ENT Flashcards
- 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
Conductive hearing loss
- 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
Cholesteatoma
- -malfunction of the cochlea and or auditory nerve
- loop diuretics, aminoglycosides, salicylates (reversible)
- meningitis, related to age of patient and when Abx are started
Sensorineural Hearing Loss
- testing appropriate for school age children who can cooperate with commands
- can differentiate bt conductive and SNHL
Conventional Pure Tone Audiometry
- testing for infants <6mo
- screening test
- if fails, must undergo ABR testing
Behavioral Observational Audiometry (BOA)
- testing for preschool children
- tests for bilateral hearing loss to prevent language impairment
Visual Reinforcement Audiometry
-flat tympanogram
middle ear fluid or stiff membrane
-peaked tympanogram
Normal TM
-low peaked tympanogram
-perforation or PE tubes
- dizziness, vomiting, pale with REM
- no LOC
- variant of migraines
Benign Paroxysmal Vertigo
- 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
Perilymphatic Fistula
-pt with bloody drainage from PE tubes and a large erythematous mass
Tympanostomy tube granuloma
- pain with movement of the pinna
- purulent DC
- MC pseudomonas
- Tx: floxacin gtts/steroid gtts
Otitis Externa
- swelling and deformity of the external ear following blunt trauma
- evacuation of hematoma by needle
Cauliflower ear
- postauricular swelling and erythema
- Dx: CT
- Tx: IV Abx and surgery
Mastoiditis
-nasal smear with eosinophils
allergic rhinitis
-teenager with nasal congestion
Cocaine
-cyanosis while feeding and resolution while crying
Choanal atresia
-first study to order in a patient with nasal polyps
Sweat testing
- persistent nighttime cough, foul breath, following a URI
- Tx: HD Amox
- complications: orbital cellulitis, brain abscess,
Acute Sinusitis
-next step in evaluating a patient with worsening epistaxis
CT sinus to r/o posterior nasopharyngeal mass
- 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
Mono
- 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
Peritonsillar abscess
- 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
Retropharyngeal abscess