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Y2 ENT > Throat Conditions > Flashcards

Throat Conditions Flashcards

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1
Q

how is neck trauma classified

A

zones 1-3

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2
Q

what are the investigations of a neck mass

A

US then FNA to determine tissue type +- MRI for nerve involvement

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3
Q

what is the cause of a laryngeal polyp

A

laryngeal mucosal reaction to trauma/stress/smoke on cords

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4
Q

what is the difference between a laryngeal polyp and nodule

A

polyp: unilateral, pedunculated
nodule: young women, bilateral

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5
Q

what is a squamous cell papilloma of the throat and what causes it

A

benign, HPV type 6 & 11 induce metaplasia of koliocyte cells

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6
Q

what is the presentation of a squamous cell papilloma of the throat

A

Persistent sore throat, neck mass

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7
Q

what is a paraganglionoma

A

neuroendocrine paraganglia tumour

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8
Q

what condition is associated with paragangliomas in people under 50yr

A

MEN2

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9
Q

what is the classification of paraganglionomas

A

chromaffin +ve or non-chromaffin

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10
Q

what type of paraganglionoma affects the nose/mouth/phayrnx

A

non-chromaffin

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11
Q

what is a sialolithiasis

A

salivary gland stone

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12
Q

what is a painful salivary gland in a young person a red flag for

A

mucoepidermoid carcinoma

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13
Q

what is the commonest salivary gland tumour

A

benign pleomorphic adenoma of the parotid

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14
Q

what is the management of a benign pleomorphic adenoma of the parotid

A

excise sine metaplasia risk

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15
Q

what is the pathophysiology of airway obstruction leading to death

A

resp distress > resp failure > resp arrest > cardiac arrest. Cardio failure > neuro failure

