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EENT > Test 2 > Flashcards

Test 2 Flashcards

1
Q

Otitis Media cause

A

Susceptible patient multiple risk factors => get allergy or URI → Blocked Eustachian tube

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2
Q

Otitis Media population affected

A

children under 10

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3
Q

Otitis Media symptoms

A

Pain
Ear drainage (otorrhea)
Fever
Lethargy
Irritability
Anorexia
Vomiting
Unilateral
Sensation of blockage
Hearing loss
Worse pain in evening
Eye symptoms

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4
Q

Otitis Media RF

A

Fall
1-5 years
Dairy at early age
Supine bottle feeding with sniffles causes aspiration into eustachian tube
Second or third hand smoke
Vitamin A def
Vitamin D def
Zinc def
Eskimo and Native american
Allergy, atopy, and food sensitivities
Fetal alcohol syndrome, Down’s syndrome, cleft palate
High hard palate
Sibling with URI
Daycare
Breastfeeding < 6 months
Early introduction of solid foods and reliance on formula
Gastroesophageal reflux disease (GERD)
Pacifier use
Antibiotic treatment in early life
Male children
Genetics
Previous viral infection
Housing

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5
Q

Otic Barotrauma cause

A

air travel or scuba diving

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6
Q

Otic Barotrauma sx

A

pain can be severe with ear fullness, < yawning, hearing loss, and dizziness.

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7
Q

Otic Barotrauma complication

A

TM perforation or round window membrane rupture

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8
Q

Impacted cerumen sx

A

Vague discomfort to severe pain; impaired hearing, dizziness, ear fullness, reflex cough, tinnitus, itchiness,

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9
Q

Impacted cerumen cause

A

history of “Q-tip abuse”
increased cerumen production

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10
Q

Impacted cerumen treatment

A

cerumenolytic agents
irrigation
manual removal
elephant ear syringe
ear drops to soften wax- olive or calendula oil or OTC preparation of Carbamide peroxide 6.5 % ® Debrox or Murine

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11
Q

Impacted cerumen Contraindication to treating

A

non-intact tympanic membrane
AOM
otorrhea
ear canal stenosis, exostoses, diabetes mellitus, immunocompromised state, or anticoagulant therapy

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12
Q

Impacted cerumen complications

A

tympanic membrane perforation, ear canal laceration, infection of the ear otitis externa and malignant otitis externa

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13
Q

foreign bodies cause

A

Sticking things in ear
Food
Beads
Plastic toys
Pebbles
Popcorn kernels
Insects

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14
Q

osteoma of the canal cause

A

history of cold-water exposure, chronic periostitis

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15
Q

referred pain causes

A

TMJ dysfunction, molars, cervical spine, head and neck malignancies, TMD

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16
Q

otitis media with efffusion (serous) cause

A

allergies or URIs

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17
Q

Herpes zoster oticus sx

A

Otalgia
Facial palsy
Pathognomonic vesicular rash of the pinna
Hearing loss
Vertigo

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18
Q

foreign bodies treatment

A

Water irrigation
Forceps removal
Roman loops
Right angle ball hooks
Suction catheters
alcohol, 2% lidocaine, or mineral oil- insects
Acetone for styrofoam
EENT referral

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19
Q

osteoma of the canal sx and complication

A

asymptomatic or conductive hearing loss
Complication: otitis externa

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20
Q

osteoma tx

A

surgery
hekla lava

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21
Q

What are red flags PMH/SH/age for further workup of ear pain?

A

smokers, drink alcohol, are older than 50 years, or have diabetes

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22
Q

Serous Otitis Media or OME sx

A

Painless
Popping or gurgling sound
Plugged feeling
Aural fullness

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23
Q

Serous Otitis Media or OME PE

A

TM yellow, amber; not pearly gray
Tympanogram is flat-Type B
Insufflation shows little or no movement
Conductive hearing loss: Abnormal whispered voice test. (Weber tuning fork test may lateralize to the bad ear, Rinne’ BC > AC)

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24
Q

Tympanometry

A

measurment of reflected pressure on the TM

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25
Q

What dose type A indicated on tympanometry

A

normal

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26
Q

What dose type B indicated on tympanometry?

