ENT problems Flashcards

1
Q

tonsils

A

lymph tissue that filter pathogens

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2
Q

adenoids

A

nasopharynx

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3
Q

palatine tonsils

A

both sides of the oropharynx

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4
Q

tubal tonsils

A

entrance to the eustachian tubes

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5
Q

lingual tonsils

A

base of the tongue

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6
Q

tonsillitis

A

infection/inflammation of the palatine tonsils

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7
Q

adenitis

A

infection/inflammation of the adenoids

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8
Q

etiology of tonsillitis

A

-can be either viral or bacterial -viral: most common in children <3 yrs -bacterial: GABHS in school age children -incidence peaks from 4-7 years old

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9
Q

s/s of bacterial tonsillitis

A

-swollen uvula -whitish spots -red swollen tonsils -throat redness -gray furry tongue **come to the health center

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10
Q

s/s of viral tonsillitis

A

-red swollen tonsils -throat redness **monitor at home, gargle with salt water

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11
Q

general s/s of tonsillitis

A

-painful or difficulty swallowing -drooling -high fever -pus

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12
Q

s/s of adenoiditis

A

-nasal speech -mouth breathing -difficulty hearing -halitosis (bad breath) -sleep apnea GABA -HA -abd pain -N/V

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13
Q

tx of viral tonsillitis

A

-analgesic/antipyretic -fluids -rest -saline gargles -throat sprays

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14
Q

tx of bacterial tonsillitis

A

antibiotics

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15
Q

tonsillectomy

A

removes palatine tonsils

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16
Q

adenoidectomy

A

removes pharyngeal tonsil

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17
Q

reasons for surgery for tonsillitis

A

-recurrent throat infections (>3yo, x3) -tonsils interfere with eating, sleeping & breathing

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18
Q

frequent swallowing and throat clearing in tosillitis

A

sign of swallowing blood

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19
Q

foods to avoid with tonsillectomy

A

-dairy will increase mucus -popsicle & jello okay -avoid red jello (d/t bleeding)

20
Q

otitis media

A

middle ear infection or effusion

  • viral or bacterial
  • presence of uninfected fluid
21
Q

if otitis media is left untreated…

A
  • permanent hearing loss
  • mastoiditis
  • meningitis
22
Q

increased incidence of otitis media

A
  • 6-36 mo
  • 4-6 yrs
  • males
  • Alaskan and Native American
  • home w/ smoker
  • cleft palate
  • formula fed infants (bottle propping)
  • winter/spring
  • pacifier use
23
Q

infant s/s of otitis media

A
  • rub and pulling affected ear
  • rolls head from side to side
  • crying, fussy, restless, irritable
  • difficulty comforting child
  • loss of appetite
24
Q

older child s/s of otitis media

A
  • verbalizes pain
  • irritability
  • lethargy
  • loss of appetie
25
Q

objective s/s of acute otitis media

A
  • reddened membrane, inflamed
  • malleus
  • no cone of light
  • fluid present
26
Q

s/s of acute otitis media

A

rapid onset of

  • sharp pain
  • rhinitis, URI
  • sudden fever
27
Q

causative organisms of acute otitis media

A
  • strep pneumoniae
  • HIB
  • moraxella catarrhalis
  • staph
28
Q

if tx of acute otitis media is unsuccessful

A

tympanocentesis is done to obtain culture

29
Q

tx of acute otitis media

A
  • watchful waiting
  • antibiotics
  • analgesics/antipyretics
  • nasal decongestants
30
Q

parent teaching for acute otitis media

A
  • complete antibiotics
  • conductive hearing loss up to 6mo
  • do not clean ears with q-tips
  • dont use nasal decongestants for 3+ days
  • offer liquids and soft foods (hurts to chew)
  • return to clinic if no improvement in 24-48 hrs
31
Q

otitis media with effusion

A
  • result of chronic OM
  • children 3-10yrs
32
Q

assessment of otitis media with effusion with otoscope

A
  • retracted tympanic membrane
  • malleus prominent
  • absent cone of light
  • no movement with puff of air
33
Q

s/s of otitis media with effusion

A
  • c/o fullness, ringing or popping
  • hearing loss (temporary)
34
Q

management of otitis media with effusion

A
  • goal: to supply air
  • control the cuase of allergies, enlarge adenoids
  • meds: antihistamines, decongestants
  • surgeries (for hearing loss >20dB): tympanocenesis; tubal myringotomy with pressure equalizing tube insertion; tympanostomy tubes (PE tube)
35
Q

PE tube

A

tympanostomy tube

  • depending on tube size, lasts 6 mo to 2-3 yrs
  • as ears grow, tubes will fall out
  • place in 5-10 minutes under brief general anesthesia
36
Q

parent teaching for myringotomy

A
  • no water in ears
  • bathe rather than shower
  • shower/swimming w/ ear plugs
  • possible temp hearing problem (notify teacher, PE tube falls out)
37
Q

croup

A

narrow, swollen airway

  • acute laryngotracheobritis (viral)
  • acute spasmodic laryngitis (viral)
  • acute (bacterial) tracheitis
  • acute (bacterial-Hib) epiglottis (life threatening)
38
Q

assessment of croup

A
  • respiratory assessment: croupy/barking cough; inspiratory stridor, resp distress
  • history of recent ear infections
  • xrays, labs, cultures
39
Q

common s/s of respiratory distress

A
  • contractions
  • nasal flaring
40
Q

treatment of croup

A
  • airway mgmt: corticosteroids, racemic epinephrine(vasoconstricts)
  • fluids
  • rest
  • humidification
  • humidified O2
  • antibiotics
41
Q

acute laryngotracheobronchitis vs acute spasmodic laryngitis

A
  • viral
  • LTB gradual onset : spasmodic rapid onset
  • LTB more severe
  • can be managed with O2, hospitalization, IV fluids, racemic epi, rest
42
Q

s/s of acute tracheitis

A
  • purulent secretions
  • high fever
  • tripod position (helps with breathing)
43
Q

tx of acute tracheitis

A
  • humidified O2
  • possible intubation
  • antipyretics
  • IV antibiotics
  • fluids
44
Q

s/s of acute epiglottis

A
  • drooling
  • dysphagia
  • dysphonia
  • distress
  • fever
45
Q

tx of acute epiglottis

A
  • do not inspect throat
  • humidified O2
  • emergency intubation
  • antipyretics
  • IV antibiotics
  • fluids
  • racemic epi