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60 terms

ENT Disorders Test 4-2

9A Test 4-2
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Treatment of foreign bodies in ear
DO NOT flush out, manually remove, if unable to remove refer.
Treatment for insect, bee, ect
Try enticing out with light, verify TM intact, flush with MINERAL OIL and remove with hemostats- immobilize c Lidocaine
Signs and Symptoms of external otitis
Inflammation of EXTERNAL AUDITORY CANAL wall, moderate to severe earache, TENDERNESS OF PENNA and PRESSURE over tragus, normal temp, PRE/POST auricular/ CERVICAL lymphadenopathy, normal hearing unless swelling present.
Medicine treatment for external otitis
Tylenol, ASA/ asprine (acetylsalicylic acid), E-mycin, keflex.
Antibiotics treatment for external otitis
Emycin, Cephalexin (Keflex)
Serous otitis media
when the EUSRACHIAN TUBE REMAINS BLOCKED for prolonged periods of time, fluid accumulated in the middle ear resulting in a negative pressure.
Signs and Symptoms of otitis media
FEELING of FULLNESS IN EAR, impaired hearing-CONDUCTIVE HEARING LOSE, 0 ear ache, TM NOT injected, DIMININISHED/ DISPLACED light reflex, accentuation of landmarks, impaired mobility of TM.
Med treatment of otitis media
pseudoephedrine hydrochloride (sudafed), entex PSE (pseudoephedrine HCL), oxymetazoline hydrochloride (afrin),
Treatment of otitis media
valsalva after each instillation of nose dropsand frequently throughout day
Differntial DX of otitis media
Eustatian tube dysfunction
Signs and Symptoms of eustatian tube dysfunction
sensation of fullness in the ear, RETRACTED TM and decreased mobility
Medicine treatment of eustatian tube dysfunction
decongestants, antihistamines, auto-inflation
Afrin (oxymetazoline HCI)
is to be taken no longer than 3 days
Otitis media/ purulent media
a BACTERIAL or VIRAL INFECTION of MIDDLE EAR
Signs and Symptoms of otitis media/ purulent media
mild to severe earache may radiate, over same side of the face, tinnitus, full feeling and pressure in ear, conductive hearing loss, fluid or pus seen behind TM, TM may appear red then yellow/ white dulness, Buldging may be present under pressure, fever
Treatment of otitis media/ purulent otitis media
tylenol/ mortin, apply heat, decongenstant ie sudafed, afrin gtts, amoxicillin, augmentin, or trimethoprim/ sulfaamethixazole (bactrim) if allergic to PCN. F/U manditory
Sinusitis (rhinosinusitis)
infection of the ACCESSORY nasal sinuses, result of coryza virus, strep, staph, pneumococci, H. influenza
Signs and Symptoms of Sinusitis
gradual or sudden on set, sharpe throbbing headache over sinuse boggy & red nasal mucosa C exudate, clear watery discharge or purulent nasal and post nasal discharge, positive head tilt C or S cough
TX of sinusitis
sudafed, afrin gtts, analgesic prn, contact preceptor for antimicrobial therapy, amoxicillin... give septra (bactrim) if allergic to PCN
complications of sinusitis
brain abcess, encephalitis, meningitis, osteomyelitis, palsy of CN V
Epistaxis (nose bleed)
hx of trauma, acute infection, violent sneezing, hyoertensive PT
Signs and Symptomes of epistaxis
bleeding for nares, most common sites kiesselbach and tip of inferior turbinate, cough up or vomit blood, shock
Management of epistaxis
PT sits erect, forward head tilt, compress (5-10 mins), ice, pack nostrils, cauterize with visual inspection, consult, foley
Rhinitis
a reaction of the NASAL MUCOSA RESULTING in EDEMA< SNEEZING and INCREASED muscosa secreations. from virus or allergens
Signs and Symptoms of viral rhinitis
non specific, nasal congestion, WATERY rhinorrhea, sneezing nasal mucosa hyperemic and edematous
Signs and Symptoms of allergic rhinitis
YEARLY SYMPTOMS, congestion, rhinorreha, sneezing, pale nasla mucosa, polyps
TX of viral rhinitis
sudafed, entex PSE, afrin
TX of allergic rhinitis
avoid agent, antihistimine (loraradine (claritin), fexofenadine (allegra), cetirizine HCl (zertec), benadryl)
TX allergic rhinitis
afrin, increase fluids, acetaminophen
Pharyngitis
inflammation of the pharynx
Most common pharyngitis
Viral pharyngitis, caused by strepococci, pneumococci, rarly diptheria
Viral Pharyngitis
may extend from infection of tonsils, nose or sinuses, associated with other diseases, inhaled irritation.
