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HEENT > Review 1 > Flashcards

Review 1 Flashcards

1
Q

Labyrinthitis

A
  • acute onset
  • continuous
  • severe
  • hearing loss
  • tinnitus
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2
Q

Labyrinthitis - Treatment

A

abx if febrile

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3
Q

Menieres disease

A
  • episodic vertigo
  • last minutes to hours
  • low frequency sensorineural hearing loss
  • tinnitus
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4
Q

Menieres disease - treatment

A

diuretics

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5
Q

Most common vertigo

A

BPV

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6
Q

BPV

A
  • recurrent
  • associate with changes in head position
  • sxs occur in clusters that persist for several day
  • epley maneuver
  • Recurrent case: MRI
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7
Q

MS

A
  • episodic vertigo
  • chronic imbalance
  • unilateral hearing loss
  • rapid onset
  • spontaneous recovery may occur
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8
Q

Vertebral artery insufficiency

A
  • MC in elderly
  • triggered by posture changes or neck extension
  • reduced flow in vertebrasilar system
  • confirm with MR angiography
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9
Q

Vestibular schwannoma

A
  • benign lesion of internal auditory canal
  • unilateral hearing loss
  • diminished speech discrimination
  • enhanced MRI
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10
Q

Vascular compression

A

compression of 8th CN causing imbalance

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11
Q

Vestibular neuronitis

A
  • herpes vestibular ganglion
  • unilateral
  • can last for several days
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12
Q

Ear drops

A

Carbamide peroxide 6.5% OTC

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13
Q

Carbamide peroxide 6.5% do not use if

A

history of infections, perforations or otologic surgery

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14
Q

prostaglandins

A

lantanoprost

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15
Q

Lantanoprost

A

increase aqueous humor outflow

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16
Q

Lantanoprost AE

A
  • patient with blue or green become brown

- stimulates eye lash growth

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17
Q

Beta-blockers

A

timolol

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18
Q

Timolol

A

decrease aqueous humor production

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19
Q

Alpha-2 agonists

A

Brimonidine

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20
Q

Brimonidine

A

decreased aqueous humor production

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21
Q

Carbonic anhydrase inhibitors

A

dorzolamide

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22
Q

Dorzolamide

A

decrease IOP

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23
Q

Cholinergic agonists

A

pilocarpine

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24
Q

Pilocarpine

A

causes miosis

-increase aqueous humor outflow

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25
Q

First Generation Histamines

A
  • more lipophilic
  • Cross BBB
  • “sediating”
  • paradoxically can be activation - espcially in kids
  • hight anticholinergic effects
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26
Q

Second Generation Histamines

A
  • less lipophilic
  • less BBB permeation
  • “less/non sedating”
  • longer duration of action
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27
Q

Oxymetazoline - Uses

A

decongestant, very potent

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28
Q

Oxymetazoline

A

no more than 3 days - risk of rebound nasal congestion

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29
Q

Antitussives

A

benzonatate

30
Q

Benzonatate -MOA

A

direct action on receptors in the cough center of the medulla

31
Q

Benzonatate - AE

A

do not chew capsules = laryngospasm

32
Q

Codeine/hydrocodone

A

MC in cough syrups

-hydrocodone can cause respiratory depression and analgesic potency more than codeine

33
Q

Dextromethorphan (DM)

A
  • no CNS effect at normal dose
  • sedative with large doses
  • 4 years and up
  • dont give with Benadryl
  • 15 to 30 minutes absorbed
  • 6 hours of action
34
Q

Expectorants

A

Guaifenesin

35
Q

Guaifenesin

A
  • loosens and thins phlegm and bronchial secretions to ease expectoration
  • no cough suppression
36
Q

Croup - Mild

A

single dose of dexamethasone

37
Q

Croup - Severe

A
  • nebulized epinephrin

- dexamethasone

38
Q

Limbus

A
  • border between cornea and sclera

- aqueous humor outflow

39
Q

Epicanthus

A

eyelid fold

40
Q

Pupil

A

what allows light to strike the retina

41
Q

Iris

A

controls size of pupil

42
Q

Structures of hearing

A

canal - TM - malleus - incus - stapes - cochlea

43
Q

Pathway of hearing

A
  • sound
  • external canal
  • TM
  • ossicles transfer vibrations and increase pressure
  • pressure pushes oval window in Scala vestibula
  • sound with low frequency travel through helicotrema and do not excite hair cells
  • sounds within range travel through cochlear duct, vibrate basilar membrane and does excite hair cells
44
Q

Structures involved with equilbrium

A

semicircular canal

utricle and saccule

45
Q

Lateral Rectus

A
  • CN 6

- move eye laterally

46
Q

Medial Rectus

A
  • CN 3

- move eye medially

47
Q

Superior Rectus

A
  • CN 3

- elevates eye

48
Q

Inferior Rectus

A
  • CN 3

- depresses eye

49
Q

Inferior oblique

A
  • CN 3

- elevates and turns out

50
Q

Superior oblique

A
  • CN 4

- depresses and turns in

51
Q

Stapedius muscle

A

muffles sound

52
Q

Sternocleidomastoid muscle

A

divides neck into anterior and posterior

-innervation of CN 6

53
Q

Ciliary Bodies

A

thickening ring of tissue surrounding the lens

54
Q

Ciliary Bodies - Function

A
  • production and outflow of aqueous humor

- lens accommodation

55
Q

Le fort fractures - class 1

A

maxilla

56
Q

le fort fractures - class II

A

palate and nose separating from face

57
Q

Le fort fractures - class III

A

facial bones separating from base of skull

58
Q

Nasorbitoethmoid fracture

A

flattening of the bridge of nose

59
Q

Diphenhydramine

A
  • CYP2D6 inhibitor
  • sedative properties
  • parkinsons
60
Q

Dimehydrinate

A
  • motion sickness - 30 minute onset
  • highly sedative
  • > 2 years
61
Q

Meclizine

A
  • OTC motion sickness
  • RX for vertigo
  • > 12 years
62
Q

Doxepine

A
  • most sedative/potent
  • pruritus/urticaria
  • usually 3rd line
63
Q

Hydroxyzine

A

active metabolite: cetirizine

-commonly added to opioids for pain

64
Q

Hydrozyzine - Pamoate (caps)

A
  • anxiety

- pruritus

65
Q

Hydroxyzine - Hydrochloride (tabs)

A
  • alcohol withdrawal
  • N/V
  • pruritus
66
Q

Promethazine

A

-N/V
-motion sickness
-commonly added to codeine
CI: <2 year
CI <12 years + codeine
-arterial/subQ administration

67
Q

Doxylamine

A

pregnancy category A

68
Q

Chlorphentramine and Brompheniramine

A
  • OTC or dimetapp >12 years

- combo for cough syrup

69
Q

Cyproheptodine

A
  • chronic use = depression

- broad spectrum “allergies”

70
Q

Loratadine (Claritin)

A
  • seasonal allergic rhinitis, urticaria
  • food = no effect
  • some antimuscarinic effects
  • peak response in a couple days of continuous therapy
71
Q

Fexofenadine (allegra)

A
  • active metabolite: terfenadine
  • best taken on empty stomach
  • avoid fatty foods and fruit juices
  • onset 1-2 hours of cont. use
72
Q

Cetirizine (zyrtec)

A
  • active metabolic of hydroxyzine

- dose related drowsiness

HEENT (1 decks)

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