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Surgery Semester 3 > Otolaryngology, Otitis, Rhinosinutitis > Flashcards

Otolaryngology, Otitis, Rhinosinutitis Flashcards

(91 cards)

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1
Q

Phase of swallowing: Voluntary, chewing

A

Prepatory oral phase

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2
Q

Phase of swallowing: reflexive phase

A

Pharyngeal phase

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3
Q

Phase of swallowing: fluid passive, solid is active

A

Esophageal phase

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4
Q

Problems with prepatory and oral phase: cause and effect

A

Cause: Tongue thrust and teeth. Effect: choking and aspiration are common

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5
Q

Problems with pharyngeal phase: Cause and effect

A

Cause: upper pharyngeal sphincter (crisopharyngeus muscle relaxes with swallowing). Effect: choking and aspiration common

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6
Q

Problems with esophageal phase: cause and effect

A

Solid and/or liquid problems swallowing

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7
Q

Test used to vizualize oral and pharyngeal phases

A

Barium Swallow

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8
Q

Risk factors for GERD

A

tobacco, caffeine, EtOH

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9
Q

Common sleep symptom found with GERD

A

Snoring

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10
Q

Gold standard for Dx hiatal hernia

A

24Hr probe (not very practical)

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11
Q

Medical management of hiatal hernia

A

GERD: 1x day PPI; EER: 2x/day PPI

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12
Q

Radiography finding of achalasia

A

Bird beak on esophagram

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13
Q

Autoimmune disorder with atrophy of smooth muscle and collagen deopsition

A

Scleroderma

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14
Q

Face is calcified and cannot exhibit expressions

A

Fixed face (sign of scleroderma)

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15
Q

CREST syndrome

A

Calcinosis, Raynauds, Esophageal dysfunction, Sclerodactyly, Telangiectasias

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16
Q

Idiopathic inflammatory myopathy of striated muscle

A

Polymyositis

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17
Q

S&S of polymyositis

A

Proximal muscle wasting, dysmotility of proximal 1/3 of esophagus, increased CPK

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18
Q

Tx of scleroderma

A

Reflux control, NSAIDS, steriods, Ca CB

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19
Q

Tx of polymyositis

A

Reflux control, immunosuppressive and steriods

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20
Q

Diverticulum of esophagus at Killian’s triangle

A

Zenker’s Diverticulum

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21
Q

Most common cause of esophageal rupture

A

Instruments during testing

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22
Q

Incomplete esophageal tear from increased pressure (i.e. vomiting)

A

Mallory-Weis syndrome

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23
Q

Rupturing od all 3 layes of the esophagus

A

Boerhaave syndrome

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24
Q

What sign is “crunching” over the heart?

