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EOR Family Medicine > HEENT > Flashcards

HEENT Flashcards

1
Q

Most common causes of pharyngitis

A

Adenovirus, Rhinovirus, Enterovirus

GABHS for streptococcal pharyngitis

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2
Q

Signs/Symptoms of pharyngitis

A
  1. sore throat

2. pain with swallowing

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3
Q

Management for viral pharyngitis

A

Fluids, warm saline gargles, topical anesthetics, lozenges, NSAIDs

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4
Q

Centor Criteria for Strep Throat

A
  1. Fever > 100.4
  2. Pharyngotonsillar exudates
  3. Tender anterior cervical lymphadenopathy
  4. Absence of cough
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5
Q

Centor Criteria Interpretation

A

Score 0-4
0-1 - no abx or culture needed
2-3 - throat culture
4-5 - give antibiotics

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6
Q

Modified Centor Criteria

A

< 15 y/o add 1 point

> 44 y/o subtract 1 point

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7
Q

Diagnosis of strep throat

A

Rapid antigen detection test

Throat culture - definitive diagnosis (gold standard)

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8
Q

Management of strep throat

A

Penicillin G or VK first line, amoxicillin, augmentin

Macrolides if PCN allergic (azithromycin, clarithromycin, erythromycin)

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9
Q

Complications of strep throat

A
  1. Rheumatic fever
  2. Glomerulonephritis
  3. Peritonsillar abscess, cellulitis
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10
Q

Acute sinusitis is defined as:

A

1-4 weeks

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11
Q

Etiologies of sinusitis

A 
S. pneumo
H. flu
GABHS
M. catarrhalis
(same as otitis media)
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12
Q

Signs/symptoms of sinusitis

A 
Sinus pain/pressure -worse with bending down and leaning forward
Headache, malaise
Purulent sputum or nasal discharge
Fever
Nasal congestion
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13
Q

Physical exam of sinusitis

A

Sinus tenderness on palpation

Opacification with transillumination

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14
Q

Diagnosis of sinusitis

A

Clinical diagnosis
CT scan diagnostic test of choice
Sinus radiographs - water’s view

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15
Q

Symptomatic management of sinusitis

A
  1. decongestants, antihistamines, mucolytics, intranasal corticosteroids, analgesics, nasal lavage
    Indicated if sx < 7 days
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16
Q

Antibiotic treatment for sinusitis

A

Sx should be present for > 10-14 days or earlier if: febrile, facial swelling, etc.
Amoxicillin drug of choice x 10-14 days
Doxycycline, Bactrim

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17
Q

Chronic sinusitis is defined as:

A

> 12 consecutive weeks

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18
Q

Most common bacterial cause of chronic sinusitis

A

S. aureus

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19
Q

Most common fungal cause of chronic sinusitis

A

Aspergillus

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20
Q

Mucormycosis

A

Fungi invade the sinuses and may enter the CNS

Seen in immunocompromised patients

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21
Q

Signs/symptoms of mucormycosis

A

Acute sinusitis sx

May be associated with black eschar on palate, face

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22
Q

Management of mycormycosis

A

IV amphotericin B first line

May need surgical debridement

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23
Q

Canker sores, ulcerative stomatitis

A

Aphthous ulcers

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24
Q

Small round or oval painful ulcers (yellow, white or grey centers) with erythematous halos. most commonly on buccal or labial mucosa

A

Aphthous ulcers

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25
Q

Management of aphthous ulcers

A
  1. Topical analgesics, topical oral steroids (Triamcinolone)

2. Cimetidine may be used if recurrent ulcers

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26
Q

Inflammation of both eyelids. Common in pts with ___________ and ________

A

Blepharitis
Down syndrome
Eczema

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27
Q

Two types of blepharitis

A
  1. Infectious (staph aureus or staph epidermidis)

