يارب الكل يجاوب ان شاء الله 🤍
نلتقي بالباطنية اذا استمر الواهس👍🏻✅
نلتقي بالباطنية اذا استمر الواهس👍🏻✅
💯3👍1😭1
Study room 808
شباب اهنا اني اعرفه هنه 3 زواجه
الجواب 7طلع نشكر زميلتنا
Forwarded from Time to Study 🌿
Acute and chronic laryngitis الدكتور كال عليهم مهمات واللي اني شفتهم مهمات 🤝
1-Acute non-specific laryngitis
(Acute simple laryngitis in adults) 👩
Perichondritis may follow the purulent form. The causal organism is usually the haemolytic streptococcus.mcq
………………………
Acute simple laryngitis in children
Acute laryngitis is a more serious condition in children than in adults. Cause The lymphatic drainage of the larynx is richer in the child and the submucosa is therefore more likely to swell.
A laryngeal spasm (‘false croup’) develops suddenly.
Laryngitis stridulosa ’ is the name given to the condition when stridor is present.
Tracheostomy is indicated when the obstruction is severe. It is better done the too early than too late.
………………………………
Acute laryngbtracheobronchitis(croup)
Causative organism .is usually parainfluenza virustype 1.mcq
Tenacious exudation and crusting. Characteristic,
Diphtheria which can be distinguished by bacteriological examination and there is no bleeding when the crust are
removed in cases of acute laryngotracheobronchitis
Should be in hospital. Tracheostomy may be needed.
…………………
Acute epiglottis
Localized oedema may obstruct the airway, especially in children. H. influenza is the usual causal organism, (mcq)B Haemolytic streptococci rarely. Submucosal abscesses may form
Dyspnoea maybe progressive and alarming, especially in children, in whom death may occur within a few hours of onset.
Constant supervision in hospital, when stridor is present
Endotracheal intubation. May prove extremely difficult.
Tracheostomy may become urgently necessary specially in, children.
…………………………
Chronic non-specific laryngitis
Myositis occurs in the intrinsic muscles.
Excessive(mcq) viscid secretions result from increased activity of the mucous glands.
The hyperaemic and oedematous stage often passes to >>a granular hypertrophic one, rarely to an atrophic one.
Soreness in the throat is a common complaint.
حمره جبيره مورمه
Laryngeal appearances
There are three types of chronic simple laryngitis:
1. Hyperaemic In severe cases the cords are deep red in colour and appear rounded and ‘sausage- like’(mcq)
2. Hypertrophic
3. Oedematous
In all types the larynx is nearly always affected bilaterally and symmetrically.
Tx:Elimination of irritating factors such as dust and tobacco smoking
Carbocisteine ( a mucolytic ) may give symptomatic benefit
Stripping of the vocal cord is performed endoscopically in resistant cases of chronic edematous laryngitis
…………………
Atrophic laryngitis (laryngitis sicca)
Uncommon
Hoarseness and irritation in the throat both of which are improved temporarily by hawking and coughing up the crusts.
Dyspnea may be caused by large obstructing crusts.
Treatment
Eradication of associated lesions in the nose and paranasal sinuses.
Change of atmospheric conditions may be beneficial.
Removal of crusts will afford some local relief.
This is aided by:
1. Inhalations of menthol, or oil of pine.
2. Carbocisteine by mouth.
3. laryngeal spray such as Benadryl or sodium bicarbonate
4. hormonal local application of hormone in oil with uncertain result
………………………………
Tuberculous laryngitis
Most infections are Sputogenic, a few are hematogenous and very small number with lymph streamاكثره عن طريق البلغم
Progress of the disease leads to masses of granulation tissue and also to cellular swelling (a pseudo-oedema) Lesions are
usually asymmetrical, except With interarytenmd granulations and the turban-like pseudo-oedema which involves the
epiglottis, 'aryepiglottic folds, arytenoids, and ventricular bands.
The posterior half of the larynx is most frequently involved,(mcq) but often one whole cord may be affected or the epiglottis,or the mucosa of the ventricle.
At a later stage there is perichondritis and cartilage necrosis.
psudoedema of the epiglottis and arytenoids ( turban larynx ) of pale susage like appearance
1-Acute non-specific laryngitis
(Acute simple laryngitis in adults) 👩
Perichondritis may follow the purulent form. The causal organism is usually the haemolytic streptococcus.mcq
………………………
Acute simple laryngitis in children
Acute laryngitis is a more serious condition in children than in adults. Cause The lymphatic drainage of the larynx is richer in the child and the submucosa is therefore more likely to swell.
A laryngeal spasm (‘false croup’) develops suddenly.
Laryngitis stridulosa ’ is the name given to the condition when stridor is present.
