MDT HEENT 15.3
Terms
undefined, object
copy deck
- What are the characteristics of Auricular hematoma?
- External ear becomes shapeless, with reddish-purple mass of blood collecting between perichondrium and cartilage.
- What is the primary TX for Auricular hematoma?
- Aspiration or incision and drainage.
- What is a complication of Auricular hematoma.
- Avascular Necrosis
- What has happened when a Tympanic membrane has a suppurative perforation.
- Pus in the middle ear, caused by otitis media has ruptured through the TM.
- A loss of hearing and tinnitus are characteristics of what HENT disorder.
- Tympanic Membrane perforation
- What does vertigo associated with TM perforation suggest?
- An associated injury to inner ear.
- If a pt with a TM perforation get water in to ear what can happen and how long could it take.
- Person may get a purulent otorrhea wich may begin in 24 - 48hrs
- What is the antibiotic of choice for a TM perforation to prevent infection?
- Pen V 250mg q6h x 7 days
- When might Tympanoplasty be indicated?
- When a TM perforation has not resolved within 2 months.
- In Tinnitus where should the focus of Tx be directed toward?
- The underlying disease.
- What are the most important things to avoid in the Tx of Tinnitus?
-
Exposure to excessive noise
Ototoxic agerates
Factors that may cause Cochlear damage - What is a complication associated with pulsatile tinnitus?
- Arterial obstruction, Anyeurism, and vascular neoplasms
- What is the db level of noise that can cause hearling loss?
- >85db
- Noise induced hearing loss occurs at what khz first, and then does what with further exposure?
- Starts a 4khz and gradually moves into the lower frequencies with further exposure.
- What is the most common epistaxis encountered?
- Bleeding from Kiesslebachs Plexus
- Define auricular hematoma and its etiology.
- Bleeding between the auricular cartilage and the perichondrium frequently follows contusions or other injuries to the auricle.
- What is the primary treatment for auricular hematoma?
- Aspiration or I&D
- Pus in the middle ear caused by OM ruptures through the TM is called?
- Suppurative perforation
- This suggests an injury to the inner ear.
- Vertigo
- Following a TM perf. what should be given to prevent infection?
- PCN V 250mg q6h x 7 days
- This type of med can be used if the ear becomes infected, but is not used prophylactically.
- Acetic Acid 2%
- What's the sig for acetic acid use on TM perf's.?
- 5 gtts tid
- After how long should a patient be referred to ENT if the TM has not healed?
- 2 months
- The perception of abnormal ear or head noise is called what?
- Tinnitus
- Persistent tinnitus usually indicates the presence of?
- Sensory hearing loss
- If the tinnitus is pulsatile, it is what?
- Synchronous with the heart
- Which ototoxic medications may cause tinnitus?
- Salicylates, quinine, CO, Heavy metals, aminoglycosides, diuretics, alcohol
- What is the #1 and #2 most common cause of sensory hearing loss?
-
#1-Presbyacusis
#2-Noise Trauma - At what decibel is noise considered damaging?
- >85 db's
- Where is the most common type of epistaxis encountered?
- Kiesselbach's Plexus
- Most cases of ant. epistaxis are usually treated by?
- Direct Pressure
- If a posterior pack is utilized, what should you administer immediately?
- Ampicillin 250 mg PO q6h
- Who is usually affected with impacted foreign bodies?
- Children or mentally incompetent PT's
- Pt's with a nasal foreign body present with what Sx's?
- May be asymptomatic or may present with nasal d/c, nasal discharge/obstruction or sinusitis
- What is the cardinal symptom of a nasal obstruction?
- Unilateral purulent nasal discharge
- What is the principal DDX for a nasal foreign body?
- Tumor
- What is the most frequently fractured bone in the body?
- Nasal pyramid
- These may occur and become infected 2ndary to nasal fracture?
- Septal hematomas
- What is the primary tx for a septal hematoma?
- I&D
- What meds should be RX to a pt after it has been I&D' for a septal hematoma?
- Ampicillin or Emycin 500 mg PO TID/QID
- This is caused by a disorder characterized by recurrent prostrating vertigo, sensory hearing loss, and tinnitus, associated with generalized dilation of the membranous labyrinth?
- Meniere's Disease
- This is caused by symptom complex including hay fever, perennial allergic rhinits, characterized by by seasonal or perennial sneezing, rhinorrhea, nasal congestion pruritis, and often conjuctivitis and pharyngitis?
- Allergic Rhinitis
- Trismus and hot potato voice are sx of what?
- Peritonsillar abscess
- This is inflammation of the laryngeal mucosa due to bacteria, virus or trauma?
- Acute laryngitis
- Symptomatic relief of vertigo may be obtained with anticholinergic agents is tx of what?
- Meniere"s Disease
- What rx is for Pos. Hemorrhage?
- Ampicillin 250mg po q6h
- If the TM becomes infected what topical med can be used?
- 2% acetic acid 5ggts tid
- What antibiotic is given to prevent an infection in a TM perforation?
- Pen V 250mg q6h x 7 days
- What antibiotic ointment can be applied for auricular hematoma?
- Gentamicin
- What is the antibiotic of choice for otitis media and what is the med if the person is allergic?
-
Amoxicillin 20-40mg/kg/d
or
Erythromycin 50mg/kg/d
plus
Sulfonamide 150mg/kg/d - What is the TX for Ludwigs Angina?
-
Aqueous PCN G 300,000 u/kg/d
or if sensitivity
Clindamycin 30mg/kg/d - What is the antibiotic of choic for Sterp Pharyngitis?
- PCN V potassium 250 qid x10 days
- What is the tx for Viral URI?
- Pseudoephedrine 30mg q4h or 120mg BID
- What is an alternattive med for Sinusitis?
- Cephalexin 250mg po bid
- What is the first choice antibiotic for sinusitis?
- Amoxicillin 250mg po tid x 10 days
- What is the antibiotic of choice for mastoiditis?
- PCN G 1 mill unit IV q6h
- What antibiotic is given to someone with a septal hematoma?
- Ampicillin or Erythromycin 500mg po tid or qid
- If cellulitis is present and extends beyond the ear canal what antibiotic is indicated?
- PCN G 250mg q6 x 7 days
- External otitis media also responds to altering the canal ph with what?
- 2% Acetic acid 5ggts tid x 7 days
- In pt. c otitis media alternative useful in resistant cases are what?
-
Cefaclor 20-40mg/kg/d
Amoxicillin clavulanate 20-40mg/kg/d