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Clinical Medicine Lecture - Professor Kramer > Exam 3 HEENT Treatments > Flashcards

Exam 3 HEENT Treatments Flashcards

1
Q

Bells Palsy

A

Tape eye shut at night, wetting drops to keep eye moist if patient can’t close it

Corticosteroids - Prednisone - MAINSTAY
artificial tears
what it it is viral pathology? acyclovir

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2
Q

Horners Syndrome

A

MAP

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3
Q

Trigeminal Neuralgia

A

Anticonvulsants: carbamazepine, gabapentin

TCAs: Ami -Nor - triptyline

Surgery: rhizotomy and neurectomy

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4
Q

Blepharitis

A

keep lids clean
avoid make-up
lid massage w/ abs ointment
baby shampoo/ lid cleanser

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5
Q

Chalazion

A

warm compresses
steroid injection
surgery

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6
Q

Ectropion

A

artificial tears

surgery

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7
Q

Entropion

A

surgery
artificial tears
abc ointment (azithromycin)

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8
Q

Hordeolum

A

warm compresses
abc ointment
lid hygiëne
PO abs if periorbital cellulitis

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9
Q

cataract

A

surgery - new lens

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10
Q

Conjunctivitis viral

A

cold compresses
steroids topical
artificial tears

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11
Q

Conjunctivitis bacterial

A

tobramycin
trimethoprim + polymyxin B
gentamycin
ECN ointment

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12
Q

conjunctivitis allergic

A

Ah drops - olopatadine
cold compresses
steroids
artificial tears

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13
Q

Dacryocystitis

A

Empiric abs
IV abs
I/D
dacryocystorhinostomy

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14
Q

Pinguecula

A

artificial tears

steroids

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15
Q

Pteryguim

A

surgery - autograft

artificial tears

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16
Q

Uveitis

A

Mydraitic / cycloplegic gtts (cyclopentolate, tropicamide)
topical corticosteroids - mainstay (prednisone?)
PO steroids

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17
Q

acute otitis external

external ear

A 
pain relief ( NSAIDS and Tylenol)
eradication of infection with ciprofloxacin or ofloxacin
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18
Q

mastoiditis organisms

A

strep pneumo
H flu
M cat
always a complication of AOM 80%

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19
Q

mastoiditis

external ear

A

pipercillin - tazobactam plus vancomycin
narrow down ATB once culture is back from tympanocyntesis
myringotomy
mastoidectomy if no improvment in 48 hrs.

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20
Q

Eustachian tube dysfunction

A 
Viral URI cause - 
systemic decongestants (pseudo ephedrine)
intranasal decongestants (oxymetazoline)
auto inflation but not with active infection
Allergic cause - desensitization or intranasal steroids
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21
Q

acute otitis media

sensorineural hearing loss b/c scarring TM

A

mot resolve spontaneously

systemic pain: ibuprofen, acetaminophen, oxycodone, hydrocodone

topica painl: antipyrine, benzocaine, lidocaine (contraindicated with TM perforation)

if ABS indicated then first line is amoxicillin, cephalosporins,
augmentin
ofloxacin,
ceftriaxone (IV), clindamycin if PCN allergy
failure of sec ABS then clinda + 3rd gen ceph.

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22
Q

otitis media w/ effusion

not like AOM cause this is not painful, AOM is painful

A 
90% resolve spontaneously
AH
decongestants
corticosteroids 
ABS
all are unproven to work 
tympanovstomy tubes - surgery
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23
Q

chronic otitis media

conductive hearing loss b/c TM is perforated

A

organisms are: Pseudomonas, Proteus, staph
Tx: ofloxacin or ciprofloxacin with dexamethasone (steroid) , these are topical ABS
Definitive Tx: TM repair (90% success), mastoidectomy if irreversible infection

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24
Q

cholesteatoma (acquired or congenital) - retraction of TM interrupts normal squamous migration - keratin accumulates

