Term
| Conductive hearing loss: 4 Mechanisms |
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Definition
1. Obstruction (cerumen). Most common.
2. Mass loading (middle ear effusion)
3. Stiffness effect (otosclerosis)
4. Discontinuity (ossicular disruption) |
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Term
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Definition
| Deterioration/disease of cochlea, due to loss of hair cells from organ of Corti. Bilateral. |
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Term
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Definition
| Sensorineural high frequency hearing loss w/ advancing age. |
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Term
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Definition
| Lesions on CNVIII, auditory nuclei, ascending tracts, auditory cortex. Least common. |
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Term
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Definition
| Rx: carbamide peroxide, mechanical, irrigation (H2O must be at body temp) |
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Term
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Definition
| Swimmer's ear. Sx: otalgia, pruritis, purulent discharge, erythema . Cause: Pseudomonas aeruginosa. Rx: remove material, Cortisporin Otic soln (polymixin B, neomycin, hydrocortisone). If substantial edema, ear wick for 48 hrs. Recalcitrant cases w/cellulitis of periauricular tissue: fluoroquinolones (Cipro). |
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Term
| Malignant external otitis |
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Definition
Persistent in DM or immunocomprimised. Evolves into osteomyelitis. Cause P aeruginosa.
Sx: Persistent foul smelling aural discharge, granulations in ear canal, boring/deep otalgia, progressive cranial nerve palsies.
CT: shows osseous erosion
Rx: Prolonged anti pseudomonal antibiotics |
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Term
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Definition
Benign tumors of external auditory canal. aka exostoses.
Rx: single, none. Multiple, surgical removal. |
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Term
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Definition
| Most common is squamos cell carcinoma. Mets to lymphatics of cranial base. |
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Term
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Definition
Herpes zoster oticus. Assoc w/reactivation of varicella zoster virus in facial nerve.
Sx: pruritis, pain over face/ear out of proportion. Vertigo, facial paralysis.
Rx: acyclovir or famciclovir |
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Term
| Eustachian tube dysfunction |
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Definition
Most common cause viral URI, allergy
Sx: fullness in ear, mild to mod impairment hearing. TM retracted, decreased mobility with pneumatic otoscopy.
Sx: decongestants |
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Term
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Definition
Eustachian tube blocked for prolonged period, resultant negative pressure results in transudation of fluid. More common in peds
Sx: TM dull, hypomobile, air bubbles, conductive hearing loss.
Rx: decongestants. If no relief, tubes. |
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Term
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Definition
Pressure not release via eustachian tube due to altitude changes.
Rx: if persistent, myringotomy |
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Term
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Definition
Bacterial infection of mucosally lined air spaces of temporal bone. Cause: inflammation and virus. Bacteria is secondary infection.
Cause: Strep pneumoniae, H influenzae, M catarrhalis, S pyogenes.
Sx: otalgia, aural pressure, decreased hearing, fever. Erythema, TM: dull, decreased mobility, can bulge outward. Infants: irritable, lethargic, decreased oral intake.
Rx: Amoxicillin, erythomycin. Recurrent: tympanocentesis, myringotomy. |
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Term
| Criteria for chemoprophylaxis for recurrent otitis media |
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Definition
1) 2 episodes acute infection, 1st yr
2) 3 infections in 6 mo
3) 4 episodes in 1 yr for peds >1 |
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Term
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Definition
Inflammation/infection of TM, secondary to viral or bacterial agent.
Sx: ***hallmark: Bullae, fluid filled vesicles, on infected TM. URI precedes, sudden onset ear pain, serosanguinous canal drainage, hearing loss
Cause: Mycoplasma pneumoniae, Strep. pneumoniae, H influenzae.
Rx: Trimethoprimsulfamethoxazole or macrolide |
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Term
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Definition
Cause: P aeruginosa, Staph aureus. Anaerobic infections. Conductive hearing loss can result from destruction of TM and ossicular chain.
Sx: ***Hallmark: purulent aural discharge.
Rx: Removal of debris, earplugs, topical antibiotic drops. Can use Cipro. |
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Term
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Definition
Variety of chronic OM. Squamous epithelium-lined sac, may fill w/desquamated keratin becomes chronically infected.
Cause: prolonged eustachian tube dysfunction.
Sx: retraction pocket with white debris, yellow crust on TM. Progressive hearing loss, foul smelling ear drainage, pain, HA, dizzy, facial paralysis, fever.
Rx: surgical marsupialization of sac |
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Term
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Definition
Sx: fever, chills, postauricular ear pain, discharge. Mastoid process.
