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EENT > Test two (weeks 2 + 3) > Flashcards

Test two (weeks 2 + 3) Flashcards

1
Q

hydrastis canadensis common name

A

Goldenseal

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2
Q

hydrastis canadensis Part used

A

Root and rhizome

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3
Q

hydrastis canadensis family

A

Ranunculacea

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4
Q

hydrastis canadensis Actions

A

Antimicrobial

Astringent, mild stimulant, anti inflammatory

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5
Q

hydrastis canadensis Indications

A

Tonic for boggy, ulcerated, cracked mucous membranes with mucopurulent discharge

Topically for conjunctivitis, otitis media, otitis externa, pharyngitis, rhinitis, sinusitis

Topical bacterial infections (nasal lavage), mouth swish for ulcers, pharyngitis

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6
Q

hydrastis canadensis CI/cautions

A

CI in pregnancy due to berberine content and potential to stimulate the uterus

Threatened in wild buy only farmed
Not reliable as systemic; needs to come in contact with infected tissue

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7
Q

Echinacea family

A

Asteraceae

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8
Q

Echinacea Part used

A

Root and rhizome, whole plant

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9
Q

Echinacea Energetics

A

Cooling
Drying
Stimulating

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10
Q

Echinacea Actions

A

Lymphagogue
Antimicrobial
Immunostimulant
Anti inflammatory
Stim leukocytes
Enhances phagocytosis
Inhibits hyaluroniase
Vulnerary

MOVER - tingly movement, stimulation to whole system via lymphatics

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11
Q

Echinacea Indications

A

Infection
Sepsis
Pharyngitis
Prevention of URIs
Ulcers

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12
Q

Echinacea Cautions/CI

A

Avoid prolonged use in inflammatory autoimmune diseases (may push them towards a flare); only use short term for these patients

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13
Q

Eupatorium perfoliatum common name

A

Bone set

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14
Q

Eupatorium perfoliatum Part used

A

Aerial part in flower or bud

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15
Q

Eupatorium perfoliatum Actions

A

Diaphoretic
Immunostimulant (4x more phagocytosis than echinacea)
Mucus membrane tonic
Anti inflammatory
Cytotoxic
Peripheral circulatory stimulant
Smooth muscle relaxant

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16
Q

Eupatorium perfoliatum Indications

A

Influenza and similar illnesses that set into bones with aching, fever, chills

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17
Q

Eupatorium perfoliatum Caution/CI

A

Low dose herb

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18
Q

Usnea family

A

Parmeliaceae

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19
Q

Usnea Part used

A

Root and rhizome, whole plant

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20
Q

Usnea Energetics

A

Drying

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21
Q

Usnea Actions

A

Immunostimulant
Anti inflammatory
Systemic antimicrobial

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22
Q

Usnea Indications

A

Respiratory infections
Cutaneous infections
UTIs

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23
Q

Usnea Cautions/CI

A

Low dose herb; liver toxicity in large doses; avoid in those with liver compromise

Remediates airborne pollutants; gather in clean areas

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24
Q

Baptista tinctora Common name

A

Wild indigo

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25
Q

Baptista tinctora Family

A

Fabaceae

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26
Q

Baptista tinctora Part used

A

Root

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27
Q

Baptista tinctora Energetics

A

Cooling

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28
Q

Baptista tinctora Actions

A

Immunostimulant
Antimicrobial

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29
Q

Baptista tinctora Cautions/CI

A

Pregnancy

Low dose herb; large doses toxic due to phenolic glycosides and alkaloids - 30g induces signs of toxicity

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30
Q

Baptista tinctora Indications

A

Infections
Protracted fever with severely depressed vital force
Ulceration of tissue

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31
Q

Verbascum thapsus common name

A

Mullein

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32
Q

Verbascum thapsus Part used

A

Flowers

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33
Q

Verbascum thapsus Actions

A

Anodyne, antimicrobial

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34
Q

Verbascum thapsus Indications

A

Soothing agent in otitis media and other irritations of TM and EAC

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35
Q

Verbascum thapsus Cautions/CI

A

Ruptured TM

36
Q

Ginkgo part used

A

Leaf

37
Q

Ginkgo energetics

A

Moving

38
Q

Ginkgo actions

A

Increases blood flow to brain and periphery
Antioxidant
Anti inflammatory
Antithrombotic (antagonizes PAF)
Benefits cogntition

