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EENT Tx Flashcards

1
Q

Chalazion

A

hot compresses or I&D or surgical excision

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2
Q

Hordeolum

A

warm compresses on and off for 15 min 4xday, if no improvement, then refer to ophthalmology for I&D, with concurrent preseptal cellulite do oral clindamycin

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3
Q

Pterygium

A

surgical referral if vision is affected, no surgery for cosmetic reasons because it will probably return, artificial tears/ lubricants for redness and irritation

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4
Q

Blepharitis

A

lid hygiene, topical azithro or erythropoietin, oral antibiotics if severe- azithro or doxy

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5
Q

Entropion

A

surgical correction if cornea affected

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6
Q

ectropion

A

surgery is definitive, artificial tears or lubricants to improve symptoms

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7
Q

Macular degeneration

A

Dry- no proven treatment, antioxidants plus zone, lutein, zeaxanthin, stop smoking
Wet- VEGF- bevacizumab, ranibizumab, aflibercept, photodyanamic therapy if not a candidate for VEGF, antioxidants, lutein, zinc, zeaxanthin

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8
Q

Cataracts

A

surgery definitive, corrective lenses if early

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9
Q

open angle glaucoma

A

aimed at lowering IOP, topical treatments that decrease aqueous production or increase outflow (pilocarpine beta blockers, etc. )

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10
Q

Acute closed angle glaucoma

A

ophthalmology consult ASAP, timolol, apraclonidine, pilocarpine topical
also acetazolamide PO or IV

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11
Q

Optic neuritis

A

IV methylprednisone

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12
Q

Preseptal Cellulitis

A

admit if systemic illness or <1yr old, usually can be out patient with oral clindamycin

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13
Q

Orbital cellulitis

A

Admit, immediate ophthoalmology consult!! IV Vanc plus ceftriaxone, or cefotaxime or unsay or zosyn

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14
Q

Orbital blowout fracture

A

ophthamo referral prophylactic antibiotic if it involves or communicates with sinus- augmenting or azithro
apply Ice unless globe trauma

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15
Q

Conjunctivitis

A

wet compress and d/c contacts, topical antibiotics or antihistamines

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16
Q

retinal detachment

A

immediate conult, laser or surgical correction depending on the type of detachment

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17
Q

retinal vascular occlusion

A

Ophtho emergency, intraarterial thrombolytic therapy, conservative- ocular massage, anterior chamber paracentesis, IV mannitol or aceazolamide,vasodialors- nitroglycerine or isosorbide dinitirate

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18
Q

dacryostenosis

A

lacrimal sac massage is first line, if unresolving by 6-7 months, then refer for surgical probing or stenting

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19
Q

Dacryostenosis

A

Ophtho consult, Mild- oral clinda, moderate to severe- admit and IV van +ceftriaxone

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20
Q

Corneal abrasion

A

remove any foreign bodies, oral pain meds but no topical anesthetics, topical antibiotics, monitor daily if heavily contaminated e.g. with soil

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21
Q

corneal ulcer

A

urgent ophthalmologist consult, topical and systemic antibiotics

22
Q

hyphema

A

urgent ophthalmologist consult, eye shield, pain control;, correct coagulopathy

23
Q

hypertensive retinopathy

A

mild and moderate- good control of hypertension, severe- papilledema present, immediately lower blood pressure

24
Q

Otitis externa

A

topical antibiotics, or combo with glucocorticoid
- ofloaxacin, ciprofloxacin, neomycin/polymixin
combos- neomycin/polymyxin B/ hydrocortisone, Ciprofloxacin/hydrocortisone, Cipro/dexamethasone
clean ear thoroughly, wick placement if canal is completely occluded, pain control

25
Otitis media
treat with antibiotics- less than 6 months, bilateral, toxic appearance, fever 102.2 or more, uncontrolled pain, over 3 days symptoms, poor follow up, otorrhea watchful waiting- >2y with mild symptoms, 6mo-2y with no systemic symptoms amoxicillin, augmentin
26
Chronic otitis media
aural toilet, flouroquinalones (ofloxacin)
27
Cholesteatoma
topical otic drops- oflaxacin, systemic antibiotics- imipenem, surgical
28
TM perforation
kids- oral amoxicillin | adults- oral amoxicillin and topical ofloxacin
29
mastoiditis
ENT consult, myringotomy and culture, admit, IV cefazolin, surgical mastoidectomy if failed IV antibiotics
30
Auricular hematoma
I and D asap, prophylactic antibiotics - levofloxacin for adults - augmentin for children
31
acoustic neuroma
options are surgery, ration, or observation | - refer to neurosurgery
32
benign paroxysmal positional vertigo
epplu maneuver meds not useful but may help symptoms, meclazine for dizziness and nausea, odnasetron for nausea surgery to occlude posterior ear canal for refractory cases (rare)
33
Meniere disease
lifestyle changes, limit salt intake, caffeine, alcohol, nicotine, stress MSG, contact with food allergens - acute- vestibular suppressants and antiemetics - diuretics if recurrent vertigo - refractory- intratympanic gentamycin, labrinthectomy, vestibular neurectomy
34
barotrauma
prevention is best- oral decongestants | most resolve with time, surgical tympanoplasty if serious
35
acute sinusitis
viral supportive care | bacteria- augmenting or doxy
36
acute fungal sinusitis
IV amphotericin B, usually in immunosuppressed and often fatal
37
Chronic sinusitis
augmenting first, clindamycin if allergic
38
Allergic rhinitis
under 2y- cromolyn nasal spray, cetirizine suspension mild to moderate- 2nd gen antihistamine- fexofenadine, loratadine, cetirizine, and glucocorticoid nasal spray mod to severe- add sudafed, a decongestant
39
epistaxis
anterior bleed- apply pressure, apply vasoconstrictor, cautery, nasal packing posterior- balloon catheter or foley, admit for observation with cardiac monitoring
40
Nasal foreign body
intrument removal is preferred, positive pressure techniques, ENT referral for magnet, button battery, penetrating/sharp object, or object that cannot be visualized
41
aphthous ulcers
symptomatic relief with triamcinolone, flucinonide, or lidocaine if severe or refractory, then oral or intralesional glucocorticoids
42
acute pahrygitis
GAS- penicillin Po | viral- supportive
43
acute ginigivitis
chlorhexidine oral rinse | systemic antibiotics rarely needs, but if immunocompromised or severe- metronidazole, augmenting, unasyn, clindamycin
44
acute necrotizing ulcerative gingivitis
debridement by dentist under anesthesia, chlorhexidine rinse, penicillin or metronidazole
45
epiglottitis
intubate if needed, or monitor closely, 3rd gen cephalosporin and antistaph agent with MRSA coverage - ceftriaxone plus linda/vanc - glucocorticoids for inflammation - ent consult
46
Acute laryngitis
voice rest, humidified air, hydration no antibiotics steroids, but only for if they NEED their voice
47
oral candidiasis
Nystatin swish and swallow HIV- attempt topical or go straight to oral fluconazole if esophageal it must always be treated systemically
48
Peritonsilalr abcess
I and D, IV antibiotics- clindamycin or unsay, glucocorticoids to reduce swelling nd pain
49
sialadenitis
pain control, cephalexing or dicloxacillin, sialogogues, warm compresses
50
oral leukoplakia
ongoing monitoring and smoking cessation
51
ludwigs angina
immunocompetent- unsyn or clindamycin PLUS vanc immunocompromised- Zosyn, imipenem or meropenem surgical I and D if access coalesces or doesn't approve
52
Lemierre syndrome
remove catheter if caused by a line, Zosyn or Unasyn Iv or a carbapenem, add vans if skin flora antocoag id extended thrombus or multiple thrombi, surgery if unresponsive to abs

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