ENT Flashcards
clue for epiglotitis(3)
sore throat
difficulty swallowing
fever
harsh shrill in epiglotitis
stridor
most common bugs causing epiglottis(2)
Hi flu
strep pyogenes
why epilotitis is an emergency?
risk of airway obstruction
how to perform rine test
place a tuning fork on mastoid
than when the patient cannot feel it put it in front of ear
interpretatin of rine test normal
air conducted sound should be heard twice as long as bone conducted sound
abnormal rine test
bone conducted sound is longer than air conducted sound
importance of rine test
detect conductive hearing problem
weber test
helps differentiate conductive from sensorineural problem
how to perform weber test(2)
tuning fork is placed on forehead
sound must be equal for both ears
weber test loudest to the left(lateralisation to the left)
conductive problem in the left
why conductive problem gives lateralisation to the left
because the affected ear is cutt off from the external noise
weber in sensorineural problem
lateralisation to the unaffected ear
interpretation of weber(2)
loudest sound can mean conductive problem in the lateralized ear
can also mean sensorineural problem in the opposite ear
cause of conductive hearing loss(4)
cerumen impaction
middle ear fluid or infection
otosclerosis
bone tumor in the middle ear
Quid of otosclerosis(2)
decreased movements of small bones of the ear
stapes foot plate become fixed to the oval window
Rx of otosclerosis(2)
hearing amplification
surgical stapedectomy
age for otosclerosis
20’ 30’
clue for leukoplakia
granular white patch in oral mucosae
risk factor of leukoplakia(2)
smoke
alcohol
complication of leukoplakia
squamous celle carcinoma in ten years
patient with fever chills difficulty swallowing sore throat muffled voice dx?
peritonsillar abcess
epiglotitis
clinical clue for peritonsillar abces helping differentiate it from epiglotitis
deviation of the uvula
unilateral lymphadenopathy
rx en urgence de peritonsillar abcess and why?(2)
needle peritonsillar aspiration
to prevent airway obstruction
dx for a patinet with recurrent mouth ulcer and abdominal pain
chron
work up for chron(4)
Abdominal CT
small bowell fluoroscopic study
endoscopy
biopsy
biopsy in chron (2)
granuloma
30% des cas
HIV patient with hearing problem
serous otitis media
physical exam for serous otitis media(2)
dull
hypomobile tympannic membrane
cause of serous otitis media in HIV
non infectious
auditory tube dysfunction by lymphadenopathy or obstruting lymphoma
type of hearing loss in serous otitis media
conductive
clue for presbycusis(3)
older people
60’
decreased hearing ability
risk factor for presbycusis(5)
age genetics medication history of infection exposure to loud noise
characteristic for pesbycusis
difficulty hearinf in noisy crowded environment
ototoxic medication(2)
furosemide
aminoglycoside
risk to have ototoxicity with furosemide(2)
renal failure
concomitant use of gentamycine
right sided ear pain in patient with normal physical exam and history of grinding teeth
temporomandibular joint dysjunction
Meniere disease cause
abnormal accumulation of endolymphe in inner ear
clue for menniere(5)
vertigo tinnitus sensorineural hearing loss nystagmus ear fullness
trigger of menniere(4)
salt
alcohol
caffeine
nicotine
medication to treat menniere
diuretics
anticholinergic
antihistamines
first measure in menniere(2)
lifestyle modification
salt restriction less than 2 a 3 g de sel par jour
If lifestyle fails in menniere what to do
medication
quid of vertigo
spinning sensation with nausea
wheezing after ingestion of aspirin
aspirin exacerbated respiratory disease
what is always associated with aspin induced respiratory disease
nasal polyps
triad for AERD
bland tasting food
recurrent nasal discharge
nasal polyps
complication of malignant externa otitis
skull osteomyelitis
facial nerve destruction
dx of complicated otitis externa malignant(2)
MRI or
CT
RX of Malignant externa otitis and bugs in cause(2)
pseudomonas aeruginosa
ciprox
patient develops neck pain and impossibilty bof open mouth after being scrathed the back of the throat by chicken bone
retropharyngeal abcess
Dx of retro pharyngeal abcess
CT of neck
lateral xrays of neck
rx of retro pharyngeal abcess
antibio
surgical drainage
quid of trismus
inability to open mouth
why retro pharyngeal abcess is an emergency
because of risk of mediastinitis
which neck space involvement carries the higher risk for mediastinitis?
retropharyngeal space
why retropharyngeal space is called danger zone
high risk of medistinitis
quid of ludwig angina
submandibular space infection
don’t cause mediastinitis
diabetes with ear pain and granulation tissue in external ear
Malignant otitis externa
rx of malignant otitis externa
systemic ciprox
