ENT Complaint

Question 1

Cobblestoning

Answer 1

-causes by post nasal drip, uncontrolled acid reflux -patches of irritated swollen lymph tissue

Question 2

Tonus Palatinus

Answer 2

• Harmless bony growth
• No surgery unless too big and affects speech and swallowing

Question 3

Pneumatic Otoscopy

Answer 3

• Detects if TM is moving
• Puff of air into ear

Question 4

Check the ears

Answer 4

• Cone of light (wont see with otitis media)
• Otitis media: bulging TM with varying degree of erythema

Question 5

Strep Throat

Answer 5

• look for beefy red soft palate
• white or yellw patches on tonsils (exudate)
• tiny red hemorrhages on soft palate
• prepallatine peticie

Question 6

Pharyngitis

Answer 6

• inflammation of pharynx
• Viral or bacterial
• Common symptoms of Viral: Coryza (inflammedmucus membrane), conjuctivitis, fatigue, low grade fever, hoarseness

Question 7

Streptococcal Pharyngitis

Answer 7

• Group A beta-hemolytic
• treat strep because can cause rheumatic fever
• Symptoms

Sore throat

HA

Fatigue

Nausea: throat next to intraabdominal homonculus

Question 8

Homonculus

Answer 8

• pharynx next to intra-abdominal organs
• genitals next to toes

Question 9

High likelihood of GABHS

Answer 9

• Children 5-15
• Winter or Spring
• Absence of cough
• Fever
• Tonsillar exudate

Question 10

Center Score=

Answer 10

Criteria

Absence of Cough 1

Swollen and tender ant. nodes 1

Temp >100.4

Tonsilar exudate 1

Age

3-14 1

15-44 0

>45 -1

Score 0: no further testing

Score 1: can do rapid strep test

Score 2: rapid strep test

Score 3: rapid strep test

Score 4 and up: antibiotics right away

RAPID STREP TEST ONLY TESTS FOR GROUP A

Question 11

Otitis Media

Answer 11

-Acute OM: symptomatic inflamm by bacteria or virus

Acute Suppurative OM: acute OM with purulent material in middle ear

OM with Effusion (Serrous OM): inflamm and fluid build up in middle ear W/O bacterial or viral infection

Chronic OM with effusion: fluid remains in middle ear and continues to return W/O infection

Chronic OM Suppurative: peristent ear infection that results in tearing eardrum

Chronic >6 wks

Question 12

Otitis Externa

Answer 12

• caused by bacteria entering a small break
• may report drainage from ear
• pain upon touching

Question 13

Otosclerosis

Answer 13

• abnormal bone growth around stapes
• Progressive hearing loss at age 10-30
  1. Conductive loss: single mass
  2. Sensory Loss: goes across otic capsule

Question 14

Weber Rinne Test

Answer 14

Weber:

Conductive loss: lateralizes to affected side

Sensorineural Loss: Lateralizes to side opposite of ear

Rinne

Normal: Air conduction>bone

Conductive loss: bone conduction>air conduction

Question 15

Causes of Conductive Hearing Loss versus Sensorineural

Answer 15

Conductive: middle ear fluid, lack of ossicle movement, trauma, obstruction

Sensorineural: hereditary, menieres, MS, trauma, ototoxic drugs

Question 16

Bacterial Sinusitis

Answer 16

• double sickening: gets better than gets worse again
• Acute bacterial rhinosinusitis: acute rhinosinusitis persists without evidence of improvement for at least 10 days beyond onset of URS

Treatment: antibiotics: amoxicillin

Question 17

Croup

Answer 17

• Barky Cough
• swelling of larynx, trachea, bronchi causing inspiratory stridor, barking cough in kids 6 months-3 years old

Causes: parainfluenza virus, influenza, respiratory syncytial virus

History: barking cough

Presentation: fever, nasal flaring, stridor

Treatment: no intervention needed

Question 18

Epiglottitis

Answer 18

-inflammation of epiglottis and adjacent structures

Cause: type b influenza, group a strep

Hisotry: rapid onset, sore throat, muffled voice, drooling

Presentation: high grade fever, toxic appearance, tripod position. stridor

Treatment: protect airway and antibiotics