Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

STEP 3 Internal Medicine > ENT > Flashcards

ENT Flashcards

(73 cards)

Start Studying
1
Q

otitis externa is associated with

A
  1. swimming

2. foreign bodies (repeated use of cotton swabs, hearing aids etc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

otitis externa is associated with swimming - why

other causes

A

washes out the acidic environment normally found it external auditory canal
other causes: foreign objects, repeated use of cotton swabs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

otitis externa - symptoms:

A
  1. itching
  2. drainage from the external canal
  3. pain (esp when tragus is manipulated)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

otitis externa - diagnosis

A

no tests are necessary
no routine culture
BASED ON EXAM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

otitis externa - treatment (no names)

A
  1. topical antibiotics
  2. topical cortisol
  3. acidic acid and water solution
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ear wax prevent otitis because

A
  1. creates acidic environment

2. blocks water (hydrophobic) –> bacteria grow in water (eps Pseudomonas)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cerumen impaction - treatment of otitis externa

A

makes it impossible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

otitis externa - treatment - topical antibiotics (names)

A
  1. ofloxacin
  2. ciprofloxacin
  3. polymyxin/neomycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

otitis externa - treatment - topical cortison (names)

A

hydrocortisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Cerumen impaction - treatments (most effective?)

A
  1. direct mechanical removal by currette/spoon (most effective)
  2. blast it out with aline irrigation via syringe
  3. use mineral oil, hydrogen peroxide or carbamide peroxide to break it down
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

malignant otitis externa - definition

A

osteomyelitis of the skull from Pseudomonas in DM patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

malignant otitis externa - diagnosis (best initial / most accurate)

A

as diagnose osteomyelitis
Best initial: CT or MRI
Most accurate: bone biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

malignant otitis externa - treatment (no names)

A
  1. surgical debridement

2. antibiotics against Pseudomonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

names of antibiotics against Pseudomonas to treat malignant otitis externa

A
  1. ciprofloxacin
  2. piperacillin
  3. cefepime
  4. carbapenem
  5. aztreonam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Otitis media - clinical manifestations (findings)

A
  1. redness
  2. bulging
  3. Decreased hearing
  4. Loss of light reflex
  5. Immobility of the tympanic membrane
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Otitis media - the most SENSITIVE finding

A

Immobility of the tympanic membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Otitis media - diagnosis

A

it is based ENTIRELY on physical examination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Otitis media - treatment (not for recurrent cases)

A

amoxicillin for 7-10 days
longer for young
shorter for old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Otitis media - treatment for recurrent cases

A

tympanocentesis (most accurate test) and aspirate for culture (VERY RARE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

MCC of otitis media

A
  1. Pneumococcus
  2. nontypeable Haemophilus
  3. Moraxella
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

If otitis media is not improving, switch amoxicillin to …

A
  1. amoxicillin-clavulatate
  2. Cefdinir
  3. carftibuten
  4. Cefuraxime
  5. Cefprozil
  6. Cefpodoxime
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Acute sinusitis - clinical manifestation

A
  1. nasal discharge
  2. fever
  3. headaches
  4. facial tenderness
  5. tooth pain
  6. bad taste in the mouth
  7. decreased transillumination of the sinuses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Acute sinusitis - MCC

A

VIRAL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Acute sinusitis - bacterial causes

A

same as otitis media

  1. Strep pneum
  2. H. influenza
  3. Moraxella
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Acute sinusitis - most accurate and best initial test
best initial --> CT | most accurate --> sinus aspiration for culture
26
Acute sinusitis - treatment
same as otitis media (amoxicillin) PLUS inhaled steroids
27
Acute sinusitis - use amoxicillin and clavulanate if
1. fever and pain 2. persistent symptoms despite 7 days of decongestants 3. purulent nasal discharge
28
chronic rhinosinusitis - treatment
nasal saline irrigation and nasal steroid therapy spray
29
Strep pharyngitis - clinical manifestations
1. pain/sore throat 2. exudate 3. adenopathy 4. NO COUGH/HOARNSESS
30
Strep pharyngitis - best initial test
Rapid strep test
31
Strep pharyngitis - most accurate
culture
32
Negative Rapid strep test in adults - next step
Nothing (very sensitive in adults)
33
positive Rapid strep test - next step
culture (the have the same specificity) but need to assess the risk for rheumatic fever or glomerulonephritis
34
strep pharyngitis - treatment
penicillin or amoxicillin
35
strep pharyngitis - treatment in penicillin allergy
azithromycin or clarithromycin | if allergy is just a rash use cephalexin
36
Influenza - clinical manifestation
1. arthralgia 2. myalgia 3. cough 4. headache 5. fever 6. sore throat 7. feeling of tiredness
37
Influenza - diagnosis
clinical --> if is in unlclear --> viral rapid antigen detection
38
Influenza - treatment names (and mechanism of action)
1. oseltamivir 2. zanamivir 3. baloxavir 4. peramivir Neuraminidase inhibitors
39
Influenza - why peramivir differs
It is IV
40
Influenza - treatment - when to give the drugs
if first 48 h
41
influenza - other than drugs
7 days isolation
42
Influenza - medications ONLY FOR INFL A
amantadine + rimantadine
43
influenza vaccine - indications
in general population at any age strongest: COPD, CHF, dialysis, steroid use, health care workers, older than 50
44
live vs inactivated vaccine for flu
- live is administrated by inhalation | - live only if younger than 50 without medical conditions
45
flu vaccine - egg allergy
no longer an absolute contraindication
46
Allergic rhinitis - present
1. recurrent episodes of nasal itching 2. stuffiness 3. rhinorrhea 4. paroxysm of sneezing 5. eye itching 6. dermatitis 7. wheezing
47
allergic rhinitis may be associated with the development of
asthma
48
allergic rhinitis - treatment (only names)
1. avoidance of the allergen 2. drugs: steroids, antihistamines, cromolyn, ipratropium bromide, leukotriene inhibitors, nasal saline spray and wash 3. immunotherapy
49
allergic rhinitis - avoidance of allergens
1. close windows and stay in airconditioned rooms to avoid pollen 2. avoid pets if there is an allergy to animal dander 3. cover mattresses and pillows with mite and dust - proof casings
50
allergic rhinitis - drugs
intranasal steroids, anihistamines (loratadine etc), intranasal antihistamines (azelastine), cromolyn, ipratropoim, leukotriene inhibitors (montlukast)
51
leukotriene inhibitors - name
montlukast
52
intranasal antihistamines - name
azelastine
53
The single most effective treatment for allergic rhinitis
intranasal steroids
54
allergic rhinitis - immunotherapy
DENSENSITIZATION | For extrinsic allergens that cannot be avoided
55
what should be done before immunotherapy
stop beta blockers | if anaphylaxis occurs, epinephrine should be given
56
Disease that causes vertigo - special characteristics
1. BPV - changes with position 2. Vestibular neuritis - without position changes 3. Labyrinthitis - acute 4. Meniere - chronic 5. acoustic neuroma - ataxia 6. perilymph fistula - history of trauma
57
Disease that causes vertigo - which of them have hearing loss/tinnitus
all except BPV and vestibular neuritis
58
vergigo - diagnostic testins is
MRI of internal auditory canal
59
BPV is no associated with
hearing loss or tinnitus or ataxia
60
BPV - management
Epley maneuver | - responds modestly to meclizine
61
vestibular neuritis - definition . manifestations
idiopathic inflammation of vestibular portion of CN8 - maybe viral vertigo+dizziness only (no positional)
62
vestibular neuritis - treamtent and diagnosis
no test treat with steroids relief with antihistamines (meclizine or diphenhydramine), benzodiazepines, antiemetics
63
Labyrinthitis - definition and manifestations
- inflam of cochlear | - hearing loss + tinnitus
64
Labyrinthitis - treatment
self limited - meclizine and steroids - STEROIDS CAN IMPROVE HEARING
65
Meniere - characteristic
chronic with remitting and relapsing episodes
66
Meniere - management
salt restriction meclizine and diuretics | if severe --> CN8 ablation
67
acoustic neuroma - can be related to
neurofibromatosis or Von Recklinghausen disease
68
a special unique of acoustic neuroma
ataxia
69
Perilymph fistula - cause
head trauma or barotrauma --> rupture of tympanic membrane and formation of fistula
70
Perilymph fistula - treatment
surgical
71
Wernicke-Korsakoff presents as
- chronic heavy alcohol use - confusion with confabulation - ataxia - memory loss - gazy palsy / opthalmoplegia - nystagmus
72
memory loss - test perform
1. Head CT 2. B12 level 3. Thyroid function (T4/TSH) 4. RPR or VDRL
73
Wernicke-Korsakoff - treatment
a

STEP 3 Internal Medicine (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions