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EENT Flashcards

1
Q

otitis externa causes

A

allergy, derm conditions, bacterial (pea- pseudomonas, stap. epidermidis and staph aureus), funghi (aspergillus, candida)

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2
Q

risk factors for otitis externa

A

warm climate with humidity

  • increase water xposure
  • trauma
  • occlusive devices
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3
Q

otitis xterna pe

A

EAC edematous and may not be able to see TM

  • purulent exudate
  • tm MOVES NORMALLY with pneumatic otoscopy
  • tenderness with tragal pressure or manip of auricle
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4
Q

ddx of otitis xterna

A

HSV causing RAMSAY HUNT SYNDROME or herpes zoster oticus (facial paralysis on affected side) with rare vesicles on outer ear canal

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5
Q

complication of otitis xterna

A

periauricular cellulitus
- malignant otitis externa/necrotizing otitis xterna causing osteomylitis of temporal bone/skull base
(increasd risk with diabetics/immunocomp, fuol smelling discharge, deep otalgia, cn palsies)
- CT reveals osseous erosion
- TX= IV ANTIBIOTICS (QUINOLONES)

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6
Q

tx for otitis externa

A

7-10 days aminoglycoside or fluorquinolone w or w/o steroids (careful of ototoxity with aminoglycosides)
- keep canal dry
- place wick if sig swelling
-

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7
Q

pathophys acute otitis media

A
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8
Q

bacteria in aom

A

strep pneumo and H influenza

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9
Q

epidemiology of aom

A

kids 4-24 months and increased in fall/winter

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10
Q

pe of aom

A

TM immobile, erythematous and bulging

- bullae with mycoplasma infx

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11
Q

tx of aom

A

1st line= high dose amoxicillin 80-90mg/kg/2 x daily

2nd line- high dose amox cluvulanate, doxy or macrolid 2nd-3rd gen- cephalosporin

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12
Q

if penicillin allergy in aom

A

give cephalosporon, doxycyclin or macrolide

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13
Q

if TM perfed in aom

A

include topical antibx with low ototxicity like OFLOXACIN

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14
Q

prevent of aom

A

PNEUMO VACCINES

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15
Q

aom criter for immediate antibiotics in kids

A

< 6 months

<24 months if severe (pain more than 48 hrs, bilateral, fever above 102)

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16
Q

comp of aom

A

labyrinthitis, mastoiditis

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17
Q

tx of mastoiditis relted to aom comp

A

presnts with spiking fever, postauricular pain,

tx= iv antibx, mastoidectomy

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18
Q

recurrent aom tx

A

tympanostomy tubes

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19
Q

chronic aom

A

etio- recurrent aom
-presentation- chronic otorrhea

phys- PERFED TM with conductive hearing loss

TX- removal of infected debris, topical or oral antibiotics, surgery to repair tm

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20
Q

serous otitis media pathphys

A

eustachian tube blocked for a long time, causing neg pressure transudating fluid into middle ear

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21
Q

serous otitis media more common in kids cuz

A

eustachian tube narrower and more horizontal

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22
Q

serous om in adult cause

A

barotrauma, uri, chronic allergies

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23
Q

pe serous om

A

TM HYPOMOBILE AND DULL

  • bubbles
  • conductive hearing loss
  • no acute signs of illness or inflammation
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24
Q

tx for serous om

A

decongestants, antihitamines, nasal steroids if underlying allergies, vent tubes if tx rersistant

