EMed - ENT

Question 1

MC cause Emed hearing loss

Answer 1

conductive (URI, ET dysfunction, etc)

Question 2

Important organism to cover for in OE ab

Answer 2

Psuedomonas

Question 3

MC organism mastoiditis

Answer 3

S pnuemo, S pyogenes, S aureus

Question 4

Mastoiditis 1st step

Answer 4

abx, don’t need to wait for culture

Question 5

Tx: OE caused by eczema

Answer 5

acetic acid +/- Al acetate

Question 6

Tx: TM perf caused by trauma

Answer 6

watch+wait, avoid dirty water

Question 7

Tx: ears blocked + flying next day

Answer 7

Afrin+psudeophedrine day before/day of flight

Question 8

Tx: middle ear hematoma

Answer 8

watch+wait, hearing returns 6-8mo

Question 9

Tx: AOM age 2+

Answer 9

NSAID, decongestant, abx to fill in 2d

Question 10

Which direction of vertigo is worst?

Answer 10

vertical

Question 11

Sudden onset vertigo v gradual onset vertigo

Answer 11

Central v. peripheral

Question 12

Peripheral vertigo tx:

Answer 12

meclizine, valium, or scoploamine patch

OR anticholinergics

Don’t drive until seen by PCP

Question 13

Unilateral HL, tinnitus, sudden onset vertigo (<24h)

Answer 13

Meniere’s dz

Question 14

Meniere’s tx:

Answer 14

periph vertigo meds + low salt diet

Question 15

Labryinthitis tx:

Answer 15

periph vertigo meds + abx/antivital

Question 16

How to cauterize anterior epistaxis:

Answer 16

silver nitrate for 5s (turns grey)
apply bactracin to area
*1 attempt only)

Question 17

Local cautery attempt fails - next step?

Answer 17

merocel packing w/ abx ointment, advance parallel to nasal floor, add 5mL saline

Question 18

Posterior epistaxis mgmt

Answer 18

• Balloon or foley cath if unavailable
• likely admit 72-96h
• ppx for TSS
• monitor for necrosis d/t packing pressure

Question 19

Anterior epistaxis mgmt

Answer 19

Hold pressure, if ineff

Rapid rhino/pack + return 48h

Question 20

Non-bacterial sinusitis tx

Answer 20

intranasal corticosteroids

Abx not needed (usually viral)

Question 21

congestion, sneezing, facial pain <4 weeks

Answer 21

acute sinusitis

Question 22

chronic low grade congestion >12 wk

Answer 22

chronic sinusitis

Question 23

viral URI improving but then sx persist 10s-2wk (<4wk)

Answer 23

acute bacterial sinusitis

Question 24

Bacterial sinusitis tx

Answer 24

cephalosporin or macrolide

|&raquo_space; benefit compared to Augmentin

Question 25

Tx: Class 2/3 tooth fx

Answer 25

Ca(OH)2 / foil temporary cap
f/u 24h if class 3

Question 26

Tx: sublaxation tooth > 2mm

Answer 26

reset, splint, foil urgent f/u dentist

if baby tooth remove

Question 27

Tx: avulsion tooth

Answer 27

Hanks solution + replant to socket immediately

Splint, ppx abx, urgent f/u dentist

Question 28

Pharyngitis + fever + lymphadenopathy + other sx W/O cough: most likely organism

Answer 28

Group A strep

Question 29

Strep pharyngitis complications

Answer 29

Glomerulonephritis, rhuematic fever BUT abx anaphylaxis actually MC than these conditions
(despite this, PCN still rec)

Question 30

Tx: infected sialoadenitis

Answer 30

Pen VK, erythromcn, or Augmentin

Question 31

Tx: dehydrated + pharyngitis

Answer 31

consider admitting

IV analgesic, dexameth, abx

Question 32

Strep-like sx + hot potato voice/drooling/trismus (inability to open mouth)

Answer 32

peritonsillar abcess

Question 33

I+D peritonsillar abcess (procedural process)

Answer 33

• pt upright, suction avail
• speculum to open/light
• lidocaine + epi
• 18g needle partially poked thru sheath - 0.5cm exposed (prvent accidental perf of carotid)

Question 34

Neck pain, B/L submanibular swelling, drooling, neck tender/creptius*

Answer 34

Ludwigs angina

*not on objectives

Question 35

Tx: Ludwigs angina*

Answer 35

IV metronidazole + clinda/PCN

*not on objectives

Question 36

MC cause of angioedema*

Answer 36

ACE inhibitor rxn (even after months)

Question 37

Tx: epiglottis

Answer 37

airway

cefotazime/ceftriaxone