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EENT > Test 5 > Flashcards

Test 5 Flashcards

1
Q

preventing the common

A

good hygiene and preventing transmission
- mask
- don’t need antibacterial soap
healthy diet
lactobacillus: reduce respiratory infections
breastfeeding
low stress
active lifestyle
echinacea and vit C: vit c is good for children, cross-contry skiers or out in cold
Vit D
Fish oil
DHA: associated with delayed onset and reduced incidence of URIs and common allergic diseases up to 3 years of age
hydrotherapy: sauna, ending cold might not be helpful

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2
Q

Non-Allergic Rhinitis with Eosinophil Syndrome/Perennial Non-Allergic Rhinitis TX

A

Address co-morbid conditions: fibromyalgia, CFS, IBS
Assess thyroid status
Trial with graded aerobic exercise, cognitive behavioral therapy and depression protocols (B-vitamins, Omega-3 fatty acids, 5-http, St John’s wort)
Consider functional adrenal testing (ASI) and treat accordingly
Treat dry nares with saline sprays, Vitamin E gels.
Capsaicin is an option for non-allergic rhinitis, it appears to have beneficial effects on overall nasal symptoms

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3
Q

Rhinosinusitis TX

A
  • Nasal vasoconstrictors - Neo-Synephrine
  • Antibiotics
  • Surgical drainage in chronic cases or acute abscess
  • Prevention - treat hay fever & viral URIs sufficiently
  • Maintain open drainage of sinus ostia, thin secretions with hydration
  • Decrease inflammation
  • Improve tissue integrity
  • Address causative factors, known risk factors
  • Keep bowels moving, use bitter bowel alterative herbs if needed
  • Diet: Same as general diet for URI, add garlic (Allium sativum) Horse Radish (Armoracia rusticana) and Ginger (Zingiber officinale) ad libitum as seasoning for immune support, mucolytic and anti-inflammatory effects
  • botanicals: Achillea, Amoracea, euphrasia or Amenopsis (Yerba mansa), Hydtastis, baptisia (sicker), echinacea (sicker), Gentian root, Primula flower, Sorrel herb, Elder flower
  • supplements: Vit A, beta carotene, Vit C, Vit E, Zinc, bromelain
  • Short wave diathermy
  • bilateral nasal specific: chronic more
  • hydrotherapy
  • Acupuncture, Chinese herbs, acupressure
  • Antibiotics: not recommended
  • HP: silica, mercurius, nux vomica, kali bichromium, arsenicum album
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4
Q

Rhinosinusitis TX chronic

A
  • anti-inflammatory diet
  • treat inhalant allergy
  • improve digestion: Bieler’s broth
  • probiotics
  • Vitamins C and A
  • Selenium
  • Vitamin E
  • Myer’s cocktail
  • N-Acetyl Cysteine
  • Bioflavonoids
  • Beta carotene
  • Vit B 5 (Pantothenic acid)
  • Echinacea, Larix
  • Glycyrrhiza, Astragalus, Lomatium isolate
  • Hoxey-like formula, thymus extract
  • Vitamin D: 25OHD levels are inversely associated with ARS
  • Stress reduction - especially breathing exercises
  • nasal specifics
  • craniosacral
  • nasal lavage
  • humming
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5
Q

indication for urgent referral with rhinosinusitis

A
  • high fevers and severe headache warrant immediate evaluation and probable imaging.
  • Abnormal vision (diplopia, blindness)
  • Change in mental status
  • Periorbital edema
  • Cranial Nerve abnormalities (CNs 2,3,4,6)
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6
Q

Fungal sinusitis TX

A

Nystatin “sniff”
Sprayed Manuka honey 50/50 mixture of honey-saline solution once a day at night for 30 days

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7
Q

Anterior Epistaxis population

A

children and young adults

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8
Q

Anterior epistaxis RF

A

< winter due to sudden temperature changes and exposure to dry air
increased URI (nose blowing)
trauma
picking

