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HEENT > Review 1 > Flashcards

Review 1 Flashcards

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1
Q

Labyrinthitis

A
  • acute onset
  • continuous
  • severe
  • hearing loss
  • tinnitus
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2
Q

Labyrinthitis - Treatment

A

abx if febrile

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3
Q

Menieres disease

A
  • episodic vertigo
  • last minutes to hours
  • low frequency sensorineural hearing loss
  • tinnitus
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4
Q

Menieres disease - treatment

A

diuretics

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5
Q

Most common vertigo

A

BPV

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6
Q

BPV

A
  • recurrent
  • associate with changes in head position
  • sxs occur in clusters that persist for several day
  • epley maneuver
  • Recurrent case: MRI
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7
Q

MS

A
  • episodic vertigo
  • chronic imbalance
  • unilateral hearing loss
  • rapid onset
  • spontaneous recovery may occur
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8
Q

Vertebral artery insufficiency

A
  • MC in elderly
  • triggered by posture changes or neck extension
  • reduced flow in vertebrasilar system
  • confirm with MR angiography
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9
Q

Vestibular schwannoma

A
  • benign lesion of internal auditory canal
  • unilateral hearing loss
  • diminished speech discrimination
  • enhanced MRI
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10
Q

Vascular compression

A

compression of 8th CN causing imbalance

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11
Q

Vestibular neuronitis

A
  • herpes vestibular ganglion
  • unilateral
  • can last for several days
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12
Q

Ear drops

A

Carbamide peroxide 6.5% OTC

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13
Q

Carbamide peroxide 6.5% do not use if

A

history of infections, perforations or otologic surgery

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14
Q

prostaglandins

A

lantanoprost

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15
Q

Lantanoprost

A

increase aqueous humor outflow

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16
Q

Lantanoprost AE

A
  • patient with blue or green become brown

- stimulates eye lash growth

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17
Q

Beta-blockers

A

timolol

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18
Q

Timolol

A

decrease aqueous humor production

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19
Q

Alpha-2 agonists

A

Brimonidine

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20
Q

Brimonidine

A

decreased aqueous humor production

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21
Q

Carbonic anhydrase inhibitors

A

dorzolamide

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22
Q

Dorzolamide

A

decrease IOP

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23
Q

Cholinergic agonists

A

pilocarpine

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24
Q

Pilocarpine

A

causes miosis

-increase aqueous humor outflow

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25
First Generation Histamines
- more lipophilic - Cross BBB - "sediating" - paradoxically can be activation - espcially in kids - hight anticholinergic effects
26
Second Generation Histamines
- less lipophilic - less BBB permeation - "less/non sedating" - longer duration of action
27
Oxymetazoline - Uses
decongestant, very potent
28
Oxymetazoline
no more than 3 days - risk of rebound nasal congestion
29
Antitussives
benzonatate
30
Benzonatate -MOA
direct action on receptors in the cough center of the medulla
31
Benzonatate - AE
do not chew capsules = laryngospasm
32
Codeine/hydrocodone
MC in cough syrups | -hydrocodone can cause respiratory depression and analgesic potency more than codeine
33
Dextromethorphan (DM)
- no CNS effect at normal dose - sedative with large doses - 4 years and up - dont give with Benadryl - 15 to 30 minutes absorbed - 6 hours of action
34
Expectorants
Guaifenesin
35
Guaifenesin
- loosens and thins phlegm and bronchial secretions to ease expectoration - no cough suppression
36
Croup - Mild
single dose of dexamethasone
37
Croup - Severe
- nebulized epinephrin | - dexamethasone
38
Limbus
- border between cornea and sclera | - aqueous humor outflow
39
Epicanthus
eyelid fold
40
Pupil
what allows light to strike the retina
41
Iris
controls size of pupil
42
Structures of hearing
canal - TM - malleus - incus - stapes - cochlea
43
Pathway of hearing
- sound - external canal - TM - ossicles transfer vibrations and increase pressure - pressure pushes oval window in Scala vestibula - sound with low frequency travel through helicotrema and do not excite hair cells - sounds within range travel through cochlear duct, vibrate basilar membrane and does excite hair cells
44
Structures involved with equilbrium
semicircular canal | utricle and saccule
45
Lateral Rectus
- CN 6 | - move eye laterally
46
Medial Rectus
- CN 3 | - move eye medially
47
Superior Rectus
- CN 3 | - elevates eye
48
Inferior Rectus
- CN 3 | - depresses eye
49
Inferior oblique
- CN 3 | - elevates and turns out
50
Superior oblique
- CN 4 | - depresses and turns in
51
Stapedius muscle
muffles sound
52
Sternocleidomastoid muscle
divides neck into anterior and posterior | -innervation of CN 6
53
Ciliary Bodies
thickening ring of tissue surrounding the lens
54
Ciliary Bodies - Function
- production and outflow of aqueous humor | - lens accommodation
55
Le fort fractures - class 1
maxilla
56
le fort fractures - class II
palate and nose separating from face
57
Le fort fractures - class III
facial bones separating from base of skull
58
Nasorbitoethmoid fracture
flattening of the bridge of nose
59
Diphenhydramine
- CYP2D6 inhibitor - sedative properties - parkinsons
60
Dimehydrinate
- motion sickness - 30 minute onset - highly sedative - >2 years
61
Meclizine
- OTC motion sickness - RX for vertigo - >12 years
62
Doxepine
- most sedative/potent - pruritus/urticaria - usually 3rd line
63
Hydroxyzine
active metabolite: cetirizine | -commonly added to opioids for pain
64
Hydrozyzine - Pamoate (caps)
- anxiety | - pruritus
65
Hydroxyzine - Hydrochloride (tabs)
- alcohol withdrawal - N/V - pruritus
66
Promethazine
-N/V -motion sickness -commonly added to codeine CI: <2 year CI <12 years + codeine -arterial/subQ administration
67
Doxylamine
pregnancy category A
68
Chlorphentramine and Brompheniramine
- OTC or dimetapp >12 years | - combo for cough syrup
69
Cyproheptodine
- chronic use = depression | - broad spectrum "allergies"
70
Loratadine (Claritin)
- seasonal allergic rhinitis, urticaria - food = no effect - some antimuscarinic effects - peak response in a couple days of continuous therapy
71
Fexofenadine (allegra)
- active metabolite: terfenadine - best taken on empty stomach - avoid fatty foods and fruit juices - onset 1-2 hours of cont. use
72
Cetirizine (zyrtec)
- active metabolic of hydroxyzine | - dose related drowsiness

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