ENT Flashcards
Duration of ABX in AOM?
5 days.
10 days if <2 yrs or age or perforation
Auricular haematoma presentation
Tender, tense, fluctuate mass, most commonly seen on the anterior pinna. Usually from direct trauma.
Auricular haematoma management
Need a aspiration of less than 2 cm incision and drainage of greater than 2 cm. Pressure dressing should be placed afterwards.
Auricular haematoma complication
Cauliflower ear
Methods for ear foreign body removal
Suction catheter, forceps, adhesive wrapped around cotton, applicator, or saline irrigation
Most common age for mastoiditis
<2 yrs of age
Two types of patients that get malignant otitis externa
Elderly diabetics and younger immuno compromised (AIDS)
Complications of otitis media
Perforation, mastitis, otic meningitis, intracranial, abscess, and Venus thrombosis
How does a malignant tern represent present?
Ear pain, drainage, periauricular pain and swelling,
Granulation tissue on ear canal floor is hallmark
Exam findings of mastoiditis
Erythema, mastoid tenderness, auricle is pushed out and down
Treatment for SSNHL
Oral prednisone
Describe Weber and Rinne tests
See google drive
Techniques for nasal foreign body removal
Mother’s kiss, Fogerty catheter, suction catheter, forceps
Percentage of anterior versus posterior epistasis
90% anterior
Management of nosebleeds
Blow nose.
Hold pressure for 20 minutes
Do this three times
Silver nitrate cautery
Topical vasoconstrictors
Anterior balloon
Posterior balloon
Foley catheter 10-14 French
Then packing in front of foley
Signs for bacterial sinusitis
Symptoms beyond 10 days or double worsening phenomenon
What is leukoplakia
Hyperkeratotic response to irritation, can pre cancerous. Does not scrape off easily
Distinguishing feature of oral thrush
Plaques are easily scrapped off and have red underneath
cavernous sinus thrombosis presentation
preceeding sinusitis or facial infection
HA, fever
CN palsy, esp CN 6
diagnosis of cavernous sinus thrombosis
CT venogram
glands and ducts of salivary system
parotid gland = Stenson’s ducs (sides)
submandibular gland = warton ducts (under tongue)
unilateral vs bilateral sialadenitis
unilateral = bacterial (often can express pus from duct)
bilat = viral (often mumps)
sialolithiasis vs sialadenitis
stone in duct causing obstruction
vs
infection of gland (infection can come from obstruction)
mgmt of sialolithiasis and sialadenitis
rehydration, secretagogue (lemons), duct massage, abx if bacterial infection suspected
what is ludwig’s angina
cellulitis of floor of mouth that spreads rapidly –> can lead to airway obstruction and death
most common trigger for Ludwig’s angina
recent dental infection or molar extraction
symptoms and dx of ludwig
dx is clinical, but can ct to confirm/characterize
neck pain/stiffness, dysphonia, dysphagia,
woody indurated swelling and floor of mouth
can also present with stridor and other signs of impending airway loss
4 causes of sore throat that aren’t “regular viral”
GAS
diphtheria
mononucleosis
gonorrhea
what is one tx you can use for any pharyngitis?
dex 10 po
severe sore throat, but oropharynx examines pretty normal.. think?
epiglottitis or supraglotitis
can do awake look with VL or nasopharyngoscopy
presentation of PTA?
trismus, deviated uvula to contralateral side, sore throat, bad breath
epiglottitis s/s
hot potatoe voice, severe sore throat (with relatively normal exam), fever only 50% of time
retropharyngeal abscess s/s
drooling, torticollis, muffled voice, pain with lateral movement of trachea (“tracheal rock sign”), trismus,
neck xray signs for:
croup
RPA
epiglottitis
croup = steeple sign (on AP is subglottic narrowing)
RPA= side retropharyngeal space
epiglottitis = thumbprint sign (lateral xray)
bacterial tracheitis most commonly mimics what
croup
how to differentiate croup for bacterial tracheitis
pts who look toxic, don’t respond to typical treatments or have ragged/hazy trachea on lateral neck xray
most feared complication of tracheostomy
tracheoinnominate fistula
