ENT Complaint Flashcards
When do frontal sinuses develop?
8-10 years of age
Torus Palatinus
- harmless bony growth
- oral exostosis
- female > male
- hereditary
- no surgery needed usually
Strep throat
- beefy red soft palate and uvula
- enlarged red tonsils
- white or yellow patches on the tonsils
- tiny hemorrhages on the soft palate
Pharyngitis
- inflammation of pharynx with resulting sore throat
- viral causes: adenovirus, rhinovirus, coronavirus, entervirus, influenza A or B, respiratory syncytial virus
- bacterial causes: GABHS, chlamydia pneimoniae, myoplasma penumoniae
- symptoms: coryza (inflamed musuc membrane), conjunctivitis, fatigue, hoarseness, and low grade fever
Symptoms patients may report
sore throat, headache, fatigue, fever, body aches, nausea
Why nausea?
pharynx right next to intra-abdominal organs on homonculus
What is GABHS?
Group A beta-hemolytic streptococcus
Highest likelihood of GABHS?
children 5-15 winter and early spring seasons absence of cough tender anterior cervical lymphadenopathy tonsillar exudate fever
Labs to consider
- rapid antigen detection test
- throat culture
- mono spot test
Treatments
antibiotics
NSAIDS, cough drops, Chloraseptic sprays
Ear Infections
Middle: air filled space behind the eardrum -acute otitis media (AOM) -otitis media with effusion Outer: outer ear canal -otitis externa Inner: inner ear structures -labyrinithitis
Acute OM
symptomatic inflammation of middle ear that can be viral or bacteria
Acute suppurative OM
acute OM with purulent material in the middle ear
OM with effusion
inflammation and build up in the middle ear without bacteria or virus infection; may occur because fluid buildup persists after an ear infection has been resolved or due to some dysfunction of eustachian tubes
Chronic OM with effusion
occurs when fluid remains in the middle ear and continues to return without bacterial or viral infection; makes children susceptible to new ear infections and may affect hearing
Chronic suppurative OM
persistent ear infection that often results in tearing or perforation of the eardrum
Appearance of acute OM
- appears TM is bulging
- red
- TM has reduced mobility when pneumatic otoscope is used
Otitis Media with Effusion
-fluid behind ear drum
-often follows acute otitis media
can last 3 months
can affect hearing if chronic
Otitis externa
- can be caused by bacteria entering small break in skin canal
- pts may report drainage from the ear
- usually associated with pain upon touching the external ear structures
Otosclerosis
- abnormal bone growth around stapes bone
- associated with progressive hearing loss beginning ages 10-30
- marked hearing loss during middle age
- conductive loss = ossicle sclerosis into a single immovable mass
- sensory loss = otic capsule sclerosis
- affects about 10% caucasians; females > males
Weber Test
Conductive Loss: lateralizes to affect side
Sensorineural Loss: lateralizes to side opposite of affected ear
Rinne Test
Normal: air conduction > bone conduction
Conductive Loss: BC > AC
Causes of Conductive:
cerum impaction, middle ear fluid, lack of movement of the ossicles, trauma, other cause of obstruction such as tumors
Causes of Sensorineural
-hereditary, Meinere, MS, trauma, otoxic drugs, barotrauma
Rhinosinusitis
- mucosal lining in the paranasal sinuses and nasal cavity inflamed
- infectious causes
- dental infections, immunodeficiency, iatrogenic, impaired ciliary motility, mechanical obstruction
- nasal discharge, couch, sneeze, congestion, fever, headache, pain, facial pressure
- treat with analgesics, intranasal corticosteroids, nasal irrigation, antihistamine
Bacterial Sinusitis
- double sickening, purulent rhinorrhea, elevated ESR
- symptoms persist for at least 10 days
- treat with first line antibiotic: amoxicillin, augmentin
- second line antibiotic: doxycycline, levaquin, clindamycin, cefixime
Croup
- Laryngotracheitis
- swelling of larynx, trachea, bronchi causing inspiratory stridor and barking cough in children 6 months to 3 years
- caused by flu, or respiratory syncytial virus
- fever, nasal flaring, respiratory tractions, stridor, barking cough
- can perform XR if needed
- treat with oxygen, dexamethasone, nebulized epinephrine
Epiglottitis
- inflammation of the epiglottis and adjacent structures
- caused by haemophilus tybe b influenza, group A beta hemolytic strep
- high grade fever, toxic appearance, child sitting or leaning forward
- consider lateral XR and white blood cell count
- protect airway, intubate if needed, broad spectrum antibiotics