39
Q

Ginkgo indications

A

Migraines
Tinnitus
Vertigo
Diabetic retinopathy
Macular degeneration
Glaucoma
Cataracts
Intermittent Claudia t ion
Raynauds
Diabetic ulcers
ED
Varicose veins
Cerebrovascular insufficiency and impaired mental performance

40
Q

Ginkgo Cautions/CI

A

Pregnancy, hemophilia, use of blood thinning meds

41
Q

Herbs for outer ear - otitis externa

A

Topical Antimicrobials - usnea, hydrastis, echinacea, verbascum flower, allium

Emollient - olive oil

Vulnerary - calendula, echinacea, hypericum

Antiinflammatory - hydrastis, echinacea, curcuma

Anodyne - verbascum, hypericum

42
Q

Dr Barrett’s ear drop formula for otitis externa

A

Equal parts infused oils - hydrastis, calendula, verbascum, hypericum

4-6 drops every 2 hours

43
Q

Herbs for middle ear - otitis media

A

Circulatory stimulant - allium, calendula
Anodyne - verbascum, hypericum
Emollient - olive oil
Antiinflammatory - hydrastis, hypericum, calendula

44
Q

Herbs for AOM with severe pain

A

Antiinflammatory - hydrastis, hypericum
Emollient - olive oil
Anodyne - verbascum flower, hypericum, aconite (LOW DOSE!!!!!)

45
Q

Herbs for inner ear goals

A

Inflammation modulation - curcuma, Tanacetum, ginkgo, vaccine management, crataegus

Nervine trophorestoratives - hypericum, arena, centella

Circulatory tonics - ginkgo, centella, vaccinia, crataegus, capsicum, zingiber

46
Q

Goals for systemic treatment in otitis media

A

Immune modulation -
Decongest tissue
Lymphatic drainage
Modulate inflammation
Astringe mucous membranes

47
Q

What is an osteoma?

A

Benign outgrowth of bone found mainly on bones of skull

48
Q

When should referred pain be considered? What are some red flags?

A

Ear pain with normal otoscopic exam and no loss of hearing

Red flags - alcohol, smokers, > 50, diabetes - higher risk of serious causes of ear pain

49
Q

What does tympanometry measure? How are linden/jerger patterns graphed?

A

Reflected pressure in TM
Graphed as compliance vs pressure

50
Q

Types of linden/jerger graphs

A

Type A - normal
Type B - fluid, early AOM, OME
Type C - Eustachian tube dysfunction

51
Q

Hx differences between AOM and OME

A

Hx AOM:
Secondary to URI
Children <10
Unilateral otalgia, blockage sensation, hearing loss > fever; worse at night/lying down
Insomnia, irritability, anorexia (best clues in infant)

Hx OME:
Painless
Popping or gurgling sounds
Plugged feeling
Aural fullness
Allergies or VRI common causes

52
Q

TM appearance in AOM vs OME

A

AOM: red, inflamed, cloudy, fullness/bulging

OME: yellow, amber

53
Q

Are fever/cervical lymphadema signs of AOM or OME?

A

AOM

54
Q

What condition may show bubbles or fluid level retraction and tenting over the short handle of the malleus?

A

OME

55
Q

Light reflex is affected how in AOM?

A

Smaller and distorted

56
Q

What finding may be found on pneumatic otoscopy in AOM?

A

Middle ear fluid or pus

57
Q

Otitis externa RF

A

Change in pH acidic>alkaline
Increased temp and humidity
Mild trauma, frequent cleaning, alterations in ear canal microbiome
Swimming
Dermatitis

58
Q

Sx otitis externa

A

Tender, swollen ear canal
Pain IN ear canal
Auricle and tragic very tender to manipulation
Pruruitis to severe pain
Aural fullness and conductive hearing loss due to blockage of auditory canal
Fever
Insomnia from pain

59
Q

Malignant (necrotizing) otitis externa RF

A

Immunocompromised: DM, alcoholic, malnourished

Pseudomonas aeruginosa
Staph aureus, fungi

60
Q

What is malignant (necrotizing) otitis externa?

