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NP > Adult - Ears, Nose, Throat, URI > Flashcards

Adult - Ears, Nose, Throat, URI Flashcards

1
Q

Common bacterial cause in otitis externa

A

staph aureus

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2
Q

Possible causes of otitis externa

A

fungal

bacterial - acute or chronic

eczema

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3
Q

Management of cholesteatoma?

A

refer for surgery

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4
Q

What are three important differentials to rule out with vertigo?

A

brain tumor
medication toxicity
otitis media

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5
Q

Treatment for vertigo (5)

A

valium

benadryl

meclizine

scopolamine

antiemetics if needed

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6
Q

What drugs tend to be ototoxic? (5)

A

aminoglycosides (-mycin)

diuretics

salicylates

NSAIDs

antineoplastics

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7
Q

Most common cause of acute otitis media in the adult?

A

viral

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8
Q

Most common three bacterial pathogens in order in acute otitis media in the adult?

A

S pneumoniae
H influenzae
M catarrhalis

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9
Q

There is a key pathogen in adults. What is the pathogen and what 4 conditions is it largely responsible for?

A

S pneumoniae

acute otitis media
meningitis
sinusitis
community acquired pneumonia

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10
Q

In children, what are the the top two pathogens in community acquired pneumonia?

A

H. influenzae
S. pneumoniae

(#1 and #2 flip from the adult)

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11
Q

What are three “weird” symptoms of acute otitis media in the adult?

A

nystagmus
anorexia
lethargy

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12
Q

Is erythema alone diagnostic for acute otitis media in the adult?

A

no

there must be fluid behind the TM

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13
Q

What is the management for acute otitis media in the adult?

A

most resolve spontaneously

if support needed=
hydration
oral decongestants
cool mist humidifiers (???)

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14
Q

If bacterial cause is suspected in acute otitis media in the adult, what antibiotics are used?

A

amoxicillin

if allergic fo PCN – Erythromycin

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15
Q

Type of chronic otitis media consisting of peeling layers of keratinized epithelium.

A

cholesteatoma

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16
Q

What are the potential sequelae of cholesteatoma?

A

erosion of the middle ear leading to nerve damage and deafness

17
Q

What is one feature of cholesteatoma that is either unremitting or frequently recurrent?

A

painLESS otorrhea

18
Q

What is the most common form of vertigo?

A

benign paroxysmal positional vertigo (BPPV)

19
Q

What sign is associated with vertigo?

A

Dix-Hallpike

aka

Nylen-Barany

20
Q

What are the diagnostics for vertigo? (4)

A

CT to rule out brain tumor or bleed
serum medication levels
ear exam
VDRL/RPR to rule out syphilis

21
Q

What are the three hallmarks of Meniere’s disease?

A

Hearing loss
Tinnitus
Vertigo

22
Q

Management of hearing loss

A

conductive hearing loss -
treat underlying cause
clear canal

sensorineural - refer

23
Q

What two symptoms set the common cold apart from other illnesses and allergies?

A

watery rhinorrhea
and
erythematous nasal mucosa

24
Q

Is fever usually associated with the common cold?

A

No

25
Q

What three symptoms are associated with a bacterial cause of pharyngitis?

A

Fever
ANTERIOR cervical adenopathy
Macropapular rash

26
Q

What symptom is associated with a VIRAL cause of pharyngitis?

A

rhinorrhea

27
Q

Is strep a common cause of pharyngitis in adults?

A

no

28
Q

What criteria is used to determine whether a rapid strep test is indicated?

A

Centor criteria = FLEA

Fever
Lack of cough
Exudate in the pharynx/tonsils
Anterior cervical adenopathy

29
Q

Is the FLEA criteria sensitive or specific?

A

Sensitive

a negative result effective rules strep out
SNOUT

30
Q

What medications may be used to treat influenza?

A

neuraminidase inhibitors - a type of antiviral

zanamivir (Relenza) - inhaler
oseltamivir (Tamiflu) - oral

31
Q

What are four hallmarks of mono?

A

severe pharyngitis
extreme malaise
POSTERIOR cervical adenopathy
splenomegaly - usu during second week

32
Q

Diagnostics for mono

A

Monospot

increased WBC with relative lymphocytosis and neutropenia (shift to the R)

33
Q

When would a predisone taper be used in mono?

A

for severely enlarged tonsils

34
Q

When is a bacterial cause suspected in sinusitis?

A

fever

purulent nasal drainage

35
Q

What antibiotics are used in sinusitis?

A

augmentin - amoxicillin/clavulunate

biaxin - clarithromycin

NP (76 decks)

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