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PANRE > ENT > Flashcards

ENT Flashcards

1
Q

Weber test

A

fork on center of head and see if sound laterizes

Conductive Hl–> lateralizes to affected ear
Sensory neural–> lateralizes to to unaffected ear

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2
Q

Rinne test

A

fork on mastoid until vibrations no longer felt and up to ear ( should continue to hear)

bone-> air= CHL
Air > bone = SNHL

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3
Q

conductive hearing loss

etiologies

A

dz of external ear canal, TM, or ossicles

causes: cerumen impaction, eustachian tube dysfunction with URI, AOM/middle ear effusion, TM perforation,

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4
Q

cholesteatoma

A

upper flaccid portion of TM is drawn inward from chronic pressure d/t eustachian tube dysfunction –> keratinization of middle ear and chronic infection
PE: retractions in the TM, perforation with keratin
complication with chronic OM
TX: refer to ENT for surgical repar

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5
Q

otoscleoris

A

abn growth of bone on stapes
females > males
hereditary
tx; refer to ENT

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6
Q

SNHL

why its happens

A

deterioration of cochlear hair cells or lesions CN 8 pathway

causes: hight frequency age-related hearing loss
trauma, ototoxic ( van com, cisplatin), Menier syndrome, auto immune ( lupus)

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7
Q

acoustic neuroma

A 
CN 8 - bening intracranial tumor 
causes hearing loss 
unilateral , gradual
do mRI 
tx: refer to ENT for observation , excision, radiotherapy
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8
Q

barotrauma

A

injury to ear
scuuba diver, pilots
prevent with yawning, auto inflation, swelling, decongestant
tx: via myringotomy

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9
Q

dysfunction of eustachian tubes

A

frequent with URI/ allergic
popping/ cracking, aural fullness
PE: retracted RM with decreased mobility
tx: anti-histamin/ anti-inflammatory

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10
Q

foreign body

A

h/o : otalgia, CHL
tx: animate: mineral oral or lidocaine and extract object
inanimate object: attempt to removal or may refer to ENT for microscopic removal

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11
Q

auricular hematoma

A 
blunt trauma
erythema, swelling at pinna 
tx; I and D followed by compression dressing
f/u to ensure complex hematoma
anti-staph  abx
complication: destruction of cartilage
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12
Q

mastoiditis

A

infection of mastoid cells after untreated AOM
- s. pneumo, h/ flu
s/s: fever, post auricular erythema, pain
testing: myringotomy for culture of middle ear fluid
CT
tx; IV cefazolin +/- surgery for drainage

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13
Q

TM perforation

A

trauma, impact
s/sx: otalgia, hearing loss, d/c bleeding, dizziness
spontaneous, monitor for infection
refer to eNT if continued dizziness, delayed TM healing

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14
Q

tinnitus

A 
abn persistent ear or head noises
check for hearing loss 
evolution; audiometry r/o HL
pulsatile- check for aneurysm 
MRI 
tx: avoid excessive noise
avoid ototoxic med 
music 
nortripyline
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15
Q

vertigo

A

sensation of movement without movement or exaggerated response to body movement
evaluation; full neuro exam 9 Rhomber, gai, nystagmus, Dix-Halpike)
if cause from peripheral source–> ENT
don’t miss cerebella ischemia
tx: base on underlying etiology
acute sxs: meclizine, diazepam, scopolamine

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16
Q

central vertigo

A

causes: brainstem vascular issues, AV malformation, MS, vertebrobasiliar migraine

sxs; more gradual onset and vertical nystagmus
no auditory sxs
commonly with motor/sensory /cerelbellar deficit

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17
Q

peripheral vertigo

A

causes: labyrinthitis, BPPV, endolymphatic hypos, vestibular neuritis

sxs; sudden onset, n/v, hearing loss, and nystagmus ( horizontal with rotary component)

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18
Q

labyrinthitis- type of peripheral vertigo

A

acute, continuous, severe vertigo associated with HL and tinnitus
sxs resolve over weeks
tx: mezclizine

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19
Q

Menieresyndrome

A

endolymph compartment of inner ear

sxs: episodis vertigo, low frequency HL, unilateral aural pressure
tx: decrease sodium, HCTZ, meclizine

20
Q

BPPV

A

recurrent episodes associated with changes in position, n/v

tx; meclizine/ diazepam

21
Q

acute sinusitis

pathophys and common bacteria

A

viral URI, allergic
inflammation from URI causes obstruction and infected

bacterial: strep pneuma. . H. flu, M catarrhalis, s. aura

22
Q

acute bacterial sinusitis

A

sx: URI sxs, purulent rhinorrhea, tooth pain
signs: nasal cavity, turinate team
testing: plain films, CT in sever cases

tx; analgesics, neti pot, intranasal steroids X 5 days, abx tx> 7 days, worsen
immunoscomprimised status