A

osteoclastic activity
surgical - excise all of it or it will recur
remove infected debris, keep ears dry, ATB drops or maybe steroid drops

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25
Q

congenital disorder of the middle ear = EAC ATRESIA from agenesis of EAC

A

narrowing of EAC b/c of failure to develop completely

results in conductive hearing loss

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26
Q

Overly patent (branching) ET

A

avoidance of decongestants

myringotomy to decrease TM stretch

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27
Q

congenital disorder of the middle ear = MICROTIA (anotia)

A

small, collapsed or only a lobe

anotia = complete absence of the ear and canal

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28
Q

congenital disorder of the middle ear = Lop Ears

A

folded down or protruding

Tx: otoplasty

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29
Q

congenital disorder of the middle ear = Low Set

A

upper pole below eyebrow level, check kidneys

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30
Q

congenital disorder of the middle ear = PRE AURICULAR TAGS

A

cosmetic problem

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31
Q

TM perforation

A

will usually resolve on own
avoid water
surgically close the TM
surgically repair ossicle chain

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32
Q

Hematoma of external ear

A

compression of ear
I / D
compression
TAPE IT!

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33
Q

Barotrauma

A

yawn, sneeze
autoinflation
decongestants - pseudophedrine
if severe: Myringotomy

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34
Q

Foreign Body (ear)

A 
Warm water irrigation
cerumenolytics - EPO colase
curette or forceps
lidocaine mineral oil
DO NOT ADD WATER why? organic substances will swell
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35
Q

Open Angle Glaucoma

A

Prostaglandin - latanoprost, bimatoprost
B-adrenergic - timolol
Combination drops - better compliance
Laser therapy or surgery

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36
Q

Closed Angle Glaucoma

A 
halo around lights, steamy cloudy cornea
Primary:
IV azetazolamide 
Diuretics - acetazolamide 
anterior chamber paracentesis 
once IOP is down then topical pilocarpine 
Secondary:
systemic azetazolamide
treat cause
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37
Q

Optic neuritis

unilateral

A

inflammation of optic nerve
if demyelinated : prednisolone
treat cause = MS, DM , HTN

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38
Q

Papilledema

bilateral

A 
inflammation of optic disc
progressive vision loss tX:
treat HTN/mass
weightless
Acetazolamide - PO or injection
cerebral spinal shunt
optic nerve fenestration
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39
Q

Retinal Detachment

unilateral-painless, 25% turn b/l

A 
retinal tear / tractional detachment = pre-retinal fibrosis
Tx: laser photocoagulation
cryotherapy 
sub retinal drainage 
pneumatic retinoplexy (bubble therapy)
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40
Q

Retinal vascular occlusion - ARTERY (unilateral)

A

cherry red spot on fovea and box car segmentation of VEINS (not arteries)
ocular massage, O2, lay flat, IV acetazolamide , anterior chamber paracentesis (like closed glaucoma)
IV thrombolytics (heparin, coumadin- uhhh! cause it is a clotting issue)

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41
Q

Retinal vascular occlusion - ARTERY due to Giant Cell Arteritis (GAS) or Temporal Arteritis —- JC

A

corticosteroids

biopsy of temporal artery (ouch!)

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42
Q

Retinal vascular occlusion Vein (unilateral)

A

neovascular glaucoma - photocoagulation
intravitreal triamcinolone for macular edema - steroid injection into the eye
tissue plasminogen activator (TPA) into retinal venous system for strokes

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43
Q

neovascular glaucoma

A

photocoagulation

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44
Q

macular edema

A

intravitreal triamcinolone

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45
Q

Proliferative Diabetic Retinopathy

A

vessel proliferation
neovascularization
control BG, BP, lipids, monitor renal function
Tx: pan retinal laser photocoagulation (NIGHT / COLOR LOSS) or vitrectomy (do this before hemorrhage occurs and causes tractional retinal fibrosis
mydriatic drops
IF MACULAR EDEMA - LASER PHOTOCOAGULATION

