ENT lecture Flashcards
allergic rhinitis
nose inflammation due to allergen
sneezing, rhinorrhea (nasal discharge), nasal obstruction
affected artery in anterior epistaxis (nosebleeds)
Kiesselbach’s plexus (vascular watershed area)
most common
affected artery in posterior epistaxis (nosebleeds)
more significant bleeding than Anterior epistaxis
(rare)
posterolateral branches of sphenopalatine artery
Infectious Mononucleosis
caused by Epstein Barr Virus (EBV)
sx: triad:
- fever
- tonsillar pharyngitis (sore throat)
- lymphadenopathy (enlarge lymphnode)
Sx of pharyngitis
Coryza (inflamed mucus memb) conjuctivitis malaise/fatigue hoarseness low-grade fever ---viral pharyngitis
type of strep causing strep pharyngitis
group A beta hemolytic streptococcus GABHS / Streptococcus pyogenes
-GABHS also causes epiglottitis (same region with pharynx so makes sense)
High Yield
- no cough, 5-15y.o chdn, winter and early spring, tender – anterior cervical lymphadenopathy
- tonsillar exudate
- fever
if untreated- can cause cardiac issues
tests for GABHS
Rapid Antigen/Step Antigen Detection Test
test for Infectious Mononucleosis if Triad symptoms are present
Monospot Test: Rapid Slide Agglutination Test
Centor Score
Clinical Decision Rule for Mgt of Sore Throat
Labyrinthitis
inner ear infection
acute Ostitis media with purulent material in middle ear
Acute suppurative OM
bulging of ear + pus
if chronic: risk of tearing/perforating ear drum
OM with effusion (serous OM)
fluid build up in middle ear w/o bacteria/viral infection
- persists after ear infection has resolved (post-acute OM)
- can be due to dysfunction/non-infectious blockage of eustachian tubes
chronic OM (>6 weeks) with effusion is high risk new infections that could affect hearing
otitis externa
bacteria enters a small break in skin of canal
post-swimming water that doesn’t drain and bacteria starts growing
abnormal bone growth around stapes bone
otosclerosis
progressive hearing loss beginning age 10-30
Ossicle sclerosis (single immovable mass)
conductive hearing loss
weber test: lateralizes to affected side
rhinne test: BC>AC
otic capsule sclerosis
sensory hearing loss
weber test: lateralizes to unaffected ear (OPPOSITE)
capsule is most sensitive..if compromised, sensory loss is gone!
normal Rinne Test
AC>BC
Weber Test Dysfunction if: sound lateralizes to right ear
either
Conduction loss in the right ear
or
Sensorineural loss in opposite ear I.E Left ear
Rinne test for ear with sensorineural loss
AC>BC
yes, normal result because conduction is intact in this ear. Sensorineural is what’s bad.
Causes of conductive hearing loss
- cerumen impaction
- middle ear fluid
- lack of mvt of the ossicles
- trauma
- other cause of obstruction such as tumors
causes of sensorineural hearing loss
Hereditary, Meniere disease, MS, trauma, otoxic drugs, barotrauma
what condition?
double sickening (better then worsens) , purulent rhinorrhea, elevated ESR, persistent acute rhinosinusitis >10days
Acute Bacterial Sinusitis
6month -3yr chn; fever, nasal flaring, respiratory, retractions, swollen airways causing stridor, barking cough,
Croup aka Laryngotracheitis
X-ray shows Steeple Sign
narrowed trachea due to swelling
Bug causing Croup
parainfluenza virus, influenza, respiratory syncytial virus
high-grade fever, drooling, toxic appearance, child sitting/leaning forward, elevating WBC, +ve Hemophilus Type B influenza or GABHS
Epiglottitis (life threatening)
inflamed epiglottis that shows on lateral neck XR
Labyrinthitis vs Vestibular neuritis
Labyrinthitis: inflammation of labyrinth that affects both branches of vestibulo-cochlea nerve hence hearing and balance loss –>vertigo
Vestibular neuritis: inflammation of vestibular nerve branch. Hearing is unaffected but balance is affected (vertigo experienced)
inner ear disorder, vertigo episodes, fluctuating hearing loss with progressive permanent loss, TINNITUS -ringing in ears, ear pressure, usually one ear
Meniere’s disease
spontaneous + hearing loss
most common cause of vertigo, spinning head with position changes, +ve Dix-Hallpike maneuver
BPPV (ear crystal otolith out of place)
episodic, triggered,
techniques for BPPV diagnosis and Tx
Diagnosis:
Dix-Hallpike maneuver:
+ve-> –>eye nystagmus, nausea, vertigo symptoms
both diagnosis and tx: Epley Maneuver
the mvts help crystal get back to o.g position
bulging otitis media, erythmia, fever, clear nasal discharge, ear pain, hearing intact
acute otitis media