Rx: IV antibiotics, myringotomy, mastoidectomy. |
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Term
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Definition
CNS infection, most common intracranial complication of OM.
Cause: H influenzae, S pneumoniae |
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Term
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Definition
| Rx: Ofloxacin. AVOID cortisporin. |
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Term
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Definition
| Rx: avoid exposure to excessive noise, ototoxic agents. Oral antidepressants. |
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Term
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Definition
Cardinal symptom of vestibular disease.
Peripheral lesions: nystagmus horizontal w a rotary component.
Nylen barany maneuver (Hallpike) used to Dx.
Rx: anitemetic. Acute: dizepam, less severe: antihistamines. |
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Term
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Definition
Aka endolymphatic hydrops. Endolymph does not reabsorb.
Sx: Episodic vertigo, low-freq sensorineural loss, unilateral tinnitus (low tone/blowing), aural pressure/fullness.
Rx: Low salt diet, diuretics |
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Term
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Definition
Aka vestibular schwannoma. Benign lesion w/in internal auditory canal. Most common of intracranial tumors.
Sx: unilateral hearing loss, gradual onset tinnitus.
Dx: CT
Rx: Surgery |
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Term
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Definition
| Sx: pale and boggy nasal mucosa as result of histamine. Allergic shiners, nasal crease. |
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Term
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Definition
Rebound congestion secondary to overuse of nasal decongestant sprays.
Rx: corticosteroids |
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Term
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Definition
Cause: S pneumoniae, H influenzae, S pyogenes, M catarrhalis.
Sx: purulent green/yellow secretions.
Maxillary: most common. Pain/pressure over cheeks, hurst to lean forward.
Frontal: severe HA over eyes, hurts supine.
Ethmoid: peds. Pain worse supine.
Sphenoid: rare, deep seated retroocular pain.
Unilateral: foreign bodies/cancer
Recurrent: in peds can be CF or Kartageners syndrome |
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Term
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Definition
Maxillary: waters pa
Frontal/Ethmoid: Caldwell pa
Frontal/occipital: Chamberlain Towne
Ethmoid/sphenoid: Submental-vertex base |
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Term
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Definition
Cause: trauma, rhinitis, drying of mucosa, alcohol, antiplatelet meds
Rx: direct pressure, phenylephrine, packing w/systemic antibiotic |
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Term
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Definition
Usually assoc urticaria.
Sx: airway. Steroids inflammation, antihistimines as mediator blockers, SC epinephrine to reverse Sx. Observe Pt min 4 hrs prior to discharge |
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Term
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Definition
HSV-1. AKA herpes labialis, herpetic stomatitis, herpetic gingivostomatitis.
Sx: Prodrome, lesions (vermillion border).
Dx: Tzanck smear. Id's multinucleated giant cells
Rx: Immunocompromised: acyclovir, valcyclovir |
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Term
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Definition
Cause: idiopathic. Poss HSV6, vitamin deficiency
Location: non keratinized mucosa, not on gingiva, dorsal tongue, hard palate.
Pain 7-10 days, heal 1-3 wks
Rx: hydration and pain control |
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Term
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Definition
Cause: coxsackievirus in summer
Sx: 1-2mm petechiae or vesiculopapular lesion on soft plate. Sudden onset of high fever
Rx: hydrate, symptomatic |
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Term
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Definition
1st manifestation HIV. Preemies, immunocompromised, irritation, broad spectrum antibiotics.
Dx: Wet prep with KOH, id's spores and hyphae
Rx: Mild: nystatin, clotrimazole. Severe: antifungals |
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Term
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Definition
Inflammation of tongue, loss of filiform papillae.
Sx: red, smooth surface tongue, rarely glossodynia
Dx: treat possible causes-smoking, nutrition, stress, menopause, |
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Term
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Definition
Gingival flap irritated, inflamed if infected = fluctuant absess.
Sx: foul taste, inability to close jaw, fever
Rx: superficial I&D, broad spectrum antibiotic |
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Term
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Definition
Most common neck space infection.
Bilateral cellulitis submandibular, sublingual, submental.
Most common infection source 2nd mandibular molar.
Sx: febrile, trismus, dysphonia, dysphagia, drooling, edema, painful, brawny induration.
Micro: strep,staph,bacteroides, fusobacteria
Rx: IV antibiotics, penicillin and for anerobes |
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Term
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Definition
Inflammation of any salivary gland.
Viral: Mumps parotitis, bilateral
Bacterial: S aureus, unilateral, elderly, diabetic, dehydrated, poor oral hygiene
Sx: glands painful and tender
Rx: Bacterial: anitbiotics w/staph coverage. Stimulate salivary flow |
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Term
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Definition
Paramyxoviral spread by respiratory droplets producing salivary gland inflammation.