1st line; amor, bacterium, doxycycline
levaquin/ augmentin
2n line: augmentin

complication: osteomyelitis, meningitis, epidural/ subdural abscesses

23
Q

allergic rhinitis

A

IGE mediated–> histamine

perenial- dust, dander, molds
seasonal: pollens, grasses, ragweed
sx: h/a nasal congestion, clear rhinorrhea, eye testing
signs; pale violaceous boggy turbinates

tx; avoid allergens, pt education, evaluate for asthma,

tx: fluticasone, mometasone daily
2ndline: oral anti histamines, decongestants, singular immunotherapy

24
Q

epistaxis

A

trauma
think cocaine, sinusitis, leukemia, coag disorders
recurrent: consider abc, pt/ put, bleeding time

anterior: unlit, continuous, can be visualized by exam 
tx; remove clot, blow nose
apply vasconstrictor- lidocaine
direct pressure 
silver nitrate, packing

posterior: brisk flow into pharynx
tx; packing
consult ENT
must admit and observe

25
Q

nasal foreign body

A

kids 2-5
presentation: history by parent
halitosis, sinusitis, stridor, wheezing

tx; mechanical removal and caution to not displace or other offices

26
Q

nasal polyps

A

yellowish, boggy masses of hypertrophic mucosa, nasal congestion and decrease send of smell

in kids- consider CF
tx: intranasal steroids
refer to ENT

27
Q

viral pharyngitis

A

adenovirus, EBC, HSV, rhinovirus, enterovirus

bacterial GABSH, myopiasma, gonoccocal

28
Q

strep pharyngitis

A

5-15 yrs
s/sxs: fever, acute sore throat, adenopathy

Centor criteria: 
fever > 38F
tender anterior CA
tonsilar exudate
lack of cough
3 or 5 criteria--> tx
0- d/c without abx 
in between--> rapid sure
tx: Pen V K or cefuroxime
augmentin or erythromycin
29
Q

peritonsilar abscess

A

s/sx: severe ST, muffled voice, truisms

tx; Aspiration and drainage an abx- amox, clindamycin
tonsillectomy

30
Q

epiglottitis

A 
decrease due to Hib vaccine
seen in adults with DM
s/s: fever, throat pain with swelling
kids; appear toxic, tripod position
diagnostic; cherry red swollen epiglottis on laryngoscope
kids: keep kids calm, OR, 
BC, IV ( ceftriazoxon)
adults: scope at bedside, 
IV abx, iV steroids, admit
31
Q

apthlous ulcers

A

single or multiple shallow lesions with yellow/ gray center seen in mouth

tx; viscus lidocaine, coricosteroids
cimetidine

32
Q

orla thrush

A

seen in pt with dentures, DM,, cancer pt

sxs: burning pain on tongue/ buccal mucose
lesions can be scarped off and underlying tissue is friable
tx: anti fungal meds- troche, swish , etc

33
Q

oral herpes simplex

A

hsv 1-acquired by childhood
hsv 2- sexually acquired

presentation: grouped vesicular lesions on erythematous base, erosion into shallow ulcer
burning , shining
tx; immunocompetent; none
immunocompromised; systemic agents - valtrex 7-10 days

34
Q

oral leukoplakia

A

small white lesions on mucosal surface
does not scape off

seen in denture wearer

all need to get a bx to r/o oral cancer

35
Q

oral squamous cell carcinoma

A

early lesions look like leukoplakia

RF: tobacco/ ETOH
Tx:

36
Q

geographic tongue

A

erythema in manlike distribution caused by filiform papillae of the tongue

removes on own

37
Q

glossitis

A

red smooth surface tongue
lack of niacin, riboflavin, chemo, adverse med rxn.

tx: tx underlying cause

38
Q

gingivitis

A

inflame of gingiva causing redness/ swelling of gum line
RF: poor oral hygiene, dry mouth, tobacco

tx: dental hygiene
6 month cleaning

39
Q

necrotizing ulcerative gingitivits

A

young adults, stress

s/s: gingiva inflammation, bleeding, fever, halitosis, CVA

tx: salt water/ peroxide rinses, oral hygiene, ora PCN

40
Q

dental access

A

starts from cavity

s/s: pain over are of tooth, localized swelling.
tooth sensitive

tx: referral to dentist with I and D, extraction

41
Q

acute laryngitis

A

causes hoarseness
almost always viral
sxs last > 1 week after URI sxs subsided

tx: vocal cord rest mandatory
sx tx

42
Q

laryngeal squamous cell carcinoma

A

> 2 week hoarseness with smoking hx

ear/ throat pain, neck pass

RF: tobacco, HPV

dx: laryngoscope and bx
CT/ MRI
tx: rad and tx
advanced: chemo, rad , tx

43
Q

siladenitis

A

salivary gland affected, parotid is common
- associated with dehydration and chronic illness causing ductal obstruction

s/s: acute swelling, increased pain an, d swelling with eating

bug: s. aureus
tx: rehydration, wam compressie, sialogogue, massage and abx ( clinda, augmentin)

44
Q

sialolithiasis

A

calculus formation in salivary glans: Wharton’s duct most common

postprandial pain with localized swelling

tx: refer to ENT for stone extraction

45
Q

salivary gland tumors

A

80% occur in parodic glad
Ct/ MRI
refer to ENT

PANRE (27 decks)

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