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Session 4 ER -3
ER -3- Nasal
| Question | Answer |
|---|---|
| This is a potentially fatal bacterial or viral infection that with compromised salivary flow and retrograde migration of oral bacteria into the salivary ducts and parenchyma. Marked by red and tender skin over the parotid gland with fever and trismus | Parotitis/ Viral mumps |
| What two bacteria do you need to cover for in parotitis | staph and anaerobes |
| If pt has suspected parotitis and they are not responding to tx what else should you consider | get a CT scan to r/o abscess, foreign body (calculus) |
| What is sialolithiasis | blockage of the submandibular gland by a calculus that causes swelling especially with meals because saliva is backed up |
| what is the tx for sialolithiasis | analgesics, +/- Ab, massage and sialogues (lemon drops) |
| What is the most common direction for mandible dislocation | anterior dislocation most common |
| What are the signs of mandible dislocation | present with pain, difficulty speaking/ swallowing and malocclusion can happen after laughing, yawning, taking a large bite, trauma, oral sex, dental extraction, general anesthesia |
| When would you need to get an x-ray with a jaw dislocation | trauma related dislocation |
| Where does the majority of epistaxis take place | anterior in the Kiesselbach plexus usually in dry winter months |
| If pressure fails to control epistaxis what can be done to stop the bleeding | packing and cautery |
| What is the most common facial fracture | nasal fracture |
| What complication of nasal fracture would you not want to miss | septal hematoma because it can cause septal necrosis |
| If you pt has CSF leaking what bone have they likely fractured | cribriform plate |
| What can you do before removing a nasal foreign body to prepare the nasal mucosa | give vasoconstrictor/anesthetic, racemic Epi if child is uncooperative |
| Pt presents with a fever, malaise and hot potato voice, odynophagia, dysphagia, otalgia they have trismus and displaced tonsils and the uvula is deflected to the side what is likely their problem | peritonsillar abscess |
| what is the tx for a peritonsillar abscess | I&D but get someone with experience as you can penetrate the internal carotid artery if not careful give Ab and ENT follow up |
| Pt present with 1-2 days of worsening dysphagia, odynophagia, and dyspnea they have a fever, tachycardia and cervical adenopathy and are drooling what should you be concerned about and not do because of this concern | they may have epiglottitis don't check them with a tongue blade and be prepared to establish a definitive airway just in case it closes off |
| What are the 4 causes of angioedema of the upper airway | congenital/acquired loss of C1 esterase inhibitor, IgE mediated allergic rxn, ACE inhibitors, Idiopathic |
| What is a concern when giving ACE inhibitors | Angioedema of the upper airway |
Created by:
smaxsmith
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