A

Fluid, early AOM, OME

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27
Q

What dose type c of tympanometry mean?

A

Eustachian Tube dysfunction

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28
Q

eosinophils otitis media presentation and population effected

A

highly viscous yellow effusion containing eosinophils
bronchial asthma

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29
Q

infectious myringits cause

A

viral, bacterial, strep pneumonia

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30
Q

Infectious myringitis sx

A

Red painful ear
Vesicles on Tympanic membrane
Hearing loss

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31
Q

Infectious myringitis complications

A

Hearing loss

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32
Q

Herpes Zoster Oticus cause

A

herpes zoster, Reactivation of the varicella-zoster virus (VZV) along the distribution of the sensory nerves innervating the ear, which usually includes the geniculate ganglion,

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33
Q

Herpes Zoster Oticus sx

A

Otalgia
Facial palsy
Pathognomonic vesicular rash of the pinna
Hearing loss
Vertigo

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34
Q

Mastoiditis cause

A

complication of untreated or poorly treated AOM

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35
Q

Mastoiditis sx

A

Pain behind the ear
Fever

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36
Q

Mastoiditis PE

A

tender, red mastoid; spasm of ipsilateral SCM; bulging in canal, protrusion of auricle

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37
Q

Mastoiditis complication

A

Abscess into brain
Meningitis
Death

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38
Q

Mastoiditis tx

A

Antibiotics

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39
Q

otitis externa cause

A

changes in pH from acid to alkaline, bacterial infection, fungal, Pseudomonas aeruginosa, Staphylococcus aureus, Candida and aspergillus, dermatological conditions, humidity

40
Q

otitis externa RF

A

mild trauma, frequent cleaning, alterations in the microbiome of the ear canal, swimming, Q-tip use

41
Q

Otitis Externa sx

A

Tender swollen ear canal
Auricle very tender to manipulation
Pruritus
Pain
Aural fullness and conductive hearing loss
One-sided or bilateral
Insomnia

42
Q

Otitis Externa PE

A

Red ear canal
Exudate
May be swollen shut
Fever
Pain with manipulation of auricle and tragus

43
Q

Otitis Externa Tx

A
  • Dry ear
  • Clean ear canal with loop or cotton swab
  • If the eardrum is visualized and intact, gentle irrigation with 1:1 dilution of 3% hydrogen peroxide at body temperature
  • Botanical eardrops: calendula, hydrastits, verbascum, hypericum 4-6 gtt, q 24
  • Otic Domeboro solution: acidify ear canal
  • Antibiotics: persistent or the patient’s temperature is higher than 38.3°C (101.0°F), if the pain is severe, regional lymphadenopathy is present in the preauricular or posterior cervical chains. Patients with diabetes or those taking systemic corticosteroids are more likely to need systemic treatment
  • Cervical spine manipulation
  • Lymphatic massage
  • Hepar sulph

Fungal cause
* Tea tree oil 1:10 for aspergillus
* Nystatin
* Clotrimazole
* Tolnaftate

44
Q

otitis media Tx

A

Diet lifestyle
Botanical
HP:
Hydrotherapy
Lymphatic massage
Craniosacral
Osteopathic thoracic pump
Cervical spine manipulation
Antibiotics: Amoxicillin and Cefdinir
Antihistamines

45
Q

otitis media complications

A

Mastoiditis
Meningitis
Perforation of tympanic membrane
Cholesteatoma
Chronic suppurative otitis media

46
Q

Streptococcus Pneumonia otitis media

A

causes more severe sx

47
Q

Haemophilus Influenzae

A

will cause conjuncitvits and otitis media

48
Q

Chronic suppurative otitis media

A

chronic infection of the middle ear and mastoid (mastoiditis), a non-intact tympanic membrane (because of perforation or tympanostomy tube), and discharge (otorrhea) that has been refractory to treatment for more than 6 weeks

49
Q

Chronic suppurative otitis media cause

A

P. aeruginosa and S. aureus

50
Q

otitis media diagnosis

A

buldging of the tympanic membrane
cloudy tympanic membrane
impaired mobility of the tympanic membrane
red tympanic membrane

51
Q

Chronic Suppurative Otitis Media tx

A

oral antibitoics
treat zinc, slenium, calcium, Vit d, and iron defiecnies
aural toilet

52
Q

are antibitoics useful in treating otitis media?

