ENT Flashcards
acute sinusitis is most commonly caused by which two pathogens?
strep pneumo. and H . flu
Oral herpes is best treated with systemic or topical antivirals
topical is the first line. Systemic antivirals will help but are only indicated for severe cases
A patient presents with severe episodes of vertigo over the past several weeks. He has had intermittent unilateral hearing loss and a “blowing” in his ears. What is the most likely diagnosis?
Meniere’s disease
White oral lesions which cannot be scraped off should make you think of what diagnosis?
oral leukoplakia
What type of hearing loss is associated with aging?
sensory
Which is the most commonly affected sinus in acute sinusitis
maxillary
A patient presents with a hot potato or muffled voice. What is the most likely diagnosis?
Peritonsillar abscess
What time frame are we talking about for chronic sinusitis
> 3 months
List the time of year when each of the following allergens is most prominent: pollen, grass, mold and ragweed?
pollen tree and flower = spring, grasses are the summer, mold and ragweed are fall
HOw long should pressure by applied to treat epistaxis
15 minutes
List the four things that suggest group A beta hemolytic strep in a patient with pharyngitis
Fever, tender anterior cervical adenopathy, no cough and an exudate in the throat
A child presenting with an erythematous sandpaper rash should make you think of your diagnosis?
Scarlet fever
When is watchful waiting with a diagnosis of acoustic neuroma an appropriate plan?
Because this tumor is so slow growing, watching in an elderly patient is appropriate
What type of hearing loss would be caused by cerumen impaction
Conductive
How do you administer the Weber hearing test
Tuning fork placed in the middle of the forehead
A 14 year old field hockey player presents with prominent adenopathy, white purple exudates in the throat and a palpable spleen. What is the most likely diagnosis?
Mononucleosis
How do you administer the Rinne hearing test
Place the tuning fork on the mastoid and then move it next to the ear
Describe the result of a Weber hearing test in a patient with conductive hearing loss
Patient will report the sound louder in the affected ear
An x-ray of the skull reveals coalescence of mastoid air cells. What is the most likely diagnosis?
Matoiditis
After 7 days of sinusitis what antibiotic would you start?
Amoxicillin or bactrim
A 45 year old female complains of feeling the ground rolling under her feet at times. WHat is the most likely diagnosis?
Vertigo
A patient with a history of smoking presents with a new onset hoarseness. This has been persistant for the past two weeks. What is the most likely diagnosis?
Laryngeal squamous cell carcinoma
A patient presents with acute onset of continuous severe vertigo for the past five days. He does have a history of URI 2 weeks ago. What is the most likely diagnosis?
Labrynthitis
What does Kiesselbach’s plexus refer to?
A group of veins in the anterior nose which bleed a lot
Small grouped vesicles on the vermillion border should make you think of what diagnosis?
herpes
How do you differentiate between preseptal and post septal orbital cellulitis?
Ct scan of the orbits can help differentiate or clinical exam (pain with eye movement in post septal)
What typically causes preseptal cellulitis?
An ascending URI
You have a patient who presents with a harden painless lump on the lid of their eye. What is this? How do you treat it?
Chalazion- warm compresses might provide symptomatic relief. Consider ophthalmologist referral
Most common etiology of viral conjunctivitis?
adenovirus
Main distinguishing factor between viral conjunctivitis and allergic conjunctivitis?
allergic conjunctivitis is itchy
You have a patient with a foreign body in their eye. Once the object is removed you notice a “rust ring”. What was the object in the eye? What is the treatment for “rust ring”
metallic foreign body
Treatment- tetanus shot, antibiotics, pain control, removal with drill by ENT
A patient has a foreign body in their eye. You tried to irrigate with saline but were unsuccessful. What should you try next?
Use a cotton ball and swipe to try to pick up the foreign body
A patient experienced blunt trauma to the eye. Visualization of the eye reveals a “tear drop pupil”What does this patient have?
Ruptured globe
The most frequent location of orbital blow out fractures
inferior wall and medial wall
Normal pH of the eye
7
Which burn is worse- alkaline or acidic burns? WHy?
alkaline because liquification necrosis
“hazy cornea”- what is the treatment?
acute angle closure glaucoma- treat with IV mannitol, topical beta blockers and call ophthalmology
You have a patient who has painless, sudden loss of vision. You do an eye exam on a patient and see a “cherry red spot” What do they have?
central retinal artery occlusion
Your patient has malignant otitis externa. What is the most likely culprit?
P. aeruginosa
What underlying disorder does a patient with malignant otitis externa most likely have?
diabetes
First line treatment for mastoiditis
IV vanco or nafcillin
YOu have a patient with an anterior nosebleed and a patient with a posterior nosebleed. Which one will be admitted?
Posterior!- anterior just gets dose of antibiotics and packing in ER and then sent home
treatment for dental abscesses
Pen VK or clinda
“hot potato voice”
peritonsillar abscess
3 D’s of epiglottis
drooling, dysphagia + distress
Pathogen causing epiglottitis
H flu
“railroad tracks “ on X-ray
bronchiectasis
“thumb print sign” on X-ray
epiglottitis