Kids, spring
Sx: Parotid tenderness, overlying facial edema
Complications: pancreatitis in peds
Rx: symptomatic |
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Term
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Definition
Stone or calculus in salivary gland or duct, usually Wharton's
Sx: swelling, pain, worse during and after meals. xerostomia,
Rx: Stimulate salivary secretions |
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Term
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Definition
Infections, idiopathic.
Sx: sore throat, gagging/foreign body sensation. Uvula red, firm, swollen, tender |
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Term
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Definition
aka Quincke's disease. Hereditary, acquired, idiopathic
Sx: Uvula hydrops: pale, boggy, edematous
Comp: Possible airway compromise
Rx: steroids, antihistimines, epinephrine |
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Term
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Definition
Sx: sore throat, dysphagia, fever, erythema, lymphadenopathy, rhinitis, cough
Comp: Cellulitis and peritonsillar abscess if penetrate tonsillar capsule
Phys exam: include chest, ab, skin
Rx: Analgesics, anti-inflammatory, lozenges, gargles, corticosteroids if severe |
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Term
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Definition
90% Pharyngitis. EBV,rhino/corona/adenoviruses and influenza.
Sx: Insidious onset, coryza, usually no exudate. Erythema and edema. Low grade fever.
Rx: Throat culture to rule out strep, supportive |
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Term
| Streptococcal Pharyngitis |
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Definition
Strep pyogenes.
Sx: acute, sore throat, fever, exudate, anterior cervical adenopathy. Poss n/v, HA, malaise, ab cramping. Beefy red palatine tonsils, palatal petechiae. White/yellow tonsilar exudate.
Unusual in peds under 3
**4 main predictors
1. Fever >38C
2. Tonsilar exudates
3. Cervical adenopathy
4. No viral symptoms
Comp: rheumatic fever
Rx: 7-9 days of onset. Penicillin VK |
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Term
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Definition
7 in one yr
5/yr for 2 yrs
3/yr for 3 yrs |
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Term
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Definition
S pyogenes.
Sx: Sandpaper rash. Pastia's lines, strawberry tongue |
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Term
| Peritonsillar Cellulitis/Abscess |
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Definition
Causes: comp tonsillitis/pharyngitis, odontogenic spread, dental procedures, mucosal trauma
Cellulitis first, if not resolved abscess
Dx: CT, pus aspiration
Sx: sore throat, dysphagia, drooling, trismus, medial deviation soft palate/peritonsillar fold, ipsilateral ear pain, hot potato voice
Early: Tonsil full, shifted medially
Late: uvula/soft palate shifted contralateral
Rx: drain, iv antibiotics or aspiration
Comp: extension retropharyngeal/deep neck/mediastinal spaces. Pneumonia. |
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Term
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Definition
N gonorrhea, immunocompromised or prostitutes.
Sx: acute sore throat. Exudate w/multiple ulcer type lesions. Cervical lymphadenopathy. Poss concurrent urethritis/cervicitis
Dx: Thayer Martin culture
Rx: Ceftriaxone, azithromycin/doxy |
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Term
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Definition
EBV.
Prodrome: malaise, constitutional Sx, sore throat
Sx: Shaggy white-purple tonsillar exudate, petechiae. Posterior cervical adenopathy. Spleno/hepatomegaly.
Dx: CBC-atypical lymphocytosis. Positive heterophile antibody. EBV specific antibodies.
Rx: supportive, no ampicillin/amoxicillin. |
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Term
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Definition
Corynebacterium, rare, alcoholics.
Sx: fever, severe sore throat, toxic. Discrete white to gray adherent pseudomembranous friable exudate.
Comp: myocarditis, respiration muscle paralysis
Rx: Diptheria antitoxin, penicillin/erythromycin, quarantine. |
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Term
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Definition
M catarrhalis, H influenzae.
Sx: hoarseness, no pain.
Rx: Lessen use of voice to avoid vocal cord nodules.
Refer is lasts more than 2 weeks. |
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Term
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Definition
Life threatening infection. H influenzae type B, Group A beta hemolytic Strep, strep pneumoniae, s. aureus.
Sx: abrupt onset high fever, dysphagia, stridor, sore throat, drooling, tripod.
Dx: Xray "thumb sign"
Rx: Airway management, 2nd/3rd generation IV cephalosporins or ampicillin w/sulbactam
Prophylaxis: Rifampin for all un-immunized |
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