A

Hammers sign

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25
Intermittent dysphagia cuased by the right subclavian artery being behind the esophagus
Dysphagia Lusoria (Bayford syndrome)
26
Elongated styloid process or ossified stylohyoid ligament, can cause odynophagis and unilateral throat pain
Eagle syndrome
27
Dysphagia from esophageal webs, iron deficeincy anemia, glossitis, and has an increased rish of squamous cell carcinoma
Plummer-Vinson Syndrome
28
Tx of Plummer-Vinson Syndrome
Iron supplementation and esophageal dilation
29
Immediate gagging or cyanosis after birth
Tracheoesophageal fistula
30
Most common esophageal malignancy and location
Squamous cell carcinoma, middle 1/3 of esophagus
31
Assoc. w/ Barretts metaplasia from reflux
Adenocarcinoma
32
Most common cause of acute pharyngitis
Viral
33
Most common cause of acute bacterial pharyngitis
Group A pyogenes
34
Causes of chronic pharyngitis
GERD, EER, smoking, allergy, rhinocinusitis
35
Commonly called hand, foot, mouth disease
Herpangina, from coxsackie A virus
36
Grading system on tonsil size
0-4 (gone to 100% to mid line)
37
S&S of peritonsilar abcess
Anterior pillar fullness, uvula shifted from tonsils, no exudate on tonsils
38
Paradise Criteria
Tonsillectomy guidelines: 7 infx/year for 1 yr, 5infx/year for 2 yrs, 3 infx/yr for 3 years
39
Non infx reasons for tonsillectomy
sleep disorder breathing, cor pulmonale (from SDB), recurrent or chrontic otitis media
40
Contraindications for tonsillectomy
Leukemia, hemophilia, systemic disease, cleft palate, acute infx, bifid uvula
41
Why is snoring important?
All snoring is pathologic
42
Complications of snoring
Cardiopulmonary disease (RHF), HTN, Failure to thrive)
43
Dx of obstructive sleep apnea
Polysomnogram shows >5 episodes per an hour
44
Most common cause of acute otitis externa
Pseudomonas (followed by proteus, staph, strep)
45
Tx of acute otitis externa
#1:cleaning! Ear drops w/ steriod, Cipro+dexamethasone
46
Difference b/t acute and necrotizing otitis externa
Necro has involvement of osteomyelitis of temporal bone, abnormally high pain for externa appearance, cranial nerve involvement (BAD prognosis)
47
Tx of necrotizing otitis externa
Control of immunodeficienies and DM
48
Most common causes of otomycosis
Aspergillus, then candida
49
Tx of otomycosis
Meticulous debridement, clean with vinegar, antifungal drops
50
Causes of acute otitis media
Strep pneumo, H Inf, Moraxella Catarrhalis
51
Risks for acute otitis media
Smoke exposure, day care, nasal intubation, breast fed <2 years
52
S&S for acute otitis media
HEARING LOSS
53
When to use myrongotomy with pressure equalization tubes?
Recurrent otitis media, poor response to Abx, persistent effusion >3months
54
S&S of serous otitis media
Hearing loss W/O pain
55
Plan for adult with unilateral persistent middle ear fluid
Must undergo inspection of nasopharynx
56
S&S of chronic otitis media
Tympanic membrane perforation, conductive hearing loss, >6 weeks of otitis media
57
Common cause of CHRONIC otitis media
Pseudomonas
58
Complications of chronic otitis media
Facial nerve paralysis, sinus thrombophlebitis, mastoiditis, Meningitis
59
Slow progressive hearing loss and ringing in ears cuased by abnormal reabsorption/deposition of bone in all 3 layers of otic capsule and ossicles
Otosclerosis
60
Cause of labryinthitis
Bacterial infx that progresses into labyrinth from otitis media or meningitis
61
Complications of labrynthitis
Permanent hearing loss and vestibular dysfunction
62
Viral infection of vestibular nerve
Vestibular neuronitis
63
S&S of vestibular neuronitis
Vertigo lasting days-weeks, no hearing loss, NYSTAGMUS
64
Cold water associated, smooth protusions of medial osseau canal
Exostoses (surfers ear)
65
White "pearly" mass in middle ear, caused by squamous epithelium in the middle ear with accumulation of keraton debri
Cholesteatoma
66
Inflammation of the nose and sinuses
Rhinosinusitis
67
Dx of rhinosinusitis
2 or more major criteria, 1 major criteria +2 minor criteria
68
Major criteria of rhinosinusitis
Facial pain, nasal obstruction, hyposmia, purulence on examination, fever
69
Minor criteria of rhinosinusitis
headache, fatigue, dental pain, cough
70
Acute rhinosinusitis: definition and cause
lasts up to 4 weeks. Rhinovirus, strep, H flu, Moraxella Cattarrahlis
71
Chronic rhinosinusitis: definition and causes
6 weels or more. (usually polymicrobial) S. aureus, anaerobes, gram negatives and pseudomonas
72
Recurrent acute rhinosinusitis: definition
4 or more times a year with resolution b/t attacks
73
Imaging for rhinosinusitis
NO XRAY, Non-contrast coronal CT is gold standard, MRI for complicated cases
74
Tx of acute rhinosinusitis
Empirically: amox+clavulanate (augmentin), bactrim, doxycycline, clarithromycin, cipro for 7-10 days
75
Tx of chronic rhinosinusitis
Culture based is preferable: 1st) amox+clavulanate OR 2nd/3rd gen cephalosporin, 2nd)quinolones (cipro, levo, moxi) OR clarithromycin
76
Use what in chronic rhinosinusitis for culture documented resistant S. Pneumonia
Clindamycin
77
Chronic rhinosinusitis in children
can be treated with PPI due to GERD/EER
78
How to thicknes/Thin mucus
acidic mucus in thick, alkaline (baking soda) mucus is thinned
79
Decongestants
Phenylephrine, pseudoephedrine (stronger)
80
Why are leukotrienes important to nasal allergic inflammation?
More potent than histamine trigger
81
Tx of leukotrienes
Antagonist (Singulair)
82
MOA of corticosteriods
Stabilizes mast cells so do not degranulate, inhibits chemotaxis of inflammatory cells
83
Use of corticosteriods in allergies
Short use is good for severe mucosal congestion
84
Contraindications for corticosteriods
DM, PUD, glaucoma, severe hypertension
85
Why is informed consent needed for high dose steriods?
Avascular necrosis and other side effects
86
rhinosinusitis associated diseases
GERD, EER, cystic fibrosis, cilia dysfunction, fungal rhinosinusitis
87
Associated with cilia dysfunction
Kartageners syndrome: situs invertus, bronchiectasis, sinusitis, male infertility
88
What is produced in fungal rhinosinusitis and no other rhinosinusitis?
IL-5 and IL-13
89
S&S of chronic rhinosinusitis
Eosinophil inflammation, epithelial damage, basal membrane thickening (SAME AS ASTHMA)
90
Tx of fungal rhinosinusitis
Amphotericin B
91
Complications of rhinosinusitis
Cavernous sinus thrombophlebitis, abcess, meningitis, sinocutaneous fistula

Surgery Semester 3 (3 decks)

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