EENT Flashcards Preview

ER 1 > EENT > Flashcards

Flashcards in EENT Deck (18)
Loading flashcards...
1
Q

Epistaxis

- posterior

A
  • rare
  • Spenopalatine artery
  • Emergency: foley cath down nose, blow up, clamp, call ENT
    Anterior
2
Q

Epistaxis

- anterior

A
  • Kiesselbach Plexus
  • Pinch nose, ice pack
  • Phenylephrine spray (Afrin)
  • Silver nitrate stick to cauterize if can ID site of bleed
  • Rhino rocket: last resort (Michelle)
3
Q

Angioedema

A
  • MC drug cause: ACEi or ARB
  • Hereditary: C1 esterase dysfunction, minor trauma can cause
  • Best tx: stop offending agent and admit, watchful waiting and spO2 monitoring.
  • Airway!! If need intubation, very difficult
4
Q

Dental Abscess

  • describe
  • RF
A
  • Infection of dental pulp
  • Poly microbial (mouth)
  • RF: poor oral hygiene, low socioeconomic, DM, smoking, substance abuse
5
Q

Dental Abscess Tx

A
  • Abx (PCN, clindamycin)
  • Most do not require I&D, if so, consult ENT
  • Pain meds: this is a common complaint of drug seekers, instead offer oragel or clove oil
6
Q

Dental blocks

- three types

A
  • Infraorbital: upper front teeth and gingiva (aim towards pupil)
  • Submental: lower front teeth and gingiva
  • Infralveolar: good for molars, only do if well trained
  • good way to tell if they are drug seeking: if they turn it away and want meds instead
7
Q

Ludwig’s Angina

- describe

A
  • true dental emergency!

- Rapidly expanding infection of submandibular space, rare, potentially life threatening

8
Q

Ludwig’s Angina

- s/sx

A
  • mouth pain
  • drooling
  • Trismus
  • Tongue protrusion
  • sublingual edema**
  • Neck swelling
  • Can look like cellulitis on the outside!
9
Q

Ludwig’s Angina

  • MC cause
  • Tx
A
  • MC from odontogenic source, spread from lower molar abscess
  • Tx: airway, IV abx, possible sx
10
Q

Peritonsillar abscess

  • describe
  • Dx
  • Tx
A
  • Commonly triaged as sore throat
  • S/sx: One sided pain, trismus, fever, myalgia, raspy voice (hot potato voice), trouble swallowing spit

Dx:
- CBC, BMP, CT neck w/contrast

Tx:

  • ENT consult, admit to watch airway, possible sx I&D
  • IV fluids, steroids, abx (Clindamycin, Zosyn), salt gargle
11
Q

Retropharyngeal Abscess

- describe

A
  • Very rare, can looks similar to peritonsillar abscess!
  • Lymph drainage dt upper respiratory and oral infections
  • Poly microbial, MRSA is increasing cause
12
Q

Retropharyngeal Abscess

  • s/sx
  • PE
A
  • s/sx: sore throat, fever, dysphasia, neck pain, dyspnea
  • PE: posterior pharyngeal edema, nuchal rigidity, cervical adenopathy, drooling, stridor, trismus, torticollis
  • Kids pathopneumonic: retropharyngeal bulge
13
Q

Retropharyngeal Abscess

- Tx

A
  • Airway (prep for cricothyrotomy)
  • ENT consult
  • IV fluids
    IV abx (clindamycin, zosyn)
14
Q

Foreign body

- ear

A

MC: bugs

  • If still alive: lidocaine 1% in ear
  • Cockroach legs stick to TM
  • Easiest method to remove is irrigation
  • Dig: alligator forceps
  • Low suction great for plastic pieces of hearing aids
15
Q

Foreign body

- nose

A
  • Smellier = been there longer
  • Good nose blow (30% success), mouth to mouth blow for parents to kids
  • Katz Extractor: small balloon catheter
  • Beware of magnets stuck together: can bleed profusely when take off, get ENT consult for this
16
Q

Foreign body

- Eye

A
  • Get visual acuity: both eyes for baseline measurement prior to procedure, CYA.
  • MC: metal from grinding

Tx:

  • 1st: irrigation
  • Fluorescein stain, slit lamp exam: allows to see how embedded it is, can see corneal abrasion also
  • Invert lid, sweep with Q-tip
  • Eye burr
17
Q

Foreign body

- Throat

A
- MC: male eating too quickly
Tx:
- Glucagon (smooth muscle relaxor), Ativan
- Should not stay impacted >24 hours
- Bones or hard debris: endoscopy (GI)

Swallowed (kids, mentally unstable)

  • 2 view XR
  • Most will pass
  • Emergent GI: batteries, magnets, sharp/pointy
18
Q

Mastoiditis

A

• Complications of OM: fluid blocked in mastoid air cells
• Presents with pain, swelling, erythema to postauricular area
- Ear canal should not be involved (OE), might be air or fluid, erythema, purulence behind TM
• Dx: CT w/contrast
• Admit to ENT for IV abx and/or typanocentesis
• Tx: rocephin or levofloxacin
• Differentiate from lymphadenopathy or abscess!