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emerg med exam III > ENT emergencies > Flashcards

ENT emergencies Flashcards

1
Q

what medication can you use to immobilize insects in ear

A
  • 2% lidocaine
  • mineral oil
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2
Q

cauliflower ear

A
  • hematoma of the pinna
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3
Q

if a laceration to pinna needs suturing, what technique is the best

A
  • running suture
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4
Q

perichondritis

A
  • infection of the skin and tissue surrounding the cartilage of the outer ear.
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5
Q

malignant otitis externa is an invasive infection that involves what bone

A
  • temporal bone
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6
Q

malignant otitis externa is seen in what patient population

A
  • immunocompromised patients
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7
Q

primary pathogen: malignant otitis externa

A
  • pseudomonas aeruginosa
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8
Q

how is malignant otitis externa diagnosed

A
  • CT scan
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9
Q

mastoiditis is caused by an extension of

A
  • otitis externa or acute otitis media into mastoid air cells
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10
Q

how is mastoiditis diagnosed

A
  • CT best
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11
Q

tx of mastoiditis

A
  • hospitalize
  • IV abx: vancomycin or Nafcillin/Oxacillin
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12
Q

most common etiology of epistaxis is

A
  • trauma
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13
Q

initial management of epistaxis

A
  • direct pressure for a minimum of 5 minutes
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14
Q

source of bleeding in children

A
  • kiesselbach’s plexus
    • source usually anteriorly on nasal septum, branch of labial artery
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15
Q

source of bleeding in adults

A
  • posterior setpum
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16
Q

source of bleeding in elderly

A
  • branch of maxillary artery
  • posterior
  • more bleeding
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17
Q

treatment options for an anterior epistaxis

A
  • topical vasoconstictor
    • neo-synephrine spray
    • cocain spray
  • cautery
  • anterior packing with petrolatum
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18
Q

treatment options for an posterior epistaxis

A
  • vasoconstrictor
  • posterior packing -> hospitalization
    • ​balloon catheter left in place for 2-5 d
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19
Q

complications of posterior packing for epistaxis

A
  • septal hematoma
  • sinusitis
  • toxic shock syndrome
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20
Q

tx for non-displaced nasal fracture

A
  • ENT referral 3-5 d
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21
Q

what should you do if a patient with nasal fracture presents with blood surrounding straw-colored fluid or seroud fluid

A
  • CSF lead
  • urgent neurosurgical consultation
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22
Q

septal hematoma are most common in what patient population

A
  • pediatric
23
Q

tx of septal hematoma

A
  • incision and drainage of hematoma to prevent avascular necrosis
  • following drainage, pack nose and cover with abx
24
Q

untreated septal hematomas are complicated by

A
  • “saddle nose” deformity
25
Q

what should be avoided if pt presents with vegetable foreign body in nose

A
  • avoid irrigation
26
Q

if more than unsuccessful attempts to remove FB from nose, refer to ENT

A
  • two
27
Q

List complications from sinusitis

A
  • periorbital cellulitis
  • orbital cellulitis
  • cavernous sinus thrombosis
  • frontal osteomyelitis
28
Q

infection with periorbital cellulitis is confined to

A
  • the eyelids
29
Q

most common pathogens causing periorbital cellulitis

A
  • Strep. pneumo
  • S. aureus
30
Q

on exam of periorbital cellulitis, assess visual acuity and EOMS because

A
  • vision loss, diplopia, and proptosis suggest intraorbital involvement consistent with orbital cellulitis
31
Q

how is periorbital cellulitis diagnosed

A
  • CT
32
Q

what imaging can differentiate between periorbital cellulitis and orbital cellulitis

A
  • CT
33
Q

orbital cellulitis is a true emergency and can lead to

A
  • vision loss
  • meningitis
  • cavernous sinus thrombosis
  • frontal abscess
34
Q

clinical presentation

  • periorbital edema
  • erythema
  • proptosis: protrusion of eyeball
  • chemosis: swelling of conjunctiva
  • impaired EOMs
  • vision loss
A
  • orbital cellulitis
35
Q

tx of orbital cellulitis

A
  • admit
  • Nafcillin + Ceftriaxone + Metronidazole
36
Q

clinical presentation

  • severe unilateral, retro-orbital headache
  • bilateral proptosis
  • opthalmoplegia
  • vision loss
  • sensory dysfunction - hypo/hyperesthesia of cranial nerve V1
  • CN dysfunction (III, IV, VI)
A
  • cavernous sinus thrombosis
37
Q

how is cavernous sinus thrombosis diagnosed

A
  • CT
38
Q

tx of cavernous sinus thrombosis

A
  • IV
    • vancomycin + ceftriaxone
39
Q

common pathogens causing frontal osteomyelitis

A
  • s. auerus
  • anaerobes
40
Q

clinical presentation

  • h/o frontal sinusitis
  • HA
  • progressive swelling of forehead
A
  • frontal osteomyelitis
41
Q

how is frontal osteomyelitis diagnosed

A
  • CT or MRI
42
Q

tx of frontal osteomyelitis

A
  • drainage of abscess and debridement of infected bone
  • IV abx: vancomycin or nafcillin
43
Q

tongue lacerations are alomst never sutures except those located

A
  • tip of tongue
  • if > 1/3 width of tongue is involved
44
Q

define Ludwig’s angina

A
  • infection involving the submandibular space
  • 85% result of dental infection
45
Q

common pathogens causing Ludwig’s angina

A
  • streptococcus
  • staphylococcus
  • bacteroides
46
Q

clinical presentation

  • neck swelling
  • tongue protrusion
  • severe pain
  • fever, malaise, trismus, bad breath
A
  • Ludwig’s angina
47
Q

most common abscess of head and neck

A
  • peritonsillar abscess
48
Q

clinical presentation

  • fever
  • severe sore throat
  • drooling
  • odynophagia
  • otalgia
  • “hot potato” voice
  • uvula displaced, unilateral erythema and swelling
A
  • peritonsillar abscess
49
Q

what is Sialoadenitis

A
  • inflammation of any of the salivary glands
    • parotid
    • submandibular
    • sublingual
50
Q

suppurative Sialoadenitis most commonly caused by

A
  • staph aureus
51
Q

Sialoadenitis most commonly found in what patient population

A
  • elderly
  • diabetic
  • poor oral hygiene
52
Q

bilateral Sialoadenitis etiolgy

A

viral

53
Q

unilateral Sialoadenitis etiolgy

A
  • bacterial
54
Q

obstructive Sialoadenitis caused by

A
  • stone or calculus in gland or duct
    • most stones pass spontaneously without complication

emerg med exam III (6 decks)

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