Throat McQ points BY Dr. MASOOM HAIDER
Adenoids
1 physiological enlargement of adenoids upto 6 year disappear by age of 20
2 chronic maxillary sinusitis is associated with adenoids
3 on MRI adenoids disappear by age of 15 years
4 viruses causing acute nasopharyngitis are
-Influenza
-Parainfluenza
-Streptococcus
-Pneumococcus
-Haemophilus influenza
5 chronic nasopharyngitis seen in smokers drinkers and those exposed to dust
6 fluctuating swelling in midline seen in phyrangeal bursitis
Acute and chronic tonsilitis
1 most common cause of acute tonsilitis is heamolytic streptococcus
2 acute catarrhal tonsilitis occur after viral infection
3 antimicrobial therapy is given for 7-10 days in acute tonsilitis
4 Paul bunnel test is done in infectious mononucleosis
5 incubation period of diphtheria is 2-6 days
6 flushing of anterior pillar compared to rest of phyrangeal mucosa is important sign of chronic tonsilitis
7 in tonsillolith Ca mg salt are deposit
Tonsillectomy chp 94
1 tonslectomy not done In child less than 3 year hb less than 10 and epidemic of polio
2 patient who can’t bear general Anastasia undergoes laser tonslectomy
3 ktp512 and CO2 laser is used in tonslectomy
4 tonslectomy is done in rose position
5 ultrasound are used in harmonic scalpel
6 protons are used in plasma mediated ablation technique
7 reactionary hemorrhage occur 24 h after
8 after tonslectomy lid edema can occur
9 secondary hemorrhage occur 5-10 day after
10 plica triangularis should be removed during tonslectomy
Tumor of Nasopharynx
1 most common bengin tumor is Angiofibroma
2 Angiofibroma is non capsulated
3 angiofibroma affect make 10-20 year
4 frog face deformity is due to orbit involvement of Angiofibroma
5 Angiofibroma appears purple or pink
6 investigation of choice of Angiofibroma is CT with contrast
7 anterior bowing of posterior wall of maxillary sinus is called Holman miller sign
8 resection of tumor done 24-48 hr after embolization
9 Zenker diverticulum occurs after 60 years of age
10 in dholman procedure diathermy is done
Head and neck space infection
1 cause of quinsy are s pyogene ans s aureus
2 quinsy is mostly unilateral
3 fever in Quincy is 104F
4 head is tilted to side of abcess but uvula is pushed to opposite side in quinsy
5 earache in quinsy is due to involvement of glossopharyngeal nerve
6 lymph nodes involved are juglodigastric
7 analgesic in quinsy is pathedine
8 interval tonslectomy done after 4-6 week of quinsy
9 most common cause of parotid abcess is s aureus
10 clinical feature appear 5-7 days after operation
11 acute retroperitoneal abcess occur in children below 3 year
12 incision drainage of retrophyrangeal abscess is usually not done under GA
13 tb cause retrophyrangeal abscess not in midline
14 cares of spine produce abcess in midline
15 last lower molar teeth infection cause paraphyrangeal abcess
16 swelling behind angle of jaw is seen in paraphyrangeal abcess
17 antibiotics used in paraphyrangeal abcess are imipenum and meropenum
Lyranx inflammation
- Bacteria causing acute lyringitis are.
-Heamophlis influenza
-Streptococcus pneumoniae
-Hemolytic streptococcus - in early stages of lyringitis vocal cords are nearly normal and white
- submucosal hemorrhage seen in vocal abuse
- acute lyringitis is viral in origin
- Most important factor in treatment of lyringitis is voice rest
- if there is chemical or thermal burn in lyrnx steroids used
- Most common cause of acute epiglottitis is Hinfluenza B
- Age of child in acute epiglottitis is 2-7 Year
- Acute epiglottitis has rapid progression
- Lateral soft tissue X ray in epiglottitis shows thumb sign
- Acute lyringotraxheobronchtis is more common than acute epiglottitis
- Thick tenacious secretions and crust seen in acute lyringotraxheobronchtis
- Steeple sign seen in acute lyringotraxheobronchtis on AP view
- Adrenaline is given in acute lyringotraxheobronchtis
- Acute lyringotraxheobronchtis affect child of 6month to 3 years
- Toxic look tachycardia bull neck
- Thready pulse seen in lyringeal diphtheria
- lyringeal diphtheria is insidious in onset
- edema of lyrnx mostly affect supraglottic and subglottic part
- bed rest in diphtheria is 2-4 week
- TB affect posterior part of lyrnx
- weakness of voice is earliest symptom of Lyrnx TB
- mouse nibble appearance and turban epiglottitis seen in TB lyrnx
- Lupus of lyrnx is painless and affect anterior part of lyrnx
- Smooth swelling later ulcerated in syphilis lyrnx
- stenosis of lyrnx is complications of syphilis
- Diffuse nodular infiltration of epiglottis is seen in leprosy
- lyringitis sicca affect women mostly
- ammonium chloride is used in lyringitis sicca
- reinkes edema mainly affect middle age
- In myxedema reinkes edema seen
- Vocal cords are like fusiform swelling and pale translucent look in reinkes edema
- smooth red swelling in subglottic region seen in scleroma lyrnx
- Lyrangeal mycosis is rare
- commonest symptoms of chronic lyringitis is hoarseness of voice
- vocal cords appear dull red and vicid mucous seen on them in chronic lyringitis
- Hyperplastic lyringitis affect mostly make of 30-50
- dusky red mucosa and nodular vocal cords in hyperplastic lyringitis 38 pachyderma lyringitis affect
posterior part of lyrnx - grey granulation tissue seen in pachyderma lyringitis
- contact ulcer formed in pachyderma lyringitis
Tracheostomy
1 if IPPR is needed beyond 72 hrs tracheostomy is done - In lyringofissure elective tracheostomy is done
3 only indication of high tracheostomy is lyrnx cancer
4 To suppress cough reflexes 4% lignocaine is used
5 as a anasthesia 1-2% lignocaine is used
6 mid tracheostomy done at 2/3 Ring - To prevent crusting hypotonic saline and ringer lactate every 2-3 hr used
8 outer canula removed after 3 days
9 for decanulation tube is plugged for 24hr - Most rapid method of airway management is endotracheal intubation
11 method not done in obese but done in ICU is percutaneous tracheostomy
12 method best till patient tracheostmised is mini tracheostomy
13 method not done in spinal injury is jaw thrust
14 method best in awake patient is nasopharyngeal airway or trumpet
Acute and chronic phyrigitis- mostly phyrigitis is caused by virus
- asymptomatic phyrigitis is gonococcal phyrigitis
- in moderate phyrigitis tonsil enlargement
- in severe case of phyrigitis cervical lymph nodes involved
- in case of viral pharyngitis hoarseness of voice and rhinorrhea present wheras bacterial are severe
- herpangina affect children and caused by cocksaki A virus
- exudative phyrigitis with splenomegaly in infection mononucleosis
- lignocaine can be used in severe phyrigitis
- White yellow solid nodule on posterior phyrangeal wall in lymphonodular phyrigitis
- Koplik spot appears 3-4 days before rash
- DOC of fungal pharyngitis is Nystatin
- Pain of chronic phyrigitis is usually during morning
- sliver nitrate used in cautery of lymphoid granules
- elongated uvula reddish nodule are seen in chronic granular phyrigitis
- KI is used in atrophic phyrigitis
Tumors of Oral cavity
1 mucocele is bluish and on lower lip
2 ranula arise from obstruction of ducts of sublingual gland
3 it is white mass shines through mucoussa “ Dermoid”
4 site of leukoplakia in India is buccal mucosa
5 leukoplakia affect 4 decade- Malignant potential of erythroplakia is 17 times more than leukoplakia
7 papiloma affect 3-4 decade
8 fibroma is caused by chronic irritation - Heamangioma affect mostly children
10 treatment of heamangioma is microembolization
11 lymphangioma cause macroglossia
12 torus are formed mostly on palate
13 caused by chronic irritation or trauma bleed on touch is Pyogenic granuloma
14 pregnancy granoloma arise in ist trimester
15 myoblastoma arise from Schwan cell
16 myoblastoma affect tongue
17 most common neoplasia of minor salivary glands is pleomorphic adenomas
18 fibrous tumor is most common in pleura
19 fibrous tumor arise from mesenchyme
20 Frey’s syndrome is a complications of parotid surgery
21 botulinum toxin can be used in Frey syndrome
ENT McQ points by Masoom haider - Congenital lesion of lyrnx
1 most common congenital lesion of lyrnx is lyringomalacia
2 treatment of severe lyringomalacia is supraglotoplasty
3 lyringomalacia reselves age of 2 year
4 stridor increase on crying and subsides on lying in prone in lyringomalacia
5 lesion of lyrnx due to birth trauma is vocal cords paralysis - Subglottic stenosis affect cricoid cartilage and area below vocal cords
- Weak cry in lyringeal web
8 subglottic heamangioma cry is normal - Bluish fluid filled smooth swelling on lyrinx is lyrabgeal cyst
10 inspiratory stridor due to supraglottic obstruction
11 biphasic strider due to glottic obstruction - Omega shape epiglottitis in lyringomalacia
13 posterior concave margin of epiglottitis in lyringeal web
14 stridor is a physical sign not a disease
15 in congenital lesion of lyrnx strider is gradual and prolonged
16 gurgling cause is phyrangeal
17 snoring cause is nasopharyngeal
18 wheez cause is bronchial obstruction
19 hoarse cry cause lies at vocal cords - Flexible fiberoptic lyringoscopy done under topical anesthetiC
Reference: Dhingra (latest edition)
Compiled by Dr. Masoom Haider