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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
Cholesteatoma
a cyst or skin growth behind the TM of into the mastoid
26
Cholesteatoma cause
recurrent infection | congenital (rare)
27
Cholesteatoma symptoms
``` recurrent drainage full feeling dizziness facial paralysis Hearing loss ```
28
Cholesteatoma Tx
surgical removal
29
Tinnitus
refer some tx available | occurs due to trauma
30
Meniere’s Disease Sxs
``` Vertigo Hearing loss tinnitus aural fullness unilateral hearing loss lasts 24 minutes to 24 hours ```
31
Meniere’s Disease Cause
syphilis chronic OM trauma Endolumpatic hydrops (fluid in middle ear)
32
Meniere’s Disease Tx
surgery vestibular sedative chemical ablation
33
Mastoiditis
Infection of the mastoid process Has the potential to spread to meningitis of brain More common in kids
34
What is the most common causative agent of mastoiditis?
Strep pneumoniae H-flu | Group A beta hemolytic strep
35
Treatment for Mastoiditis
(High dose PCN or IV abx) Augmentin Biaxin Bactrim
36
Epistaxis
nosebleed
37
What do you want to check for with epistaxis?
``` CBC liver disease (if present treat) ```
38
Causes for epistaxis
trauma | liver disease
39
Tx for Epistaxis
Ice pack, keep head up and forward (for trauma) | May need a vasoconstrictor (Neosynephrine or packing)
40
Acute Viral Rhinitis
Common cold | has a sudden onset
41
SS of Viral Rhinits
``` low or no fever mild pharyngitis erthemic TM erythemic nasal mucosa thin discharge with mucopurulent after 2-3 days post nasal drip ```
42
Treatment for Viral Rhinitis
usually not needed | self limiting
43
Allergic Rhinitis
Caused by allergens releasing histamine—Causing pale boggy turbuniates
44
SS of Allergic Rhinitis
Clear discharge Nasal crease Conjuctival edema Dry hacky cough
45
Tx for Allergic Rhinitis
``` Nasal steroids (2nd gen b/c r less drowsy than antihistamines) Leukotriene inhibitor (Singulair) ```
46
Vasomotor Rhinitis SS
Stuffiness Clear or mucoid discharge Sneezing Drippy nose
47
What causes vasomotor rhinitis?
Changes in blood flow to nares Temperature change Pollutants Tobacco
48
Tx for Vasomotor Rhinitis
``` Mast cell stabilizers (Astelin) Anticholinergic sprays (Atrovent) ```
49
Afrin
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
Acute Sinusitis SS
``` Low grade fever Mucopurulent nasal discharge or pressure PND (post nasal drainage) Edema Facial tenderness Tooth ache ```
51
Tx for Acute Sinusitis
URI >7 days therapy for 10-14days CT scan after 6 week Tx Surgery
52
Epstein Barr Virus
Pharyngitis caused by Mononucleosis | Occurs in adolescent and young adults
53
SS of Mononucleosis
``` Fever Fatigue Dysphagia Posterior and anterior pre auricular lymph eedma Soft palate petechaie ```
54
What diagnostic test is done for Epstien Barr aka Mononucleosis?
Heterophil antibody test CBC Throat Cx if unsure of viral vs. bacterial infection
55
Patient education with Mononucleosis
No contact sport x4 weeks (at least) Avoid heavy lifting x4 weeks No running x2 weeks
56
Herpangina
Usually caused by coxsackie virus | Type of phyrangitis most common in children during the summer
57
SS of herpangina
Fever Cervical lymph edema Ulcerations or vesicles on soft palate and tonsillar pillars
58
Tx for Herpangina
Usually self-limiting | Tylenol for the fever
59
Cocsackie Virus
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
Strep Throat SS
erythema sometimes white patches scarlet fecer rash 2ndry to reacton to strep toxins
61
Strep Throat Tx
Amoxil x10days (to reduce the risk of Rheumatic heart disease) Macrolides Cephalosporins Clindamycin if allergic to PCN
62
Peritonsillar abcess
in 20-30; rare <12 Excessive drooling Muffled voice (hot potato)
63
Tx fo Peritonsillar abcess
Requires aspiration in ED of ENT office | Clindamycin
64
Epiglotitis
kids <2 MEDICAL EMERGENCY Inflammation of the epiglottis (cartilage that covers the trachea)
65
Epiglotitis Tx
IV cephalosporins
66
Influenza
Highly contagious viral infection
67
Influenza Tx
Tamiflu give w/in 48hours of Sx onset
68
Tamilfu is pregnancy category
C | not safe for kids <1

FNP I (4 decks)

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