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HEENT Flashcards

1
Q

Conductive hearing loss

A
  • Obstruction, effusion, otosclerosis, ossicular disruption
  • Middle ear
  • Weber- heard louder in affected ear
  • Rinne AC
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2
Q

Sensorineuronal hearing loss

A
  • Deterioration of cochlea, hair cells,
  • Inner ear
  • presbycussis, trauma, excess noise
  • Weber- louder in better ear
  • Rinne- AC> BC
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3
Q

Tinnitus- Eti

A
  • Sensory hearing loss
  • Hearing abnormal sounds
  • Audiometry & MRI/ angio to rule out abns
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4
Q

Tinnitus- Sx

A
  • Pulsatile- listening to own heartbeat, caused by conductive HL
  • Staccato tinnitus- middle ear spasm, rapid popping
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5
Q

Tinnitus- Tx

A
  • Avoid noise, mask
  • Antidepressants
  • Habituation
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6
Q

Eustachian tube dysfunction- Eti

A
  • Following URI/ rhinitis

- Swelling

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7
Q

Eustachian tube dysfunction- Sx

A

Fullness, popping, underwater with sharp intermittent pain

- Disequilibrium, conductive hearing loss, tinnitus

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8
Q

Eustachian tube dysfunction-Tx

A

Decongestants- pseudophedrine

  • Auto-insufflation
  • Nasal steroids
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9
Q

Acute otitis media- Eti

A
  • S. pneumo MC

- Also H. flu, moraxella, strep pyogenes

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10
Q

Acute otitis media- Sx

A
  • Bulging, erythematous TM with effusion, air-fluid levels

- Fevers and otalgia

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11
Q

Acute otitis media- Tx

A

Amoxicillin x 10-14 days,

- Augmentin 2nd line

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12
Q

Chronic OM- Eti

A

Pseudomonas

- Recurrent AOM

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13
Q

Chronic OM- Sx

A

Chronic otorrhea without otalgia

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14
Q

Otitis externa- Sx

A
  • Water exposure
  • Pseudomonas
  • Otalgia on traction & pruritis, discharge
  • Erythema of ear canal
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15
Q

Otitis externa- Tx

A
  • Otic abx- cipro or dexa

- Drying agents- alcohol and vinigar

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16
Q

Perforated TM- Sx

A
  • Conductive hearing loss
  • Hemotypanum
  • Hx impact or injury
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17
Q

Perforated TM- Tx

A
  • Spontaneous healing- ear plugs

- Surg

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18
Q

Cholesteatoma- Sx

A
  • Painless otorrhea- strong odor
  • granulation tissue in TM
  • Conductive hearing loss
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19
Q

Cholesteatoma- Tx

A
  • Surgical excision
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20
Q

Cerumen impaction- Sx

A
  • Conductive hearing loss, ear fullness

- Occlusion

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21
Q

Cerumen impaction- Tx

A

Peroxide, irrigation, curettage

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22
Q

Mastoiditis- Sx

A
  • Deep ear pain, worse at night
  • Mastoid tenderness
  • Fever
  • Hearing loss, labrynthitis
23
Q

Mastoiditis- Tx

A

IV abx w/ myringotomy- ampicillin

- Mastoidectomy

24
Q

Labrynthitis- Sx

A
  • Vertigo, dizziness

- Hearing loss/ tinnitus

25
Q

Labrynthitis- Tx

A

Corticosteroids

26
Q

Barotrauma- Sx

A

Vertigo, nausea, emesis

- Otalgia, hearing loss

27
Q

Barotrauma- Tx

A
  • Decongestants, decompression
28
Q

Presbycusis

A
  • Loss of speech discrimination, hearing with age

- Tx hearing aids

29
Q

Viral rhinitis

A
  • Common cold
  • Nasal conjestion, rhinorhea
  • Tx symptoms
30
Q

Allergic rhinitis

A
  • Rhinorrhea, itchy eyes, tearing and injection
  • Boggy turbinates, polyps
  • Tx antihistamines
31
Q

Nasal polyps

A
  • Visible polyps, people with allergies

- Tx intranasal steroids

32
Q

Acute sinusitis- Sx

A
  • Impaired mucocilliary clearance- following URI
  • S. pneumo
  • Maxillary MC- cheek pain, pressure to upper incisors
  • TTP, opacification
33
Q

Acute sinusitis- Tx

A

Amoxicilin

34
Q

Chronic sinusitis

A

> 8- 12 W

  • Staph aureus
  • High dose augmentin
35
Q

Vasomotor rhinitis

A
  • Clear nasal discharge d/t dilation of BV

- Irrigation, andrenergics

36
Q

Epistaxis- Sx

A
  • Anterior MC- Kisselbach plexus

- Posterior- top of naval cavity or inferior turbinate (hemoptysis, emesis)

37
Q

Epistaxis- Tx

A

Anterior- Compression

Posterior- packing to occlude maxillary artery

38
Q

CENTOR criteria

A
  • Age (3-14, >45)
  • Absence of cough
  • Fever
  • Anterior lymph nodes
  • Tonsillar exudate
  • 2-3: rapid strep
  • 4+ treat
  • Penicillin
39
Q

Aphthous stomatitis- Sx

A
  • painful yellow ulcer w/ erythematous halo
  • Buccal or labial mucosa
  • Tx: topical analgesics
40
Q

Oral candidiasis

A
  • C. albicans
  • White, curdy plaques
  • Painful, bleed if rubbed off
  • Tx: Nystatin
41
Q

Herpetic stomatitis

A
  • Burning, vesicles that rupture and scab

- Tx: acyclovir

42
Q

Decongestant medications- Names

A
  • Oxymetazoline
  • Phenylephrine
  • Pesudophedrine
43
Q

Decongestant medications- MOA

A

Smooth muscle, alpha 1 adrenergic receptors

44
Q

Periorbital cellulitis- Sx

A
  • Infxn of paranasal sinus- Strep MC
  • proptosis, restriction of extra ocular movements, decreased vision
  • Swelling and redness of lids
45
Q

Periorbital cellulitis- Tx

46
Q

Corneal keratitis- Sx

A
  • Pain, photophobia, decreased vision
  • Corneal ulceration on slit lamp
  • Bacterial = hazy cornea
  • HSV = dendrites
47
Q

Corneal keratitis- Tx

A
  • Flouroquinolone

- PO acyclovir

48
Q

Blepharitis- Sx

A
  • Bilateral inflammation

- Eye itching, burning, crusting, red rimming and flaking

49
Q

Blepharitis- Tx

A

Eyelid hygeine

50
Q

Hordeolum-

A

Staph Aureus

  • Painful, red lump on eye lid
  • Tx warm compress, abx if draining
51
Q

Chalazion

A
  • Hard, non-tender swelling on lids
  • Following hordeolum
  • eye lid hygeine
52
Q

Conjunctivitis- Sx

A
  • Bacterial- Purulent discharge
  • Viral- watery discharge, gritty discomfort
  • Allergic- Itching, stringy discharge
53
Q

Conjunctivitis- Tx

A
  • Bacterial- topical sulfamide

- Gc/ Chlam- ceftriaxone, zithromax

PC 1 (12 decks)

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