EENT

Question 1

what can happen if you leave a posterior epistaxis packing in for too long?

Answer 1

necrosis of the nasal ala

Question 2

how do you diagnose OE?

Answer 2

• tenderness with tragal palpation or traction on external ear
• pre-auricular adenitis might be present
• exam reveals erythema, edema and sometimes otorrhea
• tympanic membrane may be difficult to visualize

Question 3

what are the types of OE?

Answer 3

• swimmer’s ear - acute
• chronic >6 week duration (foreign body, hearing aids)
• eczema - eczema, seborrheic dermatitis
• necrotizing/malignant - progression to include deeper tissues, DM or immunocompromised

Question 4

what test do you order for OE or mastoiditis?

Answer 4

high resolution CT thin temporal cuts

can do a KOH prep if you suspect fungal cause

Question 5

what’s the treatment for OE

Answer 5

non-ototoxic abx drops

(cover pseudomonas)

ear wick to get it in

admission for necrotizing - IV cefotaxime 1 g q 24 h or ceftriaxone, 1-2 g IV q 24 hours

Question 6

What are the symptoms of AOM?

Answer 6

Adults: ear pain,

Question 7

what are the causes of peripheral vertigo?

Answer 7

benign position vertigo

acute vestibular neuronitis

supparrative labrynthitis

Meniere’s disease

acoustic neuroma

Question 8

what are the causes of central vertigo?

Answer 8

cerebrovascular disease

cerebellar degeneration

migraine

MS

alcohol intox

tumors of brainstem or cerebellum

phenytoin toxicity

Question 9

what is the direction of nystagmus in peripheral vertigo and central vertigo?

Answer 9

peripheral: side to side
central: up and down

Question 10

what are the key symptoms of Meniere’s disease?

Answer 10

unilateral hearing loss

tinnitus

vertigo

sudden onset and short duration (1-24 hours) attacks

Question 11

where do most nosebleeds arise from?

Answer 11

90-95% anterior septum/Kessellbach’s plexus

Question 12

if you have posterior epistaxis, where is it coming from?

Answer 12

most likely the sphenopalantine artery

Question 13

what are distinguishing signs and symptoms between sinusitis and rhinitis?

Answer 13

Sinusitis

purulent rhinorrhea

postnasal drip

headache

facial pain

anosomia

cough, fever

Question 14

what is the definition of chronic sinusitis?

Answer 14

>12 weeks

Question 15

what is the Ellis system of tooth fractures?

Answer 15

I = enamel alone (non-urgent)

II = dentin (urgent)

III = pulp (emergent)

Question 16

what should you do for a Class II or III fractures?

Answer 16

irrigate with saline, dry it and cover with calcium hydroxide paste or foil - refer to dental

Question 17

what do you do for a tooth avulsion?

Answer 17

put it in milk or saliva at home

Hank’s solution in the clinical world, replant it right away, splint 5 days antibiotics, dentist asap

Question 18

what is a subluxation of a tooth and what is the treatment?

Answer 18

2mm or less, just soft food until dental care

>2mm reseat and splint - apply foil over and anchor

Question 19

what is sialoadenitis?

Answer 19

infection of salivary gland by bacteria from oral cavity into salivary duct