ENT Emergencies

Question 1

What do you use to determine if nasal drainage is CSF or not?

Answer 1

halo sign- blood will stay in middle and CSF will go around it in a halo

Question 2

Cause of septal hematoma

Answer 2

trauma to the anterior nasal septum

Question 3

Complications from undrained septal hematoma

Answer 3

Saddle-nose deformity, Septal perforation, Septal abscess

Question 4

Tx for septal hematoma

Answer 4

Drain and pack. Antibiotics (Augmentin) if abscess suspected IV Clindamycin and admission

Question 5

Most common facial fracture

Answer 5

nasal fracture

Question 6

Management of nasal fracture

Answer 6

closed reduction 2-10 days post injury to allow for reduction of swelling

Question 7

Tx for auricular hematoma

Answer 7

Drain within 7 days, compression dressing, daily follow up for a few days, antibiotics to cover staph

Question 8

Complicaiont from undrained auricular hematoma

Answer 8

cauliflower ear

Question 9

Sx include hemotympanum, effusion, otorrhea, hearing deficit, nystagmus, ataxis, battle sign, facial nerve deficit

Answer 9

middle ear injury

Question 10

Bone that is most commonly involved in basilar skull factures

Answer 10

temporal (75%)

Question 11

Indicative of basilar skull fracture and middle ear injury

Answer 11

hemotympanum

Question 12

Drops that are CI in ruptured TM

Answer 12

gentamycin

Question 13

Test used to evaluate for bite in mandibular fractures

Answer 13

tongue blade test

Question 14

Unilateral rhinitis, foul odor, epistaxis, pain

Answer 14

nasal foreign body

Question 15

initial management of epistaxis

Answer 15

blow nose, spray with afrin, lean forward and pinch nares together for 10 minutes

Question 16

What is next step if packing and silver nitrate sticks are unsuccessful at stopping epistaxis?

Answer 16

leave packing in place 48 hrs, follow up in 24-48 hrs.

Question 17

T/F most patients who need posterior packing are treated outpatient

Answer 17

false, most are admitted. call ENT

Question 18

Complication of frontal sinusitis or trauma characterized by osteomyelitis of frontal bone most commonly seen in kids and teens.

Answer 18

pott’s puffy tumor

Question 19

Hallmark of 7th nerve palsy (Bell’s Palsy)

Answer 19

sudden onset

Question 20

Prognosis of 7th nerve palsy (Bell’s Palsy)

Answer 20

80% recover to normal or near normal function

Question 21

What should stitch with ear laceration and what should you not stitch?

Answer 21

Can do a single layer closure through skin and perichondrium but not the cartilage

Question 22

bacteria involved with chondritis cellulitis

Answer 22

s. aureus and pseudomonas

Question 23

bacteria involved with facial cellulitis

Answer 23

staph and strep

Question 24

where can a retropharyngeal abscess spread to?

Answer 24

mediastinum

Question 25

CXR finding with retropharyngeal abscess

Answer 25

expansion of the prevertebral soft tissues

Question 26

Gold standard for retropharyngeal abscess diagnosis

Answer 26

CT scan

Question 27

Tx of retropharyngeal abscess

Answer 27

IV hydration, IV abx (clindamycin or Unasyn), ENT consult, I & D

Question 28

Etiology of ludwig’s angina

Answer 28

odontogenic 90% of cases (staph, strep and bacteroides)

Question 29

PE shows bilateral submandibular swelling and protruding tongues

Answer 29

Ludwig’s angina

Question 30

What should you avoid if there is a laryngeal crush injury?

Answer 30

cricothyroidotomy