ENT Flashcards
Sudden sensorineural hearing loss (SSHL)
timing, bilateral/unilateral?
most common cause + other categories
associated symptoms (2) possible workup (3)
treatment (3)
Onset over hours, usually unilateral
idiopathic; infection, hem/onc, vascular, metabolic, drugs
tinnitus, vertigo
MRI, ESR, FTA (syphillis test)
Tx: underlying cause, carbogen 95% O2, 5% CO2, steroids
Sudden sensorineural hearing loss (SSHL)
most common drug causes (4)
Loop diuretics (furosemide), salicylate, aminoglycoside, neomycin, vancomycin
Pictured disease
most common etiology
pathogmnemonic distribution
common cause
Perichondritis
Post traumatic (esp ear piercing)
spares pinna
Pseudomonas
TM perforation
natural history
early referral indications (2)
abx?
Infected tympanostomy tubes tx
Spontaneous healing
traumatic mechanism or posterior location
only if mechanism was forced water entry
ciprodex drops superior to oral abx
Otitis media
most common bacterial causes (1+2)
pictured disease
most common cause
treatment (2)
Strep. Pneumo [most common], H. influenzae, Moraxella catarrhali
Bullous Myringitis
NOT usually mycoplasma; usually same agent as underlying AOM
rupture bulla for pain relief, topical abx drops
Pictured disease
cause/findings (2)
Tx
Cholesteatoma
- Keratin-producing squamous epithelium overgrowth in the middle ear
- Often foul-smelling drainage
surgery
Dix-Hall-Pike
sensitivity for BPV
positive test =
vestibular neurontis vs labyrinthtis key differences - cause and sx
50 to 80%
burst of nystagmus, fast phase towards affected ear
VN: does not affect hearing; L: often affect hearing
VN: often post-viral; L: often viral infection
Meniere’s disease
cause
sx and pattern
tx (3)
Excess endolymph
paroxysmal tinnitus, vertigo, hearing loss -> progressive episodes (2-8h) and symptoms
low-salt diet, diuretics, steroids
Ototoxic drugs irreversible damage (3)
other common reversible causes (3)
Ramsay-Hunt =
irreversible: aminoglycosides, cytostatic, loop diuretics
reversible: NSAIDs, quinolones, antimalarials, erythromycin
Ramsay-Hunt = VZV affecting head/neck nerve, most commonly VII
Central vertigo causes (4)
Cerebellar/brainstem infarct or hemorrhage
vertebrobasilar insufficiency
MS (look for associated ataxia, optic neuritis)
basilar migraine
Sinusitis-causes (4)
complications of posterior pack (4)
CSF rhinorrhea antibiotics?
Most often viral, otherwise same as AOM: Strep. pneumo [most common bacterial cause] , H. flu., M. Cat., anaerobes
complications: hypoxia/CO2 retention (COPD, CHF, AMS), infection, aspiration of packing, sinusitis/AOM, cardiac ischemia
abx: controversial
Cauliflower ear and saddle-nose deformity: mechanism
salivary gland problems
bilateral parotitis cause
bacterial parotitis risk factors, common cause
siaolodenitis: location 80%
destruction of cartilage by blood-induced lysis (untreated septal and auricular hematomas)
bilateral: mumps
recent surgery, DM, dry mouth/dehydration; Staph most common
submandibular
The Fort classification - describe 1,2&3
concerns of associated injuries/complications (3)
I - Horizontal maxillary fracture
•Free-floating upper alveolar process
II - Pyramid fracture
•Free-floating mid-face (maxilla, nose, cheeks)
III - Upper jaw, nose and lateral orbits (zygoma)
Concerns: C-spine, airway, CSF rhinorrhea
Cavernous sinus thrombosis
Cavernous sinus thrombosis
clinical triad
symptom categories (3)
diagnosis (1 or 1)
ENT infection, venous congestion, ophthalmoplegia
swelling (facial edema, ecchymosis, proptosis)
cranial nerve palsy’s (3 through 6, 6 most common)
pupillary dysfunction - mydriasis from cranial nerve three
MRI or CT
Significance of this relationship
Proximity of the parotid duct and facial nerve
A vertically oriented laceration posterior to the corner of the eye and bisecting a line drawn from the tragus of the ear to the center of the upper lip can involve both the facial nerve and the parotid duct
Ludwig’s angina-organism category
pictured entity
etiology (2)
risk factors
treatment
Mixed aerobic and anaerobic
acute necrotizing ulcerative gingivitis (ANUG)
spirochetes and fusobacteria
young adult, poor oral hygiene, HIV
metronidazole, clindamycin
Pictured entity
common causes (4)
cervical lymphadenopathy cause categories (3)
Gingival hyperplasia
leukemia, phenytoin, cyclosporine, calcium channel blockers
categories
primary infection-cervical adenitis, staph or strep
response to local infection or systemic process (sarcoid, TB, Cancer)
Pictured entity
cause/natural history
agent
Lemierre’s syndrome
strep pharyngitis complicated by fusobacterium necrophorum ->
septic thrombophlebitis of the internal jugular vein ->
septic emboli too lung
child/infant Odynophagia + duck like voice + torticollis =
risk factor mechanism
Retro pharyngeal abscess
fall with stick/pencil in mouth
Retro pharyngeal abscess
