Approach to ENT Flashcards
what are the white speckles located on a tonsil when inflammed
Exudate
what is cobblestoning
Caused by nasal sinus drip
looks like a cobblestone road
what is Torus Palatinus
Harmless bony growth
AKA: oral exostosis
Probably heredeitary
No surgery needed unless it affects speech or swallowing
when inspecting the external ear what do you look at
check for tenderness, indicitve of swimmers ear
check for any drainage or redness
What is the whisper test?
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
what is the Pneumatic otoscopy used for
otoscope with a ball to blow air on the tympanic membrane, that way you can see if the tympanic membrane can move
How does ottis Media present
bulging of the Tympanic membrane with varying degree of erythema
caused due to fluid build up in the middle ear
What is Pharyngitis and possible cases and symptoms
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
what is significant about streptococcal pharyngitis
if not treated properly with antibiotics, can cause rheumatic fever
why might patients who report with pharyngitis have naseua?
in the brain, the pharynx is right next to intra-abdominal organs on the homunculus
What is the highest likelihood of GABHS if?
- Children 5-15
- Winter and early spring seasons
- Absence of cough
- Tender anterior cervical lymphadenopathy
- Tonsillar exudate
- Fever
- petechia
what is the Centor Score used for?
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
what is the lab test that determines if it is GABHS?
Rapid antigen detection test or rapid streptococcal antigen test
What is acute Ottis Media
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
What is acute suppurative OM
is acute OM with purulent material in the middle ear
what is OM with effusion (serous OM)
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
what is chronic OM with Effusion
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
what is chronic suppurative otitis Media
is a persistent ear infection that often results in rearing or perforation of the eardrum
-chronic is usually considered more than 6 weeks
What is Otitis Externa
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
what is Otosclerosis
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
WHat is the weber test and what are do the results mean
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
What does the Rinne test do
Normal: Air conduction > bone conduction
Conductive loss: Bone conduction is > air conduction
What are causes of Conductive hearing loss?
Cerumen impaction middle ear fluid lack of movement of ossicles trauma other causes of obstruction(tumors)
What are causes of sensorineural hearing loss?
Hereditary Meniere disease MS Trauma ototoxic drugs barotrauma
