ENT Flashcards
Rinne
Bone then air
Conduction loss– if equal …
Sensorineural hearing loss– if air conduction > bone conduction
Auricular hematoma
Incise and Drain
External otitis
Hallmark: tenderness of the Tragus when push and pinna when pull.
Pathogens: pseudomonas and staph
Topical therapy : cortosporin, polymyxin
Viral otitis externa
Ramsay hunt syndrome - herpes zoster oticus —shingles in the ear
Eustachian tube dysfunction
Associated with viral illness or allergies.
Ear fullness, popping, cackling, mild mod hearing loss
Barotrauma
ETD then fly…. Conductive Hearing loss, Otalgia, tinnitus
Can progress to TM perforation
Should heal in 4 weeks
Abx only if otitis media too.
Mastoiditis
Intra temporal complication of acute otitis media
Fever and ear proptosis, pain around ear
CT scan : loss mastoid air trabeculations
IV abx : Strep pneumo, h.flu, strep. Pyrogenes
Tinnitus
Most common cause is SNHL, presbycusis
Could be side effect
BPPV
Positive Dix Hall Pike
Treat with epley maneuver
Labyrinthitis
Vertigo accompanied by hearing loss after viral illness
Corticosteroids may help
Meniere disease
Episodic vertigo
SNHL at lower frequencies
Tinnitus
Aural fullness
Tx: lifestyle adjustments to avoid trigger. Salt restriction.
Diuretics for some
Vestibular schwanomma
Aka… Acoustic neuroma
Unilateral sudden hearing loss
Cranial nerve XIII
MRI is gold standard for Dx
Chronic rhinosinusitis
Recurrent : 4 or more episodes / year
Chronic: 12 weeks with inflammation documented on nasal scope
Allergic rhinitis treatment
Mainstay of treatment : Intranasal glucocorticoid
Or
Oral antihistamine can help.
Typically not taken together
Rhinitis medicamentosa
Prolonged use of Afrin
Rebound congestion
Nasal polyps
Adults: chronic sinusitis, asthma, ASPIRIN sensitivity
Children: cystic fibrosis
Tx: Intranasal corticosteroid
Samters triad
Asthma, aspirin sensitivity, and nasal polyps
Epistaxis most common location
Anterior is most common– 90% in kiesselbachs plexus
Posterior- posterolateral branch of sphenopalatine artery
How long can nasal packing stay in place?
24-48 hrs
> 72hrs risk of infection
Nasal foreign body
Unilateral Discharge
Leukoplakia
White plaques, cannot be removed
Can progress to cancer
Erythroplakia
Red plaques on tongue
Compared to leukoplakia, more likely to progress to cancer
Biopsy
Oral hairy leukoplakia
Pt with lateral tongue changes that has HIV usually..
Not premalignant
Ebstein Barr virus –
Acute Sialadenitis
Mumps
Staph aureus
Saliolithiasis
Calculus in the salivary duct
Submandibular gland usually affected
Conservative therapy : warm compress, sialogogue, analgesics
Weber test
Goes through bone
Conductive loss– something wrong with ear bones – lateralizes to bad ear
This is bc not as much competing sound in the environment.
Sensorineural loss –lateralizes to good ear
Ramsey Hunt Syndrome
Vesicles in ear canal, facial paresis, and pain
caused by herpes virus
Bullous myringitis
Severe ear pain and bullae on the TM
Pathogen for bullpus myringitis
Tx:
Mycoplasma
Tx:
