Unit 3 - Conditions of the Oropharynx, Mouth, and Nasal Regions Exam Review

Vertigo

Patient experiences a false sense of motion

Bridge

ID A

Columella

ID B

Anterior naris (nostril)

ID C

Ala nasi

ID D

Nasal polyp

Benign mucosal covered mass

- Allergic rhinitis associated

Diagnosis?

- Nasal corticosteroids, oral as well

- Endoscopic removal surgery

Nasal polyp treatment?

Deviated septum

Diagnosis?

Trauma, developmental

A deviated septum results from _____ or is _____

Surgery to straighten to clear the airway if obstructive

Deviated septum treatment?

Bacterial Rhinosinusitis Acute

- Bacterial infection of one or more of the paranasal sinuses

- Accumulation of mucus in the sinus cavity that becomes infected

- Yellow-green discharge

- Facial pain over sinuses

- Nasal obstruction

- Cough

- Fever

- Malaise

State symptoms of Bacterial Rhinosinusitis Acute

- NSAIDS, antihistamines, nasal spray

- Antibiotics if persists beyond 10 days

- Endoscopy if persists beyond 12 weeks

- Otolaryngologist referral due to intracranial extension

Bacterial Rhinosinusitis Acute treatment?

Allergic rhinitis

Diagnosis?

- Clear rhinorrhea

- Sneezing

- Tearing/itching eyes

- Blue gray turbinates

- Cough

- Dermatitis

- Environmental allergen

- 20-30% of adults in US

Symptoms of allergic rhinitis

- Intra nasal corticosteroids

- Sinus drainage massage

- Adjustment

Allergic rhinitis treatment?

Acute allergic rhinitis

Your patient has clear rhinorrhea, sneezing, tearing, itching, blue gray turbinates. What is the diagnosis?

- Nasal polyp

- Rhinosinusitis

- Deviated septum

- Acute allergic rhinitis

Epistaxis

Which of the following describes as a nose bleed?

- Fordyce spots

- Epstein Pearls

- Epistaxis

- Xerostomia

Cerumen

What is the term for earwax secreted by the apocrine glands in the distal third of the ear canal; provides an acidic pH environment that inhibits the growth of microorganisms?

- Fordyce spots

- Epstein Pearls

- Epistaxis

- Cerumen

Epstein Pearls

Which is described as small whitish-yellow masses at the juncture between the hard and soft palate?

- Fordyce spots

- Epstein Pearls

- Epistaxis

- Xerostomia

Cocaine

Mr. Sprat is a 21-year-old patient who complains of nasal congestion. He admits to using recreational drugs. On examination, you have noted a septal perforation. Which of the following recreational drugs is commonly associated with nasal septum perforation?

- Heroin

- Cocaine

- PCP

- Ecstasy

Torus Palatinus

Diagnosis?

Koplik Spots

Diagnosis?

Fordyce Spots

Diagnosis?

Diphtheria

Diagnosis?

- Most children are vaccinated against this

Thrush on the palate (candidiasis)

This patient is immunocompromised and has been on antibiotics recently. He is on corticosteroids frequently. Diagnosis?

Kaposi sarcoma in AIDS

This is a low grade vascular tumor associated with AIDS

Acute bacterial pharyngitis

- Infection of tonsils or posterior pharynx by microorganisms (Group A Beta hemolytic strep Neisseria)

- Symptoms: Sore throat, dysphagia, fever, malaise, decreased appetite

- Tonsil crypt filled with exudate, lymph node enlargement

- Antibiotics

- Culture to ID pathogen

Acute bacterial pharyngitis treatment?

Peritonsillar abscess

- Deep infection in the space between the palatine capsule and pharyngeal muscles

- Complication of adenotonsilitis or blockage of salivary glands

- Polymicrobial common A beta-hemolytic strep

- Subjective: severe sore throat, dysphagia, drooling, fever, malaise

- Antibiotics

- Culture to ID

Peritonsillar abscess treatment

Retropharyngeal abscess

- A life-threatening deep neck space infection that has the potential to occlude the airway

- More common in boys, highest incidence is children under 5

- Strep A, Staph aureus

- Predisposing factors tonsillitis, pharyngitis, dental infection

- Acute illness

- High fever

- Malaise

- Anorexia

- Respiratory distress

Retropharyngeal abscess symptoms

- Antibiotics

- Maintain airway

Retropharyngeal abscess treatment?

