HEENT 3 Flashcards
OME
middle ear fluid w/o active infection
may follow AOM
otitis media with effusion
OME most often caused by
5
AOM, allergic rhinitis, recent viral infection, barotrauma
OME objective findings
3
- TM may appear normal or slightly erythematous
- TM is intact and may or may not be retracted
- fluid behind TM is often yellow or clear
OME may resolve over the course of
12 weeks
OME sx mgmt with what
3
oral decongestants (pseudoephedrine)
antihistamines
nasal corticosteroids
vertigo is a ____, not a ____
symptom not a dx
allergic rhinitis - turbinates findings
nose has blue tinged or pale and boggy nasal turbinates
under eye circles is to and why
allergic rhinitis due to subcutaneous venodilation
allergic rhinitis first line tx is
topical nasal spray
allergic rhinitis glucocorticoid nasal spray OTC options
fluticasone/Flonase BID
or
tramcinolone/Nasacort 1-2 sprays a day
allergic rhinitis - if only partial relief with OTC steroid spray then
another option is topical antihistamine nasal spray, azelastine daily or BID
allergic rhinitis - no relief from OTC glucocorticoid nasal spray or topical antihistamine
consider combo product azelastine+fluticasone nasal spray, script only called Dysmista
rhinitis medicamentosa
prolonged use of topical nasal decongestant sprays (>3 days) that causes rebound effects that result in severe and chronic nasal congestion
cheilitis tx plan
3
- check vitamin B12 level
- remove underlying causes, check dentures fit correctly
- when infection has cleared, apply barrier cream with zinc or petroleum jelly at night
infectious mononucleosis
infection by EBV (herpesvirus family)
mono is spread mainly through
saliva
mono classic s/sx
fever
pharyngitis
lymphadenopathy
pt presents with fever, pharyngitis, and lymphadenopathy
infectious mono
infectious mono - LFTs
elevated aminotransferases are seen in majority of patients but self limited
mono - most acute sx resolve by when
1-2 weeks
steptococcal pharyngitis/tonsillopharyngitis (step throat)
an acute infections of the pharynx and/or palatine tonsils caused by group A streptococcal bacteria
acute pharyngitis - suspect viral etiology if they presents with
5
cough
stuffy nose
rhinitis
clear mucus
watery eyes
what bacteria causes strep throat
group A streptococcal bacteria/Streptococcus pyogenes
strep throat classic case
5
- abrupt onset of fever
- sore throat
- pain on swallowing
- mildly enlarged submandibular nodes
- purulent, patchy tonsillar or pharyngeal exudate
test for GAS
rapid antigen detection testing RADT and/or throat culture
GAS first line tx for adults
oral PNC V 500 mg 2-3 x day for 10 days
GAS first line tx for children
oral PNC V or amoxicillin
GAS tx - PNC or beta lactam allergy
clindamycin and macrolides are alternatives
inflammatory reaction to strep infection that may affect the heart and the valves, joints, and brain
acute rheumatic fever
poststreptococcal glomerulonephritis
abrupt onset of proteinuria, hematuria, dark colored urine, and RBC casts in urine accompanied by HTN and edema