2. Seborrheic

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28
Q

Signs/Symptoms of blepharitis

A
  1. Eye irritation/itching

2. Eyelid burning, erythema, crusting, scaling, red-rimming and eyelash flaking

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29
Q

Management of blepharitis

A

Warm compresses, eyelid scrubbing/washing with baby shampoo

May give azithromycin ointment/solution

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30
Q

Most common etiology of viral conjunctivitis

A

Adenovirus

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31
Q

Most common cause of viral conjunctivitis

A

Swimmin gpool

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32
Q

Signs/symptoms of viral conjunctivitis

A

Foreign body sensation
Erythema
Itching
Normal vision

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33
Q

Preauricular lymphadenopathy, copious watery discharge from eyes, scanty mucoid discharge. Often bilateral.

A

Viral conjunctivitis

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34
Q

Management of viral conjunctivitis

A

Supportive - cool compresses, artificial tears

Antihistamines for itching/redness

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35
Q

Signs/symptoms of allergic conjunctivitis

A

Conjunctival erythema paired with other allergic symptoms

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36
Q

Cobblestone mucosa appearance to the inner/upper eyelid, itching, tearing, redness, stringy discharge. Usually bilateral, +/- conjunctival swelling

A

Allergic conjunctivitis

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37
Q

Treatment for allergic conjunctivitis

A

Topical antihistamine: olopatadine

Topical NSAID: ketorolac

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38
Q

Most common causes of bacterial conjunctivitis

A

S. aureus
Strep pneumoniae
H. influenzae

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39
Q

Purulent discharge from eye, lid crusting, usually no vision changes

A

Bacterial conjunctivitis

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40
Q

Management of bacterial conjunctivitis

A

Topical abx - erythromycin, fluoroquinolones (moxi), sulfonamides, aminoglycosides

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41
Q

Management of bacterial conjunctivitis if contact lens wearer

A

Cover pseudomonas

Fluoruquinolone or aminoglycoside

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42
Q

Infection of the lacrimal sac

A

Dacryocystitis

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43
Q

Tearing, tenderness, edema and redness to the nasal side of lower eyelid

A

Dacryocystitis

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44
Q

Management of dacryocystitis

A

Antibiotics - clindamycin

Dacryocystorhinostomy

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45
Q

Local abscess of the eyelid margin

A

Hordeolum

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46
Q

Etiology of hordeolum

A

Staph aureus (90-95%)

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47
Q

Management of hordeolum

A

Warm compresses of eye
Most will eventually point and drain spontaneously
+/- topical erythromycin/bacitracin if actively draining

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48
Q

Inflammation of the vestibular portion of CN 8 - most common after viral infxn

A

Vestibular Neuritis

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49
Q

Vestibular neuritis + hearing loss/tinnitus from cochlear involvement

A

Labyrinthitis

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50
Q

Peripheral vertigo, dizziness, N/V, gait disturbances, horizontal nystagmus, hearing loss

A

Vestibular Neuritis and Labyrinthitis

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51
Q

Management of vestibular neuritis/labyrinthitis

A

Antihistamines (Meclizine), benzodiazepines

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52
Q

Inflammation of the larynx

A

Laryngitis

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53
Q

Most common etiology of laryngitis

A

Viral - adenovirus, rhinovirus, etc.

Trauma (vocal abuse)

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54
Q

Hallmark of laryngitis

A

Hoarseness

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55
Q

Management of laryngitis

A

Vocal rest, warm saline gargles, anesthetics, lozenges, increased fluid intake

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56
Q

Excess H20 or local trauma changes the normal acidic pH of the ear, causing bacterial overgrowth

A

Otitis Externa

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57
Q

Most common etiology of otitis externa

A

Pseudomonas (MC)

Proteus, S. aureus

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58
Q

1-2 days of ear pain, pruritus in the ear canal
May have had recent activity of swimming
Auricular discharge, pressure/fullness. Hearing usually preserved

