ENT Flashcards
(54 cards)
A patient is having inflammation of both eyelids. Patient reports eye irritation, and itching. On PE, you note erythema, crusting, scaling, red-rimming of the eyelid and eyelash flaking. What population groups are most likely to get this condition?
Blepharitis–Downs syndrome and eczema patients
A patient is having inflammation of both eyelids. Patient reports eye irritation; and itching. On PE, you note erythema, crusting, scaling, red-rimming of the eyelid and eyelash flaking. Patient is also experiencing entropion. Patient has a hx of rosacea and allergic dermatitis. What is the most likely diagnosis?
Posterior Blepharitis: Meibomian gland dysfunction
A patient is having inflammation of both eyelids. Patient reports eye irritation, and itching. On PE, you note erythema, crusting, scaling, red-rimming of the eyelid and eyelash flaking. What is the treatment for this patient?
Anterior and Posterior: eye hygeine
Anterior: Azithromycin ophthalmic solution or ointment; erythromycin or bacitracin
Posterior: Tetracyclin or Azithromycin
Orbital emphesyma is described as : ?
Eyelid swelling after blowing nose–air from the maxillary sinus
A patient is admitted for a head trauma. The patient was in a bar fight and got punched in the face. On PE, there is decreased visual acuity, diplopia upon upward gaze, and noticeable orbital emphysema. The patient is also complaining of epistaxis. What do you suspect to see on this patients CT?
A “teardrop” sign; CT is the scan of choice for orbital floor “blowout fractures”
A patient is admitted for a head trauma. The patient was in a bar fight and got punched in the face. On PE, there is decreased visual acuity, diplopia upon upward gaze, and noticeable orbital emphysema. The patient is also complaining of epistaxis. A CT is ordered and it reveals something resembling a “teardrop.” What is the best management for this patient?
- Nasal decongestants are the INITIAL tx
- Educate the patient to NOT BLOW their nose
- Corticosteroids (reduces inflammation)
- Antibiotics (Ampicillin/Sulbactam or Clindamycin)
- Surgical repair: for severe cases
- enophthalmos or for persistent diplopia
A patient is complaining of dysphagia, and unable to open her mouth completely (trismus). You notice a “hot potato voice” and a deviated uvula. The patient also has anterior cervical lymphadenopathy. What is the best test for this patient?
CT scan
A patient is complaining of dysphagia, and unable to open her mouth completely (trismus). You notice a “hot potato voice” and a deviated uvula. The patient also has anterior cervical lymphadenopathy. What is the most likely offending agent?
Polymicrobial: Strep pyrogens (GABH) and Staph. aureus
What is the hallmark of laryngitis?
Hoarseness
What is the most common cause of laryngitis?
Viral: adenovirus, rhinovirus, flu, RSV
What is the gold standard for “strep throat”?
throat culture
How is Ludwig’s angina diagnosed?
CT scan
What is the tx for Ludwig’s angina?
Unasyn: ampicillin/sulbactam
PCN + Metronidazole
Clinda
What can dental infections most commonly cause?
Ludwig’s angina
-cellulitis of the sublingual and submaxillary spaces in the neck
A patient is experiencing swelling and erythema of the upper neck and chin with pus on the floor of the mouth. What is the most likely diagnosis?
Ludwig’s angina
A 4 year old boy is seen in the ED for mucopurulent discharge. There is a foul odor in the room. The boy tells you his nose was also bleeding. Mom tells you she thinks he stuck a bead up his nose. What is the next step in evaluating the patient?
Look in his nose!
- head light & otoscope
- rigid or flex fiberoptic endoscopy
A 4 year old boy is seen in the ED for mucopurulent discharge. There is a foul odor in the room. The boy tells you his nose was also bleeding. Mom tells you she thinks he stuck a bead up his nose. What is the management of this patient?
Positive pressure technique: close the pts oppostive nostril and have him blow
-Instrumental removal
What are 2 risk factors for posterior epistaxis?
- HTN
2. Atherosclerosis
What is the most common bleeding site for posterior epistaxis?
palatine artery
What tx can be used for epistaxis when it lasts more than 15 min?
Topical decongestants/Vasoconstrictors
- Phenylephrine
- Oxymetazoline (Afrin)
- Cocaine *
*cautious use in pts w/ HTN
If a septal hematoma is not removed, what can happen?
loss of cartilage
What is the most common rhinitis of all 3 types?
Allergic: IgE mediated mast cell histamine release
What is the MC cause of infectious rhinitis?
Rhinovirus (common cold)
A patient is complaining of sneezing, nasal congestion/itchiness and clear rhinorrhea. Upon PE, you notice pale, violaceous boggy turbinates and nasal polyps with cobblestone mucosa of the conjunctiva. What is the most likely diagnosis?
Allergic rhinitis
