ENT Flashcards
1
Q
What is the main cause for ear squeeze
A
inability of eustachian tube/ear drum to equalize
2
Q
what is the cause for ear squeeze
A
changes in pressure low or high could be because of pre-existing condition infection PE tubes Iatrogenic
3
Q
How does someone with ear squeeze present to you upon examination
A
They may have ear pain, rupture, hemorrhage
damage to ossicles or round window
there is tinnitus (immediate or delayed)
If they have vertigo they will have severe damage
4
Q
If someone presents with ear squeeze what type of tests would you want to order/preform to confirm the diagnosis
A
Check hearing and balance
check the mobility of the Tympanic Membrane
See if there is bleeding or rupture of the Tym. Mem
5
Q
How would you treat someone with Ear squeeze
A
If they have a mild condition- decongestant (oxymetazalone, psedophedrine)
moderate cinditions- steroid and antibiotics as well as decongestants
Severe condition- myringotomy, pain control and ENT follow up as well as decongestant and antibiotic
6
Q
What is a myringotomy
A
it is a tiny incision that is made into the ear to relieve the pressure of excess fluid build up in the middle ear
7
Q
What causes sinus squeeze
A
changes in air pressue
pre-existing condition such as polyps, allergies, previous surgery
Chronic inflammation
sinus squeeze
8
Q
What tests/exam would you do to check to see if someone was having sinus squeeze
A
transilluminate sinus
palpate the sinus with your hands
9
Q
how will a patient present in your office with sinus squeeze
A
they may have blood vessel ruptures
pain from pressure/ blood and epistaxis
10
Q
How do you treat a patient with sinus squeeze
A
hyperbaric chamber
decongestants, pain control
oxymetazalone (afrin)
ENT follow up
11
Q
What causes tooth squeeze
A
Air that get trapped between a tooth filling
12
Q
How will a patient with tooth squeeze present to you
A
pain or pressure in their tooth
13
Q
What test/exam would you check to see if they had tooth squeeze
A
use a tongue depressor to apply pressure on the tooth and also check for possible tooth infection
14
Q
How would you treat a patient with tooth squeeze
A
use a hyperbaric chamber
15
Q
What causes a Tympanic membrane perforation
A
Infection, trauma, iatrogenic, irrigation, PE tube
16
Q
How will a patient with Tym Mem perforation present to you
A
They will have hearing loss
Pain and sounds with equalization they will hear a whistling noise
17
Q
What test/exam would to perform to see if they had an ear drum perforation
A
Otoscopy
Bubble test
18
Q
How would you treat a patient with a Tym Mem perforation
A
antibiotic for perforation
often self healing
surgical repair
19
Q
What causes an external hematoma
A
Trauma to the ear lobe
The auricular perichondrium and cartilage separate
Very common in wrestlers
20
Q
How will a patient with External hematoma present to you in the office
A
The outer helix of the ear will be inflamed there is blood accumulation in the helix
can cause the ear to become deformed or get cauliflower ear
21
Q
How do you treat a patient with an external hematoma
A
Incision and Drainage then wrap the ear properly
22
Q
What is the cause for someone who has conductive hearing loss
A
they have some blockage of the external canal because of cerumen impaction
They could have inflammation of the external ear (OM)
Middle ear fluid collection
otosclerosis
eustachian tube dysfunction
Foreign Body in ear
23
Q
What test/exam would you want to preform on a patient who you think has conductive hearing loss
A
Hearing test (bedside) finger rub Weber test Rinne test tympanometry
24
Q
How will a patient present who has conductive hearing loss
A
they will have better hearing in the blocked ear
25
How do you treat a patient who has a conductive hearing loss
Hearing aids, removal of cerumen
| cochlear implants and surgical removal of cholesteotoma
26
What is the etiology of a sensorineural hearing loss?