A

otitis externa

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59
Q

Management of otitis externa

A

Protect ear against moisture
Ciprofloxacin/dexamethasone
Ofloxacin safe
Aminoglycoside combination

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60
Q

Management of malignant otitis externa

A

Seen in DM and immunocompromised

IV Ceftazidime or Piperacillin + fluoroquinolones

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61
Q

Infection of middle ear, temporal bone, and mastoid air cells. Most commonly preceded by viral URI

A

Acute otitis media

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62
Q

4 most common organisms of acute otitis media

A

S. pneumo, H. influenzae, M. catarrhalis, strep pyogenes

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63
Q

Risk factors for otitis media

A 
Eustachian tube dysfunction
Young (ET is wider, shorter and more horizontal)
Daycare
Pacifier/bottle use
Parental smoking
Not being breastfed
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64
Q

Fever, otalgia, ear tugging in infants, conductive hearing loss, stuffiness

A

Otitis media

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65
Q

Rapid relief of ear pain + otorrhea

A

Tympanic membrane perforation

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66
Q

Management of otitis media

A
  1. Amoxicillin 10-14 days
  2. Augmentin or Cefixime
  3. If PCN allergic, erythromycin, azithromycin, Bactrim
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67
Q

Management for severe, recurrent cases of otitis media

A

Myringotomy (surgical drainage)

Tympanostomy

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68
Q

Treatment for chronic otitis media - perforated TM + persistent or recurrent purulent otorrhea +/- pain

A

Topical ofloxacin or ciprofloxacin

Avoid water/moisture/topical aminoglycosides in ear when TM rupture

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69
Q

Acute ear pain, hearing loss, +/- bloody otorrhea, +/- tinnitus and vertigo

A

tympanic membrane perforation

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70
Q

Most commonly occurs due to penetrating or noise trauma, pressure

A

Tympanic membrane perforation

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71
Q

Treatment for tympanic membrane perforation without infection

A

Most heal spontaneously. Follow up to ensure resolution

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72
Q

Eyelid and eyelashes turned outward. Due to relaxation of the orbicularis oculi muscle

A

Ectropion

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73
Q

Management of ectropion

A

Surgical correction if needed. Lubricating eye drops

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74
Q

Eyelid and lashes turned inward. Caused by spasms of the orbicularis oculi muscle

A

Entropion

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75
Q

Management of entropion

A

Surgical correction if needed. Lubricating eye drops for symptom relief.

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76
Q

Foreign body sensation in the eye, tearing, red and pain that is relieved with instillation of ophthalmic analgesic drops

A

Ocular Foreign body

Corneal abrasion

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77
Q

Diagnosis of ocular foreign body / corneal abrasion

A

Pain relieved with instillation of ophthalmic analgesic drops
Fluorescein staining - abrasions

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78
Q

Management of ocular foreign body

A

Check visual acuity first
Remove foreign bodies with sterile irrigation
Avoid sending pts home with topical anesthetics
Antibiotic drops - erythro, polymyxin/trimethoprim

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79
Q

Management of corneal abrasion

A

Check visual acuity first
Patching not indicated for small abrasions, and no longer than 24 hours for large
Ciprofloxacin, erythromycin

80
Q

Most common etiology of corneal ulcer? In contact lens wearers? With ocular trauma? Chronic topical steroid use?

A

HSV overall
Pseudomonas
Bacterial
Fungal

81
Q

Ulceration usually has regular borders and will have accompanying purulent exudate

A

Corneal ulcer

82
Q

Blue/green discharge with corneal ulcer

A

Pseudomonas

83
Q

Dendrites on fluorescein staining with corneal ulcer

A

HSV

84
Q

Satellite lesions around ulceration with corneal ulcer

A

Fungus

85
Q

Increased intraocular pressure leads to optic nerve damage, leading to decreased visual acuity

A

Acute narrow angle-closure glaucoma

86
Q

Decreased drainage of aqueous humor via trabecular meshwork and canal of schlemm in pts with preexisting narrow angle or large lens

