ENT Flashcards
how much hearing loss with tympanosclerosis
minimal
sudden onset bilateral sensorineural deafness
viral labyrinthitis
meds that cause SNHL
lasix
ethacrynic acid
aminoglycosides
salicylates
infections that cause SNHL
CMV rubella HSV syphilis bacterial meningitis
when can SNHL occur in bacterial meningitis
in first 24 hours
make sure to get hearing test
genetic syndromes that cause SNHL
Alport
mitochondrial
neurodegenerative
CHARGE (and other cleft palate syndromes)
how does ABR work
EEG waveforms, must be asleep
if > 6 mos, may need sedation
who should be tested with behavioral observation audiometry
screening test for less than 6 mos of age
who should be tested with visual reinforced audiometry
6-24 months, tests for bilateral hearing loss
who should be tested with play audiometry
2-4yrs
who gets pure-tone audiometry
4+; tests each ear independently
flat or low amplitude line on tympanogram
stiff membrane, middle ear fluid, obstructed tympanostomy tube
high volume tympanogram
perforated TM
chronic purulent drainage from perfed L TM without cholesteatoma findings
chronic suppurative OM
often pseudomonas, also Staph and fusobacterium
need topical ofloxacin
recurrence rate in cholesteatoma
50%
when can you do watchful waiting with AOM
must be non severe
- > 6 mos: unilateral
- > 24 mos: bilateral too
common complication of tymp tubes
granuloma - large red mass with bloody discharge
how to prevent OE
OTC boric acid or acetic acid solutions
tx of cauliflower ear
ice packs and pressure –> evacuation
prevent cartilage loss
nasal smear with eos
seasonal allergic rhinitis
assoc with nasal polyps
CF
asthma
chronic allergic rhinitis
chronic sinusitis
assoc with bilateral choanal atresia
CHARGE
when does maxillary sinus develop
birth
when does ethmoid sinus develop
birth
when does sphenoid sinus develop
5-6 years
when does frontal sinus devlope
5-6 years
imaging in acute vs chronic sinusitis
acute - clinical dx
chronic - get CT
worry with recurrent and worsening epistaxis
nasopharyngeal angiofibroma or other posterior nasopharyngeal mass
monospot timing considerations
> 4 yo
can become positive 2-3 weeks into illness
can be positive for up to 9 months
pharyngitis in teen with erythematous patches
gonococcal pharyngitis
complication of T&A
velopharyngeal insufficiency - hypernasal voice
herpangina vs HSV gingivostomatitis
herpangina usually posterior
HSV usually anterior with more gingical lesions
oral ulcers with gray/white coagulum, thin rim of erythema
aphthous ulcer
tender red nodule on cheek in infant
cold panniculitis
no tx needed
reasons for delayed tooth eruption
hypothyroidism hypopituitarism ecodermal hypoplasia hypohidrosis rickets
tx dental abscess
penicillin
clinda if allergic
risks with cleft palate
eustachian tube dysfn
vision, hearing, dental, speech complications
bifid uvula associations
submucous cleft palate
velopharyngeal insufficiency
middle ear effusion
post op complication of T&A for OSA
pulmonary edema
blunted inspiratory loop on spirometry
vocal cord paralysis
chronic or progressive hoarseness, worse in evening, no stridor
vocal cord nodules
biphasic stridor
usually subglottic stenosis
what other than paraflu causes croup
measles!
also RSV, flu
neck film in toxic patient with croup - ragged air column
bacterial tracheitis
what happens with needle aspiration of atypical mycobacterial lymphadenopathy
chronic drainage
should you excise thyroglossal duct cyst
no - at least until screened to see if thyroid tissue present
viral causes of parotitis
mumps
HIV
bacterial cause of parotitis
staph aureus