loss of hearing from the inner ear to the brain
auditory
cranial nerve
27
What causes a sensorioneural hearing loss
```
Most common is presbyacusis associated with aging
chronic noise exposure
menieres disease
ototoxicity
neoplasms
vascular disease
demyleniating, infections and trauma
```
28
What is presbyacusis
it is an age related hearing loss that is usually symmetric loss. People with this tend to lose their quality of hearing. Usually starts with high frequency and the affects all frequencies of hearing
29
What causes Menieres disease
starts in the 5th decade of life intermittent hearing loss it is associated with vertigo
Tx: low sodium diet, thiazide diuretic, short course of steroids
29
What causes Menieres disease
starts in the 5th decade of life intermittent hearing loss it is associated with vertigo
Tx: low sodium diet, thiazide diuretic, short course of steroids
30
what is ototoxicity
hearing loss that is caused by medications which damages the hair cells of the organ of corti
30
what is ototoxicity
hearing loss that is caused by medications which damages the hair cells of the organ of corti
31
What meds have an increased risk of ototoxicity
```
salicylates(NSAID, Asprin)
Quinine
Aminoglycosides
loop diuretics
cisplatin
```
31
What meds have an increased risk of ototoxicity
```
salicylates(NSAID, Asprin)
Quinine
Aminoglycosides
loop diuretics
cisplatin
```
32
What is an acoustic neuroma (schwanoma)
brain tumor affecting auditory pathway if this is the case most patients will present with unilateral hearing loss
32
What is an acoustic neuroma (schwanoma)
brain tumor affecting auditory pathway if this is the case most patients will present with unilateral hearing loss
33
what is the cause of tinnitus
```
associated hearing loss
can be first symptoms of serious conditions (schwanoma)
acoustic trauma
vascular tumor
If caught early enough can use steroids
```
33
What is the underlying problem with someone who suffers from a acoustic neuroma
issues with cranial nerve 8
- acoustic
- vestibular where this tumor arises from schwann cells of the myelin sheath of the nerve cell
34
What causes mixed hearing loss
from trauma to neoplasm which causes a combination of conductive and sensorineural loss
34
What causes mixed hearing loss
from trauma to neoplasm which causes a combination of conductive and sensorineural loss
35
How to test for mixed hearing loss
finger rub test or whispered word in each ear
35
How to test for mixed hearing loss
finger rub test or whispered word in each ear
36
What is tinnitus
perception of sound when there is no sound.
| they will hear the sound of buzzing or ringing
37
what is the cause of tinnitus
```
associated hearing loss
can be first symptoms of serious conditions (schwanoma)
acoustic trauma
vascular tumor
If caught early enough can use steroids
```
38
What is the underlying problem with someone who suffers from a acoustic neuroma
issues with cranial nerve 8
39
Where does this tumor arise in the brain
at the cerebellopontine angle in the posterior fossa of the brain near CN7
40
How will a patient with a acoustic neuroma
they will have asymmetric sensorineural hearing loss or unilateral tinnitis. They wont have true vertigo. They will also have unilateral facial weakness (bells palsy)
41
How do you treat a patient with acoustic neuroma
send patient for a consult with a neuro for tumor removal. The CN 8 gets sacrificed and they are very careful to spare the CN7
42
What is vertigo
is it a pathology of the cochlea, middle ear and the acoustic portion of the CN8
43
How will a patient present with vertigo?
they will have a false sense of movement. The environment will be spinning to them. They may be nauseous and vomit. They can also have ataxia
44
What is the treatment for a patient with vertigo
Bed rest, IV fluids, antihistamine, benzodiazapine and vestibular exercises. The CNS will adjust itself
45
What is the etiology of peripheral vertigo
pathology of the cochlea, middle ear, and the acoustic portion of the CN8
46
How does a person with peripheral vertigo present
they will have hearing loss, tinnitus and unidirectional nystagmus
47
What is the etiology of a person suffering from central vertigo
it affects their brainstem or cerebellum
48
How will a patient with central vertigo present
rarely causes hearing loss and tinnitus.