A

Acute narrow angle-closure glaucoma

87
Q

Leading cause of preventable blindness in US

A

Acute narrow angle-closure glaucoma

88
Q

Precipitating factors for acute narrow angle-closure glaucoma

A

Mydriasis - pupillary dilation further closes the angle

Dim lights, sympathomimetics and anticholinergics

89
Q

Severe, sudden onset of unilateral ocular pain +/- nausea, vomiting, headache. Vision changes, blurring, halos around lights, peripheral vision loss (tunnel)

A

Acute narrow angle-closure glaucoma

90
Q

Conjunctival erythema, steamy cornea, mid-dilated, fixed, non-reactive pupil, eye may feel hard to palpation

A

Acute narrow angle-closure glaucoma

91
Q

Diagnosis of acute narrow angle-closure glaucoma

A

Increased IOP by tonometry (> 21 mmHg)

Cupping of optic nerve of fundoscopy

92
Q

Management of acute angle glaucoma

A

Ophthalmic emergency
Step 1: lower IOP (acetazolamide, BB, mannitol)
Step 2: Open the angle (cholinergics - pilocarpine, carbachol)
Peripheral iridotomy definitive treatment

93
Q

Medications to avoid with acute angle glaucoma

A

Anticholinergics

Sympathomimetics

94
Q

Slow, progressive, bilateral peripheral vision loss

A

Chronic (open angle) glaucoma

95
Q

2nd most common cause of blindness in the world (after cataracts)

A

Chronic (open angle) glaucoma

96
Q

Risk factors for chronic (open angle) glaucoma

A

African-americans
> 40 y/o
Family history
DM

97
Q

Increased IOP due to reduced aqueous drainage through the trabeculae, which eventually damages the optic nerve

A

Chronic (open angle) glaucoma

98
Q

Gradual bilateral painless peripheral vision loss (tunnel vision) leading to central loss of vision

A

Chronic (open angle) glaucoma

99
Q

Management of chronic (open angle) glaucoma

A
  1. Prostaglandin analog - Latanoprost
  2. Timolol (BB)
  3. Brimonidine (AA)
  4. Acetazolamide (carbonic anhydrase inhibitor)
  5. Laser therapy if medical therapy fails (trabeculoplasty)
100
Q

Visible blood in the anterior chamber of the eye

A

Hyphema

101
Q

Complication of hyphema

A

Can lead to blindness if not properly attended to - leads to ocular hypertension

102
Q

Diagnostic testing for hyphema

A
  1. screen for sickle cell disease

2. if serious injury, CT scan for further evaluation

103
Q

Treatment of hyphema

A

Eye shield, elevated head to 30 degrees
Give adequate analgesica (topical cycloplegics) and antiemetics to prevent increased ocular pressure
Topical steroids
Topical beta blockers if increased pressure

104
Q

Surgery indications of rhyphema

A

Early corneal blood staining
> 1/2 of anterior chamber involved
Uncontrolled intraocular pressure

105
Q

Risk factors for macular degeneration

A
  1. Age > 50
  2. Caucasian
  3. Females
  4. Smokers
106
Q

Most common cause of permanent legal blindness and visual loss in teh elderly

A

Macular degeneration

107
Q

Gradual breakdown of the macula leading to gradual blurring of central vision

A

Dry atrophic macular degeneration

108
Q

Small, round, yellow-white spots on the outer retina (scattered, diffuse). Accumulation of waste products

A

Drusen - seen in macular degeneration

109
Q

New, abnormal vessels grow under the central retina which leak and bleed, leading to retinal scarring - rarer than dry

A

Wet (neovascular or exudative) macular degeneration

110
Q

Bilateral blurred or loss of central vision (including detailed and colored vision), scotomas (blind spots, shadows)

