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EENT > Nose and Throat > Flashcards

Nose and Throat Flashcards

1
Q

What classifies rhinosinusitis as subacute?

A

Between 4-12 weeks in length

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2
Q

What is the most common site of origin of sinus inflammation?

A

The ostiomeatal complex

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3
Q

Which sinus is most often affected by sinusitis in adults?

A

Maxillary or Frontal sinuses

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4
Q

Which sinus is most often affected by sinusitis in children?

A

Ethmoid sinus

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5
Q

Most common antecedent to rhinosinusitis?

A

Allergic rhinitis

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6
Q

What type of organisms most often cause nosocomial rhinosinusitis?

A

Gram-negative:

  • Pseudomonas
  • E. coli
  • Klebsiella
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7
Q

What fungi can cause rhinosinusitis?

A
  • Bipolaris
  • Curvularia
  • Aspergillus
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8
Q

What type of rhinosinusitis is associated with double sickening, maxillary pain (especially unilateral), tooth pain, and purulent secretions?

A

Bacterial rhinosinusitis

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9
Q

Gold standard for diagnosis of type of rhinosinusitis?

A

Sinus puncture w/ aspiration

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10
Q

Should you give ABX for acute rhinosinusitis?

A

No, it usually self-resolves.

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11
Q

If you decide to prescribe ABX for ARS, what is first-line?

A

Amoxicillin

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12
Q

What antibiotic should we give for recurrent RS that is believed to be caused by MRSA?

A

Bactrim

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13
Q

What ABX is best for recurrent RS caused by pseudomonas?

A

Cipro

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14
Q

Tx for chronic/recurrent RS?

A
  • Augmentin
  • Quinolones
  • Cef… drugs
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15
Q

Preferred imaging study for endoscopic sinus surgery?

A

Coronal CT scan

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16
Q

What syndrome is characterized by telangiectasias of the lips, nasal mucosa, and tongue?

A

Oscar-Weber-Rendu

-Hereditary hemorrhagic disorder

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17
Q

Which kind of epistaxis is unilateral, continuous, moderate, and usually venous?

A

Anterior epistaxis

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18
Q

Which kind of epistaxis is bilateral, brisk, and arterial?

A

Posterior epistaxis

19
Q

Tx for anterior epistaxis?

A
  • Epinephrine, phenylephrine, or oxymetazoline on cotton ball
  • Ocean spray drops
  • Petrolatum-caution
  • More agressive: cocaine, lidocaine, surgery
20
Q

Tx for posterior epistaxis?

A
  • Monitor Hct, BP, pulse
  • Cocaine or oxymetazoline for vasoconstriction
  • Cautery, packing, tamponade
  • Admit and observe for hypercarbia/hypoxia
21
Q

What type of medicines can cause rhinitis medicamentosa?

A

Azole decongestants

22
Q

What is the most common cause of chronic sinus congestion?

A

Allergic rhinitis

23
Q

What chronic inflammatory conditions can contribute to chronic sinus congestion?

A
  • Sarcoidosis

- Wegener’s disease

24
Q

What hormonal conditions can contribute to chronic sinus congestion?

A
  • Pregnancy

- Hypothyroidism

25
Q

First-line treatment for rhinitis?

A

Antihistamines

26
Q

What drugs can cause rhinitis?

A
  • ACEI, reserpine, beta blockers, prazosin, methyldopa
  • Chlorpromazine
  • ASA and NSAIDS
  • Oral contraceptives
27
Q

Most effective treatment for rhinitis?

A

Nasal steroids

28
Q

When should oral steroids be used to treat rhinitis?

A
  • Intractable rhinitis

- Significant polyposis

29
Q

What oral steroid should be used to treat rhinitis?

A

Prednisone

30
Q

What adjunct drug should be used for gustatory or exercise rhinitis?

31
Q

Non-infectious causes of pharyngitis?

A
  • GERD

- Chronic sinus drainage

32
Q

Most common viral cause of pharyngitis?

A

Adenovirus

  • Parainfluenza
  • Rhinovirus
33
Q

What virus causes pharyngitis associated with a prodrome of fever, sore throat, cervical nodes; exudate, palatal petechiae, splenomegaly, and hepatomegaly?

A

Epstein-Barr virus

34
Q

What test diagnoses EBV?

A

Monospot for IgM or IgG

35
Q

What viral pharyngitis is associated with exudates and shallow ulcers on palate?

36
Q

What viral pharyngitis is associated with tonsillar pillar/soft palate vesicles and ulcers?

A

Coxsackievirus (herpangina)

37
Q

What type of pharyngitis is associated with adherent whitish blue pharyngeal exudate?

A

Corynebacterium diptheriae

38
Q

Most common bacterial causes of pharyngitis?

A

GAS

  • Spirochetes (syphilis)
  • Yersinia (adults w/o enteritis)
  • Gonorrhea
  • Corynebacterium
39
Q

What serious complications can follow bacterial pharyngitis?

A
  • Acute rheumatic fever
  • Abscesses
  • Acute glomerulonephritis
40
Q

How do we diagnose a strep throat?

A

Rapid strep antigen test

-Culture if RSA is neg. but still suspicious

41
Q

What are the Centor criteria?

A
  • Tonsillar exudate
  • Tender cervical nodes
  • Fever
  • No cough
42
Q

Most common cause of one-sided vocal cord paralysis?

43
Q

What ABX should we use for bacterial pharyngitis?

A

Broad spectrum:

  • Clindamycin
  • Augmentin

EENT (3 decks)

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