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9
Q

Anterior epistaxis sx

A

nose bleeding

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10
Q

Anterior epistaxis tx

A

vit C
bioflavonoids
HP: phosphorus

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11
Q

Posterior epistaxis pop

A

older adults, men, fifth decade of life with HTN and arteriolosclerosis

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12
Q

Posterior epistaxis pop

A

older adults, men, fifth decade of life with HTN and arteriolosclerosis

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13
Q

Posterior epistaxis RF

A

Hypertension (prolongs bleeding) coagulopathies, Warfarin Sodium, or ASA > 325 mg/day, liver disease, alcoholism

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14
Q

Posterior epistaxis PE

A

Assess for hemodynamic stability, look for bleeding site

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15
Q

Posterior epistaxis TX

A

refer to EENT and ED

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16
Q

Vestibulitis cause

A

Bacterial infection at the nasal vestibule. Usually Staph Aureus

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17
Q

Vestibulitis tx

A

Treat with warm compresses, poultice of hydrastis, Commiphora and Arctium powdered herb
topical or an antibiotic such as Mupirocin (Bactroban)

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18
Q

Uncomplicated Acute Pharyngitis pop

A

5-15

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19
Q

Uncomplicated Acute Pharyngitis cause

A

Group A b-hemolytic Streptococcus pyogenes

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20
Q

Uncomplicated Acute Pharyngitis PE

A
  • heart
  • lung
  • eyes
  • ears
  • head
  • throat
  • skin
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21
Q

Uncomplicated Acute Pharyngitis Dx

A

centor, rapid antigen detection test, throat cultures if RADT is negative, ASO titer

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22
Q

Uncomplicated Acute Pharyngitis complication

A

Scarlet/rheumatic fever
peritonsillar abscess
retropharyngeal abscess
glomerular nephritis
guttate psoriasis
erythema nodosum
PANDAS
acute rheumatic fever

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23
Q

Uncomplicated Acute Pharyngitis TX

A

antibiotics, oral steroids

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24
Q

Strep Carrier

A

those that have strep as their normal flora
positive culture, negative ASO titer

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25
Q

Pneumonia pop

A

school-aged children and college students

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26
Q

Pneumonia cause

A

Mycoplasma pneumoniae

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27
Q

Pneumonia sx

A

cough
pharyngitis
rhinorrhea
ear pain

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28
Q

Pneumonia dx

A

multiplex PCR
xray

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29
Q

Hand, Foot, Mouth Disease pop

A

children

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30
Q

Hand, Foot, Mouth Disease cause

A

Coxsackie virus

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31
Q

Hand, Foot, Mouth Disease sx

A

Painful lesions on tongue, mouth, possible hands and feet; self-limiting, but very contagious

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32
Q

Aphthous Ulcers cause

A

autoimmune condition

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33
Q

Aphthous Ulcers sx

A

multiple painful oral ulcers
Small round or oval white ulcer 1-5 mm in size surrounded by halo of reddened mucosa
Single or multiple ulcers may coalesce.
May form on any of oral mucus membranes.
Sore throat can be caused when ulcer is in posterior 1/3rd of the tongue, innervated by the glossopharyngeal nerve (CN 9)
Resolves spontaneously in 1-2 weeks.

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34
Q

Oral Candidiasis cause

A

Candidiasis
HIV
diabetes

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35
Q

Oral Candidiasis RF

A

inhaled corticosteroids

36
Q

Mononucleosis pop

A

teenagers

37
Q

Mononucleosis cause

A

Epstein Bar Virus (EBV) infection

38
Q

Mononucleosis RF

A

Sexual activity and kissing

39
Q

Mononucleosis sx

A

sore throat persisting for > week
Posterior cervical and discreet tender nodes may have adenopathy in groin and axilla
substantial functional impairment with myalgia
tonsil exudate
petechiae on back of pharynx.
hepatomegaly
jaundice
splenomegaly
fatigue

40
Q

Mononucleosis work up

A

abdominal exam
peripheral smear
monospot positive
mild elevated transaminase levels

41
Q

Mononucleosis complication

A

severe airway obstruction
splenic rupture
hemolytic anemia
thrombocytopenia
malignancy: Burkitt’s lymphoma, nasopharyngeal carcinoma and B cell lymphomas.

42
Q

Necrotizing Gingivitis cause

A

Bacterial infection

43
Q

Necrotizing Gingivitis sx

A

papillary gingiva are gray; fever and very foul breath; cervical nodes enlarged

44
Q

Necrotizing Gingivitis RF

A

smoking, poor hygiene; teenagers most susceptible

45
Q

Non-Strep Pharyngitis cause

A

viral or other bacteria

46
Q

Non-Strep Pharyngitis TX

A

botanicals
- echinacea
- andrographis paniculata
- glycyrrhiza
- liguticum
- usnea
- ginger
- propolis
- achillea
- garlic
- thyme oil
- myrrh
- sage:
- stillingia
- mycoshield

Physical medicine
- saline gargles
- warming throat compress
- lymphatic massage
- carrot ginger poultices
- cervical manipulation

HP
- Positive study for homeopathy and viral pharyngitis RCT N=30.

47
Q

Gonococcal Pharyngitis Cause

A

Neisseria gonorrhoeae

48
Q

Gonococcal Pharyngitis sx

A
  • Sore throat
  • Difficulty swallowing
  • Redness and swelling in the back of the throat
  • White or yellow pus-like discharge from the tonsils
  • Swollen lymph nodes in the neck
49
Q

Gonococcal Pharyngitis Dx

A

swab of the throat, DNA probe

50
Q

Gonococcal Pharyngitis TX

A

antibiotics

51
Q

Peritonsillar abscess pop

A

young adults

52
Q

Peritonsillar abscess cause

A

bacterial infection, caused by untreated tonsillitis or other throat infections.

Streptococcus G and Staph A, respiratory anaerobes (including Fusobacteria, Prevotella, and Veillonella species) often polymicrobial

53
Q

Peritonsillar abscess RF

A

acute tonsillitis
pharyngitis
periodontal disease
diabetes
smoking
NSAIDs

54
Q

Peritonsillar abscess SX

A

sore throat
difficulty swallowing
fever
Unilaterally enlarged tonsil, displaced medially and inferiorly, with contralateral displaced uvula
drooling
Tender cervical nodes on ipsilateral side
Trismus - Spasm of facial and jaw muscles and unable to open mouth fully
muffled (hot potato) voice
may also experience ear pain and difficulty opening their mouth fully.
In severe cases, the infection can spread to other parts of the body and cause serious complications.

55
Q

Peritonsillar abscess DX

A

CT scans or ultrasounds
needle aspiration

56
Q

Peritonsillar abscess TX

A

draining the abscess through a small incision
antibiotics

57
Q

Peritonsillar abscess complications

A
  • death
  • Airway obstruction
  • Aspiration pneumonia if the abscess ruptures into the airway
  • Septicemia
  • Lemierre Syndrome (internal jugular vein thrombophlebitis and sepsis)
  • Carotid artery rupture
  • Mediastinitis
  • Necrotizing fasciitis
  • rheumatic fever, heart disease, glomerulonephritis
58
Q

Peritonsillar abscess prevention

A

practicing good oral hygiene
avoiding smoking
excessive alcohol consumption

59
Q

Diphtheria cause

A

Corynebacterium diphtheria

60
Q

Diphtheria sx

A

Tip-off is blue white membrane adhered to posterior pharynx
cardiac depression

61
Q

Diphtheria TX

A

antitoxin
In severe cases, hospitalization may be necessary for respiratory support and other treatments.

62
Q

Retropharyngeal abscess cause

A

bacterial infections due to
- Dental infections
- Upper respiratory infections
- Pharyngitis
- Tonsillitis
- Ear infections

63
Q

Retropharyngeal abscess SX

A
  • Sore throat
  • Painful and difficult swallowing
  • Difficulty breathing
  • Swollen lymph nodes in the neck
  • Fever
  • Headache
  • Neck stiffness
  • Drooling in children
  • hot potato voice
64
Q

Retropharyngeal abscess dx

A

CT scan or an MRI

65
Q

Retropharyngeal abscess

A

draining the abscess and administering antibiotics to treat the infection
ED

66
Q

Ludwig’s Angina cause

A

bacterial infection, most commonly arising from dental infections or dental procedures,

67
Q

Ludwig’s Angina SX

A

fever, difficulty swallowing, drooling, swelling of the neck and mouth, and difficulty breathing.
spread rapidly to the surrounding tissues, including the tongue, throat, and chest

68
Q

Ludwig’s Angina complication

A

airway obstruction and sepsis

69
Q

Ludwig’s Angina TX

A

administration of antibiotics
surgical drainage
airway management

70
Q

Necrotizing Fascitis cause

A

bacterial infection that can destroy skin, fat, and the tissue covering the muscles within a very short amount of time enter the body through surgical wounds, puncture wounds, and insect bites.

71
Q

Necrotizing Fascitis RF

A

diabetes or HIV

72
Q

Necrotizing Fascitis SX

A

intense pain and swelling, fever, fatigue, and vomiting.
The affected area may also appear red, and the skin may feel warm or hot to the touch.
As the infection progresses, blisters or ulcers may form, and the skin may turn black and die.

73
Q

Necrotizing Fascitis TX

A

antibiotics and surgery
amputation

74
Q

Epiglottitis pop

A

2-5 years old

75
Q

Epiglottitis cause

A

Haemophilus influenzae type B.
bacteria, viruses, or fungi.

76
Q

Epiglottitis sx

A
  • Difficulty breathing
  • Painful swallowing
  • High fever
  • Drooling
  • Stridor
  • Trismus - painful/difficulty to open mouth and swallow, excess drooling
77
Q

Epiglottitis dx

A

x-ray with thumb print sign

78
Q

Epiglottitis TX

A

hospitalization

79
Q

Chronic Sore Throat DDX

A

EBV
Fusobacterium necrophorum
Reflux pharyngitis
Post-nasal drip
Toxins
Improper vocal cord hygiene, vocal abuse
Chronic cough
Vascular
nasopharyngeal cancer
oropharyngeal cancer
laryngeal cancer
upper esophageal carcinomas
tumor under the sternum

80
Q

Chronic sore throat TX

A
  • The only effective means of management of the chronically sore throat is to direct therapy at the underlying cause.
  • Reflux pharyngitis - treatment the same as reflux esophagitis
  • Treat allergic rhinitis or sinusitis
  • Environmental controls – cleaning
  • Improve hydration - especially in winter
  • Vitamin A can improve epithelial integrity.
  • Probiotics can help prevent recurrent infectious pharyngitis.
81
Q

Kawasaki disease pop

A

children

82
Q

Kawasaki disease SX

A

widespread inflammation of medium- and small-sized blood vessels
bilateral nonexudative conjunctivitis
erythema of the lips and oral mucosa
rash
extremity change
lymphadenopathy
develop after a brief nonspecific prodrome of respiratory or gastrointestinal symptoms

83
Q

Kawasaki disease DX

A

The diagnosis of Kawasaki disease requires the presence of fever lasting at least five days without any other explanation combined with at least four of the five following criteria:
- Bilateral bulbar conjunctival injection
- Oral mucous membrane changes, including injected or fissured lips, injected pharynx, or strawberry tongue
- Peripheral extremity changes, including erythema of palms or soles, edema of hands or feet (acute phase),
- Polymorphous rash
- Cervical lymphadenopathy (at least one lymph node >1.5 cm in diameter)

84
Q

Kawasaki disease TX

A

immunoglobulin treatment

85
Q

Hoarseness

A

EENT (7 decks)

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