General Signs and Symptoms of Viral pharyngitis
dry/scratchy throat, hyperemic pharyngeal mucosa, swollen/ tender cervical lymphadenopathy, malaise, HA, fever, pain, dysphagia
General Signs and Symptoms of Bacterial pharyngitis
exudates, fever over 38C (100.5F), lymphdenopathy
Treatment for viral pharyngitis
rest, light diet, stop smoking, ASA/ Tylenol, throat cult, warm saline gargle, throat lozenges PO fluids
Treatment for bacterial pharyngitis
throat cult, OR based of symptomes ie CENTOR CRITERIA, rest, light diet, stop smoking, ASA/ Tylenol, throat cult, warm saline gargle, throat lozenges PO fluids. Antibiotics include pen VK (PCN), or erythromycin (if allergice to PCN)
Differental DX for pharyngitis
mono, diptheria
Sign and Symptoms of mono
same as pharyngitis, C prolonged course longer than 1 week, EXCESSIVE MALAISE, general lymphadenopathy, microptechei of soft palate, splenomegaly, heptomegally, confirm with CBC Cdiff and mono spot.
TX of mono
bed rest avoid strenuous activity to include contact sports, concider EVAC if spleen is enlarged
Signs and Symptoms of diptheria
same as bacterial pharyngitis, presence of membrane covering tonsils and extended tissue, DIRTY GRAY, TOUGH, possibly firmly adherent and bleeding, GRAM STAIN + rods.
TX of diptheria
same as bacterial pharyngitis, DIPTHERIA ANTITOXINS, EVAC
Tonsillitis
an acute inflammation of the TONSILS , commonly DUE TO STREP A beta hemolytic strep, common in military
Signs and Symptoms of Tonsillitis
sudden onset, sore throat on swallowing, kids don't eat, TONSILS are edematous and hyperemic, purulent exudates from TONSILLAR crypts, white thin membrane that peels away easily S bleeding, malaise, cervical lympadenopathy
TX medication for tonsillitis
ASA/ acetaminophen, throat cult, PCN, bicillin, erythromycin
peri tonsillar abcess
Common in YOUNG ADULTS usually caused by GROUP A BETA STREP
Signs and Symptoms of peritonsillar abcess
SEVERE PAIN upon swollowing, head tilt towards abcess, marked trismus, TONSIL DISPLACED medially, soft palate hyperemic and edeemous, UVULA DISPLACED TO OPPISITE SIDE OF INFECTED TONSIL
TX for perinsillabcess
contact preceptor, Tylenol/T3 cellulitis S pus give PCN, pus not draining within 2 days EVAC, PCN VK, augmentin or clindamycin if PCN allergy
Aphthous ulcer
signs and symptoms NON-KERATIZED BUCCAL, LABIAL mucosa, not on gingiva or palate, single or multi LESIONS
Signs and Symptoms of apthous ulcer
painful, 1-2mm ROUNG YELLOW- GREY fibrinoid center surrounded by red halos, pain lasts 7-10 days, resolved 1-3 weeks
Med TX for apthous ulcer
vicious lidocane, orabase dental paste, triamcinolone acetone (kenolog), contact dental preceptor if not resloved in 7-10 days
Laryngitis
inflamation of larynx (smokers voice)
Signs and symptoms of laryngitis
UNNATURAL CHANGE IN VOICE, horseness to aphonia, feeling of tickeling, rawness and constant clearing of throat, dysphagia, edema and hyperemia of LARNGEAL mucosa C or S exudates, stridor and dyspnia,
TX of laryngitis
stop smoking, rest voice, humidified air, tylenol and antibiotic
Upper Respitaroty Infection
an ACUTE VIRAL INFECTION of the respiratory tract C inflammation in any or all airways
Signs and Symptoms of URI
RHINORRHEA, laryngitis, sneezing, pharyngitis, cough, sinus congestion, usually afebrile
TX for URI
ASA/ acetaminophen, decongestant, cough suppressant
Barotrauma
individual with auditory tube dysfunction due to CONGENITAL NARROWING or ACQUIRED MUCOID EDEMA. inable to equalize BAROMATIC stress exerted on the middle ear by wir travel, RAPID ALTIUDE CHANGE or under water diving
TX Barotrauma
yawn/swollow/ valsalva, sudephed , afrin, tylenol. myringotomy in severe cases
Labrynthitis
acute onset of CONTINUOUS SEVER VERTIGO lasting days or weeks, C hearing loss and tinnitus. unknown cause but follows URI
TX of Labrynthitis
bed rest, treat underlying disease, diazepam, or benadryl, meclizine