ENT - SD Flashcards
Acute onset of ear pain – red, bulging TM
Otitis media
Do we use ototoxic drops in ears? why or why not?
No – in case there is a rupture/perf
Is otitis externa typically caused by one or multiple bacteria?
Multiple
What is a known complication of otitis media?
Mastoiditis
What are some findings on PE that indicate mastoiditis?
Tender over mastoid
Can see pinna displaced outwards and down
Obliteration of postauricular crease
If untreated, what can mastoiditis lead to?
Meningitis, brain abscess, epidural hematoma
Blood between mucoperichondrium and cartilage of septum
Septal hematoma
grape-like swelling to nasal septum, boggy to palpation
Septal hematoma
When someone has a nasal foreign body, what else must you assess for?
Possibility of aspiration of another FB
Are posterior or anterior nose bleeds more common?
Anterior (kiesselbach plexus)
When someone comes in with a bloody nose where else do you need to look besides their nose?
Always look in back of throat
What are out treatment options for epistaxis?
- Mechanical
- Vasoconstriction spray
- Cautery (but only if you can see the bleed)
- Inserted devices/techniques if nothing else works
If we pack someone’s nose because it won’t stop bleeding, what other actions do we have to take?
Start abx therapy – they can go into toxic shock
How long do we leave a nose packed?
2-3 days
Cellulitis/abscess to bilateral sublingual and submandible spaces
Ludwig’s angina
What is the cause of Ludwig’s angina?
Immunosuppressed state + bad teeth (dental infection dives in submandibular space)
Is Ludwig’s angina an emergency?
Yes! 50% intubation failure – people will die if not diagnosed early
how do we treat Ludwig’s angina?
Crash tracheotomy, penicillin and flagyl
Clinda if PCN allergy
Patient will appear toxic, will be in a tripod position, drooling, and muffled voice. On exam you look inside their mouth and it looks perfectly normal, but you can’t see posterior pharynx. Dx?
Retropharyngeal abscess
How do we treat retropharyngeal abscess?
Oxacillin or cephalosporins
Also Hib vaccine can help prevent
Localized cellulitis of the supraglottic area with potential for abscess formation
Epiglottitis
thumb sign on x-ray
Epliglottitis
What causes epiglottitis?
Haemophilus influenzae
How do we treat epiglottitis?
Penicillin based or cefuroxime, ceftriaxone, bactrim
Steroids to get swelling down
These patients will present with mild pain to desperately short of breath. On PE you see uvula deviation, stridor, and drooling
Peritonsillar abscess
How do we treat a peritonsillar abscess?
I&D, IM Pen VK
What is a great way to treat pain for a dental abscess?
Dental block (periapical, infraorbital, inferior alvelolar)
Will anterior or posterior lymph nodes be enlarged with strep? what about mono?
Strep – anterior
Mono – posterior
how do we treat streptococcal pharyngitis?
amoxicillin
Besides cervical lymphadenopathy, what other signs will a patient with mono have?
tender spleen, grey exudate
what is the most common cause of stridor in kids?
Croup
What causes croup?
Parainfluenza virus
Steeple sign on x-ray – think of?
croup
Pain and swelling of parotid gland?
Parotiditis
