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Flashcards in ENT Deck (78)
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What is the correct diagnosis and treatment for a 9 y/o male with purulent right ear discharge for several months despite several antibiotics...exam shows retraction of TM and squamous debris?

Cholesteatoma - referral to ENT

1

What antibiotics are ototoxic? What are 2 other medications that cause reversible hearing loss ?

Aminoglycosides (gentamicin, tobramycin)

Loop diuretics & salicylate

2

What diagnosis should you consider in a patient with foul smelling discharge despite treatment of perforated TM?

Cholestatoma

3

What is the most common cause of sudden bilateral sensorineural deafness?

Viral labyrinthitis

4

What are the 4 most common viral causes of sensorineural hearing loss?

CMV
Measles
Mumps
Rubella

5

What is the most common cause of neonatal hearing loss? How can this be prevented

Bacterial meningitis - can't prevent despite treatment with antibiotics

6

What are the two newborn hearing screens and when should this be performed by?

Auditory brainstem response (ABR) and otoacoustic emissions (OAE)

Identification of hearing loss by 3 months with treatment by 6 months

7

What test is used to detect bilateral hearing loss in infants and toddlers?

Visual reinforcement audiometry (VRA)

8

What is indicated by a flat line (low amplitude) on tympanogram?

Stiff membrane or middle ear fluid or obstructed tympanostomy tube

9

How does tympanometry measure hearing sensitivity?

Tympanometry does NOT measure hearing sensitivity (you can have normal tympanogram with sensorineural hearing loss)

10

What is indicated by a high amplitude line on tympanometry?

Hypermobile TM

11

What is measured by the area under the tympanogram curve? And what does a high volume of this area indicate?

The area of the external canal - high volume indicates perforated TM

12

You are presented with a 4 y/o with chronic drainage through left TM, what is the likely cause and how would you treat?

Pseudomonas causing chronic suppurating otitis media
Topical ofloxacin

13

What diagnosis should you consider in a patient with persistent otitis media despite appropriate antibiotics who presents with headache and vomiting ?

Bacterial meningitis

14

What diagnosis should you consider in a patient with tympanostomy tubes who presents with copious bloody discharge and large red mass in the ear?

Tympanostomy tube granuloma

15

What should you do in a patient with swelling and deformity of the external ear after trauma?

Needle aspiration of hematoma

16

What is the diagnosis and 4 most common cause of postauricular swelling and erythema ?

Mastoiditis - strep pneumoniae, h flu, strep pyogenes and staph aureus

17

How would you confirm diagnosis of mastoiditis? How would you treat?

CT and tympanocentesis with culture - IV antibiotics and surgery

18

What 4 things are associated with nasal polyps and what study should you order in a patient with this finding?

Cystic fibrosis
Asthma
Chronic allergic rhinitis
Chronic sinusitis
**sweat chloride test**

19

What diagnosis presents as cyanosis while feeding but resolution with crying? What syndrome is this commonly found in?

Choanal atresia - CHARGE syndrome

20

Which sinuses are present at birth?

Maxillary and ethmoid

21

When are the sphenoid and frontal sinuses developed ?

Sphenoid: age 3 - 7 years
Frontal: teen years

22

What should be done in a patient with fracture of the frontal sinus? Why?

Surgery for repair to avoid CNS infection

23

When is a CT indicated in the diagnosis of sinusitis?

Only for chronic recurrent sinusitis

24

You are presented with a 13 y/o make with recurrent epistaxis. Bleeding is increasing in frequency, severity and duration. What is the next step?

CT scan to rule out posterior nasopharyngeal mass such as nasopharyngeal angiofibroma

25

What clinical finding can differentiate strep pharyngitis from mono?

Only mono presents with hepatosplenomegaly

26

You are presented with a child with high fever, swollen lymph nodes, pharyngitis and hepatomegaly. Strep is positive. Monospot is negative. What is the next step?

EBV titers

27

What would you do for a sexually active teenager who presents with sore throat and erythematous patches of the pharynx?

Test for GC pharyngitis and other STD testing

28

What treatment would you consider for a patient who presents with sore throat and difficulty opening the mouth as well as muffled voice...exam shows swelling around one tonsil and uvula deviation?

Needle aspiration plus ampicillin/sulbactam or clinda or augmentin

29

What is the cause of hypernasal voice after tonsillectomy / adenoidectomy?

Velopharyngel insufficiency