ENT Flashcards
1
Q
Bacterial Pharyngitis Physical Exam
A
- tonsillar exudate
- pharyngeal erythema
- tender ANTERIOR CERVICAL lymphadenopathy
- no nasal discharge or edema
lungs clear
2
Q
Peritonsillar Abscess Exam
A
- hx of sore throat, drooling, trismus (unable to open mouth), “HOT POTATO VOICE”
- extremely swollen and fluctuant tonsil
- DEVIATION OF UVULA to opposite side
3
Q
Infectious Mononucleosis findings
A
- MALAISE STARTED BEFORE SORE THROAT
- headache
- Low-grade fever
- abdominal discomfort
- POSTERIOR LYMPHADENOPATHY
- hepatosplenomegaly
4
Q
Initial diagnostic test (IM)
A
Mono-spot
5
Q
Modified Centor Criteria
A
- tells who needs to be tested for rapid strep
Tonsillar exudate +1 Tender anterior cervical adenopathy +1 Fever +1 Absence of cough +1 Age: < 15 y.o +1; >45 y.o -1
- More than 1, you have to test
6
Q
Diagnosis of IM
A
- if IM suspected = Monospot (initial test) - detection of heterophil antibodies
- If Monospot is negative and clinical findings suggest IM = specific IgM antibodies = confirm dx
7
Q
Lab findings with Dx of IM
A
- lymphocytosis on CBC
- atypical lymphocyte on blood smear
- elevated liver enzymes
8
Q
Best initial therapy
A
supportive therapy
9
Q
IM therapy
A
- supportive
- return to sports 4 WEEKS AFTER ILLNESS ONSET
10
Q
Allergic Rhinitis
A
- hx of asthma, seasonal allergies
- BILATERAL nasal congestion
- Clear rhinorrhea
- BILATERAL CONJUNCTIVITIS
- sneezing
- nasal ITCHING
- no fever
- ALLERGIC SHINERS
- PALE NASAL MUCOSA
11
Q
Acute Rhinosinusitis Testing
A
clinical dx
- no test needed
12
Q
Bacterial Rhinosinusitis Tx
A
Augmentin
-respiratory FQ if pt has allergy to PCN
13
Q
Criteria for ABX Therapy
A
- severe symptoms for 3 consecutive days w/out improvement
- symptoms for 10 days w/o improvements
- Double Sickening: symptoms, improve, then worsen
14
Q
Acute Otitis Media
A
- no tragal tenderness
- no adenopathy
- external auditory canal w/o erythema
- TM opaque, bulging and immobile
- decreased hearing
15
Q
Malignant otitis externa findings
A
- severe otalgia that extends to TMJ
- pain with chewing
- nocturnal pain
- edema
- erythema of ear canal extending to pinna and mandibular area
- cranial nerve palsies (facial)
16
Q
Otitis media with effusion
A
- tympanic membrane with bubbles or fluid filled
- RETRACTED (malleus appears more prominent)
- decreased mobility of TM
- hearing loss without pain
- no fever
17
Q
When to start ABX for acute otitis media
A
signs of tympanic membrane effusion (bulging, not moveable) and inflammation (pain/fever)
18
Q
Best initial tx OM
A
Amoxicillin: young children
Augmentin
