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ClinMed 1 Final Review > ENT Review > Flashcards

Flashcards in ENT Review Deck (49)
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1
Q

Viral Croup _____ sign

A

Steeple

2
Q

Epiglottitis _____ sign

presentation

A

Thumb print

Pt sits in tripod breathing position, drooling, dysphagia, soft stridor, sudden airway obstruction, high fever

3
Q

Epiglottitis special consideration from PA/Stiner

A

if you see it in the neck, never look again because the pt will loose their airway!

4
Q

Tonsillitis/Pharyngitis

Tx:

A

Strep: fever, tonsillar exudate
Tx: PCN

5
Q

Centor Criteria

A

Absence of cough
Tonsillar exudate
Hx of fever
Tender cervical lymph nodes/adenopathy

6
Q

Peritonsillar Absess
presentation
tx

A

Can’t completely open mouth, pain, HOT POTATO voice, deviation in soft palate
Tx: aspiration I & D, IV abx

7
Q

Retropharyngeal abcess

A

Fever, drooling, stiff neck, MUFFLED VOICE, stridot, bulding pharynx
Tx: IV abx, soft tissue neck xray

8
Q

Deep tissue infx of submandibular space, sialdenitis, neoplasm, pharyngeal infx, staph, strep, bactericides, submental, sublingual swelling, drooling, fever, hard, tender, red

A

Ludwings Angina

Tx: soft tissue x-ray, IV abx

9
Q

Herpes Simplex Virus

Tx and Labs

A

Tx: topical abreva or acyclovir
Labs: Tzank smear– see large, multi-nucleated cells

10
Q

Oral HPV

A

MC HPV 16

inc. partners, inc. risk

11
Q

Pathology making cancer in the neck more common. (risks)

A

Oral HPV

chewing tobacco is also a risk

12
Q

Nasopharynx Cancer Risks

A

Smoking, ETOH, cervical adenopathy, squamous cell CA w/WHO type 3, lymphoepitheimoas.
asian culture with EBV

13
Q

Cervical Adenopathy

A

Tx: Abx, radial neck dissection for lmphectomy, advanced radiation at site with chemo
(Tx complications on test)

14
Q

Ceruminosis

A

ear wax.

remove only if: difficult to see TM, Otitis Externa, hearing loss, pt request, hearing air impressions

15
Q

Otitis Externa

Presentation/causes

A

Maceration from loss of protective fxn of cerumen and inc. moisture, inc pH in canal, 2º infx from OM w/TM perforation

16
Q

Otic drops (+/-) steriod, EAR WICKS with edematous canal, moist heat, no h2O in ear, no oral abx given in 1º

A

Tx Otitis Externa

17
Q

Otitis Media

Tx Guidelines

A

> 24 mo old Watchful Waiting!!

18
Q

Otitis Media

Tx

A

Abx 1st Line: AMOX

2nd is Augmentin

19
Q

Otitis Media tubes guidelines

A

only after 3-4 mo of ears- constant effusion and audiogrammed hearing loss

20
Q

Mastoiditis Tx

A

Myrinectomy w/o or w/PE tubes, IV abx, plus eardrops, surgical drain of mastoid in 24-48 hrs if no improvement.

21
Q

Foreign Body in Ear

A

Adults: insects, ear stuffing

Kids > 9 mo old- toys beads, food

22
Q

Conductive Hearing Loss happens in

A

Cholesteatoma

23
Q

Cholesteatoma

A

TM perforation, white, cheesy material

24
Q

Sensorineural Hearing Loss happen in

A

Presbyacusis and Meniere’s Disease

25
Q

Presbyacusis

A

age associated hearing loss

>40 yo

26
Q

Meniere’s Disease

A

vertigo associated with intermittent hearing loss

27
Q

Acoustic Neuroma

A

tumor- arises from vestibular branch of schwann cells in the cerebellopotine angle in the posterior fossa of the brain

28
Q

Acoustic Neuroma

A

Facial Droop-CN7: pressure involvement of close structures, affect cerebellar fxn, asymmetric sensorineural hearing loss, poor word discrimination, tinnitus, disequilibrium

29
Q

Bacterial Parotitis/ Sialendenitis

Tx

A

Tx: stimulate salivary fxn, warm compress, hydrate, massage, abx off culture, surgery I&D, is CN7 involved (bc parotid gland)

30
Q

Sialolithasis Tx

A

support!, analgesics, hydrate, antipyretic

REFER ENT- lithotropsy, sialoendoscopy

31
Q

External Hematoma Tx

A

I&D unless hematoma is older than 7 days or recurrent/chronic. Always apply a compression dressing around/over the wound/head.
Lidocaine is never used in the ear.

32
Q

TM perforation MC cause

A

MC from infection/mass (cholesteatoma).

also trauma- q-tip and iatrogenic

33
Q

“Cauliflower Ear”

A

External Hematoma

34
Q

Central vertigo

A

non positional vertigo, occurs as result of pathology or lesion involving the brainstem, cerebellum or peripheral labyrinths

35
Q

Labyrinthitis

risk, presentation

A

Viral URI

causes n/v and hearing loss, positions make it worse!

36
Q

BPPV

Benign paroxysmal positional vertigo

A

peripheral

37
Q

Meniere’s Triad

A

Hearing loss, tinnitus
Vertigo
n/v

38
Q

Aphthous Ulcers
aka
present

A

“canker sore”

recurrent apthos somatitis, starts in childhood. 2-4m round/oval ulcer in he mouth, yellow-gray

39
Q

Dental Caries bacteria

A

MC is Strep mutans

40
Q

Tetracycline abx tx considerations

A

NO PREGNANT WOMEN
NO KIDS
Don’t give it to a 7 yo. 14 is tolerable.

41
Q

“Trench Mouth” gum infection

A

Acute Necrotizing Ulcerative Gingivitis

42
Q

Acute Necrotizing Ulcerative Gingivitis

risks

A

smokers, immune compromised, poor oral hygiene, nutrition deficiencies, very foul breath, ulcerations of gingival

43
Q

Nasal Foreign bodies

present

A

sneezing, discomfort, pain, unilateral discharge, foul odor, epistaxis, mouth breathing

44
Q

Nasal Foreign bodies

check the nose but don’t forget the

A

Ears!

45
Q

Epistaxis mc location

A

Kisselbachs plexus

46
Q

Epistaxis

tx:

A

first rapid rhino

second epistat

47
Q

Candidia Albicans MC

A

Thrush- it is FRIABLE (bleeds easy and scrapes off easy), white gray plaque, common in babies

48
Q

Thrush Tx

A

sterilize bottles better also maybe yogurt if child is old enough

49
Q

Canalolithiasis

A

delayed unilateral activation of fluid in semicircular canal due to impaired endolymph flow in cochlea caused by clump otoliths “rocks falling off hair cells”