Diplopia (double vision), homonymous hemianopsia, facial weakness/numbness. They will have sensory complaints. The will have dysarthria (trouble speaking)/swallowing. Ataxia and they will have persistent multidirectional nystagmus after vertigo resolves
49
How does benign paroxsmal positional vertigo (BBPV) start
Most common form of vertigo and most recurrent. Onset of vertigo seconds after assumption of certain head position. Usually lying supine
50
How do you diagnosis a person with BBPV
you will do the dix-hallpike maneuver. The pt sit on the exam table and turn head 45 degrees to right. The examiner brings patient to the supine position on the table with head extended over the table at 30 degree. look for nystagmus
With BPPV there with be a fatigue ability of the vertigo symptoms
51
How will a patient present with movement related vertigo
they will have vertigo in almost any position. There is no latency period and there is not fatigue ability
52
How will a patient present with meniere's disease
recurrent episodes of vertigo, hearing loss, tinnitus, aural fullness, typically all symptoms are present with each episode. Attacks last 30min-24hr
53
How will a patient present acute peripheral vestibulopathy
gradual onset of peripheral vertigo attacks, incapacitating form. mild ataxia toward side of lesion
54
What is the cause of presyncope
CV problems with neurological symptoms,
| causes-hypertventilation syndrom, anxiety, othrostatic hypertension, hypoglycemia
55
what type of test would want to do for a person with presyncope
reproduce with hyperventilation and use an EKG
56
How will presyncope present in patients
lightheadness will occur while pt is standing. It will accompanying sudden pain or strong emotion. More likely in a hot crowded room. premonition of syncope, yawing, diaphoresis, pallor can be associated symptoms. Occurs in young health people
57
how do you treat someone with presyncope
adjust medication, slow postural changes, elastic stockings, avoidance of precipitants
58
what causes disequilibrium
visual impairment, vetibulopathy, medication, slow growing neoplasm of posterior fossa, peripheral neuropathy in lower extremities
59
How will a patient present with disequilibrium?
more common in the elderly, dizziness is more constant and maximized with standing or ambulation (walking), they complain of feeling off balance or unsteady
60
How do you treat a person who has disequalibrium
dopamine agents, vp shunt, cane, vestibular exercises
61
What is the cause of ceruminosis
debris off of canal which is normal shedding. Q tips can cause it to get worse
62
How do you treat a patient with pericondritis
systemic antibiotics, I&D
63
What is the cause of otitis externa
inflammation of the skin of the external ear canal and surrounding soft tissue
64
What causes Auricular cellulitis
infection of skin overlying the external ear mostly caused by S. aureus, strepococci
65
How will a person with auricular cellulitis present
tenderness, erythema, swelling, and warmth of external ear, no involvement of inner ear of canal rubor, calor, dolor, tumor
66
How do you treat a person with auricular cellulitis
warm compress, oral antibiotics, IV antibiotics
67
What is pericondritis
it is an infection of the perichondrium of the auricular cartilage due to local trauma, ear piercing, burns, or lacerations. caused by S aureus
68
how will a person with otitis media present
history of acute onset signs and symtpoms of middle ear inflammation and middle ear effusion
bulging and limited mobility of air/ fluid behind T M or otorrhea and a fever
69
How do you treat a patient with pericondritis
systemic antibiotics, I&D
70
What is the cause of otitis externa
inflammation of the skin of the external ear canal and surrounding soft tissue
71
What is the pathogen that causes otitis externa
S aureus, P aeruginosa
72
How will a patient with otitis externa present
maceration from loss of protective function of cerument and increase moisture, increased pH in the canal, trauma, ear plugs, contact dermatitis, secondary infection with MC perforation
73
How would you treat a patient with OE
```
otic drops (fluoroquinolone, neosporin, steroids) Ear wicks, moist heat,
Can be prevented with one footed dance, 1:1 white wine and 70% ethyl alcohol, 2% acetic acid drops
```
74
how to treat a person with eustachian tube dysfunction
PE tubes MEE >4months, hearing impairment
75
How would you test/ examine a pt with OM
otoscopy to check for red bulging T M, see if cerumen needs to be removed
76
How would you treat a patient with patient with a cholesteotoma
surgical repair of the Tympanic membrane (tympanoplasty, myringoplasty, mastoidectomy
77
how will a person with eustachian tube dysfunction present
