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FNP I > ENT > Flashcards

ENT Flashcards

1
Q

What are the two types of hearing loss?

A

Conductive

Sensorineural

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2
Q

Conductive Hearing Loss Consists of

A

External or middle ear

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3
Q

What are some causes of Conductive Hearing Loss?

A

Cerumen Impaction
TM perf
Fluid accumulation
Tympanosclerosis (hardening of the tissues of the middle ear)

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4
Q

Sensorineural Hearing Loss Consists of

A

Inner ear or damaged 8th Cranial Nerve

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5
Q

Causes of Sensorineural Hearing Loss

A 
Acoustic neuroma
Meniere’s Dz
Ototoxic drugs
Injury form noise
Viral (after mumps)
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6
Q

Presbycusis

A

Hearing loss due to aging

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7
Q

Any sudden hearing loss is

A

an emergency

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8
Q

Diagnostic tests for hearing loss

A
  1. Weber

2. Rinne

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9
Q

Rinne Test Normal Finding

A

AC (air conduction) > BC (bone conduction)

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10
Q

Rinne Conductive Hearing Loss

A

BC>AC
Tone heard louder in the affected ear
(CB—conductive bad)

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11
Q

Rinne Sensorineural Hearing Loss

A

AC>BC or AC=BC

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12
Q

Hearing loss can cause _________ in children

A

delayed speech

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13
Q

Hearing loss treatment

A

Remove cerumen impaction with Debrox or Murine
Abx to treat OM
Decongestants for serous otitis
Refer to ENT if conductive hearing loss does not improve w/ Tx

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14
Q

Otitis Externa

A

Aka Swimmer’s ears

Extremely painful to touch

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15
Q

Treatment for Otitis Externa

A

Ciprofloxin & Hydrocortisone (intact TM): 3 gtts BID x 7 days (>1 year)
Ofloxiacin Otic drops 5 gtts affected ear qdx 7 days (6 mos-13 years); Adults 10 gtts qd x7 days
Neomycin sulfate 3.5mg, polymixinb sulfate 1000 units & hydrocortisone 10mg/ ml (Adults 4gtts qid, 2-16 years 3 gtts tid Max 10 days)
2 % Acetic acid (50/50 mix with water) after swimming. Keeps ph acidic

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16
Q

No gtts for otitis externa if

A

TM is perforated

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17
Q

Otalgia

A

ear pain

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18
Q

Otorrhea

A

drainage form the ear

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19
Q

Otitis Median SS

A 
Otalgia
Otorrhea
TM redness (not always present)
Effusion may persist for months can cause hearing and speech problems
N/V
Fever (often coexist with URI symptoms)
anorexia
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20
Q

Otitis Media Treatment

A

Watchful waiting for kids 2-12

Amoxil 80-90mg/kg/dose

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21
Q

Tympanosotmy may be placed for

A

persistant effusions and it allows Cx of fluid

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22
Q

Foreign body in ear

A

Kill bugs w/ mineral oil or petroleum jelly

Assess object 1st before attempting to remove the foreign object

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23
Q

What is serous otitis?

A

fluid build up in middle ear

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24
Q

Treatment for serous otitis

A 
Open eustachian tube
Antihistamines
Decongestants
Nasal steroids
Valsalva
Gum chewing
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25
Q

Cholesteatoma

A

a cyst or skin growth behind the TM of into the mastoid

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26
Q

Cholesteatoma cause

A

recurrent infection

congenital (rare)

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27
Q

Cholesteatoma symptoms

A 
recurrent drainage
full feeling
dizziness
facial paralysis
Hearing loss
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28
Q

Cholesteatoma Tx

A

surgical removal

29
Q

Tinnitus

A

refer some tx available

occurs due to trauma

30
Q

Meniere’s Disease Sxs

A 
Vertigo
Hearing loss
tinnitus
aural fullness
unilateral hearing loss
lasts 24 minutes to 24 hours
31
Q

Meniere’s Disease Cause

A

syphilis
chronic OM
trauma
Endolumpatic hydrops (fluid in middle ear)

32
Q

Meniere’s Disease Tx

A

surgery
vestibular sedative
chemical ablation

33
Q

Mastoiditis

A

Infection of the mastoid process
Has the potential to spread to meningitis of brain
More common in kids

34
Q

What is the most common causative agent of mastoiditis?

