ENT

Question 1

Duration of ABX in AOM?

Answer 1

5 days.
10 days if <2 yrs or age or perforation

Question 2

Auricular haematoma presentation

Answer 2

Tender, tense, fluctuate mass, most commonly seen on the anterior pinna. Usually from direct trauma.

Question 3

Auricular haematoma management

Answer 3

Need a aspiration of less than 2 cm incision and drainage of greater than 2 cm. Pressure dressing should be placed afterwards.

Question 4

Auricular haematoma complication

Answer 4

Cauliflower ear

Question 5

Methods for ear foreign body removal

Answer 5

Suction catheter, forceps, adhesive wrapped around cotton, applicator, or saline irrigation

Question 6

Most common age for mastoiditis

Answer 6

<2 yrs of age

Question 7

Two types of patients that get malignant otitis externa

Answer 7

Elderly diabetics and younger immuno compromised (AIDS)

Question 8

Complications of otitis media

Answer 8

Perforation, mastitis, otic meningitis, intracranial, abscess, and Venus thrombosis

Question 9

How does a malignant otitis externa present?

Answer 9

Ear pain, drainage, periauricular pain and swelling,
Granulation tissue on ear canal floor is hallmark

Question 10

Exam findings of mastoiditis

Answer 10

Erythema, mastoid tenderness, auricle is pushed out and down

Question 11

Treatment for SSNHL

Answer 11

Oral prednisone

Question 12

Describe Weber and Rinne tests

Answer 12

See google drive

Question 14

Techniques for nasal foreign body removal

Answer 14

Mother’s kiss, Fogerty catheter, suction catheter, forceps

Question 15

Percentage of anterior versus posterior epistasis

Answer 15

90% anterior

Question 16

Management of nosebleeds

Answer 16

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

Question 17

Signs for bacterial sinusitis

Answer 17

Symptoms beyond 10 days or double worsening phenomenon

Question 18

What is leukoplakia

Answer 18

Hyperkeratotic response to irritation, can pre cancerous. Does not scrape off easily

Question 19

Distinguishing feature of oral thrush

Answer 19

Plaques are easily scrapped off and have red underneath

Question 21

cavernous sinus thrombosis presentation

Answer 21

preceeding sinusitis or facial infection
HA, fever
CN palsy, esp CN 6

Question 22

diagnosis of cavernous sinus thrombosis

Answer 22

CT venogram

Question 23

glands and ducts of salivary system

Answer 23

parotid gland = Stenson’s ducs (sides)
submandibular gland = warton ducts (under tongue)

Question 24

unilateral vs bilateral sialadenitis

Answer 24

unilateral = bacterial (often can express pus from duct)

bilat = viral (often mumps)

Question 25

sialolithiasis vs sialadenitis

Answer 25

stone in duct causing obstruction vs infection of gland (infection can come from obstruction)

Question 26

mgmt of sialolithiasis and sialadenitis

Answer 26

rehydration, secretagogue (lemons), duct massage, abx if bacterial infection suspected

Question 27

what is ludwig's angina

Answer 27

cellulitis of floor of mouth that spreads rapidly --> can lead to airway obstruction and death

Question 28

most common trigger for Ludwig's angina

Answer 28

recent dental infection or molar extraction

Question 29

symptoms and dx of ludwig

Answer 29

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

Question 30

4 causes of sore throat that aren't "regular viral"

Answer 30

GAS diphtheria mononucleosis gonorrhea

Question 31

what is one tx you can use for any pharyngitis?

Answer 31

dex 10 po

Question 32

severe sore throat, but oropharynx examines pretty normal.. think?

Answer 32

epiglottitis or supraglotitis can do awake look with VL or nasopharyngoscopy

Question 33

presentation of PTA?

Answer 33

trismus, deviated uvula to contralateral side, sore throat, bad breath

Question 34

epiglottitis s/s

Answer 34

hot potatoe voice, severe sore throat (with relatively normal exam), fever only 50% of time

Question 35

retropharyngeal abscess s/s

Answer 35

drooling, torticollis, muffled voice, pain with lateral movement of trachea ("tracheal rock sign"), trismus,

Question 36

neck xray signs for: croup RPA epiglottitis

Answer 36

croup = steeple sign (on AP is subglottic narrowing) RPA= side retropharyngeal space epiglottitis = thumbprint sign (lateral xray)

Question 37

bacterial tracheitis most commonly mimics what

Answer 37

croup

Question 38

how to differentiate croup for bacterial tracheitis

Answer 38

pts who look toxic, don't respond to typical treatments or have ragged/hazy trachea on lateral neck xray

Question 39

most feared complication of tracheostomy

Answer 39

tracheoinnominate fistula