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46
Q

NON - proliferative diabetic retinopathy

A

not forming new vessels

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47
Q

Hypertensive Retinopathy

A

worse in young patients with rapid rise in BP
breaks endothelial integrity
occludes capillary arterioles
(cotton-wool spots, retinal hemorrhages, edema, exudates)
CHRONIC HTN - INCREASES DEVELOPMENT OF ATHEROSCLEROSIS - and retinal arterioles become narrow and tortuous (copper silver wiring, AV nicking, superficial hemorrhages - flame)

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48
Q

Strabismus (eyes don’t line up) problem with EOMs

A

vertical = hyper/hypotropia
horizontal = exotropia (eyes turn out)/esotropia (eyes turn in)
Tx: glasses, exercises, eye muscle surgery

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49
Q

Amblyopia - “lazy eye”

one eyes experiences a blurred view while the other is normal

A

most common vision loss in children - only seen in children (one or both eyes)

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50
Q

strabismic amblyopia

A

brain ignores the eye that isn’t straight, decrease in vision

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51
Q

deprivation amblyopia

A

congenital cataract or othercontition deprives eye of vision

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52
Q

refractive amblyopia

A

unequal amount of refractive error, brain ignores the worse eye

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53
Q

amblyopia treatment

A

glasses may help
patching the normal eye (allows weaker eye to get stronger)
Atropine eye drops in good eye to make it blurry
surgery on eye muscles if from strabismus

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54
Q

Hyperopia - farsightedness

A

“plus” or CONVEX lens

55
Q

Myopia - nearsightedness

light rays at converging at a point before the retina

A

“minus” or CONCAVE lens

56
Q

Presbyopia

A

plus lenses for near work (reading distance)

57
Q

Age-related macular degeneration

A 
laser photocoagulation - reduces druse, but it can still progress
For neovascular (WET) - vascular growth inhibitors 
intravitreal injection
For Atrophic (DRY) - no treatment
58
Q

Presbycusis

sensoneural hearing loss

A

hearing aid

Coenzyme Q10

59
Q

Otosclerosis

conductive hearing loss

A

hearing aid

stapedectomy

60
Q

tinnitus

A

avoid excessive noise
mask tinnitus by music or hearing aid
avoid ototoxic medications - gentamicin
TCA’s

61
Q

Vertigo

A

vestibular suppressants

62
Q

benign (paroxysmal) positional vertigo

A

dix hall pike DX
Eply maneuver (trying to get otoliths back into utricle)
N/V/Tinnitus
horizontal nystagmus (like peripheral vertigo)
anti vestibular medication
benzodiazepines (diazepam)
AH (meclizine)

63
Q

Meniere Disease

A

Triad = vertigo, hearing loss, tinnitus
distention in the inner ear and impaired reabsorption of endolymphatic fluid
caloric test
FTA-ABS - fluorescent treponemal abs absorption
diuretic - azetazolamide
If severe - intratympanic gentamicin, intratympanic corticosteroids, surgery, AH, low sodium diet = first line,

64
Q

Labyrinthitis

A

viral infection of the inner ear
vertigo (days to weeks) and hearing loss
does not have tinnitus like MD
Tx: AH, benzodiazepines
if febrile - abs
if herpes - Ramsay hunt syndrome - acyclovir
symptomatic TX: vestibular suppression like benzodiazepines and AH

65
Q

Acoustic Neuroma (vestibular schwannoma)

A

Benign tumor of CN VIII sheath - schwann cells)
depends on severity: observation, surgical excision, radiation
if from neurofibromatosis TII (bilateral acoustic neuromas) - then consider chemotherapy with bevacizumab (which is a vascular growth inhibitor used in “wet” ARMD)
can consider surgical excision
but we also may choose not to treat considering patient population