A

Strep pneumoniae H-flu

Group A beta hemolytic strep

35
Q

Treatment for Mastoiditis

A

(High dose PCN or IV abx)
Augmentin
Biaxin
Bactrim

36
Q

Epistaxis

A

nosebleed

37
Q

What do you want to check for with epistaxis?

A 
CBC
liver disease (if present treat)
38
Q

Causes for epistaxis

A

trauma

liver disease

39
Q

Tx for Epistaxis

A

Ice pack, keep head up and forward (for trauma)

May need a vasoconstrictor (Neosynephrine or packing)

40
Q

Acute Viral Rhinitis

A

Common cold

has a sudden onset

41
Q

SS of Viral Rhinits

A 
low or no fever
mild pharyngitis
erthemic TM
erythemic nasal mucosa
thin discharge with mucopurulent after 2-3 days
post nasal drip
42
Q

Treatment for Viral Rhinitis

A

usually not needed

self limiting

43
Q

Allergic Rhinitis

A

Caused by allergens releasing histamine—Causing pale boggy turbuniates

44
Q

SS of Allergic Rhinitis

A

Clear discharge
Nasal crease
Conjuctival edema
Dry hacky cough

45
Q

Tx for Allergic Rhinitis

A 
Nasal steroids (2nd gen b/c r less drowsy than antihistamines)
Leukotriene inhibitor (Singulair)
46
Q

Vasomotor Rhinitis SS

A

Stuffiness
Clear or mucoid discharge
Sneezing
Drippy nose

47
Q

What causes vasomotor rhinitis?

A

Changes in blood flow to nares
Temperature change
Pollutants
Tobacco

48
Q

Tx for Vasomotor Rhinitis

A 
Mast cell stabilizers (Astelin)
Anticholinergic sprays (Atrovent)
49
Q

Afrin

A

It is a rhinitis medication that causes rebound reaction which is worse than the original symptoms
SS include nasal stuffiness and congestion along with pale boggy turbinates

50
Q

Acute Sinusitis SS

A 
Low grade fever
Mucopurulent nasal discharge or pressure
PND (post nasal drainage)
Edema
Facial tenderness
Tooth ache
51
Q

Tx for Acute Sinusitis

A

URI >7 days therapy for 10-14days
CT scan after 6 week Tx
Surgery

52
Q

Epstein Barr Virus

A

Pharyngitis caused by Mononucleosis

Occurs in adolescent and young adults

53
Q

SS of Mononucleosis

A 
Fever
Fatigue
Dysphagia
Posterior and anterior pre auricular lymph eedma
Soft palate petechaie
54
Q

What diagnostic test is done for Epstien Barr aka Mononucleosis?

A

Heterophil antibody test
CBC
Throat Cx if unsure of viral vs. bacterial infection

55
Q

Patient education with Mononucleosis

A

No contact sport x4 weeks (at least)
Avoid heavy lifting x4 weeks
No running x2 weeks

56
Q

Herpangina

A

Usually caused by coxsackie virus

Type of phyrangitis most common in children during the summer

57
Q

SS of herpangina

A

Fever
Cervical lymph edema
Ulcerations or vesicles on soft palate and tonsillar pillars

58
Q

Tx for Herpangina

A

Usually self-limiting

Tylenol for the fever

59
Q

Cocsackie Virus

A

causes pharyngitis
SS include malaise, diarrhea, lesions, cervical lymph edema; eroding vesicles and oral mucosa
vesicles on palms and soles of feet as well
Maalox to treat inflammation

60
Q

Strep Throat SS

A

erythema
sometimes white patches
scarlet fecer rash 2ndry to reacton to strep toxins

61
Q

Strep Throat Tx

A

Amoxil x10days (to reduce the risk of Rheumatic heart disease)
Macrolides
Cephalosporins
Clindamycin if allergic to PCN

62
Q

Peritonsillar abcess

A

in 20-30; rare <12
Excessive drooling
Muffled voice (hot potato)

63
Q

Tx fo Peritonsillar abcess

A

Requires aspiration in ED of ENT office

Clindamycin

64
Q

Epiglotitis

A

kids <2
MEDICAL EMERGENCY
Inflammation of the epiglottis (cartilage that covers the trachea)

65
Q

Epiglotitis Tx

A

IV cephalosporins

66
Q

Influenza

A

Highly contagious viral infection

67
Q

Influenza Tx

A

Tamiflu give w/in 48hours of Sx onset

68
Q

Tamilfu is pregnancy category

A

C

not safe for kids <1

FNP I (4 decks)

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