pestana: skin, optho, ENT

Question 1

basal cell carcinoma presentation

Answer 1

upper face
timetable measured in years
does not metastasize- locally invades

Question 2

what size margins when excising basal cell carc?

Answer 2

1 mm margins

Question 3

squamous cell carc presentation

Answer 3

lower lip, and body
timetable measured in months
metastasizes to lymph nodes

Question 4

what size margins when excising squamous cell carc presentation

Answer 4

0.5-2 cm

Question 5

melanomas less than how many mm only require local excision?

Answer 5

1 mm

Question 6

best chance at treating the unpredictable melanoma mets

Answer 6

interferon

targeted therapy- dacarbazine, pembrolizumab

Question 7

amblyopia cause (lazy eye)

Answer 7

interference of brain processing images during first 6-7 years of life

faced with two overlapping images –> brain suppresses one of them –> strabismus

Question 8

what will happen if amblyopia not corrected early on

Answer 8

permanent cortical blindness of suppressed eye

Question 9

if strabismus (cross eye) develops later in infancy, what is the cause of the problem

Answer 9

refraction difficulties- get corrective glasses

not a true strabismus

Question 10

white pupil in baby means

Answer 10

optho emergency! like retinoblastoma!

even tho could be congenital cataract

Question 11

acute angle closure glaucoma presentation

Answer 11

severe eye pain, frontal HA

starting in evening when pupils dilated

female asian- halos around lights

Question 12

acute angle closure glaucoma on physical exam

Answer 12

mid dilated, doesnt react to light

cornea cloudy, green ish hue

eye feels hard as a rock

Question 13

treat acute angle closure glaucoma

Answer 13

surgery- drain fluid

meds: CA inhibitors, topical beta blockers, alpha 2 agonists

Question 14

what is this: eye lids hot tender, red, swollen. patient is febrile. When eyelids pried open, pupil is dilated and fixed with limited motion

Answer 14

orbital cellulitis

Question 15

diagnose and treat orbital cellulitis

Answer 15

emergency CT and drainage

Question 16

retinal detachment presentation

Answer 16

flashes of lights and “floaters” in the eye (the more floaters, the worse it is)

Question 17

retinal detachment treatment

Answer 17

emergency- laser “spot welding”

Question 18

embolic occlusion of retinal artery presentation

Answer 18

elderly

sudden loss of vision from one eye

Question 19

in how many minutes will damage be irreversible in embolic occlusion of retinal artery

Answer 19

30 minutes! emergency!

Question 20

thyroglossal duct cyst location and size

Answer 20

midline, level of hyoid, connected to tongue

1-2 cm

Question 21

branchial cleft cysts location

Answer 21

along anterior edge of sternocleidomastoid

Question 22

cystic hygroma location

Answer 22

base of neck

occupies entrire supraclavicular area and extends deeply

Question 23

when should you start workup of enlarged lymph nodes

Answer 23

history of >4 weeks

Question 24

lymphoma presentation- age and symptoms

Answer 24

young people

multiple enlarged nodes
fever, night sweats

Question 25

which primary tumor usually produces mets to supraclavicular node?

Answer 25

lung, intraabdominal

Question 26

squamous cell carc of mucosa of head/neck population

Answer 26

old men who smoke, drink, rotten teeth | AIDS

Question 27

squamous cell carc of mucosa of head/neck presentation

Answer 27

persistent hoarseness persistent painless ulcer in floor of mouth persistent unilateral earache

Question 28

squamous cell carc of mucosa of head/neck workup

Answer 28

triple endoscopy- look for primary tumors biopsy CT to show extent

Question 29

squamous cell carc of mucosa of head/neck treatment

Answer 29

resection radial neck dissection platinum chemo, RT

Question 30

what should you suspect in an adult who has sensory hearing loss in one ear but not the other? and what testing to do?

Answer 30

acoustic nerve neuroma MRI

Question 31

what shoud you suspect with GRADUAL vs SUDDEN ONSET unilateral facial nerve paralysis (upper and lower)

Answer 31

gradual: facial nerve tumor sudden: bell's palsy

Question 32

most common parotid tumor

Answer 32

pleomorphic adenomas- benign but capable of malignancy

Question 33

benign or malignant parotid tumor? painful and hard

Answer 33

malignant

Question 34

what is contraindicated for imaging for parotid tumor?

Answer 34

FNA

Question 35

treat parotid tumor

Answer 35

formal superficial parotidectomy in malignant: nerve sacrificed, graft done

Question 36

whats most common cause of unilateral ENT problems in toddlers?

Answer 36

foreign bodies

Question 37

ludwig angina

Answer 37

abscess of floor of mouth (result of bad tooth inf)

Question 38

treating bell's palsy

Answer 38

antivirals- early! | steroids

Question 39

what is this: diplopia, facial pain, high fever in patient with frontal or ethmoid sinusitis

Answer 39

cavernous sinus thrombosis- emergency!

Question 40

treating cavernous sinus thrombosis

Answer 40

IV abx for 3-4 weeks | drain

Question 41

prime suspects for 18 year old with nose bleed

Answer 41

cocaine abuse- septal perf juvenile nasopharyngeal angiofibroma