Adult - Ears, Nose, Throat, URI Flashcards Preview

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Flashcards in Adult - Ears, Nose, Throat, URI Deck (35):
1

Common bacterial cause in otitis externa

staph aureus

2

Possible causes of otitis externa

fungal

bacterial - acute or chronic

eczema

3

Management of cholesteatoma?

refer for surgery

4

What are three important differentials to rule out with vertigo?

brain tumor
medication toxicity
otitis media

5

Treatment for vertigo (5)

valium

benadryl

meclizine

scopolamine

antiemetics if needed

6

What drugs tend to be ototoxic? (5)

aminoglycosides (-mycin)

diuretics

salicylates

NSAIDs

antineoplastics

7

Most common cause of acute otitis media in the adult?

viral

8

Most common three bacterial pathogens in order in acute otitis media in the adult?

S pneumoniae
H influenzae
M catarrhalis

9

There is a key pathogen in adults. What is the pathogen and what 4 conditions is it largely responsible for?

S pneumoniae

acute otitis media
meningitis
sinusitis
community acquired pneumonia

10

In children, what are the the top two pathogens in community acquired pneumonia?

H. influenzae
S. pneumoniae

(#1 and #2 flip from the adult)

11

What are three "weird" symptoms of acute otitis media in the adult?

nystagmus
anorexia
lethargy

12

Is erythema alone diagnostic for acute otitis media in the adult?

no

there must be fluid behind the TM

13

What is the management for acute otitis media in the adult?

most resolve spontaneously

if support needed=
hydration
oral decongestants
cool mist humidifiers (???)

14

If bacterial cause is suspected in acute otitis media in the adult, what antibiotics are used?

amoxicillin

if allergic fo PCN -- Erythromycin

15

Type of chronic otitis media consisting of peeling layers of keratinized epithelium.

cholesteatoma

16

What are the potential sequelae of cholesteatoma?

erosion of the middle ear leading to nerve damage and deafness

17

What is one feature of cholesteatoma that is either unremitting or frequently recurrent?

painLESS otorrhea

18

What is the most common form of vertigo?

benign paroxysmal positional vertigo (BPPV)

19

What sign is associated with vertigo?

Dix-Hallpike

aka

Nylen-Barany

20

What are the diagnostics for vertigo? (4)

CT to rule out brain tumor or bleed
serum medication levels
ear exam
VDRL/RPR to rule out syphilis

21

What are the three hallmarks of Meniere's disease?

Hearing loss
Tinnitus
Vertigo

22

Management of hearing loss

conductive hearing loss -
treat underlying cause
clear canal

sensorineural - refer

23

What two symptoms set the common cold apart from other illnesses and allergies?

watery rhinorrhea
and
erythematous nasal mucosa

24

Is fever usually associated with the common cold?

No

25

What three symptoms are associated with a bacterial cause of pharyngitis?

Fever
ANTERIOR cervical adenopathy
Macropapular rash

26

What symptom is associated with a VIRAL cause of pharyngitis?

rhinorrhea

27

Is strep a common cause of pharyngitis in adults?

no

28

What criteria is used to determine whether a rapid strep test is indicated?

Centor criteria = FLEA

Fever
Lack of cough
Exudate in the pharynx/tonsils
Anterior cervical adenopathy

29

Is the FLEA criteria sensitive or specific?

Sensitive

a negative result effective rules strep out
(SNOUT)

30

What medications may be used to treat influenza?

neuraminidase inhibitors - a type of antiviral

zanamivir (Relenza) - inhaler
oseltamivir (Tamiflu) - oral

31

What are four hallmarks of mono?

severe pharyngitis
extreme malaise
POSTERIOR cervical adenopathy
splenomegaly - usu during second week

32

Diagnostics for mono

Monospot
increased WBC with relative lymphocytosis and neutropenia (shift to the R)

33

When would a predisone taper be used in mono?

for severely enlarged tonsils

34

When is a bacterial cause suspected in sinusitis?

fever
purulent nasal drainage

35

What antibiotics are used in sinusitis?

augmentin - amoxicillin/clavulunate
biaxin - clarithromycin