HEENT Emergencies Flashcards
Decreases nasal arterial pressures and prevents aspiration in patient with a nosebleed
have patient sitting in a 45 degree position
Where is the most common location of a nosebleed in adults and children?
adults- posterior to Kiesselbach’s. kids-anterior to Kiesselbach’s
What is the treatment for an anterior nosebleed?
vasoconstrictive agents (afrin) followed by direct pressure to nose
How long can you leave nasal packing in place?
2-3 days
What is the treatment for a posterior nosebleed?
posterior packing, admit for observation, call ENT
Patient presents with edema, erythema of the EAC possibly with exudate. Pinna is tender
external otitis media
Treatment of external otitis media
application of wick and cortisporin otic; local heat,
How do you differentiate between central and peripheral vertigo?
peripheral has nystagmus, hearing loss, N/V, and diaphoresis whereas these are absent in central
Which type of vertigo may have one of the following etiologies: drug toxicity, cerebellar or brain stem stroke?
central vertigo
Which type of vertigo may have one of the following etiologies: Meniere’s, labrynthitis, acoustic neuroma, supprative labryinth?
peripheral vertigo
What is the treatment for BPV?
Epley maneuver
Fluctuating, progressive, sensorineural deafness.
Episodic, characteristic definitive spells of vertigo lasting 20 minutes to 24 hours with no unconsciousness, vestibular nystagmusalways present.
Usually tinnitus
Meniere’s disease
Fever, exudate, adenopathy common. Bacterial cause is Strep
actue tonsillitis
Infection/inflammation of epiglottis and surrounding soft tissue. Usually seen in children. What is your initial step in management?
obtain soft-tissue lateral of neck and call ENT/Pediatrics. DO NOT examine epiglottitis
Severe pain, hoarseness, “hot potato voice”, drooling, dysphagia. Cervical lymphadenopathy, fever. Soft palate bulging and uvula deviating AWAY
peritonsillar abscess
What is the antibiotic treatment of a peritonsillar abscess after it has been drained by ENT?
High dose PCN. Augmentin or Clindamycin if allergic
Parainfluenza airway infection. Most common in kids 3 months – 3 years. Hoarse, barking coup, possibly inspiratory stridor. How would you proceed with management of this patient?
racemic epi
Submandibular pain, trismus, and dysphagia. Markedly swollen submandibular/sublingual tissues with a “woody” apprearance. Most often in patients with poor dental hygiene or after dental procedures
Ludwig’s Angina
Severe pain, halos around lights, blurred vision, photophobia, and N&V. Affected eye is red, nonreactive midrange (often irregular) pupil, hazy cornea, shallow anterior chamber angle
acute angle closure glaucoma
Starts in ethmoid sinus. Hx of sinusitis or trauma to orbital area. Limitation in cardinal fields of gaze. Blurred disk margins, elevated WBC, and fever. What is used to diagnose this condition?
CT scan (this is orbital cellulitis)
A patient presens with painless DECREASES in vision with flashes of light and sparks. May be described as curtain dropping. IOP is normal or low. Retina appears gray w/white folds. What is you plan of action?
bilateral patch and optho consult (this is retinal detachment)
What abx is used to treat conjunctivitis in non-contact wearers?
polymyxin
Painful, non-vision threatening. Anesthesia is diagnostic. Tx is
bilateral eye patch, analgesia, rest
Ultraviolet keratitis (welder’s burn)
Stops at margin of iris. NEVER involves the visual axis
Subconjunctival hemorrhage
Treatment of a chalazion or hordeolum
hot compresses
How can you distinguish iritis from conjunctivitis?
Photophobia with iritis is severe while it is absent in conjunctivitis
What diagnosis is the term “steamy cornea” associated with?
acute glaucoma
How can you distinguish iritis from acute glaucoma?
The pupil in iritis is constricted with poor response while in acute glaucoma is mid-dilated, fixed and irregular with no light response
