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Board Review > EENT (PEARLS and BOARD REVIEW) > Flashcards

EENT (PEARLS and BOARD REVIEW) Flashcards

1
Q

Recurrent painful inflammation of the cartilage of the external auricle.

A

Polychondritis

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2
Q

How do you tell whether it’s polychondritis or cellulitis?

A

The lobule is NOT involved in polychondritis.

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3
Q

How do you treat polychondritis?

A

Prednisone (steroid)

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4
Q

Bacteria that causes otitis externa are likely what?

A

GRAM negative rods (pseudomonas, proteus)

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5
Q

How do you treat OE?

A

abx/steroid drops (be careful with neomycin because it can cause ototoxicity if the eardrum is ruptured).

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6
Q

What do you treat resistant OE with?

A

Fleuroquinolones (Cipro)

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7
Q

A pt has retracted TM with decreased mobility of the TM. They feel aural fullness, hearing issues, popping/clicking noises, and discomfort with pressure changes. What is this? How might you treat it?

A

Auditory tube dysfunction. Treat for rhinitis (decongestant)

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8
Q

Treatment for serous otitis media?

A

Short course of oral steroids

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9
Q

What is your biggest concern if you find hemotympanum?

A

Basilar skull fracture

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10
Q

Traumatic TM perforations treatment?

A

Usually resolve. Can consider ABX (water caused, etc). and referral.

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11
Q

Top causes of acute OM

A

Strep pneumo/pyogenes, h. flu, mycoplasma

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12
Q

Main complication of untreated/unresolving acute OM

A

Mastoiditis or osteomyelitis

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13
Q

Treatment for acute OM

A

Amoxicillin or erythromycin. Consider decongestant.

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14
Q

Treatment for acute OM if unresolved with abx or if recent abx

A

Augmentin.

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15
Q

A pt presents with post auricular pain, swelling, erythema, and fever. Had recent OM

A

Acute mastoiditis

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16
Q

What is the classic physical feature of acute mastoiditis?

A

Displacement of pinna anteriorly.

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17
Q

Tx for acute mastoiditis?

A

IV abx, myringotomy for culture and drainage, possible complete mastoidectomy.

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18
Q

What if a pt you suspect has had a recent bout of acute mastoiditis presents with signs of increased ICP?

A

Possible septic thrombophlebitis due to trapped infection within the mastoid air cells.

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19
Q

Green drainage from ruptured TM.

A

Pseudomonas

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20
Q

Complication of chronic OM

A

Cholesteatoma.

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21
Q

Tx for chronic OM

A

Topical abx, oral floxin, keep ears dry, may need surgical reconstruction.

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22
Q

What is it when a person has auditory tube dysfunction which causes a negative pressure drawing the upper portion of the TM inward creating a sac lined with epithelium?

A

Cholesteatoma

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23
Q

Should you refer a cholesteatoma?

A

Yes

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24
Q

Weber test lateralization to one ear means what?

A

Either conductive loss in LOUD ear or sensorineural loss in OTHER ear. (Can’t hear same ear or Sucky Senses other ear)

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25
Q

Rinne Test explanation.

A

Should hear (conductive) sound 2 x longer than hear (sensorineural) sound. AC > BC is normal UNLESS there is > 2:1 ratio. If it is MORE than 2:1, there may be sensorineural loss. If BC > AC then loss may be conductive.

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26
Q

T/F. Sensorineural hearing loss is usually symmetric.

A

TRUE

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27
Q

What is the most common type of sensorineural hearing loss?

A

Presbycusis (age related hearing loss)

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28
Q

What CN is affected by a acoustic neuroma?

A

8th cranial nerve

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29
Q

Another name for an acoustic neuroma?

A

Vestibular schwannoma

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30
Q

A pt has unilateral hearing loss, loss of speech discrimination, tinnitus, and chronic disequilibrium.

A

Acoustic neuroma

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31
Q

Meniere syndrome. Another name? Lasts? Sx? Test? Tx?

A

Endolymphatic hydrops, lasts 1-8 hours, fluctuating low frequency hearing loss, cold water calorics testing shows alteration of nystagmus on AFFECTED side, treat with low sodium diet, thiazide diuretics, antiemedics (for nausea)

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32
Q

Acute labyrinthitis. Lasts? Sx? Situation? Tx?

A

Acute onset of continuous severe vertigo lasting days to a week. Accompanied by hearing loss and tinnitus. Often follows a URI. Treat with antihistamines, anticholinergics, sedative-hypnotics.

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33
Q

Free floating otoconia in the semicircular canal.

A

BPPV

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34
Q

T/F. Acute vertigo with BPPV usually only lasts a few seconds to a minute but pts can feel unbalanced or hours.

A

TRUE

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35
Q

Maneuvers for treating BPPV

A

Epley maneuvers

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36
Q

Where does anterior epistaxis usually originate from?

A

Kiesselbach’s plexus

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37
Q

What causes nasal vestibulitis?

A

This is cellulitis or folliculitis of the hairs within the nasal vestibule. Usually staph a.

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38
Q

A black necrotic eschar found in the nose.

A

Rhinocerebral mucormycosis

39
Q

What is it when a deadly fungus invades through the vascular channels?

A

Rhinocerebral mucormycosis

40
Q

You see “cobblestoning” down the throat and have a patient with allergic shiners, and pale/violaceous mucosa

A

Allergic rhinitis

41
Q

A pt has pale, boggy masses of hypotrophic tissue that looks a lot like “peeled grapes”

A

Nasal polyposis

42
Q

When do you commonly see nasal polyposis

A

With allergic rhinitis

43
Q

A pt with a history of asthma AND nasal polyposis. What are you thinking with regard to allergies? What triad is this?

A

Allergy to ASA! Samter triad.

44
Q

What is the treatment for nasal polyposis?

A

Intranasal steroids for 1-3 months

45
Q

Most common causes of viral rhinitis/rhinosinusitis

A

Adenovirus, rhinovirus.

46
Q

What can overuse of decongestions cause?

A

Rhinitis medicamentosa

47
Q

How often can parents expect to have their child get a URI per year?

A

6 episodes.

48
Q

How often do adults get URI’s each year?

A

1-3 episodes.

49
Q

URI symptoms that persist >7-10 days.

A

Sinusitis

50
Q

Sx of sinusitis

A

UNILATERAL pain over the maxillary sinus, toothache, fever, swelling, watery/purulent discharge .

51
Q

What type of image should you perform for a dx of sinusitis?

A

Coronal CT. NOT sinus XR

52
Q

Guidelines for treatment of sinusitis?

A

Sx persistent or unimproved > 10 days, severe for > 3-4 days, or double sick > 3-4 days

53
Q

Tx for sinusitis

A

Augmentin, amox, or 1st gen ceph.

54
Q

Parameters of subacute chronic sinusitis

A

Persist 4-12 weeks LESS than 4 x yearly

55
Q

Parameters of subacute chronic sinusitis

A

Persist more than 4 weeks more than 4 x yearly

56
Q

A pt named YOUNG PERSON name VINCENT comes in with halitosis, bleeding, gum pain, and fever.

A

Acute necrotizing gingivitis aka VINCENT gingivostomatitis

57
Q

Acute necrotizing gingivitis aka VINCENT gingivostomatitis is caused by what bacteria?

A

Borrelia or fusobacterium

58
Q

Treatment for acute necrotizing gingivitis aka VINCENT gingivostomatitis

A

Oral PCN, peroxide rince, gingival curettage.

59
Q

A pt has hoarseness for > 2 weeks, persistent throat/ear pain, neck mass, hemoptysis, stridor. What do you want to do?

A

CT or MRI asap. Biopsy at laryngoscopy. Concern for squamous cell carcinoma of the pharynx.

60
Q

What STI is associated with oral cancers?

A

HPV

61
Q

What is the most common malignancy of the pharynx?

A

Squamous cell carcinoma

62
Q

What is the most common cause of sore throat?

A

Viral pharyngitis

63
Q

A pt with fever, tender cervical lymph nodes, NO cough, tonsilar exudates.

A

Group A beta h. strep pharyngitis

64
Q

A pt has a odynophagia, trismus (tight jaw), severe soar throat, “hot potato” voice.

A

Peritonsilar abscess. May also have medial deviation of soft palate.

65
Q

Treatment for peritonsilar abscess.

A

Aspirate, I&D, abx (IV or oral), tonsillectomy

66
Q

What will you see with mono?

A

Marked lymphadenopathy, occipital nodes, “shaggy” tonsilar exudate, severe fatigue, splenomegaly.

67
Q

How should you test for mono?

A

Monospot or elevation in anti EBV.

68
Q

What other pathology do 1/3 people with mono have?

A

Strep

69
Q

What medication should be avoided in treating somebody with mono and strep?

A

Ampicillin

70
Q

What activities should be avoided if a pt has mono?

A

Contact sports

71
Q

Pt presents with sore throat, nasal discharge, and malaise. You notice tenacious gray membranes on his pharynx.

A

Diphtheria

72
Q

What is the concern with diphtheria?

A

Exotoxin production that can cause myocarditis/neuropathy.

73
Q

Sialothiasis are what?

A

Calculus formations in the Wharton and Stensen ducts.

74
Q

Sialadenitis is what?

A

Bacterial infection of a salivary gland.

75
Q

Most common etiology of sialadenitis?

A

Staph aureus.

76
Q

Parotitis is commonly seen in what other diseases?

A

Metabolic disorders, sjogrens, etOH, sarcoidosis, DM

77
Q

Grayish/white, irregular hyperkeratotic plaques.

A

Leukoplakia

78
Q

Velvety-red hyperkeratotic plaques.

A

Erythroplakia

79
Q

Which can progress to squamous cell cancer? Leukoplakia or Erythroplakia?

A

Erythroplakia.

80
Q

Most common oral cancer?

A

Squamous cell

81
Q

Most lip cancers occur on the top/bottom lip?

A

Bottom.

82
Q

Half all intraoral cancers occur on the…?

A

Tongue

83
Q

What is the deep neck infection/cellulitis of the sublingual and/or submandibular spaces?

A

Ludwig Angina

84
Q

Most common offending organisms in Ludwig angina

A

Strep, staph

85
Q

Most important intervention with Ludwig angina.

A

Emergency!!! These patients with have fever, edema of the upper neck, possible airway obstruction by displacement of tongue.

86
Q

A pt has a soft cystic mass on the ANTERIOR BORDER of the sternocleidomastoid (lateral neck).

A

Brachial cleft cyst

87
Q

A pt has a soft cystic mass on the MIDLINE of the neck that MOVES with swallowing.

A

Thyroglossal duct cyst

88
Q

Tx for brachial cleft cysts and thyroglossal duct cysts?

A

ABX and surgical removal of cyst.

89
Q

Painful swollen red lump on eyelid. What? Etiology? Treatment?

A

Hordeolum caused by STAPH A. Treat with warm compress. May add erythromycin or bacitracin ointment if actively draining. I&D if it doesn’t drain within 48 hours.

90
Q

Inflammation of BOTH eyelids with crusting, scaling, RED RIMMING and eyelash flaking.

A

Blepharitis. If it’s ANTERIOR it will involved the eyelashes. If it’s POSTERIOR it will involved the meibomian gland.

91
Q

How would you treat blepharitis?

A

Anterior = warm compresses, eye hygiene, scrubbing with baby shampoo and/or applying abx ointment. Posterior = Eyelid massage. Express the meibomian gland regularly.

92
Q

Hard NON TENDER eyelid swelling with large firm granuloma. What is it? What will you do?

A

Eyelid hygiene, warm compresses. May inject steroids in large ones

93
Q

Tender, redness, swelling to nasal side of lower eyelid. What is it? Cause? Treatment?

A

Dacrocystitis. Caused by Staph A, GABHS. Treat with systemic abx (clindamicin or 3rd gen ceph)

Board Review (14 decks)

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