ENT disorders
The treatments for acute suppurative sialedenitis include ________ and methods to ________ ______
antibiotics; increase saliva
Why should irrigation not be used for ear foreign bodies containing organic material?
They will expand and become harder to extract
Which condition is described as a "curtain/veil over the vision" and may rapidly progress to vision loss? What is the treatment?
retinal detachment; surgical repair with laser in 2-3 days
What distinguishes gingivitis and periodontitis?
gingivitis is gum inflammation, periodontitis includes destruction of periodontal ligament or bone
You have a patient who presents with subjective tinnitus. He is very concerned that he will eventually lost his hearing. What guidance should you provide?
Tinnitus does not cause hearing loss
what is a patulous Eustachian tube? What is a notable symptom?
Eustachian tube is open all the time (should be closed at rest); autophony
Describe the mechanism of subperichondrial hematoma formation and "cauliflower ear." What is the treatment?
perichondrium lifts and bleeds, blood collects and can calcify and induce necrosis of the cartilage
Treat with pressure/bolster dressing, refer to ENT for drainage
soft exudates are often referred to as ____________ and result from __________. What are hard exudates?
cotton-wool spots; ischemic damage
chunks of cholesterol
What are the two ways cariogenic bacteria are transferred?
vertical transmission (primary caregiver via saliva contact) and horizontal transmission (from family members and care providers)
Meniere's; daily antihistamine, diuretic, glucocorticoids, decrease sodium intake
What is the difference between objective and subjective tinnitus?
objective- provider can hear it, pulsatile, usually caused by vascular problems or muscular spams
subjective- only patient can hear it, neural networks have the problem
Why is it so important to not miss septal hematomas? What should you do if you notice one?
they will place pressure on the cartilage and cause irreversible necrosis leading to saddle deformity of the nose; refer to ENT for immediate drainage
What condition is characterized by a small punctate area of white pus on the eye?
corneal ulcer
What are the antibiotics of choice for odontogenic infections?
amoxicillin and augmenting
A patient comes into the emergency department with a suspected nasal fracture. What two signs should you look for which would be red flags for potential intracranial hemorrhage?
Raccoon eyes/periorbital ecchymoses; battle sign/post-auricular ecchymoses
What would be seen on audiometry in vestibular schwannoma?
Asymmetric Schwannoma
anterior nasal bleed is from ________ and is less severe than a posterior bleed, which is from the _____________
Kiesselbach's plexus; sphenopalantine artery
Describe the pathophysiology of diabetic retinopathy
What should you do if an adult has an avulsed/knocked out tooth?
Place the tooth back in the socket and stabilize it with a splint or wet gauze, then refer to a dentist ASAP
An elderly patient presents to the ED with malaise, oral pain, neck stiffness, and dysphagia. What are you most concerned for? What is the treatment?
Ludwig's angina
ABCs first, ENT consult, IV steroids and abx
Vertigo time and likely diagnosis
Seconds:
Minutes/hours:
Days:
Weeks/chronic:
BPPV
Meniere's
Vestibular neuritis/labyrinthitis
Acoustic neuroma
What are significant history and physical findings in peritonsilar abcess?
hot potato voice, truisms, dehydration, drooling
Describe the symptoms of closed-angle glaucoma. What is the cause?
intense eye pain and unilateral headache, can have N/V, blurry vision, fixed and dilated pupil
Caused by acute occlusion of aqueous drainage (blockage of canal of Schlemm)
If a patient receives antibiotics for an odontogenic infection, what should you counsel them about the resolution of the infection?
Antibiotics are only used to buy time for proper dental treatment, it will come back if they do not get dental treatment!
A patient with a history of dry macular degeneration presents with new blind spots and metamorphopsia. What do you suspect is happening and what is the cause? What should next steps be?
Wet macular degeneration caused by fluid or bleeding under the central retina; next steps are to promptly refer for laser treatment