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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
What dose type A indicated on tympanometry
normal
26
What dose type B indicated on tympanometry?
Fluid, early AOM, OME
27
What dose type c of tympanometry mean?
Eustachian Tube dysfunction
28
eosinophils otitis media presentation and population effected
highly viscous yellow effusion containing eosinophils bronchial asthma
29
infectious myringits cause
viral, bacterial, strep pneumonia
30
Infectious myringitis sx
Red painful ear Vesicles on Tympanic membrane Hearing loss
31
Infectious myringitis complications
Hearing loss
32
Herpes Zoster Oticus cause
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,
33
Herpes Zoster Oticus sx
Otalgia Facial palsy Pathognomonic vesicular rash of the pinna Hearing loss Vertigo
34
Mastoiditis cause
complication of untreated or poorly treated AOM
35
Mastoiditis sx
Pain behind the ear Fever
36
Mastoiditis PE
tender, red mastoid; spasm of ipsilateral SCM; bulging in canal, protrusion of auricle
37
Mastoiditis complication
Abscess into brain Meningitis Death
38
Mastoiditis tx
Antibiotics
39
otitis externa cause
changes in pH from acid to alkaline, bacterial infection, fungal, Pseudomonas aeruginosa, Staphylococcus aureus, Candida and aspergillus, dermatological conditions, humidity
40
otitis externa RF
mild trauma, frequent cleaning, alterations in the microbiome of the ear canal, swimming, Q-tip use
41
Otitis Externa sx
Tender swollen ear canal Auricle very tender to manipulation Pruritus Pain Aural fullness and conductive hearing loss One-sided or bilateral Insomnia
42
Otitis Externa PE
Red ear canal Exudate May be swollen shut Fever Pain with manipulation of auricle and tragus
43
Otitis Externa Tx
* 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
otitis media Tx
Diet lifestyle Botanical HP: Hydrotherapy Lymphatic massage Craniosacral Osteopathic thoracic pump Cervical spine manipulation Antibiotics: Amoxicillin and Cefdinir Antihistamines
45
otitis media complications
Mastoiditis Meningitis Perforation of tympanic membrane Cholesteatoma Chronic suppurative otitis media
46
Streptococcus Pneumonia otitis media
causes more severe sx
47
Haemophilus Influenzae
will cause conjuncitvits and otitis media
48
Chronic suppurative otitis media
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
Chronic suppurative otitis media cause
P. aeruginosa and S. aureus
50
otitis media diagnosis
buldging of the tympanic membrane cloudy tympanic membrane impaired mobility of the tympanic membrane red tympanic membrane
51
Chronic Suppurative Otitis Media tx
oral antibitoics treat zinc, slenium, calcium, Vit d, and iron defiecnies aural toilet
52
are antibitoics useful in treating otitis media?
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
Otitis Media with Effusion Tx
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
patulous eustachian tube cause
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
Patulous Eustachian Tube sx
Fluctuating aural fullness Tinnitus synchronous with respiration Autophony
56
Patulous Eustachian Tube PE
Abnormal mobility of the TM synchronous with breathing Tympanometry and AC audiology show saw-toothed
57
Patulous Eustachian Tube management/tx
Increasing hydration Saline nasal drops supersaturated potassium iodide Surgery Injections of gelfoam or autologous fat
58
Hydrastis canadensis part used
root, rhizome, leaf
59
Hydrastis canadensis action
Astringent, antimicrobial, bitter, mild stimulant
60
Hydrastis canadensis indications
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
Hydrastis canadensis CI
Neonates, pregnancy due to potential to simulate the uterus Has to come in contact with the tissue to have its effects
62
Echinacea spp part used
root, rhizome, whole plant
63
Echinacea angustifolia actions
immunostimulator, anti-inflammatory, antimicrobial, stimulates leukocytes, inhibits hyaluronidase, enhances phagocytosis, stimulates fibroblasts, lymphagogue, vulnerary
64
Echinacea angustifolia indications
Infection, sepsis, pharyngitis, prevention of upper respiratory infections, snake bites, ulcers
65
Echinacea angustifolia CI
avoid prolonged use in inflammatory autoimmune diseases.
66
Echinacea pallida part used
root, rhizome, whole plant
67
Echinacea pallida actions
immunostimulator, anti-inflammatory, antimicrobial, stimulates leukocytes, inhibits hyaluronidase, enhances phagocytosis, stimulates fibroblasts, lymphagogue, vulnerary
68
Echinacea pallida indications
Infection, sepsis, pharyngitis, prevention of upper respiratory infections, snake bites, ulcers, influenza
69
Echinacea pallida CI
avoid prolonged use in inflammatory autoimmune diseases
70
Echinacea purpurea part
root, rhizome, whole plant
71
Echinacea purpurea actions
immunostimulator, anti-inflammatory, antimicrobial, stimulates leukocytes, inhibits hyaluronidase, enhances phagocytosis, stimulates fibroblasts, lymphagogue, vulnerary
72
Echinacea purpurea indications
Infection, sepsis, pharyngitis, prevention of upper respiratory infections, snake bites, ulcers
73
Echinacea purpurea CI
avoid prolonged use in inflammatory autoimmune diseases.
74
Eupatorium perfoliatum part used
Aerial part in bud or flower
75
Eupatorium perfoliatum actions
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
Eupatorium perfoliatum indications
Flu-like illnesses with pain that sets into the bone (boneset), dengue fever
77
Eupatorium perfoliatum CI
Allergic hypersensitivity resulting in contact dermatitis, pregnancy, Diarrhea with to much
78
Baptisia tinctora part
root
79
Baptisia tinctora actions
Immunostimulant, antimicrobial, febrifuge
80
Baptisia tinctora indications
infections, protracted fever with severely depressed vital force, ulceration of tissue.
81
Baptisia tinctora CI
Large doses are toxic due to phenolic glycosides and alkaloids – 30g induces signs of toxicity
82
Ginkgo biloba parts
Leaf
83
Ginkgo biloba actions
Increases blood flow to brain and periphery, antioxidant, anti-inflammatory, antithrombotic (antagonizes PAF), benefits cognition
84
Ginkgo biloba indications
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
Ginkgo biloba CI
Pregnancy Hemophilia Use of blood thinning medications
86
Sambucus nigra part
flower, berry
87
Sambucus nigra actions
Influenza, colds, cough Berries – antiviral, immunostimulant Flowers – diaphoretic, diuretic, expectorant, nervine
88
Sambucus nigra indications
influenza, colds, cough, herpes infection/recurrence
89
Sambucus nigra CI
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
Usnea spp part
whole plant
91
Usnea spp actions
Moderate astringent and hemostatic, strong antimicrobial, mild relaxant to smooth muscle, immunomodulating (stimulating), breaks down biofilms, synergistic potentiation of clarithromycin,
92
Usnea spp indications
Microbial infections, weight loss,respiratory infections, cutaneous infections, urinary tract infections
93
Usnea spp CI
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
Verbascum thapsus part
leaf
95
Verbascum thapsus actions
Expectorant, antimicrobial, demulcent, anodyne
96
Verbascum thapsus indications
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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