66
Q

Alkali burns

A

immediate topical anesthetic (proparacaine, tetracaine)
copious amounts of irrigation 2-3L
double eversion of the lids to remove material
remove particles with forceps or moist cotton swab
Irrigate until pH of 6.8 - 7.4
NO ACID FOR A ALKALI BURN CAUSE IT WILL CAUSE AN EXOTHERMIC REACTION AND CAUSE FURTHER BURN
Mydriatic / cycloplegic drops to dilate pupil and paralyze the ciliary muscles
ABS ointment
maybe PO narcotics
check IOP

67
Q

Acid burns

A 
cause more damage then alkali, but less serious b/c acids do not penetrate as deeply but they can still cause blindness
ex. nail polish remover / battery acid
topical anesthetic 
copoius irrigation (water ot ringers)
DO NOT NEUTRALIZE WITH ALKALI
check for ulcerations
PO narcotics
68
Q

Thermal Burns

A

burn of the lids, cornea, conjunctiva
(superficial or severe)
Tx: systemic analgesia, topical anesthetic, mydriatic drops if corneal invlovement

69
Q

UV radiation

A

actinic keratitis, snow blindness, welders arc burn
burns conreal epithelium cuasing pain photophobia
Tx: PO analgesics, Mydriatic drops and abs , topical anesthetic for eye exam (DO NOT LET PATIENT TAKE HOME)

70
Q

Corneal Ulcer

A

corneal transplant - universal donor so no type and screen
Can be caused by: acanthameoba keratitis, fungal keratitis, herpes simplex keratitis, exposure keratitis (eyelids do not close) = dendritic lesions, FB, SJOGRENS (dry mouth and eyes)
Tx: pain meds, protective glasses, corticosteroids drops, Empiric ABS (like dactrocystitis) but taper off when culture is back

71
Q

Corneal Abrasion

A

Sx: tearing, photophobia, blurry vision
regenerates 24-28 hrs
tx aimed at pain relief and infection prevention
cycloplegics for ciliary spasm
Patch for pain releif but no patch if fingernails, plant or CL
abrasions form contacts need pseudomonas coverage so give them cipro
DO NOT GIVE PRESCRIPTION FOR TOPICAL ANESTHETICS FOR HOME!

72
Q

Foreign Body (eye)

A

Removal: topical anesthetic, irrigate with NS, try moist cotton swab, 25 guage needle bevel up to try and poke it out using a slit lamp
Dispostion: topical ABS, cycloplegics, oral analgesics, tetanus,

73
Q

Hyphema

A

blood in the anterior chamber from trauma or surgry
grade 1 = less than 1/3 chamber filled
can clot and get stuck
Tx: monitor IOP resloves in 5-6 days

74
Q

Globe rupture

A

DO NOT MEASURE IOP
from severe trauma it can rupture the thinner parts of the eye like the sclera and limbus
anisicoria - irregular pupil
Tx: do not manipulate eye, elevate the head of bed, protective shield, Broad specturm ABS, tetanus, sedation and analgesics and antiemetics for anti vomitting (cause vomitting increases IOP when can cause the globe to ooze)
NPO ?

75
Q

Blow out fracture

A

can trap inferior rectus and disrupt upward gaze
most COMMON is the inferior wall (maxillary sinus)
fracture followed by medial wall (ethmoid)
Tx: not an emergency, can repair up to 3-10 days later, waters view xray showing maxillary sinus cloudy, CT, oral ABS

76
Q

Nystagmus

A

help with school or social situation
regular eye exams
contacts better then glasses
surgically you can reattach the extraocular muscles
Medical: BOTOX or Baclofen - CNS depressor

77
Q

Temporal Arteritis

A

AKA Giant cell artritis and also seen with retinal ARTERY occlusion
JAW CLAUDICATION
Tx: immediate prednisone
polymyalgia rheumatica - disease of connective tissue causing pain and stiffness of muscles

78
Q

Preseptal Cellulitis

A

PO ABS
hot packs
caused by staph or strep
no eye involvement so there is no eye pain when eye moves
Infection of the eyelids and periocular tissue ANTERIOR to the orbital septum

79
Q

Postseptal Cellulitis

A

Admit
IV ABS - broad spectrum w/ anaerobic and aerobic coverage
eye involvement so eye movement are painful
Infection of the eyelids and periocular tissue POSTERIOR to the orbital septum

80
Q

How can you differenciate between post and pre septal cellulitis?

A

get a CT w/ contrast and you can see if the globe is involved or is it just preseptal

81
Q

Diagnostic Criteria for Temporal Arteritis

A

you need 3 of the 5:

  1. > 50 y.o.
  2. unilateral headache, new onset
  3. temproal artery tenderness
  4. ESR > 50 mm
  5. abnormal biopsy of temporal artery = vasculitis
82
Q

Common cold

A 
adenovirus, rhinovirus
nasal saline
decongestants (pseudoephedrine)
analgesics (acetaminophen)
worse symptoms: nasal steroids (fluticasone), nasal anticholinergics (ipratropium), oral steroids taper
EBM - zinc decrease illness time
83
Q

Influenza

A

orthomyxovirus
Neuraminidase inhibitors: oseltamivir, zanamivir
patient education - quadravelent vaccine

84
Q

Rhinitis

A

allergic: saline drops, avoid potential sources, corticosteroids, AH (loratadine- claritin), decongestants, nasal anticholinergics, mast cell stabilizers

Vasomotor: avoid irritant

Medicamentosa: discontinue decongestants

severe: immunosuppressants

85
Q

nasal polyps

A

nasal corticosteroids

excision if no improvement

86
Q

Olfactory dysfunction

A

evaluate reversible cause: infection, allergies, tumor

NO TX FOR PRIMARY OLFACOTRY DYSFUNCTION

87
Q

Epistaxis

A

first line: direct pressure for 15 min, sitting position leaning forward (if still bleeding consider posterior bleed)

second line: nasal stimulants vessel constriction: cocaine, phenylephrine, oxymetazoline, cauterize with silver nitrate

If bleeding persists: nasal packing with ABS cephalexin or clindamycin. If anterior pack for 5 days, of posterior consult ENT

if severe: nasal artery ligation

88
Q

Sinusitis

A

patient education - will improve in 2 weeks w/p treatment
nasal washes ot steam
Mild: NSAIDS (ibuprofen), nasal decongestants pseudo ephedrine, nasal corticosteroids - fluticasone

Moderate/severe: ABS for 10 days - first try penicillin (augmentin, amoxicillin). If PCN allergic then tetracycline (doxycycline) or macrolide (azithromycin). refractory treatment = quinolone (levofloxacin, moxifloxacin)

Chronic: antibiotics for 3-4 weeks and same ABS as acute

89
Q

Cavernous Sinus Thrombosis

A

start IV antibiotics immediately - PCN (Nafcillin) + cephalosporin 3rd ben (ceftriaxone) or vancomycin if MRSA is considered

Heparin is considered

90
Q

Skull fractures

A

any open skull fracture requires ABS
Maxillary - wire shut
Mandibular - need surgery within couple days
Basilar - admit and aggressive evaluation (raccoon and battle sign)

91
Q

Nasal FB

A

UNILATERAL NASAL DISCHARGE!!
vasoconstrictors (phenylephrine, oxymetazoline)
remove object with alligator forceps, wire curette, suction, positive pressure technique
if can’t remove then ENT follow up

92
Q

nasal fracture

A

LATERAL NASAL XRAY
tetanus update - anytime if open wound
antibiotics if open - PCN and if allergic then doxy or azithromycin
ENT follow up

93
Q

Septal hematoma

A

I / D - bilaterally
packing x 2-5 days
oral ABS
ENT follow up

94
Q

Angioedema

A

Discontinue suspected agent like AH, Steroids, Epi (IM, SubQ)
Surgery or Procedures: Endotracheal intubation, Cricothyrotomy
MILD: observe in ED, Oral meds
Moderate: admit
Severe: admit to ICU crib kit at bed side

