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40 Cards in this Set

  • Front
  • Back
Conductive Hearing Loss
1. Describe
2. Causes
3. Test
1. impaired transmission in outer/middle ear
2. AOM, MEE, obstruction
3. Weber test (vertex of head), sound to affected ear, Rinne (air/bone) = bone > air
Sensorineural Hearing Loss
1. Describe
2. Causes
3. Tests
1. disruption to nerves, 1/5 by 55yo
2. neural degeneration, congenital, noise-induced
3. Weber = sound to good ear, Rinse = nl (AC > BC)
1. Define
2. SNHL or CHL
3. MC in who
4. type of frequency lost
1. gradual hearing loss
2. MCC of SNHL
3. MC in men
4. high frequency
2 antibiotic agents that cause hearing loss
*aminoglycosides (tobramycin, gentamycin, streptomycin)
Vestibular Neuronitis
1. Cause
2. Sx
3. Tx
1. dt viral illness
2. dizzy AND nl hearing
3. rehydrate, meds (meclizine, benedryl, prednisone), better in 1 month
Acute Labyrinthitis
1. Describe
2. Cause
3. Sx
4. Tx
1. inflammation of labyrinth (inner ear (vestibule, semi-circular canals, cochlea))
2. MCC = infxn
3. dizzy, vertigo, AND hearing loss
4. refer, rehydrate, Abx/Antivirals, high dose CS, meds (meclizine, bendryl, diazepam),audiogram @ 1st visit
Meniere's Dz
1. Describe
2. Cause
3. Sx
4. Tx
1. recurrent/progressive HL (starts unilateral --> bilateral)
2. unknown, distension of endolymphatic compartment of inner ear
3. HL + tinnitus/vertigo/N/V, aural fullness, recurrent/progressive
4. rehydrate, diuretic, ear meds (meclizine, benedryl, prednisone), surgical intervention
Benign Paroxysmal Positional Vertigo (BPPV)
1. Describe
2. Cause
3. Sx
4. Tx
1. spinning
2. dt otoliths in semicircular canals
3. dizzy, nystagmus (rotary), lasts days-weeks, reproduced w/ Dix-Hallpike maneuver
4. Epley maneuver
Acoustic Neuroma
1. Describe
2. Sx
3. tx
1. benign tumor of 8th CN (schwanooma)
2. insidious SNHL, tinnitus, vertigo, dx = CT/MRI
3. surgery
1. Descibe
2 Recurrent?
3. Cause
1. infxn of middle ear
2. >/= 3 in 6mo,>/= 4 in 1 yr
3. H. flu, M. cat, S. pneumo
AOM Risk Factors
*deformity (ET short, ET abnl, facial)
*daycare *allergies
*<6mo & no breastfed
*1st infxn <1yr *male
*smoke *low SES
Signs & Sx of AOM
*otalgia, URI sx, Fever, fullness, HL, pull on ear, irritable
*decreased mobility of TM, otorrhea w/ perf
Early vs. late signs of AOM
*Early: dull eardrum, clear fluid, increased vascularization
*Late: bulge/cloudy erythematous TM, bubbles, purulence
Tx of AOM
*APAP or ibuprfen for pain
*Watchful waiting (NOT for <6mo, 6-2yo w/ certian dx, 6- up w/ severe illness)
*Amoxicillin (Amoxil), extended spectrum PCN, 80-90mg/kg divided BID-TID x7-10d
*improve w/in 72 hrs
*PE tubes if recurrent
Otitis Media w/ Effusion
1. Describe
2. Sx
1. fluid in middle ear
2. otalgia, HL, NO FEVER
Chronic Otitis Media
1. description
2. S/S
3. Tx
1. permanent alteration of middle ear surfaces
2. HL, drainage/odor, F
3. topical Abx
Otitis Externa (Swimmer's Ear)
1. Describe
2. MCC
3. S/S
4. Tx
1. infxn of external ear/auditory canal
2. P. aeruginosa
3. otalgia, F, HL, ear pain w/ pinna manipulation
4. keep dry, bacterial cause = Abx drops, CS sol'n
1. Cause
2. S/S
3. Tx
1. complication of AOM, inflammation of mastoid air cells
2. tender, HA, otalgia, F
3. Admit, temporal bone CT, IV Abx
Bacterial Pharyngitis (Strep Throat)
1. Descibe
2 Cause
3. MC in who
1. highly contagious infxn
3. MC in 5-15yo
Bacterial Pharyngitis (Strep Throat)
1. S/S
2. Centor Criteria
1. acute onset, ST, dysphagia, F, exudates, malaise, erythematous, tender anterior cervical nodes
2. NEED ALL 4: fever, tender anterior cervical nodes, exudates, no cough
Bacterial Pharyngitis (Strep Throat)
1. Dx
2. Tx
1. rapid strep, incresed WBC
2. Supportive (analgesic, rest, fluid); PCN
-Adults: 500mg BID x 10d
-Child: 250mg BID x 10d; not contagious after 24 hrs, change toothbrush
Viral Pharyngitis
1 Description
2. S/S
3. Dx
4. Tx
1. MCC of ST, insidious onset, coryza, lacks exudates
2. ST, cough, HA, enlarged tonsils
3. r/o strep, monospot
4. supportive, salt H2O, APAP
Peritonsillar Abscess
1. Describe
2. S/S
3. Tx
1. pus b/t anterior tonsillar pillars & superior pharyngeal constrictor muscle
2. trismus, "hot potato voice," drool, deviated soft palate/uvula
3. aspiration or I&D, Abx, tonseillectomy if indicated, IV rehydrate & pain
1. Describe
2. Who should you ALWAYS refer to ENT?
3. tx
1. MCC of hoarseness, usu dt virus
2. smokers
3. supportive, voice rest, refer if >2wks/smoke/no cause/pain/neck mass/chronic EtOH
Aphthous Ulcers
1. Describe
2. MC
3. Tx
1. canker sores
2. kids 10-19, F > M
3. topical steroids, anti-inflammatories, good hygiene
1. Describe
2. Cause
3. MC
1. life-threatening infection
2. H. flu, strep, pneumococcous, staph
3. MC kids 2-6yo
1. Signs & symptoms
*abrupt onset *fever --> stridor
*4D's: drool, dysphagia, dysphonia, distress (resp)
How is Epiglottitis different than Croup (laryngotracheobronchitis)
E = muffled voice
E = minimal cough
E = no URTI hx
C = hoarse voice
C = barking croup
C = + hx of URTI
1. Dx
2. Tx
1. don't culture/examine throat, never leave alone, leukocytosis + left shift, THUMBPRINT sign on lateral xr
2. maintain airway, CS, Abx IV (Cefotaxime/ceftriaxone), tx household contacts w/ rifampin....HIB vaccine
1. also known as
2. describe
3. MC
1. croup or LTB
2. viral cause (fall/winter), MCC of upper airway obstruction/stridor in kids
3. MC in 6mo -3yo
1. s/s
2. dx
3. tx
1. URI, barky cough, stridor (at night), F, nasal flare, no drool
2. xr = steeple sign
3. admit, humidification, CS
1. Causes
2. Difference b/t acute, subacute, chronic
1. Virus, H. flu, M. cat, S. pneumo
2. Acute <4 wks, subacute 4-12 wks, chronic >12wks
1. Risk Factors
2. S/S
1. URI, allergic rhinitis, asthma, smoking, dental procedures, anatomical abnl, FB
2. HA, retroorbital pain, otalgia, nasal congestion, sinus pain, tooth pain,

*bacteria sx >10d or worsening, purulent d/c, unilateral pain/tender, Fever
1. dx of chronic
2. tx
1. CT
2. symptomatic = nasal saline, decongestant, warm packs, analgesics, expectorant
*Abx (10d w/ pain & purulence) = Amox, Amox/Clav, 2nd/3rd gen Ceph

*Amox: 1g PO TID x10d
*Amox/Clav (Augmentin) - beta-lactam PCN: 2000/125 mg BID x10d
1. other names
2. s/s
3. dx
4. tx
1. common cold, URTI
2. runny nose, scratchy throat, HA, malaise, cough, F
3. r/o strep
4. symptomatic (H2O, rest)
-decongestant (pseudoephedrine)
-antitussive (dexromethorphan (robitussin)
-expectroant (Guaifensin)
1. Describe
2. S/S
3.TRIAD sx
1. infectious via saliva, cause = EBV, MC 10-30yo
2. fatigue, ST, malaise, low grade F, petechiae, rash
3. TRIAD = fever, tonsillar pharyngitis, lymphadenopathy (post chain)
1. Labs
2. Tx
1. mono spot, WBC, EBV titer, r/o strep
2. APAP/NSAIDS, gargle w/ lidocaine, rest, avoid contact activity (increase of spleen rupture), steroids if enclosing throat
Allergic Rhinitis
1. Cause
2. S/S
1. IgE mediated response
2. itchy eyes/throat, runny nose, sneeze, congestion, allergic shiners (increase BF), allergic salute (nasal crease), Dennie Morgan lines (edema/thickening)
Allergic Rhinitis Treatment
*Antihistamine (2nd gen): loratidine (Claritin) 10mg QD
*Antihistamine (1st gen): Diphenhydramine (Benadryl): 25-50mg q4-6hrs
*Decongestant = Pseudoephedrine (Sudafed), alpha adrenegic agonist 30-60mg/dose q6hr
*Intranasal CS: Fluticasone (Flonase) 2 sprays (50mcg) per nostril QD
*Afrin x 3-5d (avoid rhinitis medicamentosa)
*remove animals, put pillows/mattress in plastic
Sjogren's Syndrome
1. Triad
2. Dx
3. Tx
1. swollen parotid/submandibular, xerostomia, xerophthalmia
2. + Schirmer's test (filter paper in lower conjunctiva <5mm in 5 min)
3. Moisture replace, NSAIDS