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Clin Med > HEENT > Flashcards

HEENT Flashcards

1
Q

What can present with painful ulcers and bleeding of the gums and bad breath that is often associated with smoking or a viral infection?

A

Acute Necrotizing Ulcerative Gingivitis - Vincent’s Disease (trenchmouth)

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2
Q

What are the signs/symptoms of acute tonsilitis?

A

Painful swallowing
Dysphagia
May have fever
Enlarged & tender lymph nodes in upper neck
Throat redness
May have tonsil calculi

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3
Q

What is the treatment for bacterial acute tonsilitis?

A

1st line: amoxicillin
Clindamycin if penicillin allergy

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4
Q

What can present with nasal secretion, congestion, facial pressure, & headache?

A

Acute viral/bacterial rhinosinusitis

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5
Q

What is the treatment for acute viral/bacterial rhinosinusitis?

A

Viral: supportive care with anti-inflammatories, decongestants, fluids
Bacterial: augmentin

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6
Q

What are the signs/symptoms of allergic rhinosinusitis?

A

Clear rhinorrhea
Sneezing
Itchy eyes and throat
Possible swollen turbinates
Eye discharge
Cobblestoning of pharynx
Fluid behind TM
Allergic “shiners”

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7
Q

What is the treatment for allergic rhinosinusitis?

A

Antihistamines

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8
Q

What presents with painful, small round lesions w/a red halo and is found on buccal or labial mucosa?

A

Aphthous ulcers (canker sores)

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9
Q

What presents with recurrent episodes of vertigo depending on head movement/position & may have N/V?

A

Benign Paroxysmal Positional Vertigo (BPPV)

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10
Q

How do you test for BPPV?

A

Check for nystagmus with Dix-Hallpike maneuvers (eyes will move towards affected ear)

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11
Q

How do you treat BPPV initially?

A

Can attempt Epley maneuver
Refer to ENT
Symptomatic relief

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12
Q

What commonly presents in infants with URI symptoms such as coughing and weezing?

A

Bronchiolitis

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13
Q

What commonly causes bronchiolitis?

A

RSV

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14
Q

What is the treatment for bronchiolitis?

A

Supportive care for outpatient non severe cases
Severe cases will likely need hospital admission for respiratory support and fluids

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15
Q

How is chronic sinusitis defined?

A

Infection lasting > 12 weeks

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16
Q

What presents with respiratory distress and a “tripod” posture in children, and a severe sore throat, dysphagia, and drooling?

A

Epiglottitis

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17
Q

What diagnostic sign will you see on an x-ray in a patient with epiglottitis?

A

Thumbprint sign

18
Q

What is the most important thing to do for a patient with confirmed or suspected epiglottitis?

A

Secure the airway

19
Q

What presents with prolonged malaise (fatigue), tonsil and lymph node enlargement, & possibly tonsil exudate, and what causes it?

A

Infectious mononucleosis caused by the Epstein-Barr virus

20
Q

How do you treat infectious mono?

A

Supportive care
Abx if co-infected with strep
Physical limitations due to enlarged spleen
NO AMOXICILLIN due to causing a rash

21
Q

What diagnostic lab can be drawn if you suspect infectious mono?

A

Monospot rapid test

22
Q

What is the most common cause of croup?

A

Parainfluenza

23
Q

What are the signs/symptoms of croup?

A

Seen in younger children
More seen in the winter
Barking cough
Biphasic stridor
URI symptoms

24
Q

What is the treatment for croup?

A

Mild: supportive care
Mod-Severe: Dexamethasone or nebulized epinephrine

25
Q

What is a complication of acute otitis media that can present with pain, fever, toxicity, fluctuance over mastoid, a prominent pinna, facial paralysis, vertigo, & changes in mental status?

A

Mastoiditis

26
Q

What is the treatment for mastoiditis?

A

Empiric IV abx (vanc + metronidazole + cefepime)

27
Q

What is the criteria for diagnosing Meniere disease?

A

2 or more episodes of vertigo lasting 20 mins - 12 hrs each
Low to mid frequency sensorineural hearing loss
Fluctuating aural symptoms (hearing loss, fullness, tinnitus)

28
Q

What is the treatment for Meniere disease?

A

Meclizine/Antivert (25mg TID)
Scopolamine patch
Diuretics (HCTZ)
Low sodium diet
Possible endolymphatic shunt

29
Q

What are the signs/symptoms of otitis externa?

A

Pain
Itching
Drainage
Swelling
Hearing loss
Erythema

30
Q

What is the treatment for otitis externa?

A

Mild: acetic acid-hydrocortisone drops
Mod: cover for staph and pseudomonas (cipro-hydrocortisone or neomycin-polymyxin B-hydrocortisone) drops
Sev: cover for staph and pseudo (same as above), but may need systemic abx
Consider wick placement
Manage pain

31
Q

What are the signs/symptoms of otitis media?

A

Pain
Fever
Irritability
Purulent drainage
Hearing loss
URI symptoms

32
Q

What diagnostic test can be performed when assessing for otitis media?

A

Tympanic mobility test (pneumatic otoscopy)

33
Q

What is the first line treatment for otitis media?

A

Augmentin

34
Q

What should be considered in children with frequent otitis media infections?

A

Myringotomy tubes

35
Q

What is the treatment for a perforated TM?

A

Small: most close on their own
Large: ENT referral

36
Q

What can present with fever, sore throat, trismus (can’t open mouth), muffled voice; may have unilateral symptoms, bulging tonsil, & uvular deviation?

A

Peritonsillar abscess

37
Q

What is the treatment for a peritonsillar abscess?

A

I&D
Possibly tonsillectomy & antibiotics
Can be life threatening if it blocks airway

38
Q

What are most cases of pharyngitis caused by and what is the treatment?

A

Most caused by virus and do not require abx (supportive care)

39
Q

What can present with headache, earache, & pain aggravated by jaw movement?

A

TMJ

40
Q

What is the treatment for TMJ?

A

NSAIDS
Soft diet
Heat/massage
Dental referral

Clin Med (15 decks)

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