ENT 2 Flashcards
acute tonsilitis organisms
majority viral - EBV, rhinovirus, influenza, prarinfluenza, enterovirus
5-30% bacterial - group a beta haemolytic strep
acute tonsillitis ix
centor criteria
treatment
no throat swab as most viral
fever, tonsils exudates, cervical LD, no cough, <15 add one >44 minus 1
3/4 ABs history of otitis media ABs
supportive first
penicillin 10 days (clarithro 5 days)
surgery for acute tonsillitis
7 or more in 1 year
5 or more in 2 years
3 or more in 3 years
peritonsillar abscess is what
symp signs
treatment
bacteria between muscle and tonsil producing pus
unilateral throat pain and odynophagia. 3-7 days preceding acute tonsillitis. medial displacement of uvula and tonsils. concavity of palate lost
aspirate. IV benzylpenicillin/penicillin 10 days (clindamycin)
If can’t swallow IV clindamycin
if not resolving by 48 hours add metro to penicillin
infectious mononucleous symp risk dx treatment
fever, LNs, spleno, sore throat
thrombocytopenia mild, anaemia (steroids), splenic rupture - rare - avoid sports for 6 weeks
increased risk of lymphoma in immunosuppressed
EBV IgM - atypical lymphocytes in peripheral blood, <100 CRP, mono spot or paul bennet test
supportive
otitis externa is what
symp
ix
rx
inflam of outer ear. more common in hot humid weather
red swollen itchy sore painful ear wax
swab if treatment fails or looks serious
topical aural toilet mild - acetic acid 7days mod - gentian, lacrotom severe - swab. pseudomonas topical gent fungal - topical clotrimazole oedema - topical corticosteroid
otitis media who
ix
rx
children and infants. URTI involving the middle ear
swab of pus if eardrum perforates
80% resolve in 4 days without treatment
bilateral AOM in <2s or AOM with otto rhea - treat
amox (clarithro) 5 days
acute sinusitis symp
rx
severe pain and tenderness with purulent nasal discharge if secondary bacterial infection
uncx - resolves within 14 d
cx - penicillin (doxy)
glue ear symp
ix
rx
poor school performence, speech delayed, behavioural problems, balance problems
TM rétraction and decreased visibility
self limiting
cholestaetima symp
ix rx
small lesions - progressive CHL
larger lesions - vertigo, headaches, facial palsy
CT surgery
congenital cholestaetoma
white pearly mass behind intact TM
BPPV is the most commonest cause of what
vertigo on looking up
BPPV cause
symp
dx
rx
otoliths material displaced from vetricle into SCC usually post
vertigo on looking up, moving head, laying down
hillpike test
employs manoeuvre, brandt tarif, sermont
vestibular insufficiency
along w BPPV symp also has
visual disturbances, weakness, numbness.
VN symp
cause
prolonged vertigo days
viral
