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Clinical Medicine > ENT emergencies > Flashcards

ENT emergencies Flashcards

Exam 2

1
Q

Common ear emergencies

A
  • Otitis externa (swimmer’s ear)
  • acute otitis media
  • foreign body
  • perforated eardrum
  • sudden hearing loss
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2
Q

Otitis externa presentation

A
  • hx of trauma or swimming
  • itching and pain
  • drainage, hearing loss
  • swelling, erythema, fever, lymphadnopathy
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3
Q

Otitis externa causes

A
  • Localized: staph
  • Diffuse: pseduomonas
  • fungal
  • allergic
  • seborrheic
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4
Q

Otitis externa tx

A
  • cleansing/debridement (typically fungal)
  • drops
  • oral abx
  • wick
  • pain meds
  • neomycin-boric acid powder
  • culture
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5
Q

Otitis externa emergency

A
  • sx: diplopia, facil paralysis

- comorbitites: DM, immunocompromised

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6
Q

Acute otitis media presentation

A
  • children age 2
  • fever, pain, irritability, purulent drainage, other URI sx
  • HEARING LOSS
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7
Q

Acute otitis media organism causes

A
  • viral

- bacterial: s. pneumococcus, h. influenza, m. catarrhalis

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8
Q

Acute otitis media tx

A
  • abx if bacterial

- myringotomy tubs: recurrent infections, hearing loss, speech delay

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9
Q

Acute otitis media complications

A
  • acute: mastoiditis, suppurative labyrinthitis, brain abscess
  • late: cholesteatoma
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10
Q

Mastoiditis presenation

A
  • fever/toxicity
  • pain, fluctuance over mastoid
  • prominent pinna
  • facial paralysis, vertigo, mental status changes
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11
Q

Mastoiditis tx

A
  • intravenous abx
  • CT scan
  • surgery: mastoidectomy
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12
Q

Aural foreign body

A
  • Presentation: hx, pain, drainage
  • Ex: beads/toys, cotton, wax, insects
  • Rx: removal, possible drops
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13
Q

Perforated TM presentation

A
  • infectious following acute OM: fever, pain, otorrhea
  • traumatic
  • asymptomatic
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14
Q

Perforated TM tx

A
  • infectious: drops, Abx
  • Traumatic: observe
  • asymptomatic
  • hearing test
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15
Q

Perforated TM emergencies

A
  • vertigo
  • sensorineural hearing loss
  • facial paralysis
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16
Q

Nasal foreign body

A
  • presentation: hx, unilateral purulent rhinorrhea

- tx: remove

17
Q

Epistaxis

A
  • anterior: septal bleeding, self limited, more common

- posterior

18
Q

Epistaxis causes

A
  • trauma
  • spontaneous
  • associated factors: HTN, poor clotting, meds
19
Q

Epistaxis tx

A
  • supportive: saline nasal spray, humidification, ointment
  • packing, cautery
  • surgical
20
Q

Acute sinusitis presentation and tx

A
  • Presentation: rhinorrhea, facial/teeth pain, congestion

- Tx: abx, mucolytics, nasal steroids

21
Q

Acute sinusitis complications

A
  • orbit: preseptal cellulitis - cavernous sinus thrombosis

- intracranial: meningitis - brain abscess

22
Q

Common throat emergencies

A
  • peritonsillar abscess
  • foreign body
  • croup
  • epiglottitis
  • bronchiolitis
23
Q

Causes of peritonsillar abscess

A
  • bacterial: cellulitis to abscess

- strep, staph, anaerobes

24
Q

Peritonsillar abscess presentation

A
  • fever, sore throat, trismus, hot potato voice
  • UNILATERAL symptoms (sore throat, ear pain)
  • bulging tonsil, uvular deviation
25
Q

Peritonsillar abscess tx

A
  • drainage: I&D, quinsy tonsillectomy
  • abx
  • steroids to take swelling down (pt comfort)
26
Q

Foreign body throat

A
  • presentation: young child or eldery, witnessed chocking, asthma, pna, chronic cough
  • tx: x-ray, fiberoptic laryngoscopy, angiogram if in tonsil bed, removal in OR
27
Q

Epiglottitis presentation

A
  • children age 2-6: fever, toxicity, sore throat, dysphagia, inspiratory stridor, rapid progression to airway obstruction
  • Adults: less severe
28
Q

Epiglottitis cause

A
  • h. influenza type B (classical children)

- staph, strep, penumococci

29
Q

Epiglottitis dx

A
  • history or PE
  • lateral neck x-ray
  • fiberoptic laryngoscopy
30
Q

Epiglottitis tx

A
  • secure airway
  • IV abx
  • steroids
  • children you need to take to OR stat
31
Q

Laryngotracheobronchitis (croup) presentation

A
  • children 6 months to 3 yrs
  • winter
  • milder URI sx
  • barking cough, biphasic stridor
32
Q

Croup cause

A
  • viral: parainfluenza, adenovirus
  • secondary bacterial infection
  • swelling of subglottis
  • low humidity
33
Q

Croup dx

A
  • H&P

- lateral and P-A x-rays: subglottic narrowing

34
Q

Croup tx

A
  • humidification, hydration, oxgyen
  • RACEMIC EPINEPHRINE
  • abx: only w/ secondary infection
  • steroids
  • airway control
35
Q

Bronchiolitis presentation

A
  • infants <18 months
  • URI followed by respiratory distress
  • cough, wheezing
36
Q

Bronchiolitis cause

A
  • respiratory syncitial virus
  • parainfluenza 3
  • other viruses
37
Q

Bronchiolitis tx

A
  • supportive care: oxygen, hydration

- Ribavirin

38
Q

Head and Neck Trauma

A
  • septal hematoma
  • auricular hematoma (wrestlers)
  • lacerations
  • mandible fx
  • clear rhinorrhea (unilateral)

Clinical Medicine (19 decks)

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