A

Macular degeneration

111
Q

Straight lines appear bent

A

Metamorphopsia

Macular degeneration

112
Q

Object seen by the affected eye looks smaller than in the unaffected eye

A

Micropsia

Macular degeneration

113
Q

Diagnosis of macular degeneration

A

Amsler grid

Wet: fluorescein angiography

114
Q

Management of dry macular degeneration

A

Amsler grid to monitor stability

Zinc, Vitamin A, C and E

115
Q

Management of wet macular degeneration

A
  1. Bevacizumab - VEGF
  2. Laser photocoagulation
  3. Optical tomography done to monitor treatment response
116
Q

Optic nerve (disc) swelling secondary to increased intracranial pressure (classically bilateral)

A

Papilledema

117
Q

Etiologies of papilledema (4)

A
  1. Idiopathic intracranial HTN (pseudotumor cerebri)
  2. Space-occupying lesion (cerebral tumor, abscess)
  3. Increased CSF production
  4. Cerebral edema, severe HTN (malignant)
118
Q

Signs/Symptoms of papilledema

A
  1. Headache
  2. Nausea/vomiting
  3. vision usually well preserved, but may have changes
119
Q

Diagnosis of papilledema

A
  1. Fundoscopy
  2. MRI or CT scan to r/o mass
  3. LP for increased CSF pressure
120
Q

Management of papilledema

A

Diuretics (acetazolamide)

121
Q

Elevated, superficial, fleshy, triangular-shaped growing fibrovascular mass

A

Pterygium

122
Q

Associated with increased UV exposure in sunny climates, as well as sand, wind and dust exposure

A

Pterygium

123
Q

Management of pterygium

A

Observation +/- artificial tears

Removal if growth affects vision

124
Q

Most common type of retinal detachment

A

Rhegmatogenous

Retinal inner sensory layer detaches from choroid plexus

125
Q

Most common predisposing factors for retinal detachment

A

Myopia (nearsightedness)

Cataracts

126
Q

Photopsia (flashing lights), floaters, progressive unilateral vision loss

A

Retinal detachment

127
Q

Shadow “curtain coming down” in periphery initially, leading to loss of central visual field. No pain or redness of eye

A

Retinal detachment

128
Q

Diagnosis of retinal detachment

A

Fundoscopy: detached tissue flapping in vitreous humor

129
Q

Clumping of brown-colored pigment cells in anterior vitreous humor resembling tobacco dust

A

+ Shafer’s Sign

Retinal detachment

130
Q

Management of retinal detachment

A

Ortho emergency
Keep patient supine
Don’t use miotic drops
Laser, cryotherapy

131
Q

Retinal artery thrombus or embolus

A

Central retinal artery occlusion (CRAO)

132
Q

Acute, sudden, monocular vision loss, often preceded by amaurosis fugax

A

Central retinal artery occlusion (CRAO)

133
Q

Diagnosis of CRAO

A

Fundoscopy

134
Q

Pale retina with cherry-red macula on fundoscopy due to obstruction of blood flow. Box car appearance of the retinal vessels (due to segmentation). No hemorrhage.

A

Central Retinal Artery Occlusion (CRAO)

135
Q

Management of CRAO

A

Ophtho emergency
No tx has shown effective but should be attempted
Decrease IOP - acetazolamide
Revascularization - place patient supine, orbital massage to dislodge clot

136
Q

Central retinal thrombus, fluid backup in retina, acute sudden monocular vision loss

A

Central retinal vein occlusion (CRVO)

137
Q

Risk factors for CRVO

A
  1. HTN
  2. DM
  3. Glaucoma
  4. Hypercoagulable states
138
Q

Extensive retinal hemorrhages (blood and thunder appearance), retinal vein dilation, macular edema, optic disc swelling

A

Central retinal vein occlusion

139
Q

Management of CRVO

A

No known effective tx
+/- anti-inflammatories, steroids, laser photocoagulation
May resolve spontaneously or progress to permanent vision loss

