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Clin Med > HENT Treatments > Flashcards

HENT Treatments Flashcards

1
Q

1st line treatment for Otitis Externa

A

Topical antimicrobials
- acetic acid
- QUINOLONES
- sulfonamides
- aminoglycosides

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2
Q

Other treatments for otitis externa

A
  • Topical corticosteroids
  • Systemic Abx for severe infection
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3
Q

Treatments for Malignant Otitis Externa

A

IV Abx - CIPROFLOXACIN (1ST LINE)

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4
Q

Treatment for acute Otitis Media

A

ABX!!
Amoxicillin = 1st line in kids
Augmentin = 1st line in adults
PCN allergy: Cephalosporins, Doxycycline, or Azithromycin

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5
Q

When do you just observe for otitis media treatment?

A
  • healthy children
  • age 6-24 months
  • unilateral non-severe pain
  • age >24 months with non-severe pain, unilateral or bilateral
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6
Q

Treatment for ruptured TM

A

ABX!!
Amoxicillin or Augmentin

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7
Q

Treatment for chronic otitis media

A

Refer to ENT for surgical repair / tympanostomy tubes

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8
Q

Treatment for mastoiditis

A

Broad spectrum IV antibiotics + Myringotomy

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9
Q

Treatment for cholesteatoma

A

Surgical repair

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10
Q

Treatment for acute OM in a patient with tympanostomy tubes?

A

Ciprodex (fluoroquinolone combination steroid drops)

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11
Q

Uncomplicated unilateral AOM in a child > 6 months

A

Observe / Amoxicillin

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12
Q

Uncomplicated, unilateral AOM in an adult

A

Augmentin

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13
Q

Unilateral ruptured TM in a child > 6 months

A

Amoxicillin

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14
Q

Uncomplicated AOE in a child > 6 months or an adult

A

Ciprodex

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15
Q

Unilateral AOM in a child > 6 months with recurrent OM recently treated with antibiotics

A

Augmentin or 2nd/3rd gen Cephalosporin

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16
Q

Unilateral or bilateral OME in a child > 6 months or an adult

A

Antihistamine, decongestant, monitor

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17
Q

Treatment for conductive hearing loss?

A

Refer to ENT

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18
Q

Treatment for sensorineural hearing loss?

A

Refer to ENT
Cochlear implants
Hearing aids

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19
Q

Treatment for Acoustic Neuroma?

A

Refer to ENT
- Surgical resection
- Radiation
- Observation

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20
Q

Treatment for tinnitus?

A

Dependent on cause

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21
Q

Treatment for barotrauma?

A

PREVENTION!
- oral decongestants
- swallowing
- ear plugs
- ventilation tubes

Treatment of injury
- Surgical repair
- Abx if TM is perforated
- Analgesics

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22
Q

What requires an urgent referral to ENT?

A

Barotrauma + vertigo + hearing loss

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23
Q

When would you treat an auricular hematoma with a needle aspiration?

A

<2cm and/or present <24 hours

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24
Q

When would you treat an auricular hematoma with an I&D?

A

> 2cm up to 7 days old

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25
Q

Treatment for BPPV?

A
  • EPLEY MANEUVER

Meds used with high frequency of episodes
- 1st line: Antihistamines
- Benzodiazepines

Surgery for severe cases

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26
Q

Treatment for vestibular neuritis?

A
  • 10 day Prednisone taper
  • Meclizine 25-50mg q8h
    OR
    Diphenhydramine 25mg q6-q8h
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27
Q

Can Ménière’s disease be cured?

A

NO! You can relieve symptoms but will not “fix” the underlying disease

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28
Q

Treatments for Meniere’s disease?

A

Lifestyle adjustments (low salt)
Diuretics
Antiemetics (MECLIZINE)
Anxiolytics
Antihistamines
TCAs

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29
Q

Treatment for persistent postural perceptual dizziness?

A

SSRI/NRI (Effexor)
Vestibular rehab
Cognitive behavioral therapy

30
Q

Treatment for mild/episodic allergic rhinitis?

A
  • 1st line: oral antihistamine
  • nasal antihistamine
  • glucocorticoid nasal spray
31
Q

Treatment for mod/severe allergic rhinitis?

A
  • glucocorticoid nasal spray
  • oral antihistamines
  • Montelukast
  • Systemic glucocorticoid
  • Allergen immunotherapy
32
Q

Treatment for bacterial infectious rhinosinusitis?

A

ABX!
- Augmentin
- Doxycycline
- Levofloxacin

33
Q

Treatment for chronic rhinosinusitis?

A
  • intranasal saline
  • intranasal steroids
34
Q

Treatment for nasal polyps?

A

Refer to ENT
- 1st line: intranasal glucocorticoid

35
Q

Treatment for epistaxis

A
  1. Conservative measures
  2. Cautery
  3. Nasal packing
  4. AUGMENTIN (prevent TSS)
36
Q

What types of nasal packing can be used to treat anterior epistaxis?

A
  • Nasal tampons (Merocel)
  • Gauze packing (Xeroform)
  • Nasal balloon catheters (Rapid Rhino)
  • Thrombogenic foams/gels
37
Q

What types of nasal packing can be used to treat posterior epistaxis?

