outer hair cells

Carboplatin: toxic to inner hair cells

150

What other things should you check for in pts with mumps (specific to ENT)?

check hearing: degeneration to stria vascularis

151

Innervation of parotid gland parasympathetics?

 

inferior salivatory nucleus -> CNIX -> Jacobsen's -> tympanic plexus -> lesser petrosal -> otic ganglion -> auricular temporal -> parotid

152

how do aminoglycosides cause damage?

forms a free radical complex w iron which damages outer hair cells

 

153

Most common bug of OE?

Pseudonomas

154

How soon prior to skin testing should you stop antihistamies? 

TCAs?

72 hrs, loratidine -> 7 days

TCAs ->2-4 days

155

How long does it take for a FTSG to get a new blood supply?

Diffusion

1-2 days vascular inosculation

2-4 days neovascularization

3-5 days blood supply established. 

156

blood supply to trap?

occipital, dorsal scapular, transvserse scapular

157

Within what time window should you give IV abx for CI for AOM?

within 2 mo's. 

Otherwise oral is ok if uncomplicated. 

158

Indications for primary hyperparathyroid surgery?

- serum ca 1.0mg/dl above upper limit nml

- creatinine clearance reduced by 30%

- < 50 yo

- 24hr urine > 400mg/dL

- bone density <2.5 std

159

Ideal helix to mastoid measurements?

Upper: 10-12mm

Middle: 16-18mm

Lower: 20-22mm

160

What is the inheritance of Bruton's agammaglobinemia?

Defect?

X linked

tyrosine kinase deficiency -. B cells cannot mature

161

What kind of cell deficiency if you get a lot of viral infections/fungual infections?

 

T cell deficiency

162

Vemurafinib?

mitogen active protein kinase pathway inhibitor effective for melanoma w BRAF mutation

163

Staging for anaplastic thyroid ca

Stage IVA: confined to thyroid

IVB: regional mets

IVC: distant mets

164

Suspicious features of thyroid nodule?

hypoechoic, mostly solid or solid, central vascularity, taller than wide on transverse, microcalfications, cervical adenopathy

165

What % of hypopharyngeal masses have regional mets at time of diagnosis?

5yr survival?

up tp 70%

< 25%

166

Innervation of parotid gland?

 

Parasympathetic: visceral motor fibers -> lesser petrosal n -> exits skull at foramen ovale -> synapse on otic ganglion -> post ganglionic fibers travel w auriculotempora n to parotid gland

167

MCC symptom of glossopharyngeal cA?

Mid frequency SNHL

Vestibular schwannomas have high frequency

168

what depth of tumor should a SLND be perform in oral cancer?

4mm or more

169

Inheritance of pendred syndrome?

Best way to dx?

AR

Genetic testing for SLC264A4 gene

170

Inheritance of aminoglycoside sensitivity?

Mitochondrial so from mother

171

When should you get an EMG for traumatic facial paralysis?

What will it show?

What will it show if FN function is returning?

2-3 wks after trauma

fibrillations

polyphasic potentials

172

Inheritance of connexin 26 hearing loss?

AR

173

CENTOR criteria?

Likelihood of having Group A strep

absence of Cough

tonsil Exudates

+ Nodes

Temp

Old oR young (+1) if young 

Score -1-5

174

What feature on immunohistochemistry do infantile hemangiomas express?

Glut-1 transporter

175

Angle of the laryngeal prominence in men/women?

90/120

176

Orientation of cochlear aqueduct? Endolymphatic sac?

parallel to IAC. IAC is anterior to cochlear aqueduct. 

perpendicular to IAC

177

Villaret Syndrome?

paresis of 9,10,11,12 and cervical sympathetic chain

indicative of lesion of the retroparotid space

178

If you have hyphema in an orbital floor fxr, what should you do?

Avoid surgery for 2 weeks min. 

179

How to remember the AD congenital conditions?

WANT CBS

Waardenberg

Aperts

Neurofibromatosis

Treacher Collins

Crouzon

Branchio oto renal

Stickler

180

Rhinophyma is assc w what bug?

Demodex folliculorum 

181

TSH should be what level in order for RAI to be effective?

> 30

182

How long should pt's wait for RAI after receiving contrast for CT?

8 wks