A

no unless they are in children younger than two years of age with bilateral AOM (infection in both ears), and in children with both AOM and otorrhea

53
Q

Otitis Media with Effusion Tx

A

Diet
Supplementation: VIt C, Vit D, Vit A, fish oils, zinc picolinate, Beta carotene, EFAs, NAC, xylitol, Lumbrokinase and Nattokinase
Adenoidectomy
Botanical
* curcuma, inula, echinacea, larix, ligusticum,
* Verbascum, euphrasia, and glycyrrhiza
* Sambucus
* Salvia
* Bupleurum
HP: Calc carb, Medorrhinum, Silica, Lyc, Tub, Pulsatilla
Eustachian tube massage
Modified muncie technique
Auto-inflation: blowing balloon through with nostril
Educate and eliminate passive smoke (even 3rd hand)
No supine bottle feeding - Slant board at 25º for bottle feeding
Encourage breast-feeding
Surgery: Grommets
Antihistamines
Oral or intranasal steroids
Antibiotics

54
Q

patulous eustachian tube cause

A

May be caused by damage to the tensor veli palatini. The tissue of the Torus Tubarius can shrink due to weight loss (colitis/cancer) or high estrogen states

55
Q

Patulous Eustachian Tube sx

A

Fluctuating aural fullness
Tinnitus synchronous with respiration
Autophony

56
Q

Patulous Eustachian Tube PE

A

Abnormal mobility of the TM synchronous with breathing
Tympanometry and AC audiology show saw-toothed

57
Q

Patulous Eustachian Tube management/tx

A

Increasing hydration
Saline nasal drops
supersaturated potassium iodide
Surgery
Injections of gelfoam or autologous fat

58
Q

Hydrastis canadensis part used

A

root, rhizome, leaf

59
Q

Hydrastis canadensis action

A

Astringent, antimicrobial, bitter, mild stimulant

60
Q

Hydrastis canadensis indications

A

Diarrhea, Used as a tonic for boggy, ulcerated or cracked mucous membranes with mucopurulent discharge. Used topically for conjunctivitis, otitis externa, otitis media, pharyngitis, rhinitis, and sinusitis.

61
Q

Hydrastis canadensis CI

A

Neonates, pregnancy due to potential to simulate the uterus
Has to come in contact with the tissue to have its effects

62
Q

Echinacea spp part used

A

root, rhizome, whole plant

63
Q

Echinacea angustifolia actions

A

immunostimulator, anti-inflammatory, antimicrobial, stimulates leukocytes, inhibits hyaluronidase, enhances phagocytosis, stimulates fibroblasts, lymphagogue, vulnerary

64
Q

Echinacea angustifolia indications

A

Infection, sepsis, pharyngitis, prevention of upper respiratory infections, snake bites, ulcers

65
Q

Echinacea angustifolia CI

A

avoid prolonged use in inflammatory autoimmune diseases.

66
Q

Echinacea pallida part used

A

root, rhizome, whole plant

67
Q

Echinacea pallida actions

A

immunostimulator, anti-inflammatory, antimicrobial, stimulates leukocytes, inhibits hyaluronidase, enhances phagocytosis, stimulates fibroblasts, lymphagogue, vulnerary

68
Q

Echinacea pallida indications

A

Infection, sepsis, pharyngitis, prevention of upper respiratory infections, snake bites, ulcers, influenza

69
Q

Echinacea pallida CI

A

avoid prolonged use in inflammatory autoimmune diseases

70
Q

Echinacea purpurea part

A

root, rhizome, whole plant

71
Q

Echinacea purpurea actions

A

immunostimulator, anti-inflammatory, antimicrobial, stimulates leukocytes, inhibits hyaluronidase, enhances phagocytosis, stimulates fibroblasts, lymphagogue, vulnerary

72
Q

Echinacea purpurea indications

A

Infection, sepsis, pharyngitis, prevention of upper respiratory infections, snake bites, ulcers

73
Q

Echinacea purpurea CI

A

avoid prolonged use in inflammatory autoimmune diseases.

