Diseases of Larynx and Pharynx Flashcards

Question

Corynebacterium Diphtheriae - Dx

Answer 1

clinical culture to confirm

Answer 2

horse serum antitoxin must be given in all cases of diphtheria (CDC) ENT (laryngoscopy) - remove membrane if airway obstruction oral abx - PCN or erythro Isolate until 3 - pharyngeal cultures vaccine to prevent

Answer 3

N. Gonorrhea (STD of pharynx, direct contact) HSV (very painful, "whitish" ulcerations post. oropharynx; gums gray and slough) Coxsackie virus (Hand, Foot, Mouth) -

Answer 4

impairment in the ability to produce sound with the vocal organs

Answer 5

tobacco use? laryngeal CA? lung CA w/ paralysis recurrent laryngeal n? weight loss? onset >2 weeks = ENT w/ laryngoscopy

Answer 6

Abnormal vibration/flow of air past the vocal folds/cords

Answer 7

Breathy Harsh Rough, low-pitched

Answer 8

Acute Laryngitis Chronic Laryngitis Overuse Benign vocal fold lesions - nodules, polyps Laryngeal cancer Neurologic dysfunction

Answer 9

Persistent symptoms > 2 weeks OR if any concern for serious underlying cause OR with any associated symptoms such as: Hemoptysis Dysphagia Odynophagia Otalgia airway compromise

Answer 10

high-pitched breath sounds produced by a narrowed or obstructed airway timing and rapiditiy of onset KEY ALL CASES NEED EVAL must rule out foreign body

Answer 11

narrowing AT or ABOVE the vocal cords

Answer 12

BELOW the vocal cords

Answer 13

Any inflammatory process that affects the larynx

Answer 14

hoarseness (hallmark symptom)

Answer 15

Hoarseness, Aphonia Reduced vocal pitch Associated URI symptoms- cough

Answer 16

Supportive therapy Bacterial- oral antibiotics Oral/IM steroids?

Answer 17

Chronic laryngitis GERD into larynx

Answer 18

throat clearing, throat discomfort, chronic cough, postnasal drip, esophageal spasm <50% heartburn excess mucus in throat increased rhinorrhea

Answer 19

ENT referral laryngoscopy critical to exclude other causes hoarsness (tumors/ nodules) + response to empiric PROTON PUMP INHIB Therapy decrease spicy foods, tomato based foods

Answer 20

Imaging CT Confirmed aspiration of pus = ENT

Answer 21

Penetration of infection through the tonsillar capsule and into adjacent tissue

Answer 22

severe sore throat Trismus (limited ability to open mouth, due to spasm) Muffled "hot potato" voice deviation of soft palate and uvula (normal side)

Answer 23

Abx tolerate PO = oral abx unable tolerate PO + more severe s/s = Admit + IV abx Tonsillectomy if more than 2x - indicated for recurrence Needle aspiration I&D

Answer 24

Acute, rapidly progressive cellulitis of the epiglottis and surrounding tissue that can lead to airway compromise MC in DM and kids (2-5 y/o)

Answer 25

viral or bacterial

Answer 26

4 D's - Drooling - Dysphagia - Dyspnea - Dysphonia (hot potato voice) Tripod position f/c

Answer 27

THUMB PRINT SIGN - lateral x-rays soft tissue Laryngoscopy - ENT + anesthesia = spasm and airway compromise

Answer 28

Keep the patient comfortable! DO NOT use a tongue depressor respiratory distress, = intubate and secure the airway! ADMIT IV abx - cephalosporins IV steroids - dexamethasone Close airway obsevation Continuous pulse ox prep intubate

Answer 29

Smooth, PAIRED lesions at the junction of the anterior 1/3 and posterior 2/3 due to vocal abuse/ overuse common cause of hoarsness

Answer 30

Modification of voice habits (most resolve) Referral to speech therapy Do not resolve = surgery ?

Answer 31

UNILATERAL masses within the superficial lamina propria Typically larger than nodules due to vocal trauma (resolution of cord hemorrhage)

Answer 32

Vocal rest, steroids for small polyps Excision- larger polyps

Answer 33

Traumatic lesions from mucus-secreting glands on the inferior aspect of vocal folds vary in size and degree of symptoms

Answer 34

rarely resolve completely - often scar (permenant dysphonia) Surgical intervention to prevent scarring by preserving the mucosal layer

Answer 35

benign, rare malign symptomatic and causes hoarness MC in kids

Answer 36

HPV type 6 & 11

Answer 37

Failure to tx= distal spread and airway compromise Tx: repeated laser vaporizations or resections Severe cases = airway compromise in adults and may require treatment every 6 weeks

Answer 38

elastin fibers and loosening of intracellular junctions within the lamina propria = swelling of superficial lamina (REINKE EDEMA)

Answer 39

SMOKING vocal abuse, chemicals, hypothyroid

Answer 40

Surgical resection if stridor or airway obstruction

Answer 41

lesion or damage to either the vagus or recurrent laryngeal nerve (RLN) breathy dysphonia or effortful voicing

Answer 42

Unilateral recurrent laryngeal nerve injury Unilateral Vagus damage/lesions BILATERAL fold paralysis = Medical Emergency!

Answer 43

CT/MRI with contrast of brain and brainstem Direct visualization with laryngoscope

Answer 44

create safe airway with normal vocal ability Vocal cord injections with ProLaryn (dermal filler) Vocal cord prosthesis - Thyroplasty (Montgomery Implant)

Answer 45

Commonly associated with hoarseness in smokers Histology = mild, moderate or severe dysplasia 35-60% with severe dysplasia = squamous cell carcinoma

Answer 46

Proton Pump Inhibitors, regular surveillance, resection and/or radiation Smoking cessation (mild/mod)

Answer 47

MC malign of larynx Occurs almost exclusively in smokers MEN, 50-70 y/o Associated with HPV 16 and 18

Answer 48

Change in voice quality (new/persist hoarsness >2 weeks in smoker) neck mass throat/ear pain

Answer 49

Laryngoscopy with BIOPSY Lung function and exercise tolerance should be evaluated prior to surgery due to risk of aspiration following procedure for resection

Answer 50

TNM - tumor, node, metastasis

Answer 51

Cure Preserve swallowing and voice Avoid permanent Tracheostoma

Answer 52

Radiation Chemo Surgical resectino Long term f/u

Answer 53

Removal of the larynx (voice box)

Answer 54

patients can eat by mouth Permanent stoma – safest airway Speech? Tracheoesophageal Puncture + Prosthesis Electrolarynx (robot voice from smokers commercial)

Diseases of Larynx and Pharynx Flashcards

(78 cards)