ENT Flashcards
(36 cards)
Epiglottitis symptoms
Caused by HIB
Tripod position or HYPEREXTENDED NECK!
Dysphagia, DROOLING, respiratory distress.
Develops very quick.. WITHIN SEVERAL HOURS without a significant prodrome.
Signs of impending airway –> MUFFLED hot potato voice, Restlessness, anxiety, worsening stridor.
X - ray = Thumb print sign
Management = Antibiotics / intubation
Bronchiolitis symptoms
Lower resp tract (so no stridor)
Seen in patients less than 2 yo
Fever, Cough, Retractions, Crackles / Wheezing
Significant Neck Edema + gradual onset of Sore throat, low grade fever + LARYNGEAL PSEUDOMEMBRANE.
Can lead to severe resp distress and stridor
diphtheria.
Barky Cough + Stridor + Fever
Laryngotracheitis (CROUP)
Continuous ear drainage for several weeks despite appropriate antibiotic therapy raises suspicion for what diagnosis?
CHOLESTEATOMA.
can be congential or acquired.
Chronic middle ear disease leads to the formation of a retraction pocket in the typmanic membrane, which can fill with GRANULATION tissue and SKIN debris.
“White mass) posterior to the tympanic membrane.
Complications - HEARING LOSS, cranial nerve palsies, vertigo, and potentially life threatening infections such as BRAIN ABSCESS or MENINGITIS.
Refer to an OTOLARYNGOLOGIST for a dedicated otologic exam, possibly accompanied by a CT and / or surgical visualization to confirm diagnosis.
A solitary area of BONY overgrowth in the OUTER ear with possible hearing loss is what condition?
OSteoma - benign condition
Bony Overgrowth of the STAPES FOOTPLATE that results in CONDUCTIVE HEARING LOSS
Otosclerosis
What kind of hearing loss do Aminoglycocydies, Chemotherapytic agents, Aspirin and Loop diuretics create?
Sensorineural or conductive?
SENSORINEURAL!
Loops are associated with reversible or permanent hearing impairment, reversible deafness, and/or tinnitus.
what are the most common causes of otitis externa?
P. Aeruginosa and S. Aureus
Treatment regimens include drugs with antipseudomonal activity –> Fluroquinolone drops.
Otitis externa = USE DROPS! not oral med.
Dental infection + slow-growing, indurated mass that forms multiple sinus tracts to the skin and a purulent discharge with YELLOW SULFUR GRANULES.
What is the organism?
Actinomyces
Oral Lekuoplakia
A reactive precancerous lesion that represents HYPERPLASIA of the SQUAMOUS EPITHELIUM.
Seen in patients that use SMOKELESS tobacco and also ALCOHOL use.
1-20 percent will progress to squamous carcinoma within 10 years.
most lesions resolve within a few weeks after cessation of tobacco use.
Laryngomalacia.. what is the confirmatory test?
Its a clinical diagnosis. But if on the exam they ask for a confirmatory test then it is LARYNGOSCOPY.
Caused by increased LAXITY of the SUPRAGLOTTIC structures –> inspiratory stridor that is worse when supine. Peaks at age 4-8 months.
Treatment is usually just reassurance. Can do a suptralottoplasty for severe cases.
Spontanoeus resolution of stridor by age 18 months.
Acute otitis media treatment?
Amoxicillin or amoxicillin-calvualnic acid
Diagnosis confirmed by OTOSCOPY showing middle ear infusion (indicated by poor tympanic membrane mobility)
Tympanocentesis with culture or Tympanostomy + surgical tube placement is done when in Acute Otits Media??
It is done in children who take antibiotics yet still have multiple episodes of AOM (more than 3 in 6 months or 4 in 12 months)
Diabetic with ear pain and drainage, GRANULATION TISSUE within the ear canal.. and FACIAL DROOPING.. what is the most likely causative organism.
P. Aeruginosa.
This is Malignant Otitis Externa… this will not be responsive to topical meds.
The facial droop is caused by damage to the facial nerve.
CT or MRI can be used to confirm the diagnosis.
Treatment is with SYSTEMIC antibiotics that are effective against PSEUDOMONAS.
How do Rhizopus infections in diabetics present?
Seen in poorly controlled diabetes.
Begin in the PARANASAL sinuses and extend into the ORBIT and BRAIN.
whistling noise post rhinoplasty?
Nasal septal perforation.
Nasopharyngeal carcinoma is caused by reactivation of what virus?
EBV.
Endemic to china, Middle east.
when it spreads to adjacent tissue –> nasal congestion with EPISTAXIS.
When it spreads to the CERVICAL lymph nodes –> Nontender NECK MASS>
What is the difference between Serous Otitis Media and Acute Otitis Media
Serous Otitis Media - does not have inflammatory signs (fever, tympanic membrane bulging).
The effusion may be asymptomatic and present in the weeks following Acute Otitis Media treatment, or if chornic can lead to hearing loss.
ACL vs MCL tears
ACL - caused by rapid deceleratoin or pivoting at the knee with the foot planted. Acute HEMARTHROSIS is common in these injuries and may limit extension of the knee.
MCL tear - Caused by Severe VALGUs stress (blow to the lateral knee) or TWISTING injury. Ligamentous laxity may be masked in the acute phase by swelling and MUSCLE SPASM. Range of Motion is preserved.
Meniscal tears
Occur from pivoting on a FLEXED KNEE while the foot is planted.
LOCKING, or CATCHING with range of motion. Small joint effusion.
Infected Mandibular Molar –> causing Fever, Dysphagia, Odynophagia and DROOLING
Ludwig Angina –> a Rapidly Progressive BILATERAL cellulitis of the sumbandibular and sublingual spaces.. arising from an infected mandibular molar.
What causes cavernous sinus thrombosis?
Contiguous spread of infection from the MEDIAL THIRD of the FACE, Sinuses, or TEETH via the VALVELESS facial VENOUS SYSTEM.
Clinical findings - Headache, Fever, Cranial Nerve Deficits, and PROPTOSIS.
What is the treatment for Malignant Otitis Externa?
Unrelenting ear pain and Pururlent drainage with a sense of fullness and CONDUCTiVE HEARING LOSS on the affected side.
IV Antibiotics. We dont do surgical excision since we have anti pseudomonla antibiotics now. Surigcal debridment is done if patient fails the antibiotics.
CIPRO is drug of choice. But you can use any antipseudomonal drug!