74
Q

Eupatorium perfoliatum part used

A

Aerial part in bud or flower

75
Q

Eupatorium perfoliatum actions

A

Stimulating diaphoretic, cholagogue and choleretic, diuretic, antispasmodic, laxative, emetic, imunostimulant, mucous membrane tonic, anti-inflammatory, cytotoxic (anticancer), bitter, febrifuge, peripheral circulatory stimulant, smooth muscle relaxant

76
Q

Eupatorium perfoliatum indications

A

Flu-like illnesses with pain that sets into the bone (boneset), dengue fever

77
Q

Eupatorium perfoliatum CI

A

Allergic hypersensitivity resulting in contact dermatitis, pregnancy, Diarrhea with to much

78
Q

Baptisia tinctora part

A

root

79
Q

Baptisia tinctora actions

A

Immunostimulant, antimicrobial, febrifuge

80
Q

Baptisia tinctora indications

A

infections, protracted fever with severely depressed vital force, ulceration of tissue.

81
Q

Baptisia tinctora CI

A

Large doses are toxic due to phenolic glycosides and
alkaloids – 30g induces signs of toxicity

82
Q

Ginkgo biloba parts

A

Leaf

83
Q

Ginkgo biloba actions

A

Increases blood flow to brain and periphery, antioxidant, anti-inflammatory, antithrombotic (antagonizes PAF), benefits cognition

84
Q

Ginkgo biloba indications

A

Cerebrovascular insufficiency
Impaired mental performance
Migraines
TInnitus, vertigo
Diabetic retinopathy
Macular degeneration
Intermittent claudication
Raynaud’s phenomenon
Diabetic ulcers
Varicose veins
Erectile dysfunction
Altitude sickness

85
Q

Ginkgo biloba CI

A

Pregnancy
Hemophilia
Use of blood thinning medications

86
Q

Sambucus nigra part

A

flower, berry

87
Q

Sambucus nigra actions

A

Influenza, colds, cough
Berries – antiviral, immunostimulant
Flowers – diaphoretic, diuretic, expectorant, nervine

88
Q

Sambucus nigra indications

A

influenza, colds, cough, herpes infection/recurrence

89
Q

Sambucus nigra CI

A

The unripe fruit, seeds, bark, leaves and root can cause diarrhea, nausea, vomiting, dizziness, tachycardia, and convulsions. Preparations of the berries should be cooked to avoid a cyananide-like toxicity.

90
Q

Usnea spp part

A

whole plant

91
Q

Usnea spp actions

A

Moderate astringent and hemostatic, strong antimicrobial, mild relaxant to smooth muscle, immunomodulating (stimulating), breaks down biofilms, synergistic potentiation of clarithromycin,

92
Q

Usnea spp indications

A

Microbial infections, weight loss,respiratory infections, cutaneous infections, urinary tract infections

93
Q

Usnea spp CI

A

Pregnancy
Cautions: May cause contact dermatitis., absorbs heavy metals or air pollution, so it should only be collected in pristine areas.
Toxicity: Purified usnic acid found to be hepatotoxic

94
Q

Verbascum thapsus part

A

leaf

95
Q

Verbascum thapsus actions

A

Expectorant, antimicrobial, demulcent, anodyne

96
Q

Verbascum thapsus indications

A

Dry, hacking coughs or wet, productive coughs (amphoteric), Soothing agent in Otitis media and other irritations of the tympanic membrane and EAC

EENT (7 decks)

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