Comprehensive: ENT

Leukoplakia vs. Oral candidiasis

Leukoplakia CANNOT be scraped off

Testing that should be done for leukoplakia

Biopsy to r/o SCC

Leukoplakia vs. Lichen planus

Lichen planus affects BILATERALLY & is painful

Tx for lichen planus

Corticosteroids

90% of oral cancers are

SCC

Oral cancer are associated with HPV ____

16 & 18

1st line Tx for oral candidiasis

Nystatin (or clotrimazole)

2nd line Tx for oral candidiasis

Oral fluconazole

Is oral candidiasis painful?

Yes

Angular chelitis/stomatitis can be seen with what nutritional deficiencies

Vit B (Riboflavin)

Inflammation of tongue, red smooth surface, loss of papillae

Glossitis

Benign bony exocytosis on the midline hard palate

Torus palatinus

Benign bony exocytosis on the floor of mouth

Torus mandibularis

1st line tx for dental abscess

Pen V K, Clinda, Erythromycin

2nd line tx for dental abscess

Augmentin

Aphthous ulcer could be HHV ___

6

Round with yellow-gray center and red halo, painful

Aphthous ulcer

Tx of herpetic stomatitis

Acyclovir, Famicyclovir, Valacyclovir

Tx of GABHS for PCN allergic

ACE: Azithromycin, Clindamycin, Erythromycin

Oral Tx of GABHS

PCN V, Amoxicillin, Cephalexin

Tx of GABHS

PCN IM

Scarlatiniform rash

Scarlet fever (GABHS)

Most frequently occurring deep space infection of the head and neck

Peritonsillar abscess

Peritonsillar abscess causes ______ deviation of the soft palate

Medial

If a peritonsillar abscess is on the left, how does the uvula deviate

To the right

Imaging for peritonsillar abscess

CT

Retropharyngeal abscess will usually follow a ______

Suppurative URI

A retropharyngeal abscess will cause _____ tenderness

Hyoid

Imaging for retropharyngeal abscess

Lateral XR

Grading of tonsils: Removed

0

Grading of tonsils: Tonsils hidden within tonsil pillars

1

Grading of tonsils: Tonsils extending to the pillars

2

Grading of tonsils: Tonsils beyond pillars

3

Grading of tonsils: Tonsils extend to midline

4

A mono test will not show positive results until after day ____ of symptoms

5

Patients with mono should avoid contact sports/strain for ______ weeks

3

Avoid prescribing _______ in a patient with mono due to rash

Ampicillin/Penicillin

Inflammation of salivary gland

Sialadenitis

Calculus formation in salivary ducts

Sialolithiasis

Tx for sialadenitis

IV Abx then PO x 10 days

What salivary duct is sialolithiasis more common in?

Wharton's

________ stones are usually large and radiopaque

Wharton's

________ stones are usually small and radiolucent

Stensen's

Tx for vocal cord nodule/polyp

Inhaled corticosteroid

MCC of hoarseness

Laryngitis

Laryngitis typically occurs 1 week after a _______

URI

Lateral neck XR shows thumbprint sign

Epiglottitis

Tx for epiglottitis

IV 3rd gen cephalosporin Abx + Corticosteroids

Ludwig's angina displaces the tongue ____

Up and back

Imaging for Ludwig's angina

CT with contrast

Neck space infection, usually from dental infection spreading the submandibular space

Ludwig's angina

Tx for Ludwig's angina

IV Abx (Vanco, Clinda, Zosyn) & I&D submental incisions

Most common laryngeal malignancy

SCC

Laryngeal cancer may be associated with HPV _____

16 & 18

80% of salivary gland tumors

Parotid tumors

"Woody mouth"

Ludwig's angina

NOT midline, massaging produces foul taste, does NOT move with swallowing

a. Brachial cleft cyst

b. Thyroglossal duct cyst

Brachial cleft cyst

Midline, MOVES with swallowing, tongue protrussion

a. Brachial cleft cyst

b. Thyroglossal duct cyst

Thyroglossal duct cyst

Most common neck mass at any age

Reactive lymphadenopathy

Most sensitive imaging of lipoma

MRI

Slow growing neural sheath tumor, most common solitary neurogenic tumor of neck

Schwannoma

Freely horizontally moving rather than vertically as it is attached to carotid artery

Fontaine's sign

Fontaine's sign

Carotid body tumor

Inflammation of auricular cartilage

Perichondritis

Tx for perichondritis

FQs, corticosteroids

______ causes flop ear or saddle nose deformity

Relapsing polychondritis

Tx for cerumen impaction

3% H2O2, Debrox OTC

Swimmer's ear

Otitis externa

Tx for otitis externa

Ciprodex (or ofloxacin)

MCC of malignant otitis externa

Pseudomonas

Tx for malignant otitis externa

IV Cipro

Pt complains of "fullness" in ear and yawning/swallowing creates pop/crackle sound. On exam, TM is retracted and hypomobile. Dx?

Eustachian tube dysfunction

Otitis media or Otitis externa: Follows URI by 1-7 days

Otitis media

Otitis media or Otitis externa:
6-24 month old most common

Otitis media

Tx for otitis media

Amoxicillin

Tx for cholesteatoma

Complete sac removal

Epitympanic retraction pocket

Cholesteatoma

Tx for bullous myringitis

Pain meds & amoxicillin (same as AOM)

Mastoiditis is a complication of inadequately treated _____

Otitis media

Imaging for mastoiditis

CT scan without contrast

Tx for mastoiditis

IV Abx (ceftriaxone)

What drops can be used for TM perforations?

Ciprodex & Ofloxacin

Tx for BPPV

Epley maneuver

Nystagmus with Dix-Hallpike

BPPV

MCC of vertigo due to head trauma

Labyrinthine concussion

Most common intracranial tumor

Acoustic neuroma

Age related high frequency hearing loss

Presbycusis

Does a cerumen impaction cause sensory or conductive hearing loss?

Conductive hearing loss

What type of hearing loss:

Rinne: BC > AC in affected ear, AC > BC in unaffected ear

Weber: Lateralizes to affected ear

Conductive hearing loss

What type of hearing loss:

Rinne: AC > BC in both ears

Weber: Lateralizes to unaffected ear, away from affected ear

Sensorineural hearing loss

What type of hearing loss:

Rinne: BC > AC in affected ear, AC > BC in unaffected ear

Weber: Lateralizes to unaffected ear

Mixed hearing loss

Tx of bacterial rhinosinusitis

Augmentin

Most cases of rhinosinusitis are viral, but you may begin to think bacterial if symptoms have been for _______

> 10 days

What sinus is most affected during acute rhinosinusitis?

Maxillary sinus

Classification of chronic sinusitis

Constant symptoms for > 3 months (12 wks) OR > 3 infections in 6 months

Samter's triad

- Severe bronchial asthma
- Nasal polyps
- ASA sensitivity

Patients with nasal polyps and asthma are advised to avoid _____

ASA/NSAIDs

Afrin nasal spray/pseudoephedrine should only be used for ______ due to rebound rhinitis

< 3 days

Common cause of clear rhinorrhea in elderly due to vidian nerve sensitivity (hot to cold airs)

Vasomotor rhinitis

Pale/blue edematous masses covered with mucosa

Nasal polyps