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Pulmonology - OMS 2 > ENT Infections > Flashcards

ENT Infections Flashcards

1
Q

What is the MC pathogen to cause acute otitis externa?

A

98% bacteria (p. aeruginosa & S. aureus)

some fungal (humid climates) and viral (few)

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2
Q

acute otitis externa is aka

A

swimmers ear

caused by things that remove cerumen (q-tip, scratching)

edema & cellulitis may be present
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3
Q

Key clue to otitis externa

mostly bacterial (P. aeruginosa or S. aureas)

A

tender tragus or pinna

otalgia, itching, fullness

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4
Q

Furunculosis of the outer 3rd of ear canal is caused by which organism?

A

S. aureus

causes edema, otorrhea, otalgia

viral = rare
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5
Q

Which organism causes malignant otitis media?

A

P. aeruginosa

creates biofilm, can spread to bones & brain

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6
Q

first sign that malignant otitis externa has spread to the brain

A

facial nerve palsy

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7
Q

how do you differentiat otitis externa from media?

A

pneumatic otoscopy

no movement of TM = otitis media

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8
Q

MC pathogens that cause otitis media

A
  1. bacterial
  2. viral

viral is clear & inflammed

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9
Q

otitis media: risk factors for infants (3)

6-9 months

A
  1. bottle fed
  2. smoking parents
  3. daycare
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10
Q

Tx: otitis media (4)

A
  1. amoxicillin or erythromycin
  2. tympanocentesis (immune-compromised)
  3. nasal decongestant
  4. myringotomy (extreme cases)
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11
Q

otitis media w/effusion

A

fluid in ear that won’t drain

must differentiate from AOM

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12
Q

causes of middle ear effusion

A

due to allergies or elevation changes

clear, no pain or infammation

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13
Q

chronic suppurative otitis media

A

12 weeks of persistent inflammation

all ENT infections

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14
Q

2 causes of chronic suppurative otitis media

A
  1. non treatment of AOM
  2. punctured TM

12 weeks of inflammattion

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15
Q

Cholesteatoma is caused by what?

A

eustachian tube dysfunction

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16
Q

Cholesteatoma due to eustachian tube dysfunction involves what?

process

A

negative pressure draws upper TM inward –> infection

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17
Q

Key clues: cholesteatoma (2)

A
  1. painless, foul-smelling otarrhea
  2. progressive hearing loss
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18
Q

3 types of cholesteatoma

A
  1. congenital (squamous epithelium trapped in temporal bone)
  2. primary acquired (retracted TM)
  3. secondary acquired (injured TM)
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19
Q

labyrinthitis

A

severe vertigo

follows URI

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20
Q

MS may cause sudden

A

sudden hearing loss

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21
Q

Which 5 ear complaints are seen in immunocompromised patients?

A
  1. middle (serous OM)
  2. external (fungal & kaposi’s)
  3. otitis media (jiroveci)
  4. hearing loss (Syphilis, C. neoformans)
  5. facial paralysis (herpes zoster)
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22
Q

what are the MC causes of the “common cold”?

A
  1. children: rhino
  2. adults: corona
  3. adenovirus (both)
  4. parainfluenza
  5. picorna
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23
Q

which infection causes bleeding from the eyes, ears and black necrotic eschar?

A

mucormysosis

immune-compromised pts

24
Q

mucormycosis key histological clues (2)

A
  1. ribbon-like hyphae
  2. branches at right angles
25
Q

sinus infections are mostly caused by what?

A

obstruction/edema blocking drainage

26
Q

Sinus infection: risk factors

A
  1. allergic rhinitis
  2. asthma
  3. swimming
  4. nasal obstruction (deviated septum)
27
Q

Systemic risk factors: sinus infection

A
  1. allergy
  2. CF
  3. immune compromised pt
28
Q

symptoms > 1week, unilateral pain, purulent secretions suggests which condition?

A

acute sinusistis

>12 weeks = chronic

29
Q

Histopathology will reveal which immune cells in chronic sinusitis?

A
  1. T & B cells
  2. MF
  3. eosinophils
30
Q

Why is the maxillary sinus infected the most?

A

biggest & drains upwards

31
Q

Toothache from a maxillary sinusitis is referred pain from what?

A

trigeminal nerve

32
Q

Where is the pain w/ehtmoiditis?

A

pain/pressure over high lateral wall of nose, radiating to orbit

33
Q

sphenoid sinusitis may affect what structure?

34
Q

Dx of sinusistis

A

transillumination: negative if you can see light in mouth

(viral will be negative)

35
Q

tx for sinusitis (3)

A
  1. irrigation
  2. nasal decongestants
  3. abx
36
Q

MC viral causes of sinusitis

A
  1. adenovirus
  2. parainfluenza
  3. rhino
37
Q

4 MC causes of fungal sinusistis

A
  1. mucor
  2. rhizopus
  3. fusarium
  4. aspergillus
38
Q

complications of fungal sinusitis

A
  1. osteomyelitis
  2. mucocele
39
Q

middle ear infections are usually due to what?

A

pharyngitis that migrates to eustachian tube

40
Q

how does cerumen protect from ear infection?

A

sticky, acidic inhibit bacterial growth

41
Q

Describe S. pyogenes colonies

A

small, pin-point

42
Q

Moraxella Catarrhalis colonizes the nasopharyngeal respiratory tract and spreads via

A

LPS buds out w/B-lactamsase, phospholipids & adhesins

43
Q

What are the 3 types of bordetella?

A
  1. B. Pertussis
  2. B. parapertussis
  3. B. bronchosepticus
44
Q

Which bordetella species causes whooping cough in children?

A

B. pertussis

45
Q

Which bordetella species only infects immunocompromised humans?

A

bronchosepticus

related to kennel cough in dogs

46
Q

tx for bordetella pertussis

A

erythromycin

prevented w/D-Tap + 10 year booster

47
Q

otomycosis aka “tropical ear” sx (2)

A
  1. pruritis
  2. thick otorrhea (black, green, white)

(aspergillus or candida)

48
Q

AOE tx (2)

A
  1. gentamicin
  2. hydrocortisone drops
49
Q

malignant OE dx

A
  1. ESR
  2. CRP
  3. CT/MRI
50
Q

Sx acute otitis externa (4)

A
  1. otalgia
  2. itching
  3. fullness
  4. hearing loss

abrupt onset; same as AOM

51
Q

Otitis media sx (3)

abrupt onset

A
  1. irritability
  2. otorrhea
  3. fever

otalgia, also

52
Q

Common cold sx (5)

80% viral

A
  1. sneezing
  2. sore throat
  3. fever
  4. cough
  5. headache
53
Q

Which cells are infected by rhinovirus

A

nasal epithelium

54
Q

How do nasal epithelial cells fight back against rhinovirus (2)?

A
  1. histamine
  2. IFN
55
Q

What are the symptoms humans feel due to the histamine and IFN released from nasal epithelial cells response to rhinovirus?

A
  • histamine: secretions
  • IFN: muscle aches, fever, malaise
56
Q

How is rhinovirus cleared?

Pulmonology - OMS 2 (28 decks)

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