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PCM II Midterm > Approach to ENT > Flashcards

Approach to ENT Flashcards

1
Q

what are the white speckles located on a tonsil when inflammed

A

Exudate

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2
Q

what is cobblestoning

A

Caused by nasal sinus drip

looks like a cobblestone road

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3
Q

what is Torus Palatinus

A

Harmless bony growth

AKA: oral exostosis

Probably heredeitary

No surgery needed unless it affects speech or swallowing

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4
Q

when inspecting the external ear what do you look at

A

check for tenderness, indicitve of swimmers ear

check for any drainage or redness

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5
Q

What is the whisper test?

A

stand behind the patient and whisper into one of their ears and have them repeat what is said

help to tell if there are any hearing problems

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6
Q

what is the Pneumatic otoscopy used for

A

otoscope with a ball to blow air on the tympanic membrane, that way you can see if the tympanic membrane can move

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7
Q

How does ottis Media present

A

bulging of the Tympanic membrane with varying degree of erythema

caused due to fluid build up in the middle ear

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8
Q

What is Pharyngitis and possible cases and symptoms

A

Inflammation of the pharynx with resulting sore throat

can be:

  • Viral (adenovirus, rhinovirus, coronavirus, influenza)
  • Bacterial (GABHS, pneumoniae)

symptoms for viral pharyngitis: Coryza (runny nose), conjunctivitis, malasie and fatigue, hoarsness, low grade fever

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9
Q

what is significant about streptococcal pharyngitis

A

if not treated properly with antibiotics, can cause rheumatic fever

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10
Q

why might patients who report with pharyngitis have naseua?

A

in the brain, the pharynx is right next to intra-abdominal organs on the homunculus

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11
Q

What is the highest likelihood of GABHS if?

A
  • Children 5-15
  • Winter and early spring seasons
  • Absence of cough
  • Tender anterior cervical lymphadenopathy
  • Tonsillar exudate
  • Fever
  • petechia
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12
Q

what is the Centor Score used for?

A

whether or not to treat with antibiotics for Pharyngitis and the risk of GABHS

higher the score, more you should treat with antibiotics

get a point if:

  • absence of cough
  • swollen and tender cervical nodes
  • temperature over 100.4
  • TOnsillar exudates or swelling
  • age is 3-14

if score over 4 probably should give antibiotics
it 2-3 then should do a culture first

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13
Q

what is the lab test that determines if it is GABHS?

A

Rapid antigen detection test or rapid streptococcal antigen test

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14
Q

What is acute Ottis Media

A

is symptomatic inflammation of the middle ear that can be caused by bacteria or virusues

  • TM is bulging
  • red/erythmatous
  • TM has reduced mobillity when pneumatic otoscope is used
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15
Q

What is acute suppurative OM

A

is acute OM with purulent material in the middle ear

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16
Q

what is OM with effusion (serous OM)

A

is inflammation and fluid build up (effusion) in the middle ear without bacterial or viral infection. This may occur because the fluid build up persists after an ear infection has resolved, It may also occur because of some dysfunction or noninfectious blockage of the eustachian tube

  • fluid behind eardrum and can often see air bubbles
  • can last 3 months and often follows acute otitis media
  • can affect hearing especially if it is chronic
17
Q

what is chronic OM with Effusion

A

occurs when fluid remains in the middle ear and continues to return without bacterial or viral infection. THis makes children susceptible to new ear infections, and may affect hearing

18
Q

what is chronic suppurative otitis Media

A

is a persistent ear infection that often results in rearing or perforation of the eardrum
-chronic is usually considered more than 6 weeks

19
Q

What is Otitis Externa

A

Can be caused by bacteria entering a small break in skin of canal

Patients may report drainage from the ear

Usually associated with pain upon touching the external ear structures

20
Q

what is Otosclerosis

A

Abnormal bone growth around the stapes bone

Associated with progressive hearing loss beginning at ages 10-30 marked hearing loss occurring during middle age. Two types

  • Conductive loss: ossicle sclerosis into a single immovable mass
  • Sensory loss: otic capsule sclerosis

affects about 10 percent of caucasians females> males

21
Q

WHat is the weber test and what are do the results mean

A

Normal: midline and hear equally

Conductive loss: lateralizes to the affected side (the side you cant hear)

Sensorineural Loss: Lateralizes to the side opposite the affected ear

22
Q

What does the Rinne test do

A

Normal: Air conduction > bone conduction

Conductive loss: Bone conduction is > air conduction

23
Q

What are causes of Conductive hearing loss?

A 
Cerumen impaction
middle ear fluid
lack of movement of ossicles
trauma
other causes of obstruction(tumors)
24
Q

What are causes of sensorineural hearing loss?

A 
Hereditary
Meniere disease
MS
Trauma
ototoxic drugs
barotrauma
25
Q

what is Rhinosinusitis/Sinusitis and causes and symptoms

A

Mucosal lining in the paranasal sinuses and nasal cavity become inflammed

Causes: viruses
-can be bacterial

symptoms: nasal discharge, cough, sneezing, nasal congestion, fever, headache, pain, facial pressure

26
Q

Bacterial Sinusitis

A

Suspicion of acute bacterial sinusitis
-double sickening (initially get slightly better then gets worse), purulent rhinorrhea, elevated ESR

treatment is antibiotics

27
Q

what is Croup

A

Laryngotracheitis

  • swelling of the larynx, trachea, bronchi causing inspiratory stridor and barking cough in children 6 months to 3 years old
  • caused by influenza or respiraory syncytial virus

-presentation: fever, nasal flaring, drespiratory retractions, stridor

28
Q

what is epiglottitis

A

VERY emergent!!

inflammation of the epiglottis and adjacent structures
causes: Haemophilus Type B influenza, Group A Beta hemolytic streptococcus

Presentation: high grade fever, toxic apperance, child sitting or leaning forward

Treatment: protect airway (intubate if needed) broad spectrum antibiotics

PCM II Midterm (9 decks)

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