140
Q

Most common cause of new, permanent vision loss/blindness in 25-74 y/o

A

Diabetic retinopathy

141
Q

Retinal blood vessel damage, leading to retinal ischemia, edema

A

Diabetic retinopathy

142
Q

Glycosylation (excess sugar attaches to the collagen of the blood vessels) leads to capillary wall breakdown

A

Diabetic retinopathy

143
Q

Microaneurysms, blot and dot hemorrhages, flame-shaped hemorrhages, cotton wool spots, hard exudates, retinal vein bleeding (tortuous/dilated veins), closure of retinal capillaries

A

Nonproliferative diabetic retinopathy

144
Q

Fluffy-gray white spots from nerve layer microinfarctions (soft exudates)

A

Cotton wool spots

Nonproliferative diabetic retinopathy

145
Q

Yellow spots with sharp margins often circinate (due to lipid or lipoprotein deposits from leaky blood vessls)

A

Hard exudates

Seen in DM retinopathy and HTN retinopathy

146
Q

Management of nonproliferative diabetic retinopathy

A

Panlaser treatment. Strict glucose control

147
Q

Neovascularization leading to abnormal blood vessel growth and vitreous hemorrhage in DM pts

A

Proliferative diabetic retinopathy

148
Q

Management of proliferative diabetic retinopathy

A

Bevacizumab - VEGF
Laser photocoagulation tx
Tight glucose control

149
Q

Macular edema or exudates, blurred vision, central vision loss in DM pts

A

Maculopathy diabetic retinopathy

Due to macular microaneurysm leakage, causing edema and damage

150
Q

Management of maculopathy diabetic retinopathy

A

Laser

151
Q

Damage to retinal blood vessels from long standing high blood pressure

A

Hypertensive retinopathy

152
Q

Hypertensive retinopathy stage I

A

Arterial narrowing, copper wiring, silver wiring

153
Q

Hypertensive retinopathy stage II

A

AV nicking (venous compression at arterial-venous junction from increased arterial pressure)

154
Q

Hypertensive retinopathy stage III

A

Flame shaped hemorrhages, cotton wool spots

155
Q

Hypertensive retinopathy stage IV

A

Papilledema

156
Q

Management of hypertensive retinopathy

A

BP control

157
Q

Abnormal keratinized collection of desquamated squamous epithelium, leading to mastoid bony erosion. Leads to chronic hearing loss

A

Cholesteatoma

158
Q

Cholesteatoma is most commonly due to:

A

Chronic eustachian tube dysfunction

159
Q

Painless otorrhea (brown/yellow discharge with strong odor), may develop vertigo/dizziness

A

Cholesteatoma

160
Q

Diagnosis of cholesteatoma

A

Otoscope - +/- performation of TM

Peripheral vertigo, conductive hearing loss (Weber/Rinne)

161
Q

Conductive hearing loss testing

A

Weber: lateralization to affected ear
Rinne: BC > AC

162
Q

Management of cholesteatoma

A

Surgical excision and reconstruction of the ossicles

163
Q

Idiopathic distention of the endolymphatic compartment of the inner ear by excess fluid, causing increased pressure within the inner ear

A

Meniere disease

164
Q

Signs/Symptoms of meniere disease

A
  1. Episodic vertigo - lasts minutes to hours
  2. Tinnitus
  3. Ear fullness
  4. Fluctuating hearing loss
  5. May have nausea/vomiting
  6. Horizontal nystagmus
165
Q

Diagnosis of meniere disase

A

Transtympanic electrocochleography most accurate test during active episode
Audiometry

166
Q

Management of meniere dz

A
  1. Symptomatic: antiemetics, antihistamines (Meclizine), benzodiazepines, anticholinergics (scopolamine)
  2. Preventative: diuretics (hydrochlorothiazide) reduces endolymphatic pressure
    Avoid salt/caffeine/chocolate/EtOH
167
Q

3 main types of rhinitis

A

Allergic
Infectious
Vasomotor

168
Q

Nonallergic/noninfectious dilation of the blood vessels (ex temperature change)

A

Vasomotor rhinitis

169
Q

MC infectious cause of rhinitis

A

Rhinovirus (common cold)

170
Q

Sneezing, nasal congestion/itching, clear rhinorrhea. Eyes, ears, nose and throat may be involved. Allergic associated with nasal polyps and tends to be worse in the morning

A

Rhinitis

171
Q

Pale/violaceous, boggy turbinates, nasal polyps with cobblestone mucosa of the conjunctiva

A

Allergic rhinitis

172
Q

Erythematous turbinates indicates

A

Viral Rhinitis

173
Q

Management of viral rhinitis

A
  1. intranasal corticosteroids
174
Q

Management of rhinitis

A
  1. Oral antihistamines

2. Decongestants - oral, intranasal

175
Q

Most common epistaxis form

A

Anterior

176
Q

Most common site of bleeding in anterior epistaxis

A

Kiesselbach’s Plexus

177
Q

Most common risk factors for posterior epistaxis

A

Hypertension and atherosclerosis

178
Q

Most common site of bleeding in posterior epistaxis

A

Palatine artery

179
Q

Management of epistaxis

A
  1. Pressure while seated and leaning forward
  2. Topical decongestants/vasoconstrictors
  3. Cauterization if bleeding can be seen
  4. Nasal packing
180
Q

Samter’s Triad

A
  1. Asthma
  2. Nasal polyps
  3. Aspirin/NSAID sensitivity/allergy
181
Q

Most are incidental findings but if large, can cause nasal obstruction or anosmia (decreased smell)

A

Nasal polyps

182
Q

Management of nasal polyps

A

Cause allergic rhinitis
Intranasal corticosteroids
Surgical removal may be needed

183
Q

Tonsillitis leading to cellulitis, leading to abscess formation

A

peritonsillar abscess

184
Q

Most common etiologies of peritonsillar abscess

A 
Strep pyogenes (GABHS)
Staph aureus
185
Q

Dysphagia, pharyngitis, muggled hot potato voice, uvula deviation to contralateral side, tonsillitis, anterior cervical lymphadenopathy

A

Peritonsillar abscess

186
Q

Diagnosis of peritonsillar abscess

A

CT first line to differentiate cellulitis vs abscess

187
Q

Management of peritonsillar abscess

A

Antibiotics + aspiration or I and D
Ampicillin/sulbactam, clindamycin, penicillin G + metronidazole
Tonsillectomy

188
Q

Most common organism causing parotitis

A

Staph aureus

189
Q

Parotitis often occurs in the setting of ___________, particularly among elderly postoperative pts

A

Dehydration

190
Q

Sudden onset of firm, erythematous swelling of the pre and postauricular areas that extends to the angle of the mandible
Exquisite local pain and tenderness. High fevers, chills, and marked toxicity

A

Parotitis

191
Q

Diagnosis of parotitis

A

Clinical

Purulent drainage at duct of stenson should be collected for gram stain and culture

192
Q

Management of parotitis

A

hydration and IV abx

Nafcillin + metronidazole or clindamycin

193
Q

Bacterial infection of the parotid or submandibular salivary glands

A

Sialadenitis

194
Q

Most common cause of sialadenitis

A

Staph aureus

195
Q

Acute pain, swelling and erythema near the gland especially with meals. Tenderness at duct opening. Dysphagia, trismus. May develop fever and chills

A

Sialadenitis

196
Q

Diagnosis of sialadenitis

A

CT scan - to assess for associated abscess/extent of tissue involvement

197
Q

Management of sialadenitis

A
  1. Sialogogues (hard candies, lemon drops) to increase salivary flow
  2. ABX - dicloxacillin, nafcillin, metronidazole or clinda

EOR Family Medicine (14 decks)

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