ENT Flashcards
Apthous Ulcer
Appearance
Causes
Painful lesion, triggered by minor trauma
Shallow, white center, erythematous border
Behcets (multisystem do w diffuse AU, vasculitis, CNS)
Coating tongue
White
Dz to consider
Benign (accumulation of dead cells with microbial colonization due to illness, poor intake, lack of hygiene)
Cadidiasis, leukoplakia, secondary syphilis (condyloma lata)
Epiglottitis bug
Presentation
Care
H influenza
Sore throat, difficult phonation, dysphagia, odynophagia, dyspnea, drooling, red epiglottis
Surgical consult, do not swab
Epistaxis
Anterior
Posterior
Causes
nasal mucosa is vascular and receives trauma and inflammation
Nares in upright
Drains through pharynx, coughed up
Benign, ask about others- cirrhosis, anticoagulants, blood dyscrasia, history
Frank;s sign
diagonal earlobe crease
Associated with CAD and PVD
Bilateral, deep is greatest risk
Gingival hyperplasia
Result of phenytoin, CCB, cyclosporine
Leukemic infiltration may mimic
Glossitis
Causes
painful tongue inflammation
With atrophy, think vitamin/mineral deficiency with signs like angular chelitis, anemia, neuropathu, dermatitis
Gorlin sign
Hoarseness
beyond 3 weeks
touch nose with tongue, usually EDS
Pathology of vocal cords (neoplasm, focal damage)
needs laryngoscopic eval
Kaposi sarcoma typical patient
associated with
presentation
AIDS individual
HHV8
Raised/flat purple red lesions on oral mucosa
Kopliks spots
White lesion on red base on buccal mucosa and lips in measles
Lead lines
Associated with
Think
grey black dots near free margin of gum
heavy metal toxicity
lead, bismuth, mercury, gold, silver, thallium, copper
Leukoplakia
Hairy leukoplakia
associated with
always get ___ test
Pre=malignant lesions associated with tobacco use
Lateral aspect of tongue in IC individuals (HIV/AIDS)
EBV induced epithelial hyperplasia
HIV
Lemierre;s syndrome
Leads tp
Presentation
May embolize to
Septic jugular vein thrombophlebitis
starts as pharyngitis due to Fusobacterium
Invades tissue and spreads to carotid sheath
Septic thrombosis of jugular vein
fever, neck stiffness, dysphagia, tenderness over jaw angle and SCM
Lung, and cavitate (septic PE_
Ludwigs angina
Presentation
Submandibular space infection
infection of mandibular teeth, extends to submandibular space
Elevates floor of mouth and tongue, airway compromise
Macroglossia
Other causes
Trauma/inflammation from ingestion/allergic reaction (angioedema)
Hypothyroidism, acromegaly, amyloidosis
Nasal pruritis (Wartenburg)
Nasal septal perforation
Saddle nose presentation
Intense and unrelieved is assocaited with brain tumor (esp floor of 4th ventricle)
Processes that destroy cartilage (intranasal cocaine, GPA, congenital syphilis, sarcoid, RP)
Depression over nasal bridge caused by underling cartilage collapse
Parotitis
Bilateral causes
Unilatral
Painless lacrimal/parotid enlargement
Glands inflamed and tender
Viral (mumps), inflammatory (SLE, sarcoid)
Swelling, tenderness, fever suggests calculus with Staph aureus
Alcoholism
Phayngeal exudate
Causes
Presentation
Exam findings
Untreated concern
Usually Strep pyo (GAS, BH)
also Fuso, EBV, gonorrhea
Child with abrupt fever, sore throat, headache, pain swallowing
Obj fever, exudative pharyngitis, tender anterior cervical LAD
RF
Pharyngeal pseudomembrane
Presentation
Exam
C. dipteria
Red, pseudomembrane, can obstruct airway
Bulls (cervical) LAD, fever, weakness, HF, neuropathy, bad breath
Rhinorrhea
CSF Rhinorrhea
Reflects
High risk for
Acute rhinits (viral, non infectious allergic)
Think prior facial/skull injury/surgery
Fistula between nose and SA space
Bacterial meningitis
Tooth tenderness
Possible etiology
Maxillary teeth tenderness
Tap teeth with tongue blade
Dental carries, tooth abscess and DKA
Maxillary sinusitis
Tragus sign
organisms
not present in
tenderness with manipulation of tragus suggests otitis externa (also pull on pinna)
Bacterial usually
Otitis media
Vertigo
Associated symptoms
Possible involved areas
Assess
Unsteadiness in motion, often rotary
Fall, problems remaining upright
Nausea, pallor, sweating
inner ear, CN 8, BS
Neurologic system, drugs, alcohol
