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Clin Med > Clinmed Ear and Sinus > Flashcards

Clinmed Ear and Sinus Flashcards

1
Q
A

Otitis Media

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2
Q

Treatment for Otitis Media

A

Amox OR

Erythromycin + Sulfonamide

AND PAIN MANAGE THEM OR THEY WILL COME BACK!

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3
Q

When would you culture otitis media

A

recurrent/relapsing episodes after abx tx.

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4
Q
A

Chronic Otitis Media

(notice the sclerosis and scarred perf)

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5
Q

Treatment for an infected chronic otitis media

A

NO DROPS (could get in the perf)

Oral abx (cipro), remove debris, surg consult

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6
Q
A

Mastoiditis

(postauricular pain with erythema)

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7
Q

Treament for mastoiditis

A

IV Abx, mastoidectomy

(they are febrile as well)

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8
Q
A

Otitis Externa

(otalgia, pruritis, discharge, WITH A NORMAL TM)

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9
Q

What type of bugs infect otitis externa?

A

Gram - rods (pseuo, proteus, also fungi)

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10
Q

Otitis External…has a normal TM, and is treated with what?

A

Adult: Cipro

Kids: Non-floroquinolones

Ear wick to get the drops in

(can also give cipro with a steroid in it for the swelling CIPRODEX or CIPRO HC)

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11
Q
A

Cerumen Impaction

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12
Q

When do you think about when trying to remove cerumen?

A

Only remove what you see (no blind sweeps)

NO irrigation if perforated

IF NOT RESOLVED: ENT consult

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13
Q

What condition results in eustachian tube dysfunction, with otalgia

A

Barotrauma

(Tx: autoinflation…pop your ears

oral decongestants before flying or diving)

AFRIN for eustachian congestion? Careful with chronic use of afrin for rebound congestions.

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14
Q

What kind of things cause this?

A

TM Perforation

Causes: Spontaneous, trauma, otitis media (photo), acoustic trauma.

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15
Q

TM perf’s heal spontaneously, but if persistent and associated with hearing loss > 3 months, think….

A

ossicle damage

(May need TM os Ossicle repair)

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16
Q

Horizontal nystagmus indicates what type of vertigo

A

peripheral

(up/down nystagmus for central)

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17
Q

what is the biggest different in the patients history between peripheral and central vertigo?

A

The time of onset

peripheral: acute/sudden/tiinnitus/hearing loss
central: slow/progressibe/no hearing changes

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18
Q

what is the maneuver to check for nystagmus and BPV?

A

Dix-Hallpike Maneuver

(same as epley maneuver)

19
Q

This condition shows an acute onset of severe vertigo with tinnitus lasting DAYS to WEEKS!

A

Labyrinthitis

GIVE MECLIZINE

If infectious s/s give abx

20
Q

This syndrome is similar to labyrnthitis but it is REOCCURING, and EPISODIC from 20 minutes to hours.

A

Meniere’s Syndrome

(Too much endolymph, needs diuretics and a low salt diet)

(check for siphyllis or head trauma)

21
Q

This type of hearing loss comes from: Lesions on CN8, acoustic neuralgia, multiple sclerosis, acoustic neuroma, and auditory neuropathy

A

Neural hearing loss

22
Q

This type of hearing loss comes from cerumen, middle ear effusion, otosclerosis, or ossicular disruption

A

Conductive Hearing Loss

23
Q

This type of hearing loss comes from noise exposure, deterioration of cochlea, systemic diseases, head trauma, etc.

A

Sensory Hearing Loss

(IT IS NOT CORRECTABLE)

24
Q

This paitient condition shows red itchy, watery eyes, sneezing and congestion with rhinorrhea, itchy/sore throat with PND, cough.

A

Allergic Rhinitis

25
Q

Chronic allergic rhinitis may show what on exam?

A

Nasal polyps

26
Q

In the elderly, a differential diagnosis may be what?

A

Vasomotor rhinitis

Increased Vidian Nerve sensetivity

(Warm/cold air, odor/scent, particulate)

27
Q

Tx for Allergic Rhinitis

A

PO/IN antihistamines

IN steroids

Avoid allergen exposure

28
Q

What is the…?

  1. Red arrow pointing to?
  2. Blue arrow pointing to?
A
  1. Sphenopalatine Artery (20% of bleeds)
  2. Kiesselbach’s Plexus (80% of bleeds)
29
Q

First, second, and third line tx for epistaxis?

A
  1. Direct pressure
  2. Afrin (vasoconstrictor)
  3. Nasal packing or tamponade
30
Q

What are you concerned about with long term use of nasal packing for epistaxis?

A

Toxic shock

(give prophylactic antibiotics)

31
Q

In chronic epistaxis what should you consider about the patient?

A

Coagulative meds, bleeding disorders, hypertension, trauma, or septal deviation

32
Q

This persons unilateral parotid gland (or submandibular) swelling is called?

A

Sialadenitis

(notice swelling extends beyond the jawline…R/O dental abcess)

33
Q

Sialadenitis usually presents with acute swelling and pain post prandial, there may be pus. What organism is frequently responsible for this infection?

A

Staph

34
Q

How is the dx usually made?

A

Palpating for a stone/obstruction near a duct.

REFER TO OTOLARYNGO for treatment

35
Q

What is this condition?

A

Sailolithiasis

(acute painfully swollen submanidublar duct from a calculi)

36
Q

What is the name of the obstructed duct in the upper lateral aspect of the roof of the mouth in Sailolithiasis?

A

Whartons Duct

Again, palpate for a stone, and refer to ENT

37
Q

This condition presents with acute onset of purulent yellow-green discharge from the nose, with sinus pressure and pain.

A

Acute Bacterial SInusitis

(cannot R/O viral if symptoms < 10 days)

38
Q

Acute bacterial Sinusitis…

  1. typically lasts for how many weeks
  2. what sinus is commonly affected the most?
A
  1. 1-4 weeks
  2. maxillary sinus

(ethmoid sinus can accompany max sinus infection)

39
Q

What is the cause of acute bacterial sinusitis?

A

an obstructed sinus pore that creates mucous accumulation and secondary infection

40
Q

What are the two major microbes in sinusitis?

A

S pneumonia & H Influenza

41
Q

What % of people show recovery without the use of antibiotics in sinusitis?

A

80%

(just need motrin and decongestants)

42
Q

When would you give antibiotics for acute sinusitis?

A

Fever, facial pain, and swelling

43
Q

If you HAVE to give an antibiotic for acute sinusitis, what are the…..

  1. First Line Treatments
  2. Second Line Treatments
A

First Line: Amox or Doxy

Second Line: Amox/Clavulanate

(For pen allergics, Levo is the best choice, or go with the second line b/c it has the clavulanate in it)

44
Q
A

Clin Med (14 decks)

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