Mouth, Throat, Nose, Sinus Disorders

These flashcards cover key concepts related to mouth and throat disorders, including clinical presentations, diagnostics, treatments, and specific conditions.

What are the “CENT” components of the CENTOR criteria?

absence of cough

exudate

anterior cervical lymphadenopathy

temperature

What do the results of the “CENT” components of the CENTOR criteria indicate?

2 or less: lower likelihood of GAS

3 or more: higher likelihood of GAS

What is the “OR” component of the CENTOR criteria?

3-14 y/o is more likely to have GAS

45+ y/o are less likely to have GAS

Generally, when is GAS testing indicated in children?

presence of tonsillopharyngitis without viral signs and symptoms

exposure to someone with GAS and has symptoms

What is the criteria for Tonsillectomy?

7 episodes in last year

5 episodes annually in last 2 years

3 episodes annually in last 3 years

What are the various types of cleft lip/palate disorders?

cleft lip alone

cleft lip with cleft palate

cleft palate alone

What is the concern with malocclusion of teeth?

mandibular injury

How is an avulsed tooth reimplanted?

hold crown of tooth

rinse tooth and socket with water or saline, then anesthetize with 1% lidocaine

replace tooth, should hear “click”

split or wire tooth in place

What is the most common genetic abnormality in head and neck cancer?

P53 tumor suppressor gene

What are concomitant disorders of allergic rhinosinusitis?

allergic conjunctivitis

sinusitis

asthma

atopic dermatitis

eustachian tube dysfunction

What are the types of allergy skin testing?

prick skin test

intradermal skin test

What allergy skin test is most commonly used?

prick skin test

What allergy skin test is most sensitive?

intradermal skin test

What is the Samter Triad?

immunologic salicylate sensitivity causes severe episode of bronchospasm

How do you remove a metal or magnetic nasal FB?

heavy duty magnet

How do you remove non-graspable objects?

right angle hook

currette

What are some indications that acute rhinosinusitis is bacterial instead of viral?

persistent symptoms (10+ days)

severe symptoms (high fever, etc)

worsening after initial improvement

What are strategies to promote antibiotic stewardship in URIs?

diagnose carefully

set clear expectations with patient

watchful waiting

recommend symptomatic relief

avoid “just in case” imaging

educate about resistance

What symptoms of acute rhinosinusitis require urgent imaging?

abnormal vision

periorbital edema or erythema

altered mental status or CN deficits

high fever with severe headache

neck stiffness

What are indications for ENT referral with acute rhinosinusitis?

no response after 2 antibiotic courses

recurrent or chronic sinusitis

severe infection

suspected fungal disease

anatomic obstruction

What are indications for ENT referral with chronic rhinosinusitis?

failure of max medical therapy

recurrent

nasal polyps or suspected fungal cause

unilateral or atypical

complications seen on CT

What is the atopic triad?

asthma

atopic dermatitis

allergic rhinitis

What are the symptoms of early phase allergic rhinitis?

sneezing, itching, and rhinorrhea from histamines

What are the symptoms of late phase allergic rhinitis?

congestion and mucosal swelling from cytokines

When should allergic rhinitis be referred?

unclear dx

poor symptom control

medication s/e

severe obstruction

unilateral or atypical

When should someone be admitted for epistaxis?

posterior epistaxis in elderly or hypertensive patients with uncontrolled bleeding

How should smooth nasal FBs be removed?

positive pressure (parent’s kiss or BVM)

How should visible nasal FBs be removed?

forceps

suction

balloon catheter

What is involved in anterior epistaxis?

Kiesselbach plexus

What is involved in posterior epistaxis?

Woodruff plexus

Sphenopalatine artery