Diphtheria

This patient is a 10 year old unvaccinated amish child with sore red throat, there is a gray red exudate as shown in the photo. The airway may become obstructed, so this is a life threatening bacterial infection. What is the diagnosis?

- Rubeola

- Kaposi's Sarcoma

- Diphtheria

- Thrush

Angular Cheilitis - with candida at angles of mouth

Diagnosis?

Actinic Cheilitis - precancerous sun exposure

Diagnosis?

Herpes Simplex - new vesicular and older yellow brown lesions

Diagnosis?

Angioedema - allergic and NSAID. Self limiting unless in the larynx, tongue, upper airways (life threatening)

Diagnosis?

Telangiectasia

Diagnosis?

Peutz-Jehers Syndrome

Diagnosis?

Primary Syphilis

Diagnosis?

Carcinoma of the lip

Diagnosis?

Candidiasis

This patient has been diagnosed with an autoimmune disease and has been on antibiotics of a severe tooth infection recently prior to the onset of this white accumulation on the oral pharynx. It can be scraped off but returns quickly. What is the diagnosis of the oral pharynx?

- Acute bacterial pharyngitis

- Retropharyngeal abscess

- Candidiasis

- Peritonsillar abscess

Vertigo

Which condition results in a false sense of motion, as though the surroundings are moving, there is an acute onset of the room spinning with imbalance and ataxia, and nystagmus.

- Vertigo

- Presyncope

- Peripheral Neuropathy

- Panic Disorder

- CN XII lesion

- Asymmetric protrusion suggests a lesion of CN XII (tongue points toward the side of the lesion)

Diagnosis?

Varicose veins

Diagnosis?

None

Varicose veins clinical significance

Leukoplakia

Diagnosis?

Raises the possibility of squamous cell carcinoma

Leukoplakia clinical significance

Carcinoma of the floor of the mouth

Diagnosis?

Canker sore

Diagnosis?

Mucous patch of syphilis

Diagnosis?

Tori Mandibularis

Diagnosis?

Geographic tongue: benign

Diagnosis?

Black hairy tongue

Diagnosis?

Fissured tongue

Diagnosis?

Geriatric

Fissured tongue is common in _____ patients

Smooth glossitis

Diagnosis?

Hairy leukoplakia

Diagnosis?

Oral cancer

- Cancer involving the oral cavity or related structures

Diagnosis?

Referral to oncology/EENT

Oral cancer recommendations?

Squamous cell

_____ is the most common form of oral cancer

Basal layer, oral mucosa

Oral cancer originates in the _____ or _____

Periodontitis disease

- Chronic infection of the gums, bones, and other tissues that support and surround the teeth

- Plaque builds up

- Gums swell

- Bone loss

- Bleeding gums

- Swollen puffy gums

Periodontitis disease signs

Dental appointment

Periodontitis disease treatment

- Attrition of teeth

- Recession of gums

Diagnosis?

Erosion of teeth

Diagnosis?

Abrasion of teeth with notching

Diagnosis?

Hutchinson teeth in congenital syphilis

Diagnosis?

Malocclusion

- Rotated teeth molars aligned

- Lower molars are distally positioned

- Lower molars medially positioned

Orthodontics

Malocclusion treatment

Cleft palate and lip

- Failure of the palate to close prior to 12th week

- 1/1000 births incidence

- Seen in genetic conditions

- Mothers use of alcohol, anticonvulsants

- Diabetes, folate deficiency, smoking

Cranio facial surgery

Cleft palate and lip treatment

Labyrinthitis

Which condition below has a hearing loss as part of the clinical presentation?

- Vertigo from BPPV

- Labyrinthitis

- Vestibular neuritis

- All have hearing loss