Ear, Nose, and Throat

Question 1

Remember, a radiologic diagnosis is never the most accurate in infectious diseases!

Answer 1

Ok!

Question 2

What’s the first diagnostic test for sinus infex?

Answer 2

CT

Question 3

What’s the most appropriate initial treatment for sinus infex with fever and ear infex?

Answer 3

Amoxicillin/clav plus decongestant

Could also use Doxy or TMP-SMX

Question 4

What dx presents with recent h/o sinusitis and CN II, IV, VI damage?

Answer 4

Cavernous sinus thrombosis

Question 5

What’s the tx for cavernous sinus thrombosis?

Answer 5

Ampicillin/sulbactam with vancomycin and steroids

Question 6

What dx is a granulomatous inflammation of the cavernous sinus with opthalmoplegia?

Answer 6

Tolosa-Hunt Syndrome

Question 7

How do you treat Tolosa-Hunt Syndrome?

Answer 7

Steroids

Question 8

Where do 95% of epistaxes come from?

Answer 8

Anterior (Kiesselbach venous plexus)

Question 9

What abx do you need to give after packing posterior epistaxis?

Answer 9

Cephalexin

Question 10

What’s the most sensitive physical exam finding for otitis media?

Answer 10

Immobility of the tympanic membrane

Question 11

What dx has pain on moving the tragus?

Answer 11

Otitis externa

Question 12

What’s the tx for otitis externa?

Answer 12

Topical neomycin & hydrocortisone

Question 13

What causes swimmer’s ear (otitis externa)?

Answer 13

Increased pH in the ear canal

Question 14

What’s the best initial agent for necrotizing external otitis?

Answer 14

Ciprofloxacin

Question 15

What dx involves a psudomonal infex causing cranial osteomyelitis in the portion of the skull near the auditory canal?

Answer 15

Malignant (necrotizing) external otitis

Question 16

What’s the best abx for mastoiditis?

Answer 16

Ceftriaxone

Question 17

T/F: delayed tx of mastoiditis can cause deafness?

Answer 17

True

Question 18

Which seizure drug can cause vertigo/nystagmus?

Answer 18

Phenytoin

Question 19

What’s the difference between labyrinthitis vs Meniere disease?

Answer 19

Labyrinthitis is acute and Meniere’s is chronic

Question 20

How is Meniere’s disease treated?

Answer 20

Diuretics and carbonic anhydrase inhibitors

Question 21

If all the criteria of strep throat are present but the rapid strep test is negative, do you treat for strep?

Answer 21

Yes, Amoxicillin

Question 22

What dx is cellulitis of the floor of the mouth caused by the spread of oral flora with dental infex of the mandibular molars into the submandibular and sublingual spaces?

Answer 22

Ludwig angina

Question 23

What’s the best initial test for Ludwig angina?

Answer 23

CT

Question 24

Can Ludwig angina cause the tongue to swell and compromise the airway?

Answer 24

Yes

Question 25

What abx do you use for Ludwig angina?

Answer 25

Ampicillin/sulbactam

Question 26

What is sialadenitis?

Answer 26

Infex of the parotid or submandibular gland with swelling and pain when eating

Question 27

How do you treat sialadenitis?

Answer 27

Abx and sour candy