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HENT > ENT Emergencies (Dr. Mao) > Flashcards

ENT Emergencies (Dr. Mao) Flashcards

1
Q

presentation of otitis external

A
  • hx of trauma or swimming
  • itching, pain
  • drainage, hearing loss
  • swelling, erythema, fever, lad
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2
Q

What organism may cause otitis externa in a localized infection such as a furuncle?

A

staph

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3
Q

which organism overwhelmingly causes otitis externa

A

psuedomonas

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4
Q

What are other causes of otitis externa

A

fungal, allergic (eczematoid, flaky), seborrheic

-these are more difficult to treat

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5
Q

treatment of otitis externa

A
  • cleansing, debridement
  • drops (cipro, cortisporin)
  • oral abx, wick, pain meds
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6
Q

How is tx in otitis externa different with fungal cause?

A

abx and drops make fungal infections worse, so you have to dry it out

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7
Q

What are sx of otitis external when it becomes an emergency

A

diplopia, facial paralysis

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8
Q

comorbitities of otitis externa emergency

A

diabetes, immunocompromised

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9
Q

Acute Otitis Media presentation (sx, and age group)

A
  • children age 2
  • fever, pain, irritability, purulent drainage, other URI sx
  • hearing loss
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10
Q

causative organisms of acute otitis media

A

viral

-bacterial - s. pneumococcus, H. influenza, M. catarrhalis

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11
Q

tx for acute otitis media

A
  • abx if bacterial

- myringotomy tubes

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12
Q

When would you give myringotomy tubes for acute otitis media

A

(often in children)

  • recurrent infections
  • hearing loss, speech delay
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13
Q

Acute complications of acute otitis media

A

Can spread to following regions and cause:

  • mastoiditis
  • suppurative labyrinthitis
  • brain abscess
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14
Q

Late complication of acute otitis media

A

cholesteatoma

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15
Q

Clinical features of mastoiditis

A
  • fever, toxicity
  • pain, fluctuance over mastoid
  • prominent pinna
  • facial paralysis, vertigo, mental status changes
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16
Q

Treatment of mastoiditis

A
  • IV abx
  • CT scan
  • surgery: mastoidectomy
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17
Q

Presentation of an Aural Foreign Body

A

-hx, pain, drainage

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18
Q

Examples of aural foreign bodies

A

beads/toys, cotton, wax, insects

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19
Q

Treatment for aural foreign body

A

removal, possible drops

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20
Q

presentation of perforated tympanic membrane

A
  • infectious following acute OM: fever, pain, otorrhea
  • traumatic
  • asymptomatic (people might not know)
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21
Q

treatment of infectious tympanic membrane

A

drops, abx

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22
Q

treatment of traumatic tympanic membrane

A

observe

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23
Q

emergencies associated with perforated TM

A
  • vertigo
  • sensorineural hearing loss
  • facial paralysis
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24
Q

Presentation of hearing loss

A
  • hx

- associated tinnitus or vertigo

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25
Q

Two types of sudden hearing loss

A

conductive vs. sensorineural

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26
Q

Treatment for sudden hearing loss

A

-audiogram, steroids?, antivirals? other

27
Q

Presentation of nasal foreign body

A
  • hx

- unilateral purulent rhinorrhea

28
Q

treatment of nasal foreign body

A

remove

29
Q

Anterior epistaxis

A
  • septal bleeding

- self limited and more common

30
Q

Two types of epistaxis

A

anterior and posterior

31
Q

causes of epistaxis

A
  • trauma

- spontaneous

32
Q

associated factors of epistaxis

A

HTN, poor clotting, medications

33
Q

epistaxis tx

A
  • supportive (saline nasal spray, humidification, ointments)
  • packing
  • cautery
  • surgery if nothing else helps (may clot off artery)
34
Q

presentation of acute sinusitis

A
  • rhinorrhea
  • facial and teeth pain
  • congestion
35
Q

tx of acute sinusitis

A

abx, mucolytics, nasal steroids

36
Q

complications of acute sinusitis

A

Near your eye and brain so you can have orbital and cranial complications

37
Q

Orbital complications of acute sinusitis

A
  • more common complications

- preseptal cellulitis–>cavernous sinus thrombosis (high mortality rate..50%?)

38
Q

intracranial complications of acute sinusitis

A

meningitis –> brain abscess

39
Q

Cause of Peritonsillar Abscess

A 
bacterial infections (cellulitis of tonsils can lead to an abscess)
-can be strep, staph, anaerobes (usually mixed)
40
Q

sx of peritonsillar abscess

A
  • usual tonsillitis sx but usually unilateral
  • fever, sore throat, trismus (can’t open mouth all the way), hot potato voice (muffled)
  • bulging tonsil, uvular deviation
  • usually referred ear pain on affected side
41
Q

treatment of peritonsillar abscess

A
  • drainage (I&D or quinsy tonsillectomy)
  • abx
  • steroids for inflammation- helps pt feel better
42
Q

Presentation of foreign body throat

A
  • young child or elderly
  • witnessed choking event
  • asthma, pneumonia, chronic cough
43
Q

treatment of throat foreign body

A
  • xray (only sometimes object is radiopaque)
  • fiberoptic laryngoscopy (if you feel like it’s something you would be able to see like a fish bone)
  • angiogram if in tonsil bed
  • removal in OR
44
Q

age epiglottitis is normally seen

A

children age 2-6

less severe in adults

45
Q

sx of epiglottitis

A
  • fever, toxicity, sore throat, dysphagia
  • inspiratory stridor, rapid progression to A/W obstruction
  • often leaning forward, drooling
46
Q

Why is epiglottitis seen less often now?

A

vaccine for H. influenza type B (HIB vaccine)

47
Q

What are some causes of epiglottitis

A
  • classically HIB, esp. children

- in adults, can be staph, strep, pneumococci

48
Q

Diagnosis of epiglottitis

A
  • h & p
  • lateral neck x-ray (look for thumb print sign)
  • fiberoptic laryngoscopy
49
Q

tx of epiglottitis

A
  • secure A/W
  • IV abx
  • steroids
50
Q

Name for Croup

A

Laryngotracheobronchitis

51
Q

Presentation of croup

A
  • barking seal cough
  • biphastic stridor (trouble breathing in and breathing out)
  • winter
  • children
  • milder URI sx
52
Q

Where is the problem with stridor

A

upper airway problem

53
Q

causes of laryngotracheobronchitis

A
  • viral (parainfluenza, adenovirus)
  • swelling of subplots
  • low humidity
  • can get secondary bacterial infection
54
Q

Dx of croup

A

h & p

-lateral and PA XR looking for subglottic narrowing

55
Q

tx of croup

A
  • humidification (epi infused), hydration, oxygen
  • abx
  • steroids (used a lot! to get swelling down)
  • A/W control is most important
56
Q

Bronchiolitis presentation

A

-infants

57
Q

Where is problem with bronchiolitis

A

lower resp problem

58
Q

causes of bronchiolitis

A
  • respiratory syncitial virus
  • parainfluenza 3
  • other viruses
59
Q

tx of bronchiolitis

A
  • oxygen, hydration, bronchodilator

- not an A/W probl, but a resp prob

60
Q

What are some conditions to look for in Head & Neck Trauma

A
  • septal hemotoma (collection of blood in the septum)
  • auricular hematoma (wrestlers)
  • lacerations
  • mandible fractures
  • clear rhinorrhea
61
Q

What could clear rhinorrhea after head trauma indicate?

A

Could be spinal fluid; could increase risk of meningitis, etc

62
Q

tx for septal hematoma

A

drain and dress so it doesn’t recollect

63
Q

tx for auricular hematoma

A

needs to be incised and put compressive dressing so it doesn’t recollect

64
Q

why are mandible fractures more emergent?

A

especially if it involves the teeth because this break often involves a mucosal break (very dirty area) so higher risk of infection

HENT (7 decks)

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