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Flashcards in ENT Deck (46):
1

Are most vocal cord tumors benign or malignant?

benign

2

Is leukoplakia benign or malignant?

Normally benign but can have early signs of cancer of cancer may sprout adjacent to it

3

Are most ENT tumors glottic or supraglottic?  Which has a better prognosis?  Why?

Most are glottic

Glottic have better prognosis b/c there is limited lymphatic drainage

4

Patient presents with painless, soft mass in the location of the parotid gland.  It is unilateral.  What is the diagnosis?  Benign or malignant?

Pleomorphic adenoma

Benign

(can occur in any salivary gland)

5

Patient presents with bilateral painless, soft masses of the parotid gland.  What is the diagnosis?  Benign or malignant?

Warthin's Tumor (aka papillary cystadenoma lymphomatosum)

Benign

(Can be in any salivary gland)

6

What is the prognosis of an Adenoid cystic cylindroma?  Why?

Poor prognosis (malignant)

Perivascular and perineural invasion

7

What is the appearance of erythroplakia?  What is the prognosis?

  • Erythroplakia:
    • red spots in the oral cavity
  • Prognosis:
    • high incidence of squamous cell carcinoma
    • need to biopsy

8

Patient presents with unilateral sinusitis with some bleeding and a bad odor.  What is the diagnosis?

Nasal/Sinus tumors

9

Nasal and sinus tumors can result from metastasis from which locations?

Breast

Lung

Kidney

Thyroid

10

Young child presents with an inspiratory stridor with a gradual onset,a barky cough, and horseness.  What is the Ddx? What is the difference in risk, and how can they be differentiated?

  • Croup
    • Low risk of obstruction
    • Viral cause
    • Steeple sign on CXR
  • Acute Epiglottitis
    • Risk of airway obstruction
    • Bacterial
    • lateral soft tissue x-ray has thumb sign

11

Patient presents with acute swelling of face and tongue.  They are diagnosed with angioneurotic edema.  What is the most likely cause?

ACE inhibitors: Lisinopril, Ramipril

12

Where is erythema present in GERD?

posterior larynx

13

What does LeFort I fracture include?

Maxilla

14

What does LeFort II fracture involve?

Midface

15

What does LeFort III fracture include?

Midface and nose

16

What is the classic sign of orbital fractures/ blow-out?

Diplopia

17

What is the classic sign of mandibular fracture?

Malocclusion of teeth

Most common fractures: body > angle > condyle

18

What is the difference between Obstructive Sleep Apnea vs simple snoring?

Decreased O2 levels

19

Which has a higher risk of cancer: Cold or Hot thyroid nodules?

Cold

20

What is the characteristic finding of papillary carcinoma?  What is the prognosis?

  • Finding: 
    • Psammoma bodies (Ca accumulation)
  • Prognosis:
    • malignant, but best of malignant

21

MEN (or MEA) syndrome is associated with which type of malignant thyroid cancer? What is the cause?

Medullary carcinoma

Cause: familial (genetic)

22

Which malignant thyroid cancer has the worst prognosis?

Anaplastic carcinoma

23

What are the malignant thyroid cancers and what is the difference in their prognosis?

  1. Papillary carcinoma (Best prognosis)
  2. Follicular carcinoma
  3. Medullary carcinoma
  4. Anaplastic carcinoma (worst)

24

Patient presents with a soft, doughy mass anterior to the ear.  What is the diagnosis?

First branchial cleft cyst

25

Patient presents with a soft, doughy mass on the neck at the anterior border of the SCM.  What is the diagnosis?

Second branchial cleft cyst

26

Patient presents with a soft, doughy mass in the midline of the neck between the chin and the thyroid.  What is the diagnosis?

Thyroglossal duct cyst

27

What signs should be present to diagnose acute otitis media (AOM)?

  1. Recent onset 
  2. Middle ear effusion
    • bulging membrane
    • limited mobility of membrane
  3. Middle ear inflammation
    • erythemia of tympanic membrane
    • otalgia

28

What is the initial treatment of AOM?

Observation (if low risk)

Amoxicillin

29

What differentiates Otitis Media with Effusion (OME) from AOM?

  1. Effusion does not have purulent characteristics of AOM
  2. TM flat or retracted rather than bulging
  3. Present for weeks or months following resolution of AOM (AOM is abrupt)

30

What type of middle ear infection can be caused by allergies or GERD?

Otitis Media with Effusion

31

What is the treatment plan for OME?

Generally just treat whatever is contributing to inflammation

(decongestants, antihistamines, ect.)

32

What are the symptoms of Chronic Otitis Media (COM)?

  1. Chronic otorrhea
  2. Retracted TM
  3. Cholesteatoma (skin growth onto TM)
  4. Tube otorrhea

33

Where can infection from the adenoids spread?

Middle ear

Sphenoid sinus

Ethmoid sinus

34

What is the treatment for recurrent tonsillopharyngitis?

Adenotonsillectomy

35

What is the most common predisposing factor for pediatric sinusitis?

Viral URI

36

What is the treatment for viral URI lasting more than 7-10 days?

Treat for sinusitis

37

What is the second most common predisposing factor for peds sinusitis?

Allergic Rhinitis

38

What bug normally colonizes the respiratory tract of cystic fibrosis patients?

Pseudomonas

39

Sinonasal polyps are most common in what disease?

Cystic fibrosis

40

What are the findings associated with Allergic Fungal Sinusitis?  What is the infectious organism?

  • Mucin in sinuses and nasal cavities
    • peanut-butter consistency
  • Abundant eosinophils
  • Cause:
    • Aspergillus

41

What are the signs and symptoms of Acute Bacterial Sinusitis?

  1. Rhinorrhea
    • mucopurulent
    • bilateral
  2. Cough
  3. Nasal congestion
  4. fever

42

What is indicated by CT scan findings of opacification of one sinus?

Acute Sinusitis

43

What is indicated by CT scan findings of mucosal thickening of the maxillary and ethmoid sinuses with osteomeatal unit obstruction?

Chronic sinusitis

44

What is indicated by CT scan findings of complete opacification of all sinuses, expansion of sinus cavities, thinning of bone, and polyps on the mucosa?

Cystic Fibrosis

45

What are the signs and symptoms of Chronic Sinusitis?

  • At least 2 of the following
    • mucopurulent discharge
    • nasal obstruction
    • facial pain or pressure
  • Inflammation
  • Mucosal thickening on CT
  • History

46

What is the treatment for Chronic Sinusitis?

  • Drugs:
    • broad-spectrum beta-lactamase resistant drugs
  • May require surgery
    • adenoidectomy first