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Urgent Care Guide > ENT 5 > Flashcards

ENT 5 Flashcards

1
Q

dental pain/abscess - hx and clinical presentation
2

A
  1. facial swelling, dental pain
  2. prior dental work or prior infection
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2
Q

dental pain/abscess - complicating factors
3

A
  1. immunosuppressed
  2. anticoags
  3. bleeding disorders
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3
Q

dental pain/abscess - physical exam, what suggest severe/deep space infection
2

A
  1. trismus or elevation/protrusion of the tongue
  2. inability to swallow saliva or hot potato voice
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4
Q

dental pain/abscess - physical exam
4 (inspect, palpate, percuss, inspect)

A
  1. inspect for facial and gingival swelling, erythema, obvious trauma, dental caries
  2. palpate gingiva for tenderness, induration, crepitus, warmth
  3. percuss tooth in questions for tenderness
  4. inspect and palpate neck for swelling, tenderness, crepitus, lymphadenopathy
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5
Q

dental pain/abscess - img/testing

A

none usually; in concern for infection, consider CT w/ IV contrast

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6
Q

dental pain/abscess - non trauma tx
2

A

pain control (NSAID)
dental/intraoral nerve block

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7
Q

dental pain/abscess - infection tx
4

A

7-14 days
Penicillin VK 500 mg PO q6H
amoxicillin/clavulanate 875 mg PO BID
severe pnc allergy - clindamycin 450 mg PO q8h

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8
Q

dental pain/abscess - f/u

A

w/ dentist in 24-48 hours

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9
Q

dental pain/abscess - when to refer to ER
2

A
  1. deep space infection of face or neck
  2. evidence of systemic infection
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10
Q

oral laceration/trauma - history and clinical presentation
3

A
  1. facial swelling
  2. signs of injury
  3. difficult speaking/moving jaw
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11
Q

oral laceration/trauma - physical exam
3

A
  1. obvious trauma, bleeding
  2. facial and gingival swelling, damage to teeth
  3. misalignment of upper and lower teeth
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12
Q

oral laceration/trauma - img/testing

A

concern for mandibular/facial fx - CT of face w/o contrast

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13
Q

oral laceration/trauma - tx avulsion of primary and secondary teeth

A

primary - refer to dentist
secondary - replace teeth immediately, consult dentist

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14
Q

oral laceration/trauma - unable to replace tooth

A

put in milk, refer to dentist

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15
Q

oral laceration/trauma - intraoral lacerations tx for small/superficial

A

no repair/sutures

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16
Q

oral laceration/trauma - intraoral lacerations repair or sutures needed when
3

A
  1. large lacerations >2 cm
  2. deep lacerations that may trap food
  3. cheek lacerations that interfere w/ chewing
17
Q

oral laceration/trauma - gingival bleeding

A

direct pressure 10-15 mins then consider injection lidocaine w/ epi, hemostatic agent i.e. TXA, or surgicel if available

18
Q

parotitis/sialadenitis

A

inflammation of the parotid gland (salivary gland that sits in front of and below each ear)

19
Q

inflammation of the parotid gland (salivary gland that sits in front of an posterior to the ear)

A

parotitis/sialadenitis

20
Q

parotitis/sialadenitis - etiology
6

A

viral
bacterial
obstructive
infiltrative
neoplastic
iatrogenic

21
Q

parotitis/sialadenitis - what accounts for 50% of all benign salivary disorders

A

obstructive parotitis/sialadenitis

22
Q

parotitis/sialadenitis - acute sx
5

A
  1. pain
  2. swelling
  3. fever
  4. viral prodrome
  5. purulent discharge from Stensen’s duct (near 2nd upper molar)
23
Q

parotitis/sialadenitis - commonly linked with other conditions
5

A

Sjogern’s syndrome
amyloidosis
HIV
malnutrition
bulimia

24
Q

parotitis/sialadenitis - ask about use of what med

A

anticholinergic meds can cause this - especially in elderly

25
Q

parotitis/sialadenitis - ask about hx of
4

A
  1. radiation for head/neck
  2. poor oral hygiene
  3. change in taste
  4. diabetes
26
Q

parotitis/sialadenitis - physical exam findings
4

A
  1. fever possibly
  2. purulent discharge when gland is milked
  3. lymphadenopathy
  4. facial swelling/tenderness, warm to touch
27
Q

parotitis/sialadenitis - img/testing

A

consider imaging for suspected abscess or obstruction

28
Q

parotitis/sialadenitis - tx for obstruction
4

A
  1. parotid massage
  2. warm compresses
  3. lemon drops
  4. hydration
29
Q

parotitis/sialadenitis - tx for viral
3

A
  1. hydration
  2. supportive care
  3. NSAIDs
30
Q

parotitis/sialadenitis - tx for bacterial
3 rx

A

tx 10-14 days
1. Augmentin 875 (45 mg/kg) PO BID
2. clindamycin 450 mg (P 10 mg/kg) PO q8H
3. cephalexin 500 mg (P 12.5 mg/kg) PO q6h + metronidazole 500 mg (10 mg/kg) PO q8h

Urgent Care Guide (38 decks)

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