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25
cholesteatoma pathopyhs
type of chronic om - prolonged etd causes neg middle ear pressure - draws in part of TM adn creates a sac lined with squamous epithelium that produces keratin - 2ndarily infected with pseudomonas or proteus
26
pe of cholestatoma
tm pocket with tm perf exuding debris
27
tx of cholesteatoma
antibx drops and sx removal
28
comp of cholesteatoma
erosion into inner ear, facial nerve or brain abscess
29
eustachian tube dysfx
edema or tubal lining, air trapped in middle ear causing neg pressure usually from viral uri or allergie
30
etd presnetation
popping/cracking senatins | - fluctuatng hearing
31
pe of etd
retracted TM with hypomobility
32
tx of etd
decongestants (topical via intranasal or systemic oral) - autoinflation - desensitivatoin therapy for allergies - intranasal steroids - sx
33
etd comp
increaed risk for serous om and cholesteatoma
34
otic barotrauma
inability to equalize pressure exrted on middle ear during air travel, rapid alt change and underwater diving
35
otic barotrauma pres
more pain during airplane descent than ascent
36
tx for etd
enhance etfx - take systemic decongestants a few hrs b4 air travel - topical nasal decongestants 1 hr b4 descent
37
comp of etd
TM rupture, middle ear infx, persistent pressure after anding
38
condx hearing loss
amt of sound transmitted to inner ear is imited due to dysfx of external/middle ear
39
mechanisms of conductive hearing loss
DOMS (discontinuity tm perf, obstruction, mass effects, stiffness effects)
40
most common cause of conductive heqring loss in adults
cerumen impx
41
weber and rinne on conductive hl
wber lateralizes to crummy ear, rinner bc>ac in crummer ear
42
sensorineural hearing loss
sensory loss- dysfx of chochlea often from loss of hair cells' neural loss- dyfx of cn viii or central auditoy pathway
43
most common cause of sensorineural loss
presbycusis
44
causes of sensorineural hearing loss
menieres dz, hEAD TRAUMA, ACOUSTIC schwannoma, ms
45
weber and rinnne on sensorineural
weber laterlize to good ear, rinner ac>bc
46
other labs for sensorneural
glucose, cbc, tsh, syphilis, sjogrens
47
tx for sensoriuelra
hearing aids
48
tx for conductive hearing loss
sx
49
pulsatile tinnitus
hearing own heartbeat | - indicative of vascular abnormality
50
staccato tinnitus
rapid series of pops or clicks with sensation of ear fluttery - occurs from middle ear muscle spasm
51
patho of tinnitus
somatic sounds near cochlea vs disruptions of normal neural firing patterns along auditory pathway
52
indication for MRI/ further testing in tinnitus
unilateral w/o etiology - with pulsatile consider MRA, MRV and temp bone CT
53
experimental therapy for tinnitus
transcranial mag stim of central aud system - transcranial direct current stim - deep brain stim - brain surface implants - vagus nerve stim
54
disequilibrium causes
peripheral neuroapthy, msk disoders affeting gait, vestibular disorders, cerebelalr disorders, cervical spondylosis, parkinson, visual impairment
55
presyncompe causes of dizzy
cardiac dysarrythmia, orthostatic hypotension, med side efect, brain hypoperfusion
56
nonspecific cause of dizziness
psych disorders, fibromyalgia, hyperventilation, s/p head trauma, hypoglycemia
57
peripheral vertigo
syns are sudden onset - n/v - tinitus - vestibular neuritis meniere, benign positional vert, alc
58
nystagmus with peripheral causes
horizontal with rotary component - latent - fatigueuable
59
central cause vertigo
symps gradual onset (cuz think about brain tumor growing slowly) - progressive increase in severity - gait severly impaired - seizure, wernicke enceph, MS, chiari malformation, cerebeallar ataxia syndromes
60
nystagmus for cental cause
any direction, nonfatigueable, comes on right away
61
mixed central adn peripheral vertigo
migraine - stroke and vascular insuff - vestibular schwannoma - meningioma - infx from lyme dz or syphilis - vascular compression - hyperviscosity syndromes
62
diz hallpike maneuver
lower head and extend 30 degrees over ledge, turn 45 degrees left or right - look for nystagmus types
63
labyrinthtis
vestibular neuriti - inflammation of vestibular portion of cn viii - AFTER VIRAL INFX -
64
labyrinthitis tx
self lmiiting - antibiotics if signs of a bacterial infx
65
meniere dz
endolymphatic hydrops symps wax and wane as endolymph pressure rises and fallls
66
presentation of menirer
TINNITUS, VERTIGO, HEARING LOSS fluctuating sensorineural hearing losss with low freq tinnitus low tone, blowing/roaring quality
67
tx for meniere
diuretic acetazolamide and low salt diet to decreaed inner ear fluid

EENT (1 decks)

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