ENT pics

Triad: pain/pressure of sinuses, headache, fever; also nasal congestion and purulent rhinorrhea, double sickening and sx persist longer than 7-10 days

acute bacterial rhinosinusitis (ABRS)

pressure over maxillary/frontal sinus, watery discharge, NO fever, sx improve within 7-10 days

acute viral rhinosinusitis (AVRS)

sinus mucosa chronically inflamed, persistent low grade infection with periodic flare ups, sx persist longer than 3 months, repeated sinus infections (>3x in 6 months)

Chronic sinusitis

severe bronchial asthma, nasal polyps, aspirin sensitivitiy, presents as chronic sinusitis

Samter’s Triad / AERD

pale, boggy inflamed lower turbinates; rhinorrhea, eye irritation, seasonal

allergic rhinitis

edematous, erythematous nasal mucosa or posterior oral pharynx; watery discharge / clear rhinorrhea, malaise, decreased sense of smell

viral rhinitis

common cause of clear rhinorrhea in elderly, increased sensitivity of vidian nerve

vasomotor rhinitis

c/o nasal obstruction; erythema, edema, clear rhinorrhea; hx of chronic decongestant nasal spray or cocaine use

rhinitis medicamentosa

What should you think of with purulent nasal discharge and double sickening?

bacterial rhinitis

pale, blue, edematous mass covered with mucosa

nasal polyps

from kiesselbach plexus

anterior epistaxis

from sphenopalatine artery

posterior epistaxis

vestibulitis

sx similar to bacterial sinusitis; facial pain is more severe; palate/nasal mucosa is black necrotic tissue; cranial neuropathies

rhinocerebral mucormycosis

hx of trauma, pain, epistaxis, pain, periorbital ecchymosis, edema, nasal obstruction

nasal fracture

blood accumulation between septal cartilage and mucoperichondrium

septal hematoma

saddle nose deformity

rare; asymptomatic at first but later may develop proptosis, pain/expansion of cheek, poorly fitting maxillary dentures

malignant nasopharyngeal & paranasal sinus tumor

unilateral nasal obstruction, hemorrhage, benign tumor on lateral nasal wall appears as cauliflower-like growth around middle meatus

inverted papilloma

Triad: necrotizing granulomas of airways, glomerulonephritis, disseminated vasculitis

wegeners (granulomatosis w/ polyangitis)

can’t be scraped off

oral leukoplakia

erythroplakia

Wickham striae, painful

oral lichen planus

squamous cell carcinoma

can be scraped off; painful

oral candidiasis

angular cheilitis

glossitis

torus mandibularis

torus palatinus

pus, painful

dental abscess

what we will all probably get bc stress <3

necrotizing ulcerative gingivitis

yellow-gray center surrounded by red halo; painful

aphthous ulcer

burning, stinging, small grouped vesicles

herpetic stomatitis

fever > 38C; tender anterior cervical adenopathy; lack of cough; pharyngotonsillar exudate; along with sandpaper-like rash

Group A Beta Hemolytic Strep (GABHS)

prominent adenopathy, white to purple tonsillar exudate, malaise, fever, rash, and splenomegaly in young adult patient

mononucleosis

severe odynophagia, trismus, uvula deviation, hot potato

peritonsillar abscess / quinsy

follows suppurative URI, posterior pharynx swelling, sore throat, fever, neck stiffness, stridor, drooling

retropharyngeal abscess

inflammation of salivary gland; pain & edema with/after meals

sialadenitis

calculus formation in salivary duct; postprandial pain, local swelling

sialolithiasis

abnormal vibration of vocal folds

hoarseness

high pitched, inspiratory sound, turbulent airflow from narrowed glottis

stridor

vocal cord nodules / polyps

most common cause of hoarseness, difficulty talking, cough, odynophagia

laryngitis

thumb print

epiglottitis / supraglottitis

edema/erythema of upper neck under chin and floor of mouth, hot potato voice, cellulitis

Ludwig angina

most common laryngeal malignancy; voice change most common complaint

Squamous cell carcinoma

angioedema

cauliflower ear, canal blockage

auricular trauma

fluctuant bluish swelling anterior superior auricle, blunt trauma

auricular hematoma

perichondritis

cerumen impaction

otitis externa

malignant otitis externa

foreign body

TM retraction and decreased mobility

Eustachian tube dysfunction

caused changes in pressure (underwater diving)

otic barotrauma

red, bulging, dec mobility, fluid behind TM

acute otitis media

dull, hypermobile

serous otitis media

tympanostomy tube

tympanosclerosis

chronic suppurative otitis media

TM drawn inward, sac lined with squamous epithelium

cholesteatoma

bullous myringitis

mastoiditis

TM perforation

hemotympanum

battle sign

ramsey hunt / herpes zoster oitcus

perception of abnormal ear or head noise; mid high pitches buzzing

tinnitus

sensation of motion

vertigo

sudden onset sensation of motion, N/V, tinnitus, horizontal nystagmus

peripheral vestibulopathy

gradual progression of sensation of movement, vertical nystagmus, TIA or CVA

central origin vestibulopathy

short episodes of vertigo brought on by sudden head movements

Benign Paroxysmal Positional Vertigo (BPPV)

tetrad: vertigo, hearing loss, tinnitus, aural pressure

Menieres disease / endolymphatic hydrops

vertigo, hearing loss, often after viral URI; inflammation of inner ear structure

labryinthitis

vertigo w/o hearing loss, spontaneous horizontal nystagmus; acute vestibular nerve inflammation w/o cochlear involvement

vestibular neuritis / neuropathy

constant positional vertigo + severe nausea with tinnitus; cerebellopontine angle

vascular compression of vestibular nerve

noncancerous slow growing tumor on branch of CN VIII; asymmetric or unilateral hearing loss, tinnitus, vague vertigo

acoustic neuroma / vestibular schwannoma

what kind of hearing loss would this cause?

conductive hearing loss

What kind of hearing loss would hair cell loss from organ of Corti cause?

sensory hearing loss

What kind of hearing cause would acoustic neuroma, MS, auditory neuropathy cause?

neural hearing loss

what kind of hearing loss would side effects from a medication cause?

ototoxic hearing loss

what kind of sleep apnea would this cause?

obstructive sleep apnea (OSA)

What kind of sleep apnea is characterized by brain failure to transmit appropriate signals to muscles?

central sleep apnea (CSA)

pain exacerbated by chewing or bruxism, clicking when opening/closing mouth, headaches, ear pain

TMJ syndrome

carbuncle

common soft tissue infection in children; fever, localized swelling and redness on lymph node; localized pain

suppurative lymphadenitis

mass doesn’t move with swallowing

branchial cleft cyst

moves with swallowing and tongue protrusion

thyroglossal duct cyst

most common neck mass at any age

reactive lymphadenopathy

granulomatous neck masses, single or matted nodes; could be painful or painless; may not respond to abx

infectious lymphadenitis

benign soft tissue neoplasm, adipose cells, asymptomatic

lipoma

tumor of CNS; most common solitary neurogenic tumor of neck, slow growing sheath tumor

schwannoma

group of genetic disorders that cause tumors to form on nerve tissue; can develop anywhere in nervous system; usually benign but can sometimes become malignant

neurofibromatosis (NF)

lisch nodules (NF)

plexiform neurofibroma

cafe au lait spots (NF)

positive Fontaine’s sign

carotid body tumor

can be due to benign adenomatous hyperplasia, graves disease, iodine deficiency

goiter

reed-sternberg cell present; painless swelling of lymph nodes, fever, chills, weight loss, anorexia, pruritus

hodgkin lymphoma