middle ear fills with serous fluid which is caused by Eustachian tubes that don't drain properly
78
How would you check to see if someone had eustachian tube problems
pneumatic otoscopy, tympanometry, toynbee test, MRI/CT/ET cath, nasopharyngoscopy
79
What are risk factors for eustachian tube dysfunction
younger than 6yo, tobacco, suction, obesity
80
how to treat a person with eustachian tube dysfunction
PE tubes MEE >4months, hearing impairment
81
what is the cause of foreign bodies in children
present in children >9mo
| food particles, organic material, small toys, beads pencils erasers, rocks
82
how to remove foreign bodies from ears
reduce swelling, vasoconstriction meds, suction/glue, forceps immobilize insects, positive pressure
83
How would you treat a patient with patient with a cholesteotoma
surgical repair of the Tympanic membrane (tympanoplasty, myringoplasty, mastoidectomy
84
What causes mastoiditis
inflammation of the mastoid periosteum to bony destruction of the mastoid air system
85
How will a patient present with mastoiditis
unilateral, tender inflamed, painful abcess
86
How do you treat a patient with mastoiditis
ENT consult, drainage, myringotomy, mastoidectomy( last result) ct scan
87
what is the cause of foreign bodies in adults
insects, teeth, hardened concrete, illicit drugs,
88
what is the cause of foreign bodies in children
present in children >9mo
| food particles, organic material, small toys, beads pencils erasers, rocks
89
how to remove foreign bodies from ears
reduce swelling, vasoconstriction meds, suction/glue, forceps immobilize insects
90
what is the etiology for allergic rhinitis
atopic triad -eczema,asthma, allergic rhinitis
91
How will a patient with allergic rhinitis present to you
clear watery rhinorrhea, sneezing, nasal congestion/obstruction, increased lacrimation/red eyes, pruritis of conjunctiva, nasal mucosa and oropharynx, post nasal drip with sore throat, cough. allergic salute. It shows a patter of seasonality linked to environmental history, occupational exposure
92
What labs/exam would you want to perform on someone you suspect had allergic rhinitis
look up their nose with a scope it will appear pale bogy nasal mucous, they may have nasal polyps, nasal smears, allergen specific IgE
93
How to treat a patient with allergic rhinitis
avoid allergens, antihistamines, nasal spray, decongestants, afrin, glucocorticoids, immunotherapy
94
What is the cause of vasomotor rhinitis
resembles perennial rhinitis but is secondary to non-specific stimuli like chemical odors, temp, humidity variation and position changes, pregnancy
95
How to treat a person with vasomotor rhinitis
treated with topical antihistamines, topical decongestants and topical anticholinergics
96
what are nasal polyps
pale edematous mucosally covered masses
mostly benign
can cause chronic nasal congestion and decreased sense of smell. There can be single or multiple polyps. They are seen in pt's with asthma, allergies, CF
97
What are the signs or symptoms of a person with nasal polyps
nasal obstruction, anomia (lack of smell), chronic sinusitis, snoring and bad breath,
98
How would to determine if someone had nasal polyps
physical exam of anterior rhinoscopy, check ears and pharynx, CT scan
99
How would you treat nasal polyps
topical steroids is primary treatment, oral steroids- short taper. Treating co-morbities. ENT referral for surgical removal if needed
100
What is the pathology for sinus infections
most common due to viral URI. IT can be very hard to tell if it is viral or bacterial
101
What bacteria are responsible for infecting sinuses
S. pneumonia, and H. Influenza they make up about <2% of infection
102
What causes acute sinusitis
mucosal edema which decreases mucus transport which leads to the mucus not moving which promotes viral or bacterial proliferation
103
What are some risk factors for sinusitis
smoking, rhinitis, asthma, structural deformities (deviated septum,polyps, tumor, foreign bodies)
104
What are some of the complications of acute sinusitis
orbital cellulitis, osteomyelitis, subcutaneous abcesses, CNS complications, potts puffy tumor
105
what are the signs and symptoms of a person with acute sinusitis
purulent discharge, facial pain, nasal obstruction, fever,headache, halitosis, fatigue, dental pain, ear fullness, cough, anosmia
106
what is the best test/exam you can preform to acute sinusitis
sinus aspiration and culture
107
how do you treat sinusitis
analgesics and antipyretics, fluids, intranasal corticosteroids, decongestants, mucolytics, saline irrigation, antibiotics
108
What causes chronic sinusitis
symptoms lasting longer than 12 weeks due to infections with MRSA, fungal
