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102 Cards in this Set
- Front
- Back
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which kind of light on an otoscope is brighter and lasts longer? |
LED |
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Which kind of head on an otoscope gives better illumination? |
round head |
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which kind of curette is better? |
wire better than plastic |
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preauricular pits are common and usually _____ but could be associated with brachio-oto-renal syndrome so ____ ____. |
-benign -check hearing |
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___, ____ and ___ ear are benign but? |
refer to ent early so they can be splinted |
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microtia is? |
small, absent or abnormally shaped ear |
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aural atresia is? |
absence or incomplete formation of EAC |
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Microtia and aural atresia are often associated with ___ and the ___ is affected. repair is done around age ___. |
-syndromes -hearing affected -repair at 7 y/o |
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_____ is an infection of skin and tissue that surrounds the cartilage of the ear and trauma is involved. |
perichondritis |
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what are the symptoms of perichondritis? |
-redness -swelling -pain -pus or other discharge (severe) -fever (severe) -deformation of the ear (severe) |
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what is the treatment for perichondritis? |
oral antibiotics (cipro, levaquin) -most common cause is pseudomonas |
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a hematoma is ____ in space between skin and cartlidge. Refer to ENT. Treatment is? |
-blood -treatment is drainage and compression dressing |
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____ ___ is permanent changes in the cartilaginous portion of the auricle caused by repeated trauma, resulting in the separation between the cartilage and perichondrium that interrupts the blood supply. |
cauliflower ear |
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what are some things used to soften cerumen? |
-colace -bicarb -mineral/olive oil -H2O2 and warm water |
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do not irrigate the ear if you don't know the ____ status. |
TM status -fluid into the middle ear is painful |
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____ is a bony growth of EAC also called surfers ear. It can affect hearing so refer. |
exocytosis |
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Otitis externa is also called? |
swimmers ear |
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otitis externa is an inflammation of the _____ |
EAC |
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what are the symtoms of otitis externa? |
-pain -itching -discharge -water exposure -sometimes hearing loss |
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what is the exam of otitis externa? |
-swollen canal -pain -redness/edema of EAC - moist debris in EAC |
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what is the treatment for otitis externa? |
-clean ear -topical abx and steroid (ciprodex) |
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what is the prevention of otitis externa? |
-keep ears dry (1/2 vinegar, 1/2 rubbing alcohol) |
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otomycosis is a ___ infection with ear fullness, super-itching, discharge and HL. |
fungal |
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on exam of otomycosis what will you see? |
-grey/white debris -spores -hyphae |
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what is the treatment for otomycosis? |
-5-10 days QID 2% acetic acid (white vinegar) -lotrimen or tinactin drops |
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___ ___ ___ is when OEspreads to the bones surrounding the EAC and base of the skull...can lead to meningitis, brain abscess. |
malignant otitis externa |
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malignant otitis externa symptoms are? |
-sx of OE -fever -trouble swallowing -facial weakness/asymmetry *REFER* redness around ear can indicate facial nerve involvement |
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regarding foreign bodies, do not irrigate what two things? |
-vegetable matter -battery |
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_____ and ____ are scarring and Ca deposits |
myringosclerosis and tympanosclerosis |
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myringosclerosis is ____ whereas tympanosclerosis may have ____. |
-asymptomatic -hearing loss |
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a TM perforation can be from? |
-acute OM -chronic OM -trauma |
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symtoms of a TM perf? |
-HL -drainage -pain |
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management of TM perf? |
-dry ear -hearing test -should close spontaneously in 2 weeks, if not refer *no steroid drops-prolongs healing -maybe abx (no gent, neo, toby) |
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when is the highest incidence of acute otitis media? when is the peak? |
-6mo-2yr -peak: 18 months |
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what is the job of the eustachian tube? |
-vent the middle ear and equalizes the pressure -connect from the nose to the back of the ear -in kids it is about 10 degree angle making it easier for fluid to get from nose to ear |
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strep pneumo is responsible for how many cases of AOM? |
-25-50% |
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what are the symptoms of AOM? |