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16
Q

what is stridor

A

high pitch inspiratory noise due to turbulent airflow

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17
Q

what is the management of airway obstruction

A

ABC; O2, heliox, CCS, adrenaline

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18
Q

what is the management of burns causing airway obstruction

A

intubate asap

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19
Q

what investigation should be avoided in airway obstruction

A

tracheostomy

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20
Q

what are the types of patients who get oral squamous cell carcinoma

A

young: HPV type 16/18

old smoker/drinker

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21
Q

how does HPV cause squamous cell carcinoma

A

produce proteins disrupting p53 & RB

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22
Q

where do HPV induced squamous cell carcinomas of the throat occur

A

oropharynx: tongue base/tonsil

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23
Q

where do alcohol/smoking induced squamous cell carcinomas of the throat occur

A

vocal cord

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24
Q

what are the investigations of squamous cell carcinoma

A

biopsy for TNF staging

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25
what is the presentation of HPV SCC
young, lymphadenopathy,
26
does HPV or alcohol/smoking SCC have a better response to chemotherapy and radiotherpay
HPV induced
27
what is the 1st step of the WHO pain ladder
non-opioid (e.g. NSAID) +- adjuvant
28
give examples of NSAIDs
paracetamol, aspirin, ibuprofen
29
what is an adjuvant analgesic
primary indication not for pain
30
give examples of adjuvant analgesics
gabapentin, pregabalin, amitriptyline
31
what is the 2nd step of the WHO pain ladder
mild opioid + non-opioid +- adjuvant
32
give examples of mild opioids
codeine, co-cocodamol, tramadol
33
what is the 3rd step of the WHO pain ladder
opioid +- non-opioid +- adjuvant
34
give examples of moderate-strong opioids
morphine, diamorphine, fentanyl, oxycodone
35
when should you refer a sore throat from primary care
dysphagia for longer than 3wk, red/white patch/ulcer for longer than 3wk, stridor
36
how to decide when to give antibiotics for a sore throat
centor criteria
37
what type of bacteria is diphtheria
cornyebacterium
38
what is the presentation of diphtheria
very sore throat, grey white membrane on posterior pharynx
39
what is the treatment of diphtheria
antitoxin + penicillin/erythromycin
40
what type of vaccine is the diphtheria vaccine
toxoid
41
what is a risk factor for oral thrush
CCS inhaler
42
what is the infecting organism in oral thrush
candida albicans
43
what is the treatment of oral thrush
nystatin
44
what is paramyoxovirus
mumps; bilateral parotid salivary gland infection
45
what are complications of mumps
meningitis, male infertility
46
what is the infecting organism in primary syphilis
treponema pallidum
47
what is an aphthous ulcer
round recurrent self limiting mouth ulcers without infection/systemic disease
48
what virus causes hand foot and mouth
coxsackie enterovirus
49
what is the presentation of hand foot and mouth disease
pyrexic, anorexia, leg ache, itchy papules on hand, foot and mouth
50
what is the transmission of hand, foot and mouth
faecal-oral
51
how is hand, foot and mouth diagnosed
clinical Dx or swab in viral transport medium for pcr
52
what is the management of hand, foot and mouth
self limiting, fluids, NSAID, hand-washing
53
what is the infecting organism in herpangina
enterovirus coxsackie
54
what is the presentation of herpangina
ulcers on the soft palate of a child
55
what is the management of herpangina
self-limiting
56
what is herpetic whitlow
herpes simplex infection on finger, often dentist/ anaesthetist
57
how is HSV1 transmissed
saliva
58
how is HSV1 infection diagnosed
clinical or swab virus in transport medium for viral DNA PCR
59
what is the management of active HSV1 infection
acyclovir
60
what is a complication of HSV1
encephalitis
61
what type of herpes causes oral lesions
type 1 (i think?)
62
what is primary gingivostomatitis
primary HSV1 infection in young child causing ulcer plus systemic upset
63
what are the commonest infecting organisms in tonsillitis
viruses: rhinovirus / influenza / enterovirus / adenovirus. rarely EBV
64
which bacteria can cause tonsillitis
h. influenzae, s. pyogenes, s. aureus, s. pneumoniae
65
which tonsil inflam will cause AOM
pharyngeal
66
what is the difference in the presentation of viral and bacterial tonsillitis
viral no fever bacterial lymphadenopathy bacterial odynophagia & halitosis bacterial lasts longer
67
what is the commonest bacteria causing tonsillits
s. pyogenes
68
what are the complications of s. pyogenes tonsillits
rheumatic fever, glomerulonephritis
69
what are the infection control precautions for s. pyogenes tonsillits
SICPS+ contact +- droplet precautions
70
how to decide whether to give antibiotics for tonsillits
centor criteria
71
how to do the centor criteria
``` one point for: fever no cough tonsillar exudate tender anterior cervical LN <15yr - one point if >45yr ```
72
do you give antibiotics for a centor criteria score of 0-1
no
73
do you give antibiotics for a centor criteria score of 2-3
if symptoms progress
74
do you give antibiotics for a centor criteria score of 4-5
start empirical ABx
75
what antibiotics can be prescribed for tonsillitis
1st penicillin | 2nd clarithromycin
76
when is surgery indicated for tonsillitis
episodes prevent ADL + 5+ in past 2yr given ABx OR 3 in past 1yr given ABx
77
what is the commonest complication of tonsillitis
quinsy
78
what is quinsy
unilateral peritonsillar abscess
79
what is the presentation of quinsy
odynophagia, trismus, tonsil/uvula medial displacement
80
what is the management of quinsy
aspirate + ABx
81
what is the infecting organism in glandular fever aka infectious mononucleosis
epstein barr virus
82
what is seen on examination in glandular fever
enlarged tonsils + exudate, cervical lymphadenopathy, +- jaundice, +- rash, +- palatal petechiae, +- hepatosplenomegaly
83
what would the patient complain of in glandular fever
fever, sore throat, malaise
84
what is diagnostic of glandular fever
EBV IgM (not IgG since could have had childhood infection)
85
what investigations can be done for glandular fever
FBC, LFT, serology, blood film, Paul Bunnel, Monospot heterophile Ab, CRP
86
what is seen on a blood film in glandular fever
large atypical lymphocytes plus leukocytosis
87
what is the management of glandular fever
self limiting over 2-4weeks
88
what drug shouldn't be prescribed for glandular fever and why
amoxicillin causes macular rash
89
what is the management of glandular fever if its causing anaemia or tonsillitis
CCS
90
what are complications of glandular fever
anaemia, spleen rupture, lymphoma, thrombocytopaenia

Y2 ENT (12 decks)

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