ENT emergencies Flashcards
(54 cards)
1
Q
what medication can you use to immobilize insects in ear
A
- 2% lidocaine
- mineral oil
2
Q
cauliflower ear
A
- hematoma of the pinna
3
Q
if a laceration to pinna needs suturing, what technique is the best
A
- running suture
4
Q
perichondritis
A
- infection of the skin and tissue surrounding the cartilage of the outer ear.
5
Q
malignant otitis externa is an invasive infection that involves what bone
A
- temporal bone
6
Q
malignant otitis externa is seen in what patient population
A
- immunocompromised patients
7
Q
primary pathogen: malignant otitis externa
A
- pseudomonas aeruginosa
8
Q
how is malignant otitis externa diagnosed
A
- CT scan
9
Q
mastoiditis is caused by an extension of
A
- otitis externa or acute otitis media into mastoid air cells
10
Q
how is mastoiditis diagnosed
A
- CT best
11
Q
tx of mastoiditis
A
- hospitalize
- IV abx: vancomycin or Nafcillin/Oxacillin
12
Q
most common etiology of epistaxis is
A
- trauma
13
Q
initial management of epistaxis
A
- direct pressure for a minimum of 5 minutes
14
Q
source of bleeding in children
A
- kiesselbach’s plexus
- source usually anteriorly on nasal septum, branch of labial artery
15
Q
source of bleeding in adults
A
- posterior setpum
16
Q
source of bleeding in elderly
A
- branch of maxillary artery
- posterior
- more bleeding
17
Q
treatment options for an anterior epistaxis
A
- topical vasoconstictor
- neo-synephrine spray
- cocain spray
- cautery
- anterior packing with petrolatum
18
Q
treatment options for an posterior epistaxis
A
- vasoconstrictor
- posterior packing -> hospitalization
- balloon catheter left in place for 2-5 d
19
Q
complications of posterior packing for epistaxis
A
- septal hematoma
- sinusitis
- toxic shock syndrome
20
Q
tx for non-displaced nasal fracture
A
- ENT referral 3-5 d
21
Q
what should you do if a patient with nasal fracture presents with blood surrounding straw-colored fluid or seroud fluid
A
- CSF lead
- urgent neurosurgical consultation
22
Q
septal hematoma are most common in what patient population
A
- pediatric
23
Q
tx of septal hematoma
A
- incision and drainage of hematoma to prevent avascular necrosis
- following drainage, pack nose and cover with abx
24
Q
untreated septal hematomas are complicated by
A
- “saddle nose” deformity
25
what should be avoided if pt presents with vegetable foreign body in nose
* avoid irrigation
26
if more than unsuccessful attempts to remove FB from nose, refer to ENT
* two
27
List complications from sinusitis
* periorbital cellulitis
* orbital cellulitis
* cavernous sinus thrombosis
* frontal osteomyelitis
28
infection with periorbital cellulitis is confined to
* the eyelids
29
most common pathogens causing periorbital cellulitis
* Strep. pneumo
* S. aureus
30
on exam of periorbital cellulitis, assess visual acuity and EOMS because
* **vision loss, diplopia, and proptosis** suggest intraorbital involvement consistent with orbital cellulitis
31
how is periorbital cellulitis diagnosed
* CT
32
what imaging can differentiate between periorbital cellulitis and orbital cellulitis
* CT
33
orbital cellulitis is a true emergency and can lead to
* vision loss
* meningitis
* cavernous sinus thrombosis
* frontal abscess
34
clinical presentation
* periorbital edema
* erythema
* proptosis: protrusion of eyeball
* chemosis: swelling of conjunctiva
* impaired EOMs
* vision loss
* orbital cellulitis
35
tx of orbital cellulitis
* admit
* Nafcillin + Ceftriaxone + Metronidazole
36
clinical presentation
* severe unilateral, retro-orbital headache
* bilateral proptosis
* opthalmoplegia
* vision loss
* **sensory dysfunction** - hypo/hyperesthesia of cranial nerve **V1**
* CN dysfunction (III, IV, VI)
* cavernous sinus thrombosis
37
how is cavernous sinus thrombosis diagnosed
* CT
38
tx of cavernous sinus thrombosis
* IV
* vancomycin + ceftriaxone
39
common pathogens causing frontal osteomyelitis
* s. auerus
* anaerobes
40
clinical presentation
* h/o frontal sinusitis
* HA
* progressive swelling of forehead
* frontal osteomyelitis
41
how is frontal osteomyelitis diagnosed
* CT or MRI
42
tx of frontal osteomyelitis
* drainage of abscess and debridement of infected bone
* IV abx: vancomycin or nafcillin
43
tongue lacerations are alomst never sutures except those located
* tip of tongue
* if \> 1/3 width of tongue is involved
44
define Ludwig's angina
* infection involving the **submandibular space**
* 85% result of dental infection
45
common pathogens causing Ludwig's angina
* streptococcus
* staphylococcus
* bacteroides
46
clinical presentation
* neck swelling
* tongue protrusion
* severe pain
* fever, malaise, trismus, bad breath
* Ludwig's angina
47
most common abscess of head and neck
* peritonsillar abscess
48
clinical presentation
* fever
* severe sore throat
* drooling
* odynophagia
* otalgia
* "hot potato" voice
* uvula displaced, unilateral erythema and swelling
* peritonsillar abscess
49
what is Sialoadenitis
* inflammation of any of the salivary glands
* parotid
* submandibular
* sublingual
50
suppurative Sialoadenitis most commonly caused by
* staph aureus
51
Sialoadenitis most commonly found in what patient population
* elderly
* diabetic
* poor oral hygiene
52
bilateral Sialoadenitis etiolgy
viral
53
unilateral Sialoadenitis etiolgy
* bacterial
54
obstructive Sialoadenitis caused by
* stone or calculus in gland or duct
* most stones pass spontaneously without complication
