ENOT/Ophthamology

Question 1

Acute Otitis Media Treatment

Answer 1

1st-line: Amoxicillin

Question 2

Acute pharyngotonsillitis treatment

Answer 2

Viral: self limited

Gonorrhea pharyngitis: IM ceftriaxone

Fungal: clotrimazole, miconazole or nystatin

Strep pharyngitis: 1st line- penicillin

Rheumatic fever: aspirin, prednisone, abx prophylaxis

Question 3

Allergic rhinitis treatment

Answer 3

Avoid known allergens and use antihistamines

Question 4

Conjunctivitis treatment

Answer 4

Viral: eye lovage with normal saline bid 7-14 days; antihistamine drops, warm to cool compress

Bacterial: Gentamicin/to army in (Tobrex)
— Erythromycin ointment (E-Mycin)
— Trimethoprim and polymyxin B
— Ciprofloxacin

Allergic: Contact lens use = pseudomonas to = Floroquinolone (Ciprofloxacin)

Question 5

Epiglottitis treatment

Answer 5

Airway management most important —> OR best setting for intubation
Dexamethasone for airway edema
1st line: 2nd or 3rd generation Cephalosporin
— Inpatient: ceftriaxone or cefotaxime + vancomycin
— Outpatient: ceftriaxone + supportive care
Prevention: Rifampin given to all close contacts

Question 6

Epistaxis treatment

Answer 6

1. Direct pressure
2. Short-acting topical decongestant
3. Anterior nasal packing
4. Posterior balloon packing

Question 7

Mastoiditis treatment

Answer 7

Simple = oral and IV abx (ceftriaxone)

ENT referral in more serious cases

Question 8

Oral candidiasis treatment

Answer 8

Nystatin, oral fluconazle

Question 9

Orbital cellulitis treatment

Answer 9

Hospitalization and IV broad-spectrum antibiotics

Vancomycin for MRSA coverage

Question 10

Otitis externa treatment

Answer 10

Bacterial (Swimmer’s ear): abx drops- aminoglycoside or fluoroquinolone +/- corticosteroids + avoid moisture

Fungal: Topical therapy, anti-yeast for Candida: 2% acetic acid; CLOTRIMAZOLE 1% solution; itraconazole oral

Question 11

Peritonsillar abscess treatment

Answer 11

Aspiration, I & D, and/or antibiotics

IV abx— amoxicillin, amoxicillin-sulbactam and clindamycin

Question 12

Strabismus treatment

Answer 12

Referral if constant anytime or intermittent > 6 mo

Patch exercises, if untreated after age two, amblyopia results

Question 13

Tympanic membrane treatment

Answer 13

Usually, resolves on own; surgical repair my be necessary w/ persistent hearing loss

Keep dry

The only class of abx that are non-ototoxic are Floxin drops (the only you use if you’re gonna prescribe drops in perf TM)

Surgery if persists past 2 months