PANCE Blueprint EENT (7%)

Laryngitis

Patient will present as → a 27-year-old mezzo-soprano who states that she developed acute hoarseness 2 days ago. Prior to that, she had a cold, the symptoms of which are improving. There is no history of smoking or other tobacco use. She is very worried as she has an upcoming performance 3 days from now.

Laryngitis is inflammation of the larynx, usually the result of a virus or overuse. The result is an acute change in the voice, with decreased volume and hoarseness.

  • Associated with a viral infection.
  • Consider squamous cell carcinoma if hoarseness persists > 2 weeks, history of ETOH and or smoking. 
  • Consider GERD if no associated viral etiology.

Diagnosis is based on clinical findings

  • Laryngoscopy is required for symptoms persisting > 3 wk
  • Deviation of the soft palate and asymmetric rise of the uvula are highly suggestive of abscess

Symptomatic treatment (eg, cough suppressants, voice rest, steam inhalations)

  • Viral laryngitis is self-limited. Other infectious or irritating causes may require specific treatment.
  • Oral or IM corticosteroids may also hasten recovery for performers but requires vocal fold evaluation before starting therapy.
Congratulations - you have completed LARYNGITIS. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%
Your answers are highlighted below.
Question 1
Your patient is a 39-year-old second grade teacher who states that she developed acute hoarseness 3 days ago. Prior to that, she had a cold, the symptoms of which are improving. There is no history of smoking or other tobacco use. What is the most important intervention for the patient at this time?
A
Discuss that due to her occupation, she is at increased risk of leukoplakia of the vocal cords
Hint:
Leukoplakia is related to tobacco and alcohol use, along with dental irritation.
B
She should be placed on an antibiotic as she most likely has a bacterial infection
Hint:
Most cases of laryngitis are viral in etiology and this patient’s symptoms were resolving, therefore antibiotic treatment is not indicated.
C
Discuss her increased risk of vocal cord paralysis
Hint:
Laryngitis is not a risk factor for vocal cord paralysis. There are many causes of vocal cord paralysis, but laryngitis, even if protracted is not one of them.
D
Advise the patient to avoid singing or shouting until her normal voice returns
Question 1 Explanation: 
Acute laryngitis is a common cause of hoarseness and often persists for a week or more after resolution of other symptoms of an upper respiratory infection. The patient should be warned to avoid vigorous use of the voice such as singing, shouting, or excessive talking until their voice returns to normal, since persistent use may lead to the formation of traumatic vocal fold hemorrhage, polyps, and cysts. Leukoplakia is related to tobacco and alcohol use, along with dental irritation. Most cases of laryngitis are viral in etiology and this patient’s symptoms were resolving, therefore antibiotic treatment is not indicated. Laryngitis is not a risk factor for vocal cord paralysis. There are many causes of vocal cord paralysis, but laryngitis, even if protracted is not one of them.
Once you are finished, click the button below. Any items you have not completed will be marked incorrect. Get Results
There is 1 question to complete.
List
Return
Shaded items are complete.
1End
Return
Oral herpes simplex (ReelDx) (Prev Lesson)
(Next Lesson) Peritonsillar abscess (ReelDx + Lecture)
Back to PANCE Blueprint EENT (7%)

NCCPA™ Content Blueprint

The Daily PANCE and PANRE

Get 60 days of PANCE and PANRE Multiple Choice Board Review Questions delivered daily to your inbox. It's 100% FREE and 100% Awesome!

You have Successfully Subscribed!