NUR 676 Final Exam with precise detailed answers ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
otitis externa ||//\\||
is cellulitis of the external canal that may extend to the auricle (swimmer's ear). p391
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
otitis externa risks factors ||//\\|| ||//\\|| ||//\\||
comprise the integrity of the inherent defense mechanism against infection, including; ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
removal of protective cerumen w damage to fragile skin from vigorous cleaning,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
accumulation of moisture from swimming, and alterations to the tissues that result from ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
wearing devices such as headphones or earplugs. p391 ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Otitis Externa Expected findings ||//\\|| ||//\\|| ||//\\||
pain of the affected ear and auricle developing over the course of 48 hours or less, feeling of
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
fullness or itching. S&S that may be present drainage and hearing loss. Chronic Otitis
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
externa- pruritus ||//\\||
Otitis Externa bacterial cause ||//\\|| ||//\\|| ||//\\||
most common pseudonomas aeruginosa and staphyloccocus aureus. Uncommon candida,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
and aspergillus organisms. ||//\\|| ||//\\||
otitis externa diagnostics ||//\\|| ||//\\||
usually unnecessary, culture of canal if symptoms persist with antibiotic sensitivity if no
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
improvement after 14 days of antibiotic therapy (C&S, and potassium hydroxide preparation ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
of drainage). ||//\\||
otitis externa Oral antimicrobial therapy ||//\\|| ||//\\|| ||//\\|| ||//\\||
Fluoroquinolone antibiotics- effective against s aureus and P. aeruginosa (ofloxacin, ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
ciproflaxin). antibiotic-corticosteroids (Cipro Hc) for infection and inflammation. Improvement ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
should occur within 48 to 72 hours, and resolution occurs usually at 7 to 10 days. p392
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Meniere's disease ||//\\||
chronic condition of the inner ear S&S recurrent vertigo and hearing loss. symptoms may or
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
may not occur simultaneously dizziness describe as spinning vertigo, low frequency
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
sensorineural hearing loss, tinnitus, and feeling of fullness in the affected ear p388 ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Meniere's disease pathophysiology ||//\\|| ||//\\||
,excess fluid and pressure in the labyrinth of the inner ear that episodically distends the
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
structure of the labyrinth and damages the vestibular system (Involved in balance) &
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
cochlear cells (involve in hearing). Unknown etiology p388 ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Meniere's disease clinical presentation ||//\\|| ||//\\|| ||//\\||
PCP should ask patient about history of recurrent symptoms. Early-patients have intermittent
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
attacks of vertigo that last from minutes to hours often associated with nausea and vomiting.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
these symptoms usually are accompanied by ear pressure, low-pitched tinnitus, fluctuating
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
intensity, and unilateral hearing loss ||//\\|| ||//\\|| ||//\\|| ||//\\||
Meniere's disease diagnostics ||//\\|| ||//\\||
essential diagnostics- 2 episodes of spontaneous vertigo lasting at least 20 minutes
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Audiogram- documented hearing loss ||//\\|| ||//\\|| ||//\\||
Labs- TSH, serum glucose, rapid plasma reagin, lyme serology
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Meniere's disease pharmacological management ||//\\|| ||//\\|| ||//\\||
should refer to otolaryngologist for testing and management.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Goals of therapy-managing the episodes of vertigo and arresting the disease process drug
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
therapy- short term oral steroid course, IM on affected ear may last longer.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
symptom relief- Meclizine and antiemetics(least sedating), Benzodiazepines prescribe for
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
GABA agonist effect but not commonly used. Lorazepam has a quick onset may be
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
appropriate for infrequent use. ||//\\|| ||//\\|| ||//\\||
P.389
Oropharynx Pharyngitis ||//\\||
Streptococcus pyogenes. GAS can cause rheumatic fever. Infection with GAS peaks in late ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
winter. Group C is the most common in college students. p438
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Oropharynx Pharyngitis clinical presentation Allergies ||//\\|| ||//\\|| ||//\\|| ||//\\||
varies on the offending agent. ||//\\|| ||//\\|| ||//\\|| ||//\\||
non-infectious- sore throat and dryness, if allergens are the cause S&S rhinorrhea, postnasal ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
drip, and watery eyes ||//\\|| ||//\\|| ||//\\||
Oropharynx Pharyngitis clinical presentation Viral ||//\\|| ||//\\|| ||//\\|| ||//\\||
most common, self limiting- sore throat, fever, malaise, headache, myalgias, and fatigue,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
rhinitis, and conjuctivitis, congestion, and cough with sputum. p438
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Oropharynx Strep throat clinical presentation bacterial ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
, most prevalent in children under 15 y.o incubation period of 2 to 5 days. S&S onset of sore
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
throat, painful swallowing, fever (higher than 101.3F), chill, headache, vomiting, and
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
abdominal pain. GAS may present with erythema of the throat and tonsils, patchy, discrete||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
white or yellowish exudate, pharyngeal petechiae, and tender anterior cervical adenopathy.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
p439
Oropharynx Strep throat diagnostics ||//\\|| ||//\\|| ||//\\||
throat culture, a rapid antigen detection test (RADT), and sometimes an antistreptolysin
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
(ASO) titer. ||//\\||
Oropharynx Strep throat treatment ||//\\|| ||//\\|| ||//\\||
antibiotics: penicillin or amoxicillin for 10 days, penicillin is low cost, safe, and efficacy. If
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
allergic to PCN clindamycin or Clarithromycin for 10 days is given. Another option is
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Azithromycin for 5 days. ||//\\|| ||//\\|| ||//\\||
