ENT 2

Question 1

otitis externa

Answer 1

cellulitis of the external auditory meatus (ear canal)

Question 2

cellulitis of the external auditory meatus (ear canal)

Answer 2

otitis externa

Question 3

otitis externa - history and clinical presentation
6

Answer 3

1. swimming or water exposure
2. frequent ear cleaning
3. rapid onset
4. otalgia
5. itching
6. fullness w/ or w/o hearing loss

Question 4

otitis externa - signs of ear canal inflammation
4

Answer 4

1. tragal and/or pinna tenderness
2. canal edema and/or erythema
3. otorrhea (drainage)
4. TM erythema

Question 5

otitis externa - img/testing

Answer 5

none usually reqd
POC glucose if concern for underlying DM or hx of uncontrolled DM

Question 6

otitis externa - tx rx and duration

Answer 6

topical abx 7-10 days
polymyxin B/neomycin/hydrocortisone 4 drops (P 3 drops) q6h
ofloxacin 10 drops (P 5 drops) once daily
cipro/hydrocortisone 3 drops (P 3 drops) q12H

Question 7

otitis externa - avoid aminoglycosides in who

Answer 7

pts with tympanostomy tubes or suspected TM rupture

Question 8

mastoiditis

Answer 8

infection of the mastoid air cells, typically following AOM

Question 9

infection of the mastoid air cells, typically following AOM

Answer 9

mastoiditis

Question 10

mastoiditis - hx and clinical presentation
3

Answer 10

1. recent OM
2. fever
3. otalgia

Question 11

mastoiditis - physical exam
6

Answer 11

1. signs of OM
2. redness
3. swelling
4. tenderness
5. fluctuance over mastoid process
6. pinna may be displaced

Question 12

mastoiditis - img/testing

Answer 12

none usually

Question 13

mastoiditis - tx

Answer 13

refer to ED for all suspected cases - serious infection

Question 14

septal fracture/hematoma

Answer 14

septal hematoma - blood that collects between septal cartilage and perichondrium within the nasal septum

Question 15

blood that collects between septal cartilage and perichondrium within the nasal septum

Answer 15

septal hematoma

Question 16

septal fracture/hematoma - can deprive…

Answer 16

septal cartilage of its vascular supply

Question 17

septal fracture/hematoma - hx of
4

Answer 17

1. trauma
2. sports injuries
3. recent nasal surgeries
4. bleeding condition

Question 18

septal fracture/hematoma - hematoma typically occurs when

Answer 18

24-72 hrs after trauma

Question 19

septal fracture/hematoma - symptoms
3

Answer 19

1. nasal obstruction is most common - may be bilateral
2. pain
3. rhinorrhea

Question 20

septal fracture/hematoma - physical exam findings
5

Answer 20

1. septal fx
2. ecchymosis
3. reproducible pain
4. clear rhinorrhea
5. crepitus

Question 21

septal fracture/hematoma - external deformities

Answer 21

not always present

Question 22

septal fracture/hematoma - complication of untreated septal hematoma
3

Answer 22

1. ischemia
   2 permanent necrosis
2. saddle nose deformity

Question 23

septal fracture/hematoma - physical exam intervention
2

Answer 23

nasal speculum or otoscope
suction blood clots

Question 24

septal fracture/hematoma - hematoma appears
3

Answer 24

bluish
boggy
may be soft/fluctuant on exam

Question 25

septal fracture/hematoma - img/testing

Answer 25

none usually - most often clinical dx

Question 26

septal fracture/hematoma - x ray

Answer 26

does not change mgmt of injury

Question 27

septal fracture/hematoma - simple fx tx
4

Answer 27

ENT f/u 3-5 days
rest
ice
head elevation

Question 28

septal fracture/hematoma - when to refer to ER
3

Answer 28

septal hematoma
CSF rhinorrhea
facial trauma beyond nasal bones

Question 29

septal fracture/hematoma - rhinorrhea, think…

Answer 29

possible CSF leakage

Question 30

OE can be commonly caused by 2

Answer 30

Swimmers, ear, and frequent ear cleaning