95
Q

Airway assessment

A 
LEMON
Look externally for physical clues
Evaluate 3:3:2 rule- three finger width between incisors, three between mandible an hyoid and two between hyoid and thyroid
Mallampati - class 0-4:
0 =  can see epiglottis
1 = SP, Fauces, Uv, pillars
2 = SP, F, U
3 = SP, U
4 = SP not visible 
Obstructive - soft tissue swelling, obesity
Neck mobility - ROM
96
Q

What are the 7 P’s of Rapid Sequence Intubation?

A 
Preparation - 10 min before
Pre oxygenation - 5 min
Pretreatment - 3 min
Paralysis - induction
Protection - 30 sec after
Placement - Proof - 45 sec after
Post- Intubation management  - 60 sec after
97
Q

Hereditary Angioedema

A

Generally refractory to these Tx: anabolic steroids, C1 esterase inhibitor, (berinert & Cinryze)
Kvllikrein inhibitor (Kalbitor $$$$$)
Bradykinin 2 receptor antagonist, Firazyr

98
Q

Glossitis

A

Nutrition replacement

99
Q

Glossodynia

A

burning and pain of tongue
stop smoking
benign
consider: Anxiolytic or Gabapentin ( also used in trigeminal neuralgia )

100
Q

Aphthous Ulcer

A

maybe related to herpes Virus 6
Tx is supportive:
Diclofenac, or corticosteroids with adhesive base (or Orabase)
oral mouthwashes / prednisone

101
Q

Oral Candidiasis (thrush)

A

Oral antifungals: Fluconazole
Nystatin liquid
Clotrimazole
If they have dentures then maybe Nystatin powder on them

102
Q

Oral Herpes Simplex (cold sores)

A

Supportive Care: will go away on own,DO NOT GIVE CORTICOSTEROIDS
Magic Mouthwash (BMX)
1. benadryl - diph
2. Maalox
3. Xylocaine
Viscous Lidocaine 2%
If severe: oral antivirals like acyclovir

103
Q

Oral Leukoplakia

A

Biopsy - premaglignant hyperkeratosis
ENT consult
Monitor for development into SCC

104
Q

Oropharyngeal Abscesses

A

I / D
IV antibiotics like PCN, Macrolides, Cephalosporins
admit
cricothyrotomy kit besides

If peritonsillar (quinsy) then consider a tonsillectomy or oral ABS in minor cases

If sublingual (ludwig angina) then consider bilateral submittal incisions if airway threatened

105
Q

Parotitis (Sialadenitis) viral

A

Self limited

analgesics

106
Q

Parotitis suppurative (bacterial)

A 
IV ABS to cover staph
PCN
Cephalosporins
Clindamycin for MRSA often requires I / D 
admit
107
Q

Parotitis Juvenile recurrent

A

supportive care - analgesics

oral ABS like PCN or cephalosporins

108
Q

Sialolithiasis

A

Whartons duct most common
CT w/o contrast

stone removal
consider gland excision if severe or recurrent

Procedures: duct dilation, (make sure clamp proximal duct) or distal duct incision

Newer options: Extracorporeal shock-wave lithotripsy and fluoroscopically guided basket retrieval
Sialendoscopy

109
Q

diseases of mouth and gums

A

normally strep mutant main pathogens
Increased acid
and decrease saliva

110
Q

caries

A

loss of integrity of tooth enamel from hydroxyapatite dissolution maybe be from infection acid or no saliva

Tx: Fluoride rinse / topicals

111
Q

Gingivitis

A

bacterial and particles constantly forming plaque and forms TARTAR

gums become red swollen and can bleed easily but this can be reversed with cleaning

no loss of bone and tissue

112
Q

Periodontitis

A

forms from not treating gingivitis

the gums pull away from the teeth and form pockets and harbors bacteria and particles and then the bacterial toxins break down the bone and connective tissue and can destroy the gums and bones

