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Adult Health > HEENT > Flashcards

HEENT Flashcards

1
Q

Common cold

A

Most common virus : Rhino virus

Nasal congestion, sore throat, low grade fever

Tx : symptomatic , Sudafed, Afrin nasal spray

Duration 1.5 weeks

Self limiting

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2
Q

Conjunctivitis - definition

A

Inflamed lining of the inside surface of the lids and surface of the globe to the limbus

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3
Q

Conjunctivitis - clinical presentation

A

Redness, discharge, foreign body sensation, preauricular tenderness

NO ocular pain or vision loss

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4
Q

Viral conjunctivitis

A

Red, watery d/c
Symptoms worse 3-5 but resolve in 7-14 days
Associated with URI

Tx: symptomatic

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5
Q

Bacterial Conjunctivits

A

Red eye, yellow copious discharge, crusting over lid, sudden onset

Gram + organism

  • staphylococcus aureus
  • strep pneumonia
  • Haemophilus influenza

Tx : bacitracin or iieotcyin (erythromycin)

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6
Q

Allergic conjunctivitis

A

Exposure with allergen

Tx: moderate- symptomatic
Severe - zaditor ( eye drops, antihistamine )

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7
Q

Allergic Rhinitis

A

Inflammation of mucous membrane often after an exposure to an allergen which releases a histamine

  • increased mucus production
  • local vasodilation
  • Mucosal edema

Clinical presentation : runny nose with clear d/c. Afebrile

Tx: remove allergens, intranasal corticosteriods, antihistamine 2nd generation (Claritin)

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8
Q

Epistaxsis

A

Local or systemic
Location of bleed
- anterior ( involing kiessebach plexus)
- posterior ( concerning)
- blood into pharynx, causing nausea , see ENT

Apply direct pressure bottom of nose
Avoid ASA, NSAIDS, increase humidifiers, Vaseline to promote hydration

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9
Q

Sinusitis - definition

A

Inflammation of the mucus membrane that lines the paranasal sinus which causes blockage of normal drainage pathways
- decrease mucus clearing, increase mucus retention, promotes bacterial growth

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10
Q

Bacterial sinusitis

A 
Symptoms for > 10 days without improvement 
Pathogens
  - streptococcus pneumonia
  - h. Flu
  - morexella

Clinical presentation
- fever, nasal d/c, cough, ill appearing, no improvement

Tx: uncomplicated - observe for 7-10 days
1. Augmentin 500 mg or 750 q 12 hrs 7-10 days
2. PCN allergy : Doxycline, Moxiflacin, levoflocin
3. Preg: Azithromycin
Nasal corticosteriods

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11
Q

Allergic or viral sinusitis

A

Symptoms peak at 3-5 days but improve

Tx: analgesics, topical decongestions or oral

Do not use antihistamines

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12
Q

Chronic rhinosinusitis

A

Treat underlying cause
Nasal corticosteriods
Oral corticosteriod burst
Consider specialist

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13
Q

Recurrent rhinosinisutis

A

Increase antibiotic dose and length
Use second line
Topical steroid
Refer to specialists

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14
Q

Pharyngitis - viral

A

Pathogens

  • adenovirus
  • coronavirus
  • coxasckie

Clinical presentation

  • gradual onset
  • URI, Conjunctivits, afebrile
  • wax and wane

Tx: NSAIDs, tylenol, gargle w/ warm water

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15
Q

Pharyngitis - bacterial

A

Pathogens

  • strep group A
  • n. Gonorrhea

Clinical presentation
- sudden onset, fever 101 , headache, beefy red throat with exudate, enlarged anterior cervical nodes

DX: strep test, CBC with diff, mono spot

TX: Penicillin VK 500 mg BID or TID for 10 days
PCN allergy : Azithromycin 500 mg /day for 5 days or 500 mg on day 1 and 250 mg 2-5 or clindamycin 300 mg 4 x a day for 10 days

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16
Q

Pharyngitis - non infectious

A

Allergic
No fever, persistent post nasal drip

Tx: symptomatic relief, avoid allergen, use antihistmines

17
Q

Mono

A

Acute viral syndrome

Pathogen: Epstein Barr virus

Clinical presentation : fever, exudative pharyngitis ( white or grey), posterior cervical lymphadenopathy , palatial petechial rash , fatigue, enlarged spleen

3-4 weeks with lingering fatigue for 6-12 months

DX: strep test, mono spot ( may not get early disease), CBC w/ diff ( > atypical lymphocytes)

Tx: NSAIDS, tyenlol, no contact sports

18
Q

Acute Otitis Media

A

Middle ear inflammation
Frequent in winter months after URI

Pathogens

  • s. Pneumonia
  • h. Flu

Clinical presentation : earache, fever, hearing loss, vertigo

Unilateral , TM is red, and bulging , conductive hearing loss ( Weber test would have affected ear hearing noise louder) , preauricular and cervical adenopathy

Tx: amoxcillin 500 mg BID for 5-7 days,
- if no better in 48 -72 hours switch to augmentin 500 mg BID for 10 days
PCN allergy Azithromycin : 500 mg day 1 then 250 mg daily for 2-5 day

19
Q

Otitis externa

A

Diffused inflammation of external auditory canal , can be bacterial or fungal
Associated with moist environments - swimmers ear

Clinical presentation : itching, purulent d/c, tenderness of Tragus, pinna, diffuse canal edema

Canal red and swollen, difficult to insert ear speculum

Tx: remove exudative debris, via mechanical or irrigation
Use cortisporsin otic suspension - 3-4 drops in canal TID 7-10 days

20
Q

Serous otitis media

A

Fluid in middle ear with NO sign of infection

Clinical presentation: hearing loss, or fullness, preceding URI

Fluid is visualized and clear

Tx: resolves on its own, can linger for 12 weeks

  • autoinsufflation
  • decongestant
21
Q

Ear cerumen impaction

A

Anatomical narrowing of ear canal

Clinical presentation : hearing loss, ear fullness, tinnitus, dizziness

Dx: based on history and inspection of ear canal

Tx: removal of cerumen
- debris, irritation, manual removal

Asymptomatic patients may not require removal

Aggressive irrigation = perforated TM, maceration of skin and potential infection

22
Q

Aphthous ulcers

A

Canker sores
Common with pt with celeriac, IBS and HIV

Small clearly defined painful oral lesions that are shallow oval shaped with grayish base, heal time 10-14 days

Tx: triamcinolone/ oracort symptomatic relief via gel applied to ulcer BID or QID until healed

23
Q

Candidiasis tx for partials of dentures

A

Remove thoroughly and clean daily
Soak in 1:1 dilution of chlorhexidine gluconate

1% sodium hypochlorite ( if no metal )
Benzalkonium chloride 1:750 if metal used

Get new toothbrush

May use fungizone on tissue side or nystatin power before insertion

24
Q

Xerostomia

A

Dry mouth

Tx: saliva stimulants, artificial salvia products

Adult Health (12 decks)

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