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EENT Flashcards

1
Q

What are some signs and symptoms of Mastoiditis?

A

characterized by pain, postauricular cellulitis, and a spiking fever

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2
Q

What is the best way to diagnose mastoiditis?

A

CT Scan: reveals coalescent mastoiditis: bony destruction of the mastoid air cells

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3
Q

If mastoidiits if present what other condition will almost, always be present?

A

Acute otitis media (AOM)

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4
Q

INITIAL treatment for mastoiditis?

A

IV antibiotics: Cefazolin AND myringotomy for culture and drainage

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5
Q

How do you treat mastoiditis if antibiotics do not work?

A

Mastoidectomy

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6
Q

Acute Otitis Externa

A

“Swimmer’s Ear;” inflammation of the external auditory ear canal

MC in summer months and warm climates

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7
Q

What is the most common orgnaisms that cause acute otitis media?

A

Pseudomonas
Proteus
Aspergillus

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8
Q

S/S of acute otitis externa?

A
  • ear pain (otlagia)
  • tugging on the auricle elicts pain ear canal edema and erythema often with purulent exudate
  • periauricular cellulitis
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9
Q

PE of acute otitis media

A

TM is hrd to visualize due to the swelling, but there is erythema

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10
Q

What are immunocompromised and diabetic patients at risk for developing regarding acute otitis media?

A

malignnant otitis media

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11
Q

malignnant otitis media

A

MC in the elderly

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12
Q

S/S of malignnant otitis media

A

Severe auricular pain, persistent otorrhea
**Cranial Nerve palsies if osteomyelitis occurs
**May radiate to TMJ (pain with chewing)
Severe auricular pain on traction of the ear canal or tragus.

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13
Q

Dx of malignant otitis media

A

CT or MRI: granulation tissue at the bony cartilagenous junction of the ear canal floor

Biopsy: most accurate

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14
Q

Tx of otitis externa

A

Fluoroquinolone (Ciprofloaxcin) drops
Older kids get oral cipro

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15
Q

What causes acute otitis media?

A

**Viral URIs: lead to Eustachian tube dysfunction.

**Most commonly associated with a preceding viral URI’s

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16
Q

S/S of acute otitis media

A

fever
DECREASED HEARING/TM mobility (MOST SENSITIVE)
eair pain
aural pressure
often a fever

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17
Q

MC organisms that cause acute otitis media

A

Strep pneumoniae (MC)
H. influenzae
Strep pyogenes

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18
Q

Tx of acute otitis media

A

FIRST LINE: Amoxicillin

If patient was on Amoxicillin < 30 days or he is clinically failing within 48-72 hours: Augmentin

If PCN allergy: Cefuroxime, Cefpodoxime

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19
Q

**Tx of RECURRENT Otitis media

A

Sulamethoxazole or Amoxicillin

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20
Q

S/S of chronic otitis media

A

HALLMARK: aural purulent discharge
pain is uncommon
CONDUCTIVE HEARING LOSS result from destruction of the tympanic membrane or ossicular chain or both

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21
Q

Tx of chronic otitis media

A

regular removal of infected debris, use of earplugs to protect against water exposure, and topical antibiotic drops (fluoropunilone + dexamtheasone)

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22
Q

Tx for a chronically discharged ear of chronic otitis media?

A

oral ciprofloaxcin

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23
Q

DEFINITIVE treatment of chronic otitis media

A

surgery

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24
Q

Otitis media with effusion

A

** middle ear fluid + NO signs of acute inflammation (no fever or ear pain)
Often a result of viral URI
May be seen after resolution of AOM or in pts with ET dysfunction.*

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25
S/S of acute otitis media with effusion
*** decreased sound conduction and hearing. ** → may cause language and * speech issues.
26
PE of acute otitis media with effusion
**gray, amber, colorless effusion** (air fluid levels or bubbles behind the membrane, loss of light reflex, **Retracted or flat tympanic membrane that is hypomobile.**
27
Tx of acute otitis media with effusion
observation
28
S/S of TM perforation
* Discharge from the ear. * Rapid relief of pain with** bloody otorrhea**
29
Tx of TM perforation
Perfs d/t AOM usually heals spontaneously within a couple weeks. Ototopical Abx for a 10-14 day course with referral to an ENT 2-3 weeks after the reuprure. Limit water activities to surface swimming with use of ear plgs. Avoid otic aminoglycosides, they are ototoxic
30
Foreign body in the EAR
MC in kids may be removed with a loop or hook (make sure not to push object further in the ear)
31
32
Why should aqueous objects NOT be performed in for organic foreign bodies (beans, insects)?
because the water may cause them to swell
33
How are living insect best immobilized before being removed from the ear?
by filing the ear with lidocaine or mineral oil
34
Why should lidocaine NEVER be used in a patient with a possible tympanic membrane perforation?
becuase it may result in a profiund vestibular repsonse
35
Foreign body of the **EYE**
patient reports a history of "something hitting the eye" tearing, painful red, irritated eyes
36
Tx of Foreign body of the **EYE**
If on cornea: apply anesthestic and remove with help of slit lamp or fluroscein If lid: removed with wet Q-Tip and hypodermic needle If UNDER lid: apply local anesthetic and EVERT the lid; removed FB with wet Q-tip If suspect laceration: refer immediately
37
Foreign body of the **NOSE**
kid will have BAD breath!
38
Periorbital Cellulitis
infectons arising from the **ANTERIOR** orbital septum
39
Where can periorbital cellulitis arise from?
abrasion insect bite of the eye lid hordeolum or dacryocystitis may result as a hematogenous spread from respiratory infection or OM
40
S/S of periorbital (preseptal) cellulitis
red, swollen eye lids, pain, and mild fever The vision, EOM, and eye itself are NORMAL
41
Dx of periorbital and orbital cellulitis
CT with contrast
42
Orbital cellulitis typically arises from
paranasal sinus infection (most commonly ethmoid sinuitis)
43
What organism in orbital cellulitis causes a more serious infetion with increased frquency of intracranial or spinal abscess that may require a surgical intervention
S. anginosis
44
S/S of orbital cellulitis
* fever * swelling and redness of the eyes * proptosis * restriction with EOM * DECREASED vision * ABD
45
Orbital cellulitis most commonly involves an infection _________ to the septum
POSTERIOR
46
Tx of orbital cellulitis
Nafcillin + Metronizadole or Clindamycin
47
What if trauma is an underlying causing in a patitent with orbital cellulitis?
Cefazolin or Ceftriaxone should be added
48
Strabismus
49
Strabismus
50
S/S of strabismus
51
Dx of strabismus
52
Tx of strabismus
53
S/S of allergic rhinitis
54
PE of allergic rhinitis
55
Tx of allergic rhinitis
56
Risk factors for allergic rhinitis
57
What are the most common causes of allergic rhinitis?
58
What are the most common causes of allergic rhinitis?
59
S/S of epiglottis
60
Dx of epiglottis
61
What position would see a child in, who has epiglottis?
62
Tx for epiglottis
63
Most common cause of pharyngitis?
64
S/S of pharyngitis
65
CENTOR criteria
66
Traits of scarlet fever
67
A kid with GABHS is in danger of developing what?
Scarlet fever
68
What is the definitive diagnosis for a kid with pharyngitis?
69
Tx for pharyngitis
70
Peritonsillar abscess
71
Risk factors for pharyngitis
72
S/s of pertonsillar abscess
73
Tx for peritonsollar abscess
74
Tx for peritonsollar abscess

PEDIATRICS (8 decks)

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