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Physician Assistant > Otolaryngology > Flashcards

Otolaryngology Flashcards

1
Q

Describe the Weber test and what the results mean

A

Use a 512 Hz tuning fork and place on the bridge of forehead

Ask the paient where they hear the sound? Both sides or does it lateralize to one side?

Results
Lateralization to affected side = conductive loss
Lateralization to normal side = sensorineural loss

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2
Q

Describe the Rinne test and what the results mean

A

Testing air vs bone conduction

Hold tuning fork to mastoid process and ask pt to tell you when they no longer hear the sound

Immediately move tuning fork near external auditory meatus and ask pt to tell you when they no longer hear the sound. Note how long pt hears sound through air conduction.

Results
A>B = normal
A>B for much shorter time = Sensorineural hearing loss
B>A = Condunction hearing loss

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3
Q

Patient presents with recurrent vertigo, lower range hearing loss, tinnitus, and one-sided aural pressure. What do you suspect?

A

Ménière disease

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4
Q

A dx of Meniere disease requires what?

A

2 episodes of vertigo (>20 min <12 hours)

Hearing loss verified by hearing test

Tinnitus or feeling of fullness in ear

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5
Q

Meniere disease tx

A

Low-Na diet and diuretics (acetazolamide)

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6
Q

What’s the mose common etiology of sensorineural hearing loss?

A

Presbycusis (age-related hearing loss)

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7
Q

What are some common examples of ototxic agents?

A

aminoglycosides

loop diuretics

anticancer drugs

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8
Q

A kid presents complaining of ear pain. Mom states the child has a fever and has had a cold for the last couple days. Otoscope exam shows tympanic membrane erythema. What do you suspect?

A

Acute otitis media

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9
Q

What are the most common organisms that cause acute otitis media?

A

S. pneumoniae

H. influenzae

M. catarrhalis

S. pyogens

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10
Q

Acute otitis media tx

A

Amoxicillin

TMP-SMX, azithromycin

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11
Q

medical term for ear pain

A

otalgia

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12
Q

Patient presents with ear pain, fever, postauricular pain and eythema. What do you suspect?

A

Mastoiditis

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13
Q

Most common organisms that cause chronic otitis media?

A

P. aeruginosa

S. aureus

Proteus

anarobes

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14
Q

Etiology of Otitis externa

A

Pseudomonas

Proteus

fungi

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15
Q

Patient presents with ear pain that worsens with movement of the tragus/auricle. Exam shows redness and swelling of the ear canal. What do you suspect?

A

Otitis externa

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16
Q

Otitis externa tx

A
  • Check TM- is it perforated?
  • Antibiotic otic drops
    • aminoglycoside or fluoroquinolone +/- corticosteroids)
    • Ciprofloxacin /dexamethasone
  • If TM perforated
    • Ofloxacin 0.3% otic 4 ggt BID x 5 days
  • Keep dry
17
Q

How do you test for benign paroxysmal positional vertigo (BPPV)?

A

dix hallpike maneuver

18
Q

Benign paroxysmal positional vertigo (BPPV) tx

A

Epley maneuver

Some cases may require interventional/surgical therapies

19
Q

Patient presents with purulent nasal discharge, facial pain, and congestion. PE shows tnderness to palpation over the affected sinus. What do you suspect?

A

Acute sinusitis

20
Q

Acute sinusitis tx

A
  • NSAIDs for pain
  • saline washes
  • decongestants
  • antibiotics for severe sx or sx >10-14 days
    • Amoxicillin 7-10 days
    • TMP-SMX, doxycycline (PNC allergy)
21
Q

3 types of rhinitis

A

Allergic

Vasomotor

Medicamentosa

22
Q

What is rhinitis medicamentosa?

A

Rhinitis caused by overuse of decongestants. This causes rebound congestion which prompts increased use of the agent, creating a vicious cycle.

23
Q

etiology for acute sinusitis

A
  • S. pneumonia
  • H. influenzae
  • S. aureus
  • M. catarrhalis
24
Q

Acute pharyngitis etiology

A
  1. Viral
  2. Bacterial
    • Group A Beta-hemolytic streptococci (GABHS)
25
Q

Patient presents with a sore throat, fever, and tender anterior cervical adenopathy. Patient denies cough. Exam showed pharyngotonsillar exudate. What do you suspect?

A

Acute pharngitis- Group A strep

26
Q

Group A Strep (GABHS) tx

A
  • Children
    • Amoxicillin (better taste)
  • Adults
    • Penicillin V 10 days
    • IM penicillin G (single dose)
    • Macrolides
    • Clindamycin
27
Q

“Hot Potato” voice is associated with what

A

Peritonsillar abscess

28
Q

Patient presents with a sore throat, pain with swallowing, trismus, deviation of soft palate/uvula, and muffled “hot potato” voice. What do you suspect?

A

Peritonsillar abscess

29
Q

peritonsillar abcess tx

A
  • Aspiration, incision and drainage
  • Antibiotics
    • amoxicillin
    • augmentin
    • clindamycin
  • Tonsillectomy may be considered
30
Q

Oral candidiasis vs leukoplakia

A
  • Oral candidiasis
    • can be scraped off
    • throat/mouth pain
  • Leukoplakia
    • cannot be rubbed or scraped off
    • painless
31
Q

What is pictured and what increases a patients risk for this?

A

Oral candidiasis from candida albicans

MC in patients:

  • dentures
  • diabetes
  • immunocompromised states (chemo/rad)
  • corticosteroids or broad spectrum abx
32
Q

Oral candidiasis (thrush) tx

A
  • Antifungals
    • ketoconazole
    • fluconazole
    • clotrimazole
    • nystatin liquid rinses
33
Q

What is pictured and what do you need to be concerned about?

A

Leukoplakia

Linked with tobacco, alcohol, and denture use

About 5% are dysplastic or squamous cell carcinomas

If erythroplakia is also present, risk of dysplasia or cancer is 90%

34
Q

etiology of epiglottitis

A

H. influenzae

Group A Strep (GABSH)

viral

35
Q

“thumb sign” on x-ray

A

epiglottitis

36
Q

Epiglottitis tx

A
  • Manage airway (intubation)
  • IV antibiotics
    • Ceftizoxime
    • Cefuroxime
  • IV corticosteroids
    • dexamthasone

Physician Assistant (11 decks)

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