A

Progressive otitis externa that invades underlying cartilage/bone; rare but dangerous

61
Q

Malignant (necrotizing) otitis externa sx

A

Sever otalgia and otorrhea with pain that appears out of proportion to PE findings

Bell’s palsy, facial nerve paralysis and death, osteomyelitis, hearing loss

62
Q

What is Otis barotrauma?

A

Inflammation of middle ear caused by the pressure difference between air in middle ear and external atmosphere

63
Q

RF otic barotrauma

A

Eustachian tube dysfunction (allergies, colds, serous otitis media)

64
Q

Otic barotrauma sx

A

Otalgia with severe ear fullness (aural fullness)
< yawning
Hearing loss
Dizziness
Severe cases - TM perforation or round window membrane rupture

65
Q

RF impacted cerumen

A

Elderly
Pts with cognitive impairment

66
Q

Sx impacted cerumen

A

Vague discomfort > severe pain
Impaired hearing
Dizziness
Ear fullness
Reflex cough
Hx of Q tip abuse
Increased cerumen production

67
Q

Tx impacted cerumen

A

Manual removal with curette/alligator forceps

Softening with olive/calendula oil and carbamide peroxide

Irrigation with elephant ear syringe

68
Q

CI to drops/irrigation with impacted cerumen

A

Non-intact TM
AOM
Otorrhea

69
Q

Why should you never irrigat hygroscopic bodies?

A

Beans and other hygroscopic bodies can swell and become more difficult to remove

70
Q

Where do foreign bodies often get lodged?

A

The point at which the external auditory canal narrows at the cartilaginous junction

71
Q

What is an osteoma of the ear canal?

A

Exostoses of the external auditory meatus; present at gradual narrowing of the bony canal by mounds of bone that arise from canal walls from temporal bone

72
Q

RF osteoma of canal

A

Hx cold water exposure (surfers or swimmers)

73
Q

Sx osteoma of canal

A

Asx
Conductive hearing loss if canal becomes occluded

74
Q

RF serous otitis media/OME

A

Allergies
VRI

75
Q

serous otitis media/OME Sx

A

Usually painless
Popping or gurgling sounds
Plugged feeling; aural fullness
Conductive hearing loss

76
Q

serous otitis media/OME PE findings

A

Yellow, amber TM
Bubbles or fluid level retraction, tenting over short handle malleus
Type B tympanogram
Insufflation shows little or no movement
Abnormal whispered voice test

77
Q

What is EOM/eosinophils otitis media

A

Intractable otitis media with viscous yellow effusion containing eosinophils

78
Q

RF EOM

A

Pts with bronchial asthma
Pts resistant to conventional treatments for otitis media

79
Q

Infectious myringitis def

A

Inflammation of TM; usually viral, sometimes bacterial

80
Q

Infectious myringitis Sx

A

Red painful ear
No middle ear involvement
May be hearing loss
If caused by strep, vesicles on TM

81
Q

Herpes zoster oticus def

A

Reactivating of VZV along distribution of sensory nerves inner acting the ear

82
Q

Herpes zoster oticus sx

A

Hearing loss
Vertigo
Otalgia
Facial palsy
Pathognomic vesicular rash of pinna, external auditory canal, and occasionally TM

83
Q

What is Ramsay hunt syndrome?

A

Herpes zoster oticus Associated with facial paralysis; worse prognosis than bells palsy

84
Q

Mastoiditis def

A

AOM spread to mastoid air cells

85
Q

Mastoiditis sx

A

Similar to AOM but pain is also behind ear
High fever (102-105F) complication of untreated or poorly treated AOM

86
Q

Mastoiditis PE findings

A

Tender, red mastoid
Spasm of ipsilateral SCM
Bulging in canal, protrusion of auricle

87
Q

mastoiditis complications

A

Abscess into brain
Meningitis
Death

EENT (6 decks)

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