109
How will a patient present with xerostomia
dry mouth,lips, throat, difficulty chewing, swallowing, speaking, oral pain and pale mucosa
110
What is epistaxis what causes it
bleeding in the nose from anterior to posterior
111
where does most anterior epixtaxis occur
in kiesselbach's plexus which are capillary in origin more common in young patients less severe and easier to control
112
Where does posterior epistaxis occur and whats its origin
common in woodruffs plexus harder to control because they are aterial in origin can compromise the airway. more common in adults
113
what are causes of epistaxis
trauma, irritation, inflammation, tumors, dessication, foreign body, infection, ateriosclerosis, bleeding problems, hypertension
114
How do you treat epistaxis
use PPE, have pt blow nose first, use anesthetic, vasoconstricting meds, cautery, silver nitrate , nasal packing, antiobiotics, plug nose for 10minutes, sticks monitor vitals NEVER USE EPINEPHRINE
115
what causes xerostomia
decreased salivary flow, constant antimuscarinic meds, chemotherpay, autoimmune disorders (sjorgen's syndrome) and social habits
116
How will a patient present with xerostomia
dry mouth,lips, throat, difficulty chewing, swallowing, speaking, oral pain and pale mucose
117
How do you treat a patient with xerostimia
preventative measure to prevent decay and erosion of teeth, fluoride, good dental hygiene,
Oral rinses and gels, mouthwash, water and decrease caffeine and ETOH, Chew gum or sugar free candy
Pilocarpine and cevimeline
118
What is a mucocele
it is a fluid filled cyst caused by trauma or obstruction which usually occurs on the lower lip that is usually painless
119
How will a patient present with mucocele
fluid filled cyst on lower lip, it is as big as a few mm to a few cm. The cyst will be painless
120
How would you treat a person with a mucocele
small ones will go away on their own larger ones will sometimes need surgical excision particularly ranula's (located on the floor of the mouth
121
how will a patient present with salivary gland enlargement
there will be an area of hardness, erytherma, edema, heat would suggest infection, dry mucous membranes, look for lymphadenopathy and look for facial nerve function
122
How do you treat a patient with bacterial parotiditis
stimulate salivary glands, Antibiotics, Surgery I&D if no improvement after 2-3 days on antibiotics, warm compress
123
how will a patient with mumps parotitis present
usually age 4-6, short prodrom with a low temp maliase, ear pain, sudden painful lump of salivary gland
124
How do you treat mumps parotitis
treat symptoms, MMR vaccine
125
what causes bacterial parotitis/ sialadentitis
caused by S. aureus including MRSA anaerobic bacteria the most common
126
What are some risk factors for bacterial parotiditis/Sialadenitis
dehydration, chronic illness, advanced age, postop state, immuno compromised, poor oral hygiene, trauma
127
How will a patient present with bacterial parotitis/ Sialadenitis
its an acute sudden onset of unilateral swollen and painful salivary gland, tender, purulent discharge coming from duct which may be expressed
128
what causes parotitis
it can be viral, bacterial, sialolithiasis, tumors, chronic disease. These are parotid gland disorders
129
What are the most common places these salivary gland tumors are found
in parotid gland most common is pleomorphic adenoma (begnin) the most common malignant is warthrins. treatment id based on staging
130
what type of test/exam would you want to perform for a patient with salivary gland enlargement
X-ray to rule out stones, Ultrasound, Sialography, CT/MRI
131
How do you treat a patient with bacterial parotiditis
stimulate salivary glands, Antibiotics, Surgery I&D if no improvement after 2-3 days on antibiotics, warm compress
132
What is the etiology of Sialolithiasis
its unknown, occurs primarily in the submandibular gland
133
How does a pt present with Sialolithiasis
history of acute, painful intermittent swelling of the affected gland, swells when the pt eats
134
How would you test/examine for sialolithiasis
history and palpation, X-ray, U/S, CT, Sialoendoscopy
135
How do you treat a patient with sialolithiasis
supportive (analgesics, hydration, antipyretics, Abx) and referral to ENT surgery
136
How will a patient present with salivary gland tumors
slow growing, painless, that are non-tender mobile and firm
137
What are the most common places these salivary gland tumors are found
in parotid gland most common is pleomorphic adenoma (begnin) the most common malignant is warthrins. treatment id based on staging
138
What is the pathophysiology of viral croup
parainfluenza virus that usually occurs during the fall/winter months.
139
How will a patient present who has viral croup
afebrile or low grade fever, stridor barking cough, most common at night
140
How do you treat a patient with croup
cool moist air, O2, epinephrine via nebulizer, steroid
141
What is the pathology of epiglottitis
hemophilus influenza type B
142
how will a patient present with epiglottitis
high fever, toxic appearance, drooling, dysphagia, muffled voice, inspiratory retractions, soft stridor, tripod breathing stance, sniffing dog positon
143
What would you want to test/examine to determine if a pt had epiglottitis
An x-ray will show a thump print sign
144
How do you treat a patient with epiglotitis
immediate intubation, blood work, IV antibiotics, then tailor Abx after culture, extubate
145
What is the cause of laryngitis
it can be because of infection viral, bacterial, non-infectious (cancer, overuse, reflux)
146
how will a patient present with laryngitis
they will have hoarness, reduced vocal pitch or aphonia, pt will point to larynx, red swollen vocal cords will irregular edges
147
how to treat a patient with laryngitis
treat symptoms decrease time talking even whispering, hydration, inhale humidified air
148
what is the pathology of laryngopharyngeal reflux
larynx is sensitive to small amounts of acid or pepsin
149
how will a pt present with laryngopharyngeal reflux
they will frequently clear their throat, dry cough, hoarsness, globus sensation (feels like you have something in your throat) lacks heartburn
150
how will you treat a pt with laryngopharyngeal reflux
modify diest and behavior, avoid greasy and acidic foods, tobacco, alcohol, caffeine, lose weight, avoid laying down after meals, proton pump inhibitors
151
How will a patient present with GERD
heartburn, indigestion, regurgitation, vomitus does not reach the larynx or upper aerodigestive tract
152
what is the pathophys of leikoplakia
premalignant lesion which is basically a scab in larynx
153
how will a patient present with leukoplakia
they will have a hoarseness
154
what do you do with a patient who might have leikoplakia
biopsy
155
How will a patient present with squamous cell carcinoma
its most common in males, pts will have SOB, odynophagia, globus sensation, stridor, hemoptysis, mass in their neck, weight loss
156
How do you treat a person with squamous cell carcinoma
biopsy it,, then usually use surgery, radiation, chemoptherpy
157
What is the cause of laryngeal papillomatosis
HPV 6,11, 16
158
How will a patient present with Laryngeal papillomatosis
usually 1st born, teen mother, vaginal delivery. Mom has HPV. Pt will have hoarness, voice changes, croupy cough, and stridor
159
how do you treat a person with laryngeal papillomatosis
surgical excision, HPV vaccine
160
what causes vocal cord nodules
benign lesions arising from mechanical trauma, hyperthyroidism
161
how will patient present with vocal cord nodules
hoarseness
162
How will exam show vocal cord nodules
solid lesions usually in anterior 1/3 of vocal fold
163
how do you treat a patient with vocal cord nodules
speech therapy, treat underlying condition, surgery if recalcitrant
164
what causes a vocal cord cyst
it is a fluid filled lesion that arises from possible trauma, benign growth
165
how to treat a person with vocal cord cyst
speech therapy, treat unerlying condition and surgery if necessary
166
what causes cricopharyngeal spasms
dysfunction of upper most esophageal valve which doesn't allow esophagus to open right
167
how will a patient present with cricopharyngeal spams
dysphagia, collection of liquid or food in back of throat
168
how do you treat a person with cricopharyngeal spams
its self limiting, can use muscle relaxers, decrease stress
169
what causes vocal cord paresis (paralysis)
latrogenic surgical injury, nonlaryngeal malignancy, trauma, neuro cause, idopathic
170
how do you treat a patient with glottic stenosis
tracheostomy with subsequent cartilage graft for reconstruction
171
how to treat a patient with vocal cord paralysis
treat underlying cause, can inject substances to plump up paralyzed cord, surgery
172
what is the patho of reinkes edema
its a bilateral edema which is most common in smokers, chronic edema
173
how will a patient present with reinkes edema
hoarseness
174
how to treat a person with reinkes edema
stop smokeing, speech therapy, possibly surgery
175
what causes glottic stenosis
narrowing of the larynx at the glottis level, narrowed cricoid region, most common from prolonged intubation
176
how will a patient present with glottic stenosis
stidor, recurrent croup, think neonates and infants
177
how do you treat a patient with glottic stenosis
tracheostomy with subsequent cartilage graft for reconstruction
178
what causes pharyngitis
viral or bacterial
179
how will a patient with viral strep present
sore throat, cough, cold, joint and muscle pain, low fever
180
how will a patient with bacerial strep present
sore throat, anorexia, maliase,headache, mid to high fever, cough is rare. tonsillar exudate, strawberry tongue
181
how do you treat viral strep
tx symptoms
182
how do you treat bacterial strep
Penicillin or erythromycin
183
what are the causes of tonsillitis
can be bacterial or viral
184
how will a patient with tonsillitis
sore throat, dysphagia, fever, headache, earache
185
How to treat tonsillitis
culture, if viral treat symptoms, if bacterial penicillin or erythromycin
186
How do you determine whether pharyngitis is bacterial or viral
rapid strep
187
what causes perotonsillar abcess
an infection with an abscess and puss between the anterior and posterior tonsillar pillars and the superior pharyngeal constrictor muscle. called quinsy
188
how will a patient present with peritonsillar abscess
worsening sore throat 1-2 wks, painful throat and neck, high fever, dysphagia, hot potato voice, usually follows pharyngitis, or tonsillitis
189
how to check for peritonsillar abscess
Ct will show cavity and edema
190
how do you treat a patient with peritonsillar abscess
prompt ENT consult, needle apsiration, I&D, tonsillectomy, ABx
191
what causes a retropharyngeal abscess
collection of puss in the tissues in the back of the throat, affects children under 5.
H. parainfluenzae, GABS, Staph
192
how will a patient present with retropharngeal abscess
fever, dysphagia, drooling, neck rigidity, unilateral bulging, hot potato voice, stridor
193
how to treat retropharngeal abscess
x-ray or Ct or culture
| Secure air way if signs of respiratory distress, consult with ENT, I&D and broad spectrum Abx
194
what is the cause of apthous ulcers
etiology is unknown
195
how does a aphthous ulcers present
single or multiple recurrent round ulcerations that are yellow or gray surrounding erythema. found
if they are painful stage 7-10 day
healing stage 1-3 weeks
196
how to treat aphthous ulcers
topical coritcosteroids, 1-2 weeks of prednisone
197
who is at high risk for periodontal disease
diabetics, alcoholics, tobacco users, low economic status
198
what are things that can affect teeth and gums
tetracycline, phenytoin, Ca blockers, cyclosporine
199
what causes cavities
bacteria that change food to acids which form plaques
200
what causes gingivitis
inflammation of the gums most common periodontal disease
201
how does ramsey hunt syndrome present
painful rash around the ear and on one side of the mouth, hearing loss on one side and difficulty eating on one side
202
What causes trigeminal neuralgia
involves entire branch or part of the mandibular or maxillary branches
203
how does trigeminal neuralgia present
pain present in one or more teeth with normal neuro exam
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how to treat trigeminal neuralgia
relieve pain
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what is ramsey hunt syndrome
varicella zoster infection around the ear that infects the facial nerve
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how does ramsey hunt syndrome present
painful rash around the ear and on one side of the mouth, hearing loss on one side and difficulty eating on one side
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what causes oral herpes infection
mucocutaneous infection of the mouth and lips by HSV
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how to treat temporomandibular disorder
reat, heat, anti-inflammatories, referral to specialistmore common in women, pain is limited to the mandibular movements, myofacial pain reffered from muscle of mastication
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how will a patient present with HSV
it will be seen on the lips or vermillion border of people but can be anywhere in the mouth,
they will be painful, sore, with burning or tingling or itching
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what causes most of the oral lesion
HSV-1
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how does HSV spread
touching infected saliva or mucous membranes or skin it is highly contagious
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what is a stage 1 of HSV
primary infection where virus enters thought the small cracks in skin or mucous membranes
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what happens during stage 2 of latency
from indirect site virus moves to dorsal root ganglia
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what happens during stage 3
recurrence, the virus is reactivated by certain emotional or physical stress
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how to treat HSV
need to treat within 48 hrs of onset with acyclovir. most require no treatment
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what is the cause of candidiasis
species of yeast that involves the mucosal membranes including the oropharynx
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Who is most susceptible to Candidiasis
males more than females, more prevalent in infants.
PTs usually taking steroids, oral contraceptive or abx's
seen in immunocompromised adults
Pts with DM
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How does candidiasis present in pts
develops suddenly, trouble feeding infants, sore throat, burning tongue, and sores slowly increase in size and number. The tongue will have white or gray plaques on gingiva or tongue. Sores bleed easily, Can scrape paques off
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how is the diagnosis usually made
made on physical exam, tongue scrapings can be sent for fungal culture
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how to treat a patient with candidiasis
sterilize nipples and bottle for infants,
mild cases acidophilus capsules are fine, diabetics need to get blood sugar in check,brush tongue, nystatin, clotrimazole, fluconazole,
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how to treat pts who cant take oral med for candidiasis
IV amphoterecon, anidulafungi
