EENT > Test 5 > Flashcards

Test 5 Flashcards

(85 cards)

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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
Pneumonia pop
school-aged children and college students
26
Pneumonia cause
Mycoplasma pneumoniae
27
Pneumonia sx
cough pharyngitis rhinorrhea ear pain
28
Pneumonia dx
multiplex PCR xray
29
Hand, Foot, Mouth Disease pop
children
30
Hand, Foot, Mouth Disease cause
Coxsackie virus
31
Hand, Foot, Mouth Disease sx
Painful lesions on tongue, mouth, possible hands and feet; self-limiting, but very contagious
32
Aphthous Ulcers cause
autoimmune condition
33
Aphthous Ulcers sx
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.
34
Oral Candidiasis cause
Candidiasis HIV diabetes
35
Oral Candidiasis RF
inhaled corticosteroids
36
Mononucleosis pop
teenagers
37
Mononucleosis cause
Epstein Bar Virus (EBV) infection
38
Mononucleosis RF
Sexual activity and kissing
39
Mononucleosis sx
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
Mononucleosis work up
abdominal exam peripheral smear monospot positive mild elevated transaminase levels
41
Mononucleosis complication
severe airway obstruction splenic rupture hemolytic anemia thrombocytopenia malignancy: Burkitt’s lymphoma, nasopharyngeal carcinoma and B cell lymphomas.
42
Necrotizing Gingivitis cause
Bacterial infection
43
Necrotizing Gingivitis sx
papillary gingiva are gray; fever and very foul breath; cervical nodes enlarged
44
Necrotizing Gingivitis RF
smoking, poor hygiene; teenagers most susceptible
45
Non-Strep Pharyngitis cause
viral or other bacteria
46
Non-Strep Pharyngitis TX
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
Gonococcal Pharyngitis Cause
Neisseria gonorrhoeae
48
Gonococcal Pharyngitis sx
- 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
Gonococcal Pharyngitis Dx
swab of the throat, DNA probe
50
Gonococcal Pharyngitis TX
antibiotics
51
Peritonsillar abscess pop
young adults
52
Peritonsillar abscess cause
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
Peritonsillar abscess RF
acute tonsillitis pharyngitis periodontal disease diabetes smoking NSAIDs
54
Peritonsillar abscess SX
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
Peritonsillar abscess DX
CT scans or ultrasounds needle aspiration
56
Peritonsillar abscess TX
draining the abscess through a small incision antibiotics
57
Peritonsillar abscess complications
- 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
Peritonsillar abscess prevention
practicing good oral hygiene avoiding smoking excessive alcohol consumption
59
Diphtheria cause
Corynebacterium diphtheria
60
Diphtheria sx
Tip-off is blue white membrane adhered to posterior pharynx cardiac depression
61
Diphtheria TX
antitoxin In severe cases, hospitalization may be necessary for respiratory support and other treatments.
62
Retropharyngeal abscess cause
bacterial infections due to - Dental infections - Upper respiratory infections - Pharyngitis - Tonsillitis - Ear infections
63
Retropharyngeal abscess SX
- 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
Retropharyngeal abscess dx
CT scan or an MRI
65
Retropharyngeal abscess
draining the abscess and administering antibiotics to treat the infection ED
66
Ludwig’s Angina cause
bacterial infection, most commonly arising from dental infections or dental procedures,
67
Ludwig’s Angina SX
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
Ludwig’s Angina complication
airway obstruction and sepsis
69
Ludwig’s Angina TX
administration of antibiotics surgical drainage airway management
70
Necrotizing Fascitis cause
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
Necrotizing Fascitis RF
diabetes or HIV
72
Necrotizing Fascitis SX
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
Necrotizing Fascitis TX
antibiotics and surgery amputation
74
Epiglottitis pop
2-5 years old
75
Epiglottitis cause
Haemophilus influenzae type B. bacteria, viruses, or fungi.
76
Epiglottitis sx
- Difficulty breathing - Painful swallowing - High fever - Drooling - Stridor - Trismus - painful/difficulty to open mouth and swallow, excess drooling
77
Epiglottitis dx
x-ray with thumb print sign
78
Epiglottitis TX
hospitalization
79
Chronic Sore Throat DDX
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
Chronic sore throat TX
- 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
Kawasaki disease pop
children
82
Kawasaki disease SX
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
Kawasaki disease DX
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
Kawasaki disease TX
immunoglobulin treatment
85
Hoarseness
EENT
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