A
  • Nasal balloon catheters: Rapid Rhino, EpiStat, Foley Cath
38
Q

Treatment for foreign bodies in the nose?

A
  • Positive pressure
  • instrumentation (Katz extractor, Alligator forceps)
39
Q

Treatment for asymptomatic, minimal swelling, no septal deviation or hematoma?

A

None

40
Q

Treatment for a nasal fracture without hematoma?

A

Follow up with ENT in 3-5 days

41
Q

Treatment for a septal hematoma?

A

ENT consult

42
Q

Treatment for viral infectious rhinosinusitis?

A

Symptomatic

43
Q

What is the treatment for GABHS?

A
  • 1st line: Penicillin V 250mg po TID or 500mg BID x 10 days
    OR
    Cefuroxime acetil 250mg bid x 5-10 days
  • PCN allergy: erythromycin, azithromycin 500mg QD x 3 days
  • Unable to take PO meds: single IM benzathine PCN
44
Q

What is the treatment for peritonsillar abscess?

A

ABX
- Less severe: Amoxicillin, Augmentin, Clindamycin
- More severe: parenteral Amoxicillin, Amoxicillin-sulbactam, Clindamycin

Needle aspiration
I&D
Tonsillectomy

45
Q

What is the treatment for a retropharyngeal abscess?

A

Begin with conservative Abx
- Bactrim, Clindamycin, Vancomycin, Linezolid, Augmentin

If Abx fail, surgical I&D

46
Q

What is the treatment for Ludwig’s angina?

A
  • AIRWAY PROTECTION
  • Broad spectrum IV Abx: Unasyn or Clindamycin
  • IV steroids
47
Q

What is the treatment for Epiglottis?

A
  • STABILIZE AIRWAY
  • Humidified O2
  • IV ABX (2 DRUG REGIMEN)
    3rd gen cephalosporin + Vancomycin
48
Q

What is the treatment for Croup?

A
  • DEXAMETHASONE (steroid)
  • antipyretics for fever/pain
  • humidified RA
49
Q

Treatment of laryngitis > 2 weeks without symptoms of URI?

A

Refer to ENT (suspect cancer)

50
Q

Treatment for xerostomia?

A
  • Eliminate med that is causing if possible
  • promote gum chewing
  • encourage oral hydration
  • OTC saliva substitutes
  • Cholinergic agonist
  • Pilocarpine hydrochloride (Salagen)
51
Q

Treatment for mucocele affecting speech, feeding or discomfort?

A

Surgical removal of entire lesion + minor salivary gland

52
Q

Treatment for oral ranulas?

A

Surgical removal of sublingual gland

53
Q

Treatment for plunging ranulas?

A

Surgical removal of sublingual gland

54
Q

Treatment for sialolithiasis?

A
  • Conservative
  • Sialogogues
  • Hydration
  • NSAIDs
  • Warm compress
  • Massage gland
  • Remove anticholinergic med
  • Abx only if bacterial
55
Q

Treatment for bacterial sialadenitis?

A

IV Abx - Nafcillin + Flagyl or Unasyn
Supportive

IF SYMPTOMS DO NOT IMPROVE OR REOCCUR REFER TO ENT

56
Q

Treatment for viral sialadenitis?

A

Symptomatic treatment
Prevention (MMR vaccine)

57
Q

What meds do you prescribe for dental prophylaxis?

A

1st line: Amoxicillin
PCN allergic: Cephalexin, Cefadroxil, Azithromycin, Clarithromycin, Doxycycline

58
Q

Treatment for gingivitis?

A
  • Effective tooth brushing and flossing
  • Regular dental visits
59
Q

Treatment for gingival hyperplasia?

A
  • Meticulous oral hygiene
  • Regular cleanings
  • May require gum resection surgery
60
Q

Treatment for ANUG?

A
  • ABX: Metronidazole, Augmentin, Clindamycin
  • Debridement
  • Chlorohexidine rinses
  • Augmented oral hygiene
61
Q

Treatment for periodontitis?

A
  • Effective brushing and flossing
  • Stop tobacco, cannabis & other irritants
  • Dental referral for deep root scaling
62
Q

Treatment for leukoplakia >3 weeks?

A

REFER TO ENT FOR EVAL AND BIOPSY

63
Q

Treatment for aphthous stomatitis?

A

mild forms - no treatment
Can use topical or intralesional steroids

64
Q

Treatment for herpes labialis?

A

Systemic antiviral agents - acyclovir or valacyclovir

65
Q

Treatment for Coxsackie A virus?

A

Supportive

66
Q

Treatment for pyogenic granulomas?

A

Conservative surgical excision

67
Q

Treatment of geographic tongue?

A

No treatment

68
Q

Treatment of a bony tori?

A

Surgical removal only if it affects oral function, interferes with denture fabrication or is subject to recurrent trauma or ulceration

69
Q

Treatment of candidiasis?

A

Topical or systemic antifungals:
- Nystatin swish swallow
- Clotrimazole
- Fluconazole

70
Q

Treatment of lichen planus?

A
  • Asymptomatic - no treatment
  • Topical corticosteroid gels or mouth rinses

Clin Med (9 decks)

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