Adult - Ears, Nose, Throat, URI Flashcards
Common bacterial cause in otitis externa
staph aureus
Possible causes of otitis externa
fungal
bacterial - acute or chronic
eczema
Management of cholesteatoma?
refer for surgery
What are three important differentials to rule out with vertigo?
brain tumor
medication toxicity
otitis media
Treatment for vertigo (5)
valium
benadryl
meclizine
scopolamine
antiemetics if needed
What drugs tend to be ototoxic? (5)
aminoglycosides (-mycin)
diuretics
salicylates
NSAIDs
antineoplastics
Most common cause of acute otitis media in the adult?
viral
Most common three bacterial pathogens in order in acute otitis media in the adult?
S pneumoniae
H influenzae
M catarrhalis
There is a key pathogen in adults. What is the pathogen and what 4 conditions is it largely responsible for?
S pneumoniae
acute otitis media
meningitis
sinusitis
community acquired pneumonia
In children, what are the the top two pathogens in community acquired pneumonia?
H. influenzae
S. pneumoniae
(#1 and #2 flip from the adult)
What are three “weird” symptoms of acute otitis media in the adult?
nystagmus
anorexia
lethargy
Is erythema alone diagnostic for acute otitis media in the adult?
no
there must be fluid behind the TM
What is the management for acute otitis media in the adult?
most resolve spontaneously
if support needed=
hydration
oral decongestants
cool mist humidifiers (???)
If bacterial cause is suspected in acute otitis media in the adult, what antibiotics are used?
amoxicillin
if allergic fo PCN – Erythromycin
Type of chronic otitis media consisting of peeling layers of keratinized epithelium.
cholesteatoma
What are the potential sequelae of cholesteatoma?
erosion of the middle ear leading to nerve damage and deafness
What is one feature of cholesteatoma that is either unremitting or frequently recurrent?
painLESS otorrhea
What is the most common form of vertigo?
benign paroxysmal positional vertigo (BPPV)
What sign is associated with vertigo?
Dix-Hallpike
aka
Nylen-Barany
What are the diagnostics for vertigo? (4)
CT to rule out brain tumor or bleed
serum medication levels
ear exam
VDRL/RPR to rule out syphilis
What are the three hallmarks of Meniere’s disease?
Hearing loss
Tinnitus
Vertigo
Management of hearing loss
conductive hearing loss -
treat underlying cause
clear canal
sensorineural - refer
What two symptoms set the common cold apart from other illnesses and allergies?
watery rhinorrhea
and
erythematous nasal mucosa
Is fever usually associated with the common cold?
No
What three symptoms are associated with a bacterial cause of pharyngitis?
Fever
ANTERIOR cervical adenopathy
Macropapular rash
What symptom is associated with a VIRAL cause of pharyngitis?
rhinorrhea
Is strep a common cause of pharyngitis in adults?
no
What criteria is used to determine whether a rapid strep test is indicated?
Centor criteria = FLEA
Fever
Lack of cough
Exudate in the pharynx/tonsils
Anterior cervical adenopathy
Is the FLEA criteria sensitive or specific?
Sensitive
a negative result effective rules strep out
SNOUT
What medications may be used to treat influenza?
neuraminidase inhibitors - a type of antiviral
zanamivir (Relenza) - inhaler
oseltamivir (Tamiflu) - oral
What are four hallmarks of mono?
severe pharyngitis
extreme malaise
POSTERIOR cervical adenopathy
splenomegaly - usu during second week
Diagnostics for mono
Monospot
increased WBC with relative lymphocytosis and neutropenia (shift to the R)
When would a predisone taper be used in mono?
for severely enlarged tonsils
When is a bacterial cause suspected in sinusitis?
fever
purulent nasal drainage
What antibiotics are used in sinusitis?
augmentin - amoxicillin/clavulunate
biaxin - clarithromycin
