ENT

Question 1

What is one way to test mandible fx and fxn?

Answer 1

have pt bite down on tongue blade and pull/twist, if painful suspect mandible fx

Question 2

What are signs and risks of frontal sinus/bone fx?

Answer 2

Sig. MOI, crepitus, limited upward gaze, deformity, ptosis, sensory deficits, risk for pneumocephalus, intracranial injury, dural tear

Question 3

What are signs of nasoethmoidal fx?

Answer 3

trauma & pain to bridge, medial orbits, pain w/EOMs, crepitus, lacrimal injury, dural tears

Question 4

How should you treat frontal and nasoethmoidal fx’s?

Answer 4

CT, ABX, admit, oral max. surgery consult

Question 5

What are signs of orbital floor +/- blowout fx?

Answer 5

fat/blood in maxillary sinus on CT, diplopia on upward gaze, globe rupture

Question 6

What are s/sx’s of retrobulbar hematoma?

Answer 6

porptosis, swelling, vision loss, papilledema, increased IOP, irregular pupil. Need CT and ophthalmology consult, abx, pain control, lateral canthotomy w/compartment syndrome

Question 7

What is a complication of nasal fx’s?

Answer 7

nasal-septal hematoma which needs I&D or it will lead to septal necrosis

Question 8

What other injury should be considered in almost all facial fx’s?

Answer 8

head injury

Question 9

What are s/sx’s of mandible fx’s?

Answer 9

trismus, malocclusion, jaw ecchymosis, misaligned teeth, missing teeth, blood, gingival lacs, sublingual hematoma. admit open fx’s

Question 10

A pt presents w/their mouth open, they are unable to close it, what do they have?

Answer 10

temporomandibular joint dislocation, tx is liquid diet x3d

Question 11

Describe malignant otitis externa

Answer 11

osteomyelitis of ear, unresponsive OE, painful, conductive hearing loss, granulation, facial n palsy, ADMIT!

Question 12

How do you treat auricular hematoma?

Answer 12

incise and remove clot, wrap and pack

Question 13

What is Ramsay Hunt syndrome?

Answer 13

herpes zoster of face w/auricle and TM, Hutchinson’s sign is lesions on tip of nose, check for corneal involvement

Question 14

What should you do before removing a FB from the nose?

Answer 14

vasoconstrict w/Afrin, lidocaine

Question 15

What is an Ellis I vs Ellis II vs Ellis III fx?

Answer 15

Ellis I is enamel only, Ellis II is yellow dentin exposed, Ellis III is pulp/blood exposed

Question 16

What is concussion, subluxation, avulsion of a tooth mean?

Answer 16

concussion–painful, not loose, subluxation–loose, avulsion–completely removed

Question 17

What are s/sx’s of necrotizing ulcerative gingivitis/trench mouth?

Answer 17

fetid breath, punched out lesions on gum line, bleeding, fever, pain, immunocompromised. Give flagyl, chlorhexidine, dental f/u

Question 18

What is sialoadenitis?

Answer 18

inflammation of salivary gland, i.e. mumps

Question 19

What is Ludwig’s angina?

Answer 19

bilateral cellulitis of submandibular space w/fever, dysphagia, dysphonia, pain, edema

Question 20

S/sx’s of retropharyngeal abscess?

Answer 20

neck pain, fever, dysphagia, pain out of proportion, need CT to Dx