ENT Module 3 Flashcards
What is the causative organism that causes group a strep pharyngitis?
S pyogenes (gram-positive cocci)
In group a strep pharyngitis what are the symptoms? Do they get fever?
Set an onset of sore throat, fever, headache, abdominal pain, nausea, and vomiting especially in children.
When can a patient go back to work or school? When they have strep
Until they are afebrile and 12 hours after started anabiotic therapy.
Children who developed group a strep or at risk for developing what?
Acute rheumatic fever
What is the treatment for group a strep?
Penicillin v or amoxicillin
What is the treatment course for patients who have a penicillin allergy when receiving treatment for group a strep?
Take cephalexin, cefadroxil, clindamycin, azithromycin
What is the current Initial management for pediatric acute sinusitis?
Watchful waiting for three days maybe offer for children with a cute bacterial sinusitis the persistence symptoms
What is the first pharmacological line of treatment for pediatric acute sinusitis?
Amoxicillin or Augmentin remains for sign therapy
What is the second line of therapy for pediatric children that are allergic to penicillins who have acute sinusitis?
A single dose of ceftriaxone (Rocephin) can be used and then switch to oral anabiotics, if improving.
For acute otitis media in children, in mild cases what is the recommendation per CDC guidelines?
In children 6 to 23 months of age or unilateral or bilateral symptoms in children less than two years may be appropriate for water waiting based on shared decision making
What is the first line therapy for a cute otitis media in pedi population?
Amoxicillin remains first-line therapy for children who have not received amoxicillin within the past 30 days.
In acute otitis media the recommendation for children who have had amoxicillin within the past 30 days or has concurrent Purulent conjunctivitis present should be given what ?
Augmentin
For children who have acute otitis media that are allergic to penicillin, what is the next line of meds they should be given?
Cefdinir
Cefuroxime
Ceftriaxone
What is the pediatric treatment for pharyngitis? List 2 meds
Amoxicillin and penicillin V remain first line therapy
For children or pediatric pharyngitis, what is the treatment if there is a hypersensitivity to penicillin?
Cephalexin, cefadroxil,, myosin, clarithromycin, or azithromycin are recommended.
If there is a type one hypersensitivity to penicillin give Clindamycin, clarithromycin or azithromycin.
In adults with acute rhinosinositis what is the initial recommendation for uncomplicated cases for management?
Watch for waiting is encourage for uncomplicated cases for retro to follow up is available 
What is the first line therapy for acute rhinosinusitis in adult patients?  What is the second line?
First line therapy is amoxicillin or Augmentin. Second line therapy For penicillin allergic patient is doxycycline or a respiratory fluoroquinolone such as levofloxacin.
For adults who test positive for group a strep pharyngitis, what is the first line therapy?
Amoxicillin and penicillin V remain first line therapy due to their reliable antibiotic activity against group a strep.
For adults that are allergic to penicillin, what is
The second line treatment for group a strep?
Cephalexin, cefadroxil, clindamycin, or macrolides are recommended
Is it viral or bacterial pharyngitis?
Cough rhinorrhea hoarseness and Coryza 
Viral pharyngitis
Is is viral or bacterial pharyngitis?
Fever, tender anterior cervical lymphadenopathy, tonsillar erythema with or without exudate and swelling
 What are the two post infection syndromes of group A Beta hemolytic strep?
Acute rheumatic fever and acute poststreptococcal glomerulonephritis
What is some findings of acute poststreptococcal glomerulonephritis?
Occurs one or two weeks after group a strep pharyngitis. Important findings are edema hematuria proteinuria and hypertension
When is a tonsillectomy indicated?
When a patient has four or more episodes of severe pharyngitis in a year
What are the three main symptoms of infectious mononucleosis?
Severe sore throat, fever, lymphadenopathy
Patients diagnosed with mononucleosis should avoid what?
They should avoid contact sports and heavy lifting for four weeks due to risk for splenic rupture
Patients who are given amoxicillin or penicillin when they have mononucleosis can expect what
A rash
Based on the symptoms what would be the diagnosis:
Fever, malaise, severe sore throat that is worse on one side, dysphasia, ipsilateral otalgia 
Peritonsillar abscess
What is lemierre syndrome?
Septic thrombophlebitis of internal jugular vein
Remember these things about Lemierre syndrome
It is rare, potentially life-threatening cause of a sore throat. Positive agent is anaerobic gram negative rod F necrophorium. Nonspecific symptoms of sore throat neck tenderness or swelling or both and fever. CT scan of neck is best diagnostic modality. They don’t like them antibiotics clindamycin Flagyl or antibiotics to treat this. Surgery may be needed.
Sensorineural hearing loss associated with what part of the ear?
The inner ear
Mechanical conduction hearing loss is associated with what part of the ear?
Middle ear, issues are often reverseible
What disease process has fluctuating here in loss, usually unilateral, associate with tinnitus and vertigo?
Menieres disease
What differential diagnosis is this? Do you know lateral, constant or progressive hearing loss possibly associated with a headache, facial weakness, tingling, loss of taste and dysphasia. Cranial nerve 8 affected
Acoustic neuroma
What differential is this : high frequency hearing loss that is bilaterally symmetrical?
Indicator Prebycusis 
Describe the weber test
Please the tuning fork on the midline of the patient’s skull.
The sound is heard equally in both ears by the patient which is a normal result
In doing the Weber test, sensorineural hearing loss is heard loudest in what ear?
SUA
The unaffected ear
In doing the Weber test, conductive hearing loss is heard loudest in what ear?
CA
The sound is louder in the affected ear 
What is the differential for reoccurring attacks of tinnitus, vertigo and progressive hearing loss.
Ménière’s disease
What do Patients need to be educated about for meniere’s disease?
Acute attacks are best treated with quiet bedrest and careful protection from falls.
Patient should not drive, climb ladders, work near operate dangerous machinery, walk without assistance, read or look at glaring lights
Dysphonia is a cardinal sign of what type of cancer?
Laryngeal cancer
