Catch-up BS Flashcards
What symptoms are typical of mastoiditis?
inflammation, pus, pain, fever, swelling/redness behind ear, ear discharge, hearing loss, headache
What are risk factors of mastoiditis?
chronic OM, recent URI, poor ETF
What commonly causes mastoiditis?
s. pneumoniae, h. influenzae, s. pyogenes, infection from OM to the mastoid air cells
What signs are typical of mastoiditis upon exam?
Redness, swelling, over mastoid process, protrusion of the ear, fluctuance over mastoid, signs of systemic infection
How do you treat mastoiditis?
cefazolin (broad spectrum)
Mastoidectomy if abscess formation/lack of response
What are potential complications of mastoiditis?
abscess formation, meningitis, facial nerve paralysis
What are symptoms of herpes stomatitis?
fever, irritability, malaise, painful vesicles, volcanic “erosion”, difficulty swallowing, vesicular lesions, swollen gums, fever, lymphadenopathy
What causes HSV?
viral HSV1 and HSV2 (genital), transmitted through infected saliva, lesions, mucosal surfaces, and don’t need a lesion to be able to transmit it!
How do you diagnose HSV?
viral culture, PCR, HSV specific antibodies, compare to apthous ulcers
How do you treat HSV?
acyclovir, oral or topical (need oral though), valacyclovir or famciclovir too; supportive care too!
What are complications of HSV?
secondary bacterial infection, herpetic gingivostomatitis, encephalitis, disseminated HSV in immunocompromised
What is angioedema?
rapid swelling of deeper layers of skin and mucous membranes, w abdominal pain, cramping, difficulty breathing, swelling of hands, feet, genitals
What causes angioedema?
hereditary, acquired (certain diseases), histamine-mediated (allergic reactions), bradykinin (vasodilation)
How do you diagnose angioedema?
non-itching, non-pitting, swollen, pale, pink-colored areas, resp distress upon exam
history, labs (C4, C1 inhibitors for hereditary or acquired, IgE for allergic), imaging, differential…not anaphylaxis
How do you treat angioedema?
epinephrine, antihistamines, corticosteroids (allergic)
C1 inhibitor concentrate, fresh frozen plasma (hereditary)
Icatibant or ellantide (bradykinin)
What are the symptoms of candidiasis?
sore throat, dysphagia, xerostomia (dry mouth), metallic/unpleasant taste, white plaques (CAN come off), erythema of mucosa, glossitis
What are risk factors for candidiasis?
immunosuppression, diabetes, abx use, use of corticosteroids, poor oral hygiene, denture use
What fungus causes candidiasis?
candida albicans
How do you diagnosis candidiasis?
inspection, potassium hydroxide prep of lesions, oral swab for cultures
How do you treat candidiasis?
Nystatin swallow, clotrimazole lozenges
sys: fluconazole, ketoconazole, itraconazole
address underlying conditions
How do you treat ACE-I induced angioedema?
stop ace-1 never prescribe again! (common in HTN meds like lisinopril)
focus on airway!
tranexamic acid, icatibant (bradykinin-2 antagonist)
C1 esterase inhibitor
not “true” allergy, more of a side effect, needs to be listed in allergy
ECALLANTIDE NOT BENEFICIAL
Where do deep neck abscesses commonly originate from?
odontogenic infections from teeth!
What are other causes of deep neck infections?
suppurative lymphadenitis, direct spread of pharyngeal infection, penetrating trauma, pharyngoesophageal foreign bodies, cervical osteomyelitis, IV injection of internal jugular vein
What should you assume in suppurative lymphadenopathy in middle-aged persons who smoke cigarettes and drink alcohol?
cancer
What are common symptoms of deep neck abscesses?
marked neck pain and swelling, fever sometimes
What should you do for a neck abscess?
CT scan for abscesses of course
What’s the common bacteria for epiglottitis?
h. flu
How do you treat allergic (histamine-mediated) angioedema?
epinephrine, antihistamines, corticosteroids
How do you treat hereditary angioedema?
C1 inhibitor concentrate, fresh frozen plasma
How do you treat bradykinin-mediated angioedema?
icatibant or ecallantide
How do you treat ACE-1 angioedema?
stop ACE-I, tranxemic acid, icatibant, C1 esterase inhibitor, ecallantide NOT BENEFICIAL