Tracheostomy is indicated when the obstruction is severe. It is better done the too early than too late.
………………………………
Acute laryngbtracheobronchitis(croup)
Causative organism .is usually parainfluenza virustype 1.mcq
Tenacious exudation and crusting. Characteristic,
Diphtheria which can be distinguished by bacteriological examination and there is no bleeding when the crust are
removed in cases of acute laryngotracheobronchitis
Should be in hospital. Tracheostomy may be needed.
…………………
Acute epiglottis
Localized oedema may obstruct the airway, especially in children. H. influenza is the usual causal organism, (mcq)B Haemolytic streptococci rarely. Submucosal abscesses may form
Dyspnoea maybe progressive and alarming, especially in children, in whom death may occur within a few hours of onset.
Constant supervision in hospital, when stridor is present
Endotracheal intubation. May prove extremely difficult.
Tracheostomy may become urgently necessary specially in, children.
…………………………
Chronic non-specific laryngitis
Myositis occurs in the intrinsic muscles.
Excessive(mcq) viscid secretions result from increased activity of the mucous glands.
The hyperaemic and oedematous stage often passes to >>a granular hypertrophic one, rarely to an atrophic one.
Soreness in the throat is a common complaint.
حمره جبيره مورمه
Laryngeal appearances
There are three types of chronic simple laryngitis:
1. Hyperaemic In severe cases the cords are deep red in colour and appear rounded and ‘sausage- like’(mcq)
2. Hypertrophic
3. Oedematous
In all types the larynx is nearly always affected bilaterally and symmetrically.
Tx:Elimination of irritating factors such as dust and tobacco smoking
Carbocisteine ( a mucolytic ) may give symptomatic benefit
Stripping of the vocal cord is performed endoscopically in resistant cases of chronic edematous laryngitis
…………………
Atrophic laryngitis (laryngitis sicca)
Uncommon
Hoarseness and irritation in the throat both of which are improved temporarily by hawking and coughing up the crusts.
Dyspnea may be caused by large obstructing crusts.
Treatment
Eradication of associated lesions in the nose and paranasal sinuses.
Change of atmospheric conditions may be beneficial.
Removal of crusts will afford some local relief.
This is aided by:
1. Inhalations of menthol, or oil of pine.
2. Carbocisteine by mouth.
3. laryngeal spray such as Benadryl or sodium bicarbonate
4. hormonal local application of hormone in oil with uncertain result
………………………………
Tuberculous laryngitis
Most infections are Sputogenic, a few are hematogenous and very small number with lymph streamاكثره عن طريق البلغم
Progress of the disease leads to masses of granulation tissue and also to cellular swelling (a pseudo-oedema) Lesions are
usually asymmetrical, except With interarytenmd granulations and the turban-like pseudo-oedema which involves the
epiglottis, 'aryepiglottic folds, arytenoids, and ventricular bands.
The posterior half of the larynx is most frequently involved,(mcq) but often one whole cord may be affected or the epiglottis,or the mucosa of the ventricle.
At a later stage there is perichondritis and cartilage necrosis.
psudoedema of the epiglottis and arytenoids ( turban larynx ) of pale susage like appearance
Time to Study 🌿
Photo
ركز اهنآ غلطانين
الاختيار الأول هو صح
الاختيار الأول هو صح
Forwarded from Time to Study 🌿
Allergic rhinitis
This allergic conjunctivitis occurs in about 60% of those with AR and is the symptom that most reliably differentiates AR from other types of rhinitis.
Topical steroid sprays and drops are now considered to be the cornerstone in the treatment of rhinitis.
↪️Crusting and bleeding are the main side effects.
↪️ safe to use long term in most patients.
↪️Examples include fluticasone, mometasone sprays.
Leukotriene receptor antagonists appear to have an additive effect to intranasal corticosteroids in controlling seasonal AR, particularly in patients with asthma.
Surgical treatment in form of inferior turbinate sub-mucosal diathermy and more recently inferior turbinate laser turbinoplasty.
⏏️⏏️⏏️⏏️⏏️⏏️⏏️
Non-Allergic Rhinitis
Causes
*Psychological and emotional
*Endocrine (puberty, menstruation and pregnancy).
*Drugs (angiotensin-converting enzyme [ACE] inhibitors, β-blockers,methyldopa, aspirin and oral contraceptives).
*Climate changes in humidity and temperature.
*Alcohol induced
*Smoking ( tobacco nasal mucosal inflammation)
Anterior and posterior rhinorrhea:(excessive post nasal drip)
complain of marked blockage when lying flat trying to sleep.
diagnosis of exclusion, If a systemic inflammatory process is suspected, an anti-neutrophil cytoplasmic antibody (ANCA) and ACE assay may be indicated.
short course of oral steroids + local + Topical ipratropium bromid
Systemic sympathomimetics can be helpful (e.g. pseudoephedrine), though they may produce unpleasant side effects such as dry mouth, constipation and excitability. They should not be used long term or in children.
