ENT Flashcards

1
Q
  • failure of sounds to progress to the cochlea
  • MC cause is effusion
  • ignoring commands, increased TV volume
  • often correctable with surgery and hearing devices
  • causes: small malformed ears, perforated TM, tympanosclerosis, cholesteatoma
A

Conductive hearing loss

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2
Q
  • purulent ear DC despite Abx, foul smelling
  • retraction of the TM with squamous debris
  • keratinization of the epithelial cells in the middle ear
  • refer to specialist
A

Cholesteatoma

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3
Q
  • -malfunction of the cochlea and or auditory nerve
  • loop diuretics, aminoglycosides, salicylates (reversible)
  • meningitis, related to age of patient and when Abx are started
A

Sensorineural Hearing Loss

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4
Q
  • testing appropriate for school age children who can cooperate with commands
  • can differentiate bt conductive and SNHL
A

Conventional Pure Tone Audiometry

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5
Q
  • testing for infants <6mo
  • screening test
  • if fails, must undergo ABR testing
A

Behavioral Observational Audiometry (BOA)

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6
Q
  • testing for preschool children

- tests for bilateral hearing loss to prevent language impairment

A

Visual Reinforcement Audiometry

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7
Q

-flat tympanogram

A

middle ear fluid or stiff membrane

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8
Q

-peaked tympanogram

A

Normal TM

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9
Q

-low peaked tympanogram

A

-perforation or PE tubes

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10
Q
  • dizziness, vomiting, pale with REM
  • no LOC
  • variant of migraines
A

Benign Paroxysmal Vertigo

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11
Q
  • acute onset of unsteadiness and decreased hearing
  • abnl course of communication between middle and inner ear
  • progressive loss of perilymph, vertigo with ataxia, and hearing loss
A

Perilymphatic Fistula

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12
Q

-pt with bloody drainage from PE tubes and a large erythematous mass

A

Tympanostomy tube granuloma

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13
Q
  • pain with movement of the pinna
  • purulent DC
  • MC pseudomonas
  • Tx: floxacin gtts/steroid gtts
A

Otitis Externa

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14
Q
  • swelling and deformity of the external ear following blunt trauma
  • evacuation of hematoma by needle
A

Cauliflower ear

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15
Q
  • postauricular swelling and erythema
  • Dx: CT
  • Tx: IV Abx and surgery
A

Mastoiditis

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16
Q

-nasal smear with eosinophils

A

allergic rhinitis

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17
Q

-teenager with nasal congestion

A

Cocaine

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18
Q

-cyanosis while feeding and resolution while crying

A

Choanal atresia

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19
Q

-first study to order in a patient with nasal polyps

A

Sweat testing

20
Q
  • persistent nighttime cough, foul breath, following a URI
  • Tx: HD Amox
  • complications: orbital cellulitis, brain abscess,
A

Acute Sinusitis

21
Q

-next step in evaluating a patient with worsening epistaxis

A

CT sinus to r/o posterior nasopharyngeal mass

22
Q
  • fever, ST, fatigue, LAD, HA
  • fever can last 1-2 weeks
  • thick exudate and palatal petichiae
  • HSM
  • Dx: monospot, EBM titers
  • Tx: restrict activity, steroids if airway compromise
23
Q
  • dysphagia, difficulty opening mouth, unilateral swelling around the tonsil, and deviation of the uvula
  • trismus, drooling, hot potato voice, cervical LAD
  • Tx: needle aspiration and drainage, Unasyn, Clinda, or Augmentin
A

Peritonsillar abscess

24
Q
  • widening of the retropharyngeal space on the lateral neck film
  • neck is hyperextended with drooling and respiratory difficulties
  • surgical emergency
  • Tx: Clinda or Unasyn
  • MC in pts <4yo
A

Retropharyngeal abscess

25
- hypothyroidism - hypopituitarism - hypoplasia (ectodermal) - hypohidrosis - rickets
Causes of delayed eruption of teeth
26
- tissues at the entrance of the larynx collapse into the airway with inspiration - MC cause of extra-thoracic airway obstruction - suprasternal and subcostal retractions - worsens with agitation, improves when prone - improves with time - wet, variably pitched stridor
Laryngomalacia
27
- due to traumatic injury of the recurrent laryngeal nerve - weak cry - high pitched inspiratory stridor - if unilateral, persistent hoarseness
Vocal Cord Paralysis
28
- -presents with a weak cry | - does not change with position
Laryngeal web
29
- progressive hoarseness less severe in the morning without stridor or dysphagia - MC in males - improve with puberty
Vocal Cord Nodules
30
- weak tracheal wall rings collapse during expiration - expiratory stridor - associated with TEF repair
Tracheomalacia
31
- fixed wheezing from extrinsic compression of the trachea and esophagus - feeding difficulties
Vascular ring
32
-biphasic stridor with louder inspiratory component
subglottic stenosis
33
- -supraglottic stenosis presenting with biphasic stridor - leaning forward and drooling - dysphagia, dysphonia, distress - agitated, refusing to lie down - may be unvaccinated (H. flu) - keep the patient calm, prepare for intubation, CTX
Epiglottitis
34
- AKA psuedomembranous croup, membranous laryngotracheitis - inspiratory stridor and barking cough - thick purulent secretions, fever, and severe resp symptoms - prefer supine position - Tx: removal of secretions vis scope, airway mgmt, hydration, airway humidification, and IV Abx
Bacterial tracheitis
35
- allergic etiology (h/o atopic derm, or FHx) - recurrent croup in the absence of a preceding URI - no fever and no viral URI Sx - Tx: may need steroids
Spasmodic croup
36
- -hoarse, barky cough, inspiratory or biphasic stridor - may be tripoding with mouth breathing and dysphagia - etiology: RSV, influenza, parainfluenza - Tx: racemic epi and cool mist, decadron - MC in age 2 - preceded by URI and mild fever
Croup (laryngotracheobronchitis)
37
- MC tumor in the larynx of children - cause hoarseness - HPV - Tx: laser exision - can become malignant
Laryngeal papillomas
38
- midline lesion on the anterior neck | - do not remove! Only thyroid tissue left
Thyroglossal duct cyst
39
- preauricular adenopathy | - conjunctivitis
Adenovirus LAD
40
- MC cause is Staph and GAS - order CBC, ESR, bld Cx, PPD, Bartonella - Tx: Augmentin, Clinda, erythromycin
Bacterial LAD
41
-Tx for atypical mycobacteria LAD
Surgical excision
42
- chronic adenopathy, HSM | - exposure to farm animals, or ingestion of unpasteurized milk
Brucellosis
43
- school aged child with parotid swelling and weakness and fever - swelling and erythema around the opening of Stenson's Duct - no erythema of the overlying skin - may be unimmunized or HIV
Viral parotitis
44
- occurs before age 10 - toxic appearing with high temp - MC Staph parotitis
Bacterial parotitis
45
-swelling of both parotid glands
Salivary gland stone