113
Q

Necrotizing Ulcerative Gingivitis (trench mouth, Vincents Infection)

A

Spirochetes and fusiform bacilli

painful acute gingiva inflammation and necrosis

Tx: warm half strength peroxide rinses
ABS 10 days
dentinal gingival curettage

114
Q

Temporomandibular jaw disorders

A

NSAIDS (naprosyn)
massage
if severe: carbamazepine

Patient edu: jaw rest, soft food, avoid teeth clenching

Skeletal muscle relaxants - methocarbamol
Tricyclic antidepressants - nortriptyline
Corticosteroids - prednisone taper

Surgery: correct anatomic abnormalities 5% of cases

115
Q

Acute Strep Pharyngitis

A

WE ONLY TREAT STREP TO PREVENT RHEUMATIC FEVER

first line - PCN, penicillinVK , penicillin G (bacillin LA)
amox, cephalosporins

If PCN allergic: clinda, azithromycin, clartihramycin

Surgery: tonsillectomy if recurrent
if peritonsillar abscess then I / D

116
Q

Mononucleosis

A 
EBV
supportive care
NSAIDS, tylenol , chloraseptic
steroids but not recommended
warm saline for throat gargles 4x / day
avoid contact sports
117
Q

Diphtheria

A

Corynebacterium diphtheria gram +, drooling

grey membrane on tonsils extending to throat

Tx: STAT antitoxin form horse, PCN, erythromycin
isolation until 3 consecutive neg. cultures
remove membrane broncho/laryngoscopy

prevention: vaccine, booster
education - vaccine isolation

118
Q

croup

A

steeple sign
acute laryngotracheobronchitis cause by parainfluenza
“Barking cough”
inspiratory stridor
worse at night - cool air outside during drive
steam in bathroom

119
Q

Epiglossitis

A

from H. influenza type , 45 yo cause vaccine started in 80s
cherry red epiglottis, and thumbprint sign

Admit to ice/picu
airway protection
ceftriaxone

120
Q

Foreign Bodies (throat)

A

trachea - ziemlich maneuver or cricothyrotomy , bronchoscopy and extraction

Esophagus - glucagon, benzodiazepines, if meat then papain,
swallow test with coke etc

121
Q

Laryngitis

A

viral URI and common cause of hoarseness
rest voice
supportive care
stop smoking

NSAIDS
acetaminophen
Chloraseptic
No ABS

122
Q

Sleep Apnea (obstructive)

A

you need @ lest 5 events of apnea / hr that last as long as 10 sec during a polysonmnogrpahy sleep study

education - weight loss
Tx: continuous positive airway pressure (CPAP)
Mandibular advancement splint (MAS)
surgical repair

123
Q

general head and neck CA

A

chemo w. radiation ( cetuximab, methotrexate, 5 FU, cisplatin, docetaxel)

124
Q

Oral CA

A

surgical excision

125
Q

Salivary CA

A

parotid most common and are benign

Tx: excision (careful of facial nerve)

126
Q

Larynx CA

A

chemo first
then
induction therapy w/ 3 agents : 5 FU, cisplatin, docetaxel

127
Q

Neck CA

A

excision, radiation, chemo

Hx: drooling, dyspnea, odynophagia, dysphagia

PE: trismus - spasm of jaw muscles, Drooling, lymphadenopathy

128
Q

TNM Staging 0 - III

A

no Nodes involved (N0) and no metastasis (M0)

but III can have N1

129
Q

N0

A

no regional LN involvement

130
Q

N1

A

metastasis to a single ipsilateral LN

131
Q

N2

A

metastasis to a single ipsilateral LN but 3 - 6 cm

132
Q

N2c

A

LN involvement to contralateral

133
Q

N3

A

metastases in LN

Clinical Medicine Lecture - Professor Kramer (28 decks)

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