Ear, Nose and Throat Conditions Flashcards
(21 cards)
What is the difference between outer, middle and inner ear infection?
outer - itch, pain, discharge, deafness
middle - discharge, deafness, dizziness
inner - deafness, dizziness, tinnitus
What are the symptoms of excess cerumen/ear wax?
hearing loss
blocked ears
ear discomfort
itch
What are the treatments for excess cerumen?
ear drops: used 3-4 times a day
- cerumol, earex: olive oil, arches/peanut oil, almond oil
- sodium bicarbonate
- earex, otter: urea hydrogen peroxide
- waxol: docusate sodium
lie down, warm bottle in hands, tilt head/straighten ear canal, hold for 5 minutes
When should excess cerumen be referred?
pain in middle ear
mucinous discharge
trauma related
dizziness/tinnitus
foreign body
failure of OTC
What is otitis externa?
inflammation of the external ear canal - can involve oedema
bacterial infection
What are otitis externa symptoms?
itching and irritation
scratching causing pain
swelling, redness, eczematous
watery discharge
temporary deafness
What is treatment for otitis externa?
acetic acid 2% spray: earcalm
- >12 years
- continued 48 hours post resolving
- max 7 days
analgesics: paracetamol, ibuprofen
What is otitis media?
inflammation in the middle ear + effusion (fluid) + rapid onset of signs and symptoms of an ear infection.
affects mainly children
What are otitis media symptoms?
ear pain
rubbing of ear
restlessness
fever
What is treatment for otitis media?
pharmacy first - aged 1-17 years (if pregnant + <16yrs refer)
analgesics: paracetamol, ibuprofen
moderate-severe and NO ear perforation or otorrhoea
- phenazone 40 mg/g with lidocaine 10 mg/g ear drops for up to 7 days
severe + ear perforation or otorrhoea
- amoxicillin for 5 days
- allergy: clarithromycin for 5 days
- allergy + pregnant: erythromycin for 5 days
What is rhinitis?
acute: short lived, caused by viral illness
chronic: >12 weeks
allergic: triggered by allergens
non-allergic: no clear cause
nasal congestion, runny nose, sneezing, and itching.
What are treatment options for rhinitis?
sodium chloride 0.9% solution - nasal irrigation
antihistamines - acrivastine, cetirizine hydrochloride, loratadine), fexofenadine hydrochloride, chlorphenamine, cyclizine
topical antihistamine - azelastine hydrochloride
nasal corticosteroids - mometasone, fluticasone, beclometasone
ipratropium bromide (non-allergic rhinitis)
max 7 days - rebound congestion
What is sinusitis?
inflammation of the mucosal lining of the paranasal sinuses
nasal blockage or congestion
nasal discharge
dental or facial pain or pressure
reduction or loss of the sense of smell.
last 2-3 weeks
What is treatment for sinusitis?
<10 days
- analgesics: paracetamol, ibuprofen
> 10 days
- high-dose nasal corticosteroid: mometasone furoate [unlicensed use] or fluticasone [unlicensed use] for 14 days
- phenoxymethylpenicillin OR doxycycline/clarithromycin in allergy OR erythromycin in pregnancy
> 10 days + systemically very unwell, has signs and symptoms of a more serious illness or condition, or is at high-risk of complications
- co-amoxiclav.
What is a sore throat?
red swollen tonsils
swollen lymph glands
painful when swallowing
FeverPAIN
- fever
- purulence
- first attendance within 3 days of symptoms
- severely inflamed tonsils
- no cough or coryza (cold symptoms)
antibiotics if FeverPAIN score >3
What is the treatment for sore throat?
pain relief: lidocaine, benzocaine
anti-inflammatories: benzydamine, flurbiprofen
FeverPAIN score >3
- phenoxymethylpenicillin for 5 days
- penicillin allergy: clarithromycin for 5 days
- penicillin allergy + pregnancy: erythromycin for 5 days
What are the types of cough?
non-productive
- dry, tickly, tight
- worse at night
productive
- sputum secretion: clear (non-infected), yellow/green (infected)
What are the treatments for a cough?
non-productive
- glycerol & sucrose, simple linctus, dextromethorphan (>12 yrs)
productive
- guaifenesin (>12 yrs)
diphenhydramine - for nocturnal cough, sedating
What is the difference between cold and influenza?
cold
- runny/congested nose, sneezing, sore throat, cough, mild chills, tiredness, earache
flu
- fever >38ºC, headache, congested nose, sneezing, sore throat, dry cough, body chills, sweating
What are the treatments for common cold and influenza?
analgesics
- ibuprofen, paracetamol
topical or systemic sympathomimetic
- pseudoephedrine, phenylephrine (Sudafed, Lemsip, Beechams, Benylin)
antihistamines
- chlorphenamine, promethazine, loratidine, fexofenadine
When should topical or systemic sympathomimetics be avoided?
- pseudoephedrine, phenylephrine
hypertensive patients - due to stimulant effects raising blood pressure
hyperthyroidism - due to risk of stimulant effect in heart irregularities
diabetes - due to risk of adverse effect on diabetic control
beta-blockers - due to contradictory effect
monoamine oxidase inhibitors - due to risk of hypertensive crisis