Surgical treatment by Vidian neurectomy This operation was proposed for the relief of watery rhinorrhea.
Nasal Polyps:
اما يجي ما بي اعراض او عنده اعراض مثلا ما يشتم يحجي من خشمه يحس اكو ضغط باعله خشمه ورشح من الانترير والبوستيرر و راسه يوجعه الفتحات مال خشمه كلش واضحات ويجي المسافه بين العينين كلش جبيره والتهاب الجيوب اثانوي
CT scan is needed prior to Endoscopic sinus surgery
Investigations to rule out AR
Treatment:
Saline irrigation will help to thin and wash away the inspissated mucous that patients produce, allowing nasal steroids to then coat nasal polyps more reliably.
Steroid drops, an increased dose of nasal steroid spray or a short courseof oral steroids is necessary,
A long (at least 12 weeks) course of doxycycline may reduce polyp size and sensation of blockage as well as reducing post nasal
drip.
surgical treatment: endoscopic polypectomy under either local or general anaesthetic. A more radical clearance by means of an endoscopic fronto-ethmoidectomy leads to better longer-term disease control.
post-operative Long-term saline nasal douching is recommended. Intranasal steroids reduce recurrence in the first year and may make a difference to the recurrence rate long term .
This allergic conjunctivitis occurs in about 60% of those with AR and is the symptom that most reliably differentiates AR from other types of rhinitis.
Topical steroid sprays and drops are now considered to be the cornerstone in the treatment of rhinitis.
↪️Crusting and bleeding are the main side effects.
↪️ safe to use long term in most patients.
↪️Examples include fluticasone, mometasone sprays.
Leukotriene receptor antagonists appear to have an additive effect to intranasal corticosteroids in controlling seasonal AR, particularly in patients with asthma.
Surgical treatment in form of inferior turbinate sub-mucosal diathermy and more recently inferior turbinate laser turbinoplasty.
⏏️⏏️⏏️⏏️⏏️⏏️⏏️
Non-Allergic Rhinitis
Causes
*Psychological and emotional
*Endocrine (puberty, menstruation and pregnancy).
*Drugs (angiotensin-converting enzyme [ACE] inhibitors, β-blockers,methyldopa, aspirin and oral contraceptives).
*Climate changes in humidity and temperature.
*Alcohol induced
*Smoking ( tobacco nasal mucosal inflammation)
Anterior and posterior rhinorrhea:(excessive post nasal drip)
complain of marked blockage when lying flat trying to sleep.
diagnosis of exclusion, If a systemic inflammatory process is suspected, an anti-neutrophil cytoplasmic antibody (ANCA) and ACE assay may be indicated.
short course of oral steroids + local + Topical ipratropium bromid
Systemic sympathomimetics can be helpful (e.g. pseudoephedrine), though they may produce unpleasant side effects such as dry mouth, constipation and excitability. They should not be used long term or in children.
Surgical treatment by Vidian neurectomy This operation was proposed for the relief of watery rhinorrhea.
Nasal Polyps:
اما يجي ما بي اعراض او عنده اعراض مثلا ما يشتم يحجي من خشمه يحس اكو ضغط باعله خشمه ورشح من الانترير والبوستيرر و راسه يوجعه الفتحات مال خشمه كلش واضحات ويجي المسافه بين العينين كلش جبيره والتهاب الجيوب اثانوي
CT scan is needed prior to Endoscopic sinus surgery
Investigations to rule out AR
Treatment:
Saline irrigation will help to thin and wash away the inspissated mucous that patients produce, allowing nasal steroids to then coat nasal polyps more reliably.
Steroid drops, an increased dose of nasal steroid spray or a short courseof oral steroids is necessary,
A long (at least 12 weeks) course of doxycycline may reduce polyp size and sensation of blockage as well as reducing post nasal
drip.
surgical treatment: endoscopic polypectomy under either local or general anaesthetic. A more radical clearance by means of an endoscopic fronto-ethmoidectomy leads to better longer-term disease control.
post-operative Long-term saline nasal douching is recommended. Intranasal steroids reduce recurrence in the first year and may make a difference to the recurrence rate long term .
Forwarded from Time to Study 🌿
Hot potato voice in large lesions.ونشوف
Time to Study 🌿
Hot potato voice in large lesions.ونشوف
In Supraglottic cancer
ولو مداكدر انام بس لحظة ادراك اخر مرة حنمتحن بهيج وقت تقريبا طول عمرنا🥳
🆒3