Oropharnygeal and Laryngeal Disorders Flashcards Preview

Adult/Ped Med 3 > Oropharnygeal and Laryngeal Disorders > Flashcards

Flashcards in Oropharnygeal and Laryngeal Disorders Deck (40):
1

Where do branchiogenic cysts open into?

tonsillar fossa

2

Patient presents with a midline mass on their neck. You ask them to swallow and observe that it moves. What will this require?

This is a thyroglossal duct cyst and will require removal. You will want to do a U/S to confirm, and ID the tract. They commonly present before age 20.

3

What is the occlusion of a minor salivary gland?

mucoele. they can present anywhere along the mucosa. Drainage and excision is needed.

4

patient presents with a mass on the floor of their mouth. an U/S reveals that it plunges deep into the neck. what is it most likely?

ranula, surgival removal is needed.

5

Patient presents to clinic with difficulty swallowing and painful swallowing. When you try to examine their mouth, they have difficulty opening their jaw. Eventually, you can see a deviated uvula. There is unilateral swelling. If you order a CBC, what will you see?

This is peritonsillar abscess. WBC, they usually have a fever. usually preceded by step A tonsillitis infection.

6

Patient presents to clinic with difficulty swallowing and painful swallowing. When you try to examine their mouth, they have difficulty opening their jaw. Eventually, you can see a deviated uvula. There is unilateral swelling. What should your treatment be?

MEDICAL EMERGENCY!! REFER. hospitalization antibiotics or aspiration(which should be referred)

7

What is the main organism involved in mono?

epstein barr virus

8

How can you confirm mono?

monospot, which may take several days to elevate. Also there will be an elevated AST/ALT (a liver function test)

9

What are the signs/symptoms of mono?

EGV, males:females, sore throat, fever, and malaise. Atypical lymphs, elevated AST/ALT, monospot.

10

You look in the mouth and see intranuclear lesions. There are vessicles with an ulcerated rim. What is this?

HSV (usually type I)

11

Upon examination of a child's mouth, you see small lesions less than 1 cm that have a erythematous ring, and a yellow/gray base. What is a risk factor for this?

these are aphthous stomatitis. a risk factor is familly history.

12

Upon examination of a child's mouth, you see small lesions less than 1 cm that have a erythematous ring, and a yellow/gray base. The patient is worried about pain, how long do you tell them this will last? Will it happen again?

usually lasts around 7-10 days. They usually occur 3-6 times a year (there are both minor and major) You can prescribe corticosteroids to provide some relief. Most common during early adolesence and lasts for several years.

13

Upon examination of a child's mouth, you see small lesions less than 1 cm that have a erythematous ring, and a yellow/gray base. What is the predicted pathogeneisis for this?

T cell mediated response.

14

Upon examination of a child's mouth, you see small lesions less than 1 cm that have a erythematous ring, and a yellow/gray base. Where do you normally see these?

non-keratinized surfaces.

15

Upon examination of a child's mouth, you see small lesions less than 1 cm that have a erythematous ring, and a yellow/gray base. After giving treatment, there is no response. They may have an underlying systemic condition. What might that be?

Behcet's, celiac disease, nutritional deficiences, erythema multiforme (there will be 100's that appear in the mouth), and toothpastes.

16

Patient comes in with mouth discomfort. They have recently been treated for a systemic illness with immunosuppresives. When you see in their mouth, there is white, cottage-cheese like exudates on tongue and back of throat. What is your next step?

See if you can wipe it off with a tongue blade. If it wipes off--> candidas. If not--> think leukoplakia.

17

Patient comes in with mouth discomfort. They have recently been treated for a systemic illness with immunosuppresives. When you see in their mouth, there is white, cottage-cheese like exudates on tongue and back of throat. Who is more likley to get these type of infections?

AIDs patients and diabetics. (this is thrush)

18

What is a candidal infection that can affect the corners of the mouth? What is it associated with? How do you treat?

Angular chelitis. Decreased vertical heigh between mandible and maxilla. Increase heigh and give anti-fungals.

19

Patient presents with swollen face and neck. They are having trouble breathing. Their tongue is located posterior and superior. what is going on?

inflammation of the sublingual and submandibular compartments. This is called Ludwig's angina.

20

Patient presents with swollen face and neck. They are having trouble breathing. Their tongue is located posterior and superior. what should you do?

REFER, ADMIT!! this will require incision and drainage to manage.

21

Patient presents with swollen face and neck. They are having trouble breathing. Their tongue is located posterior and superior. what is a pre-disposing factor?

poor dental hygeine.

22

A young student who has been under a lot of stress recently presents to your clinic because they have a fever and noticed enlarged lymph nodes around their neck. Upon your PE, you see that their mouth has inflammation of gingiva, bleeding, halitosis. What is this?

ANUG (acute necrotizing ulcerative gingivitis)

23

A young student who has been under a lot of stress recently presents to your clinic because they have a fever and noticed enlarged lymph nodes around their neck. Upon your PE, you see that their mouth has inflammation of gingiva, bleeding, halitosis. What is your treatment? What is this typically caused by?

ORAL PCN and peroxide mouth washes, usually surgical debridement is necessary. Spirochetes and fusiform bacilli (anaerobic)

24

A young student who has been under a lot of stress recently presents to your clinic because they have a fever and noticed enlarged lymph nodes around their neck. Upon your PE, you see that their mouth has inflammation of gingiva, bleeding, halitosis. What pre-disposes you to this?

poor nutrition and debilitating disease.

25

What are two major causes of leukoplakia?

smoking and trauma. this is a PRE-cancerous lesion.

26

What is the pathologic process for leukoplakia?

dysplasia and irritation.

27

Examination of a child's mouth shows a lace like pattern in the cheek. The mom is worried that this is contagious, what do you tell her?

non-contagious, unknown triggers, unknown etiology, no known cure. (lichen planus)

28

What tool might you use for looking into the back of the throat?

laryngoscopy

29

What are the 3 D's of epiglotittis?

drooling, dysphagia, distress

30

how will patient with epiglottitis present?

tri-pod position: trunk forward, neck extended, chin thrust foward.

31

who do you typically see epiglottitis with? What is the "bug"

children, H. flu

32

How do you diagnose epiglottitis? what is your treatment?

do radiographs, you will be looking for the "thumb sign". could do a laryngoscopy to look at epiglottis. MED EMERGENCY! hospitalize, give IV Abx

33

A patient presents to the clinic with a hoarse voice? You should be worried about...

unliateral polyp, bilateral polyps, intracordal cysts, intracordal nodules, intracordal granulomas, leukoplakia, carcinoma

34

In what population do you most commonly see bilateral polyps

female smokers, those with vocal abuse.

35

What is ALWAYS the treatment for nodules?

voice therapy

36

Where do vocal nodules usually occur?

the "striking zone"

37

Where do granulomas of the vocal cords normally appear?

posterior glottis

38

What can lead to the formation of vocal cord granulomas?

GERD, auctioneers, bass singers

39

What should you always do with vocal cord carcinoma?

REFER!! patients will usually present with acute and persistant hoarseness (seen often in somkers), a breathy voice, bloody cough, etc...Dx is made by biopsy of the lesion

40

What do reccurent respiratory papillomas affect?

the mucus membranes of the respiratory tracts, viral etiology. vertical transmission.