Mononucleosis clinical presentation ||//\\|| ||//\\||
more common in adolescents and young adults. S&S headache, malaise, fatigue, and
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
anorexia before the sore throat occurs. Hepatosplenomegaly may be noted during
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
examination. p439 ||//\\||
Mononucleosis clinical diagnostics ||//\\|| ||//\\||
CBC reveals leukocytosis with a right shift of atypical lymphocytes. A positive monospot test
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
reveals heterophil antibodies, this test may take 2 to 3 weeks of illness to produce a positive
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
test result. Patients should start to feel better 24 to 48 hours after antibiotic therapy has
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
started. p440 ||//\\||
Sinusitis
Symptomatic inflammation of the mucosal surface of the paranasal sinuses. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
acute (ARS) resolves in less than 4 wks
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
subacute- resolves in 4 to 12 wks ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
chronic (CRS)- continues beyond 12 wks ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Acute Rhinosinusitis (ARS) clinical presenation
||//\\|| ||//\\|| ||//\\|| ||//\\||
often confused with URIs. S&S nasal congestion, purulent nasal discharge, headache that
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
becomes more intense when pt bend forwards, fever, and fatigue. onset is abrupt, halitosis,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
postnasal drip, ear fullness, otalgia, and decreased lack of smell p411 ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Acute Rhinosinusitis (ARS) diagnostics
||//\\|| ||//\\|| ||//\\||
otitis externa ||//\\||
is cellulitis of the external canal that may extend to the auricle (swimmer's ear). p391
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
otitis externa risks factors ||//\\|| ||//\\|| ||//\\||
comprise the integrity of the inherent defense mechanism against infection, including; ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
removal of protective cerumen w damage to fragile skin from vigorous cleaning,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
accumulation of moisture from swimming, and alterations to the tissues that result from ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
wearing devices such as headphones or earplugs. p391 ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Otitis Externa Expected findings ||//\\|| ||//\\|| ||//\\||
pain of the affected ear and auricle developing over the course of 48 hours or less, feeling of
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
fullness or itching. S&S that may be present drainage and hearing loss. Chronic Otitis
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
externa- pruritus ||//\\||
Otitis Externa bacterial cause ||//\\|| ||//\\|| ||//\\||
most common pseudonomas aeruginosa and staphyloccocus aureus. Uncommon candida,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
and aspergillus organisms. ||//\\|| ||//\\||
otitis externa diagnostics ||//\\|| ||//\\||
usually unnecessary, culture of canal if symptoms persist with antibiotic sensitivity if no
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
improvement after 14 days of antibiotic therapy (C&S, and potassium hydroxide preparation ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
of drainage). ||//\\||
otitis externa Oral antimicrobial therapy ||//\\|| ||//\\|| ||//\\|| ||//\\||
Fluoroquinolone antibiotics- effective against s aureus and P. aeruginosa (ofloxacin, ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
ciproflaxin). antibiotic-corticosteroids (Cipro Hc) for infection and inflammation. Improvement ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
should occur within 48 to 72 hours, and resolution occurs usually at 7 to 10 days. p392
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Meniere's disease ||//\\||
chronic condition of the inner ear S&S recurrent vertigo and hearing loss. symptoms may or
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
may not occur simultaneously dizziness describe as spinning vertigo, low frequency
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
sensorineural hearing loss, tinnitus, and feeling of fullness in the affected ear p388 ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Meniere's disease pathophysiology ||//\\|| ||//\\||
,excess fluid and pressure in the labyrinth of the inner ear that episodically distends the
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
structure of the labyrinth and damages the vestibular system (Involved in balance) &
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
cochlear cells (involve in hearing). Unknown etiology p388 ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Meniere's disease clinical presentation ||//\\|| ||//\\|| ||//\\||
PCP should ask patient about history of recurrent symptoms. Early-patients have intermittent
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
attacks of vertigo that last from minutes to hours often associated with nausea and vomiting.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
these symptoms usually are accompanied by ear pressure, low-pitched tinnitus, fluctuating
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
intensity, and unilateral hearing loss ||//\\|| ||//\\|| ||//\\|| ||//\\||
Meniere's disease diagnostics ||//\\|| ||//\\||
essential diagnostics- 2 episodes of spontaneous vertigo lasting at least 20 minutes
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Audiogram- documented hearing loss ||//\\|| ||//\\|| ||//\\||
Labs- TSH, serum glucose, rapid plasma reagin, lyme serology
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Meniere's disease pharmacological management ||//\\|| ||//\\|| ||//\\||
should refer to otolaryngologist for testing and management.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Goals of therapy-managing the episodes of vertigo and arresting the disease process drug
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
therapy- short term oral steroid course, IM on affected ear may last longer.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
symptom relief- Meclizine and antiemetics(least sedating), Benzodiazepines prescribe for
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
GABA agonist effect but not commonly used. Lorazepam has a quick onset may be
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
appropriate for infrequent use. ||//\\|| ||//\\|| ||//\\||
P.389
Oropharynx Pharyngitis ||//\\||
Streptococcus pyogenes. GAS can cause rheumatic fever. Infection with GAS peaks in late ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
winter. Group C is the most common in college students. p438
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Oropharynx Pharyngitis clinical presentation Allergies ||//\\|| ||//\\|| ||//\\|| ||//\\||
varies on the offending agent. ||//\\|| ||//\\|| ||//\\|| ||//\\||
non-infectious- sore throat and dryness, if allergens are the cause S&S rhinorrhea, postnasal ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
drip, and watery eyes ||//