-otalgia -ear tugging -irritability -fever -fullness -poor sleeping -non specific |
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what is the PE of AOM? |
-bright red TM -bulging TM -decreased or absent mobility of TM |
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what is the diagnostic criteria for AOM? |
effusion as evidence by bulging TM or decreased/absent motility AND symptoms of inflammation |
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what is the definition of recurrent OM? |
-3 in 6 months or -4 in 1 year |
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what is persistent OM with effusion? |
fluid present after 3 months of treatment |
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what is chronic suppartive OM |
chronic drainage |
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what are the 3 classes of people who get treated with abx for AOM? |
-children with AOM and severe symptoms (otalgia 48 hours+ or fever>102.2) -children with bilateral AOM even w/o severe symptoms -children with TM rupture |
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____ and ____ are not recommended because they can prolong the infection |
antihistamines and decongestants |
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what are complications of AOM? |
-extracranial: mastoiditis, bullous myringitis -cholesteatoma -hearing loss -vertigo -facial nerve paralysis -TM perf -myringo/tymano sclerosis -Intracranial: meningitis, abscess |
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what happens in mastoiditis? |
infection spreads to mastoid bone, aggressive abx therapy |
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what is bullous myringitis? |
-blister on the TM, painful, associated with AOM viral infection -treat pain aggressively |
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what is cholesteatoma? |
-skin cyst in the middle ear, can cause chronic ear damage, hearing loss, chronic retraction *refer* |
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what are PE tubes? |
pressure equalization tubes-act to aerate the middle ear |
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when do you think about PE tubes? |
-recurrent AOM (3 in 6 months, 4 in a year) -poor response to abx (persistent AOM) -chronic OME (>3 months) -complications of OM (mastoiditis) -chronic eustachian tube dyfunction -craniofacial anomalies |
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how long do PE tubes stay in? |
6-24 months -if AOM, there will be drainage through the tubes -use earplugs in non-chlorine water -ototopicals first line for AOM |
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___ ____ __ is sound not efficiently conducted through the outer ear canal, TM and or middle ear (cerumen, FB, TM perf, effusion, otosclerosis) |
conductive hearing loss |
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___ ___ ___ is damage to the cochlea or nerve pathways-typically permanent (genetic, inner ear abnormality, cause usually unknown) |
sensorineural hearing loss |
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when to refer to audiology/ENT |
-foreign body -chronic otitis externa -persistent OM -recurrent AOM -Chronic OME -chronic perf -cholesteatoma -hearing loss |
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what are the types of hearing aids? |
-behind the ear (BTE)- conduction or sensorineural -Bone anchored (BAHA)- conductive, surgical -Cochlear Implant (CI)- sensorinerual, extensive workup |
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which sinuses are present at birth but very small? |
ethmoid and maxillary |
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when does the sphenoid sinus start to develop |
around age 2 |
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when does the frontal start to develop? |
around 4 (visible on xray by 7) |
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what is the function of the turbinates? |
warm clean and humidify air |
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what are the S&S of a URI? |
-snotty nose (green, yellow, clear) -nasal obstruction -ST -fever up to 102 -HA -cough |
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how long does a URI last? |
2-14 days |
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how many URIs do children average? Toddlers? |
children = 6-8/year toddlers = 8-10/year |
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what can you do for a URI? |
afrin short term 1-3 days -saline rinse (no antihistamines or decongestants) |
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Pediatric Sinusitis Acute Sinusitis= Subacute sinusitis= Chronic sinusitis= Recurrent sinusitis= |
Acute Sinusitis= 10-14 days Subacute sinusitis= 30-90 days Chronic sinusitis= >12 weeks Recurrent sinusitis= 4-6/year |
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diagnosing sinusitus? |
1. persistent illness (nasal discharge or daytime cough or both lasting more than 10 days without improvement or 2. worsening course (sx worsen after initial improvement) or 3. sever onset (fever 102.2) and purulent nasal discharge for at least 3 consecutive days |
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do you get any imaging for acute sinusitis? |
not unless you suspect orbital or CNS involvement |
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what is the treatment for sinusitis? |
abx (amox, augmentin) or observe for 3 more days |
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how do you manage chronic sinusitis? |
-saline rinse TID -nasal steroids -testing immunity -sweat Cl for CF -extended abx (4 weeks) -allergy eval -PPI or H2 blocker |
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what are the complications of sinusitis? |
-meningitis -subdural/epidural abscess -orbital celulitis -brain abscess -osteomyelitis(bone infection) -potts' puffy tumor -oroantral fistual -blood clots |
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what are the S&S of allergic rhinitis (most common chronic condition) |
-clear rhinorrhea -nasal congestion -watery eyes -sneezing -allergic shiners -crease and salute -pale gray boggy turbinates |
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to treat allergic rhinitis -avoid ____ -medications: -immunotherapy: |
-avoid allergens -medications: zyrtec, allegra, claritin, singulair, flonase -immunotherapy: refer to allergist |
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______ or nosebleeds are usually benign and common between ages 2-10 |
epistaxis |
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what makes people have nosebleeds and how do you stop them? |
-kesselbach's plexus anterior septum -hold pressure for 10 mins and tilt head forward |
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how do you prevent nosebleeds? |
-keep mucosa moist -saline TID, Vaseline BID -no nose picking |
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what are the "bad" things that can cause nosebleeds? |
-HHT (hereditary hemorrhagic telangestasia) -Nsal angofibroma (teenage boys) |
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____ ___ is the congenital narrowing or blockage of the back of the nasal airway. It is usually unilateral and can involve bone only or cartilege or both |
choanal atresia -cyanosis relieved by crying *refer to ENT* |
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for nasal FB always refer ASAP for what? |
-button battery (can generate local current and cause extensive damage) |
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what are the S&S of tonsilitis? |
-fever -sore throat -redder than normal tonsils -white or yellow exudate -voice change due to swelling -dysphagia -swollen nodes -bad breath |
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"strep throat" most common cause is? |
group A beta-hemolytic strep -red tonsils- |
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what are common viruses that cause tonsilitis? |
-EBV -adenovirus -coxsackie -para flu -enterovirus -herpes -RSV *white exudate* |
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you diagnose strep throat (bacterial pharyngitis) by ____ ___ ___. and you treat most commonly with? |
-rapid strep test -treat with amoxicillin |
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what are the complications of strep throat? |
-acute rheumatic fever -poststreptococcal glomerulonephritis |
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___ ___ causes a sore throat and deviated uvula, send to ED |
peritonsillar abscess (PTA) |
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what are the indications for tonsillectomy/adenoidectomy? (T and A) |
-recurrent tonsilitis -OSA |
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what is recurrent tonsilitis defined as? |
-7 cases in 1 year -5 cases a year for 2 years -3 cases a year for 3 years |
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____ ___ ___ is characterized by snoring, pauses/gasping at night, frequent waking, sleep walking or talking, daytime sleepiness. |
obstructive sleep apnea
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what meds can be tried to reduce symptoms of OSA? |
-singulair and nasal steroid (flonase) |
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what is the most common craniofacial anomaly |
cleft lip and palate |
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____ is a high pitched wheezing sound produced by turbulent airflow of upper airway? |
stridor |
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Location of obstruction and timing of stridor: inspiratory: expiratory: biphasic: |
inspiratory: at or above vocal cords expiratory: trachea and bronchi biphasic: subglottic |
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what is the most common cause of inspiratory stridor that worsens with activity or URI. Resolves by 12 months, refer if more than milder |
laryngomalacia |
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_______ or croup is the most common cause of stridor in __ mo- _ years. treat with? |
-laryngotracheobronchitis -6 mo- 5 years -treat with steroid |
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____ is potentially life threatening. Symptoms are tachypnic, drooling, anxiety and stridor. Send to ED |
epiglotitis |
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if hoarseness is not from vocal abuse, refer to ENT because it could be vocal cord ____ or recurrent respiratory papilloma. |
vocal cord nodules |
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_____ is the most common neck mass in children. treat with abx and recheck in 2 weeks |
lymphadenitis |
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thyroglossal duct cyst is midline at the ___ bone. Can be asymptomatic or can be infected. refer for excision. |
hyoid |
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___ ___ ___ is lateral, congenital and can drain. refer. |
branchial cleft cyst |
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how can you treat a hemangioma? |
-time -steroids -lasers -surgery -BB *refer to ENT or derm |
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___ ____ are made up of dilated lymphatic channels, refer to ENT or derm |
lymphatic malformations (dermoid cyst) |
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for tongue tip and lip tie refer if? |
-baby has poor latch, mom has pain or long ineffective feeds |
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for maxilofacial traumas: prompt assessment and management following the ____. Look for S&S of fractures. Refer to ED, ENT or facial plastics. |
ABCs |
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surgical intervention for a nasal fracture has to be within __-__ days. A septal hematoma has to be seen same day! |
7-10 days |
