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36 Cards in this Set

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causes, Sx, Dx of otitis externa

bacterial, fungal, allergic;


pseudomonas, proteus, aspergillus


swimming, trauma (Qtip), contact dermatitis



Sx: pain, discharge; +/- itching, hearing loss



Dx: culture


(only if severe, immunocompromised, refractory)

Tx for otitis externa

clean canal; treat inflm/infx;


control pain; avoid causes (e.g. Qtip)



abx​ drops (quinolone, aminoglycoside)


steroid drops,


acetic acid drops

Sx acute otitis media

otalgia, hearing loss, dizziness, fever (rare)

Tx for acute otitis media

antibiotics (amoxicillin, cephalosporin)


BUT caution w/ TM perforation



complications: spread (mastoiditis), perforation, hearing loss;


could be life-threatening

pathogens: otitis media

S. pneumonia,


H. influenza,


S. aureus,


M. catarrhalis

chronic otitis media

chronic serous/purulent drainage


w/ TM perforation

choleseatoma

keratinizing squamous epithelial


growth in middle ear and/or mastoid process



S/Sx: discharge, hearing loss



Tx: surgery

benign paroxysmal position vertigo

predictable vertigo,


in certain positions;



Dx: Dix-halpike maneuver



Tx: Epley maneuver


(resets position of otoliths)

vestibular neuritis labyrinthitis

viral or post-viral;


affects vestibular portion of CN 8;



severe, persistent vertigo;


N/V (stimulation of vagus n);


gait instability

Ramsay Hunt Syndrome

aka herpes zoster oticus;



acute vertigo, hearing loss,


facial paralysis, ear pain,


vesicules in auditory canal

Meniere disease

excess endolymphatic fluid pressure;



spontaneous vertigo, tinnitus, hearing loss, ear fullness

acoustic neuroma

from vestibular shwannoma;


unilateral hearing loss or tinnitus



can put pressure on facial n.

common causes of anterior epistaxis

Kiesselbach's plexus;



trauma, irritation, dryness, hyperemia (infx, allergy), foreign body



others: meds, bleeding disorder

possible causes of posterior epistaxis

could suggest carotid aneurysm, tumor



others: meds, bleeding disorder

Tx of epistaxis

pressure (10-15 min), packing;


cautery (silver nitrate, electrical);


oxymetazoline (Afrin nasal spray);


bend forward, cotton w/ antiseptic;


cold compress



if post = packing, surg., embolization



consider lowering BP (if contributing)

S/Sx of allergic rhinitis

sneezing, rhinorrhea, nasal obstruction;


itchy eyes/nose, post-nasal drip;


cough, fatigue, can't concentrate

Tx of allergic rhinitis

antihistamine,


steroids,


avoid exposure,


allergy testing

S/Sx of acute sinusitis

mostly viral (even bacterial is self-limiting),



rhinorrhea, HA, dizziness,


nasal drainage, fatigue

allergic rhinitis vs. acute sinusitis?

rhinitis: sneezing, itching, cough



sinusitis: HA, dizziness

Tx acute sinusitis

spontaneous resolution within 10d



symptomatic Tx: NSAIDs, saline irrigation, topical glucocorticoids, topical/oral decongestants, antihistamines, mucolytics, oral steroids, surgery



abx: augmentin, Z-pack, Bactrim


If acute sinusitis shows no improvement..

consider CAT scan, cultures

Refer a pt w/ acute sinusitis if...

high fever,


visual disturbance,


altered mental stats,


severe HA,


meningeal sinus

S/Sx of acute pharyngitis

sore throat, exudate, cervical adenitis,


fever, enlarged tonsils

Dx acute pharyngitis

rapid strep antigen,


throat culture

Tx acute pharyngitis

mostly symptomatic,



abx if it's Group A Strep

S/Sx of epiglotitis

stridor, hoarseness,


pharyngitis, fever, neck tenderness,


cough, difficulty swallowing,


drooling



is an emergency

What is a peritonsillar abscess?


S/Sx?

collection of pus between capsule of palatine tonsil & pharyngeal muscles



severe sore throat, fever, muffled voice, saliva pooling, trismus, very swollen & fluctuant tonsil, deviated uvula, bulging of post. soft palate, erythema, exudate

Tx for peritonsillar abscess

surgical drainage

causes of chronic laryngitis

GERD,


chronic sinusitis,


vocal strain,


alcohol,


smoking



(acute causes = viral, bacterial)

S/Sx of laryngitis

hoarseness, cough

Tx for laryngitis

voice rest,


Tx underlying cause



rarely abx,


sometimes steroid

What is sialadinitis? S/Sx?

inflammation of salivary glands;


from dehydration, poor oral hygeine



pain, swelling, redness,


fever, purulent exudate

Tx for sialadinitis

hydration, analgesics, antibiotics

causes of parotitis?

viral or bacterial


(e.g. mumps, Epstein-Barr, CMV, flu, staph aureus, mixed oral flora)

lab test for parotitis?

elevated amylase, but not lipase

When is referral appropriate in looking for an oral malignancy?

esp. if smoker, heavy drinker, 50+ y/o:



oral ulcer/mass for >3 wks


pain >4 wks


persistent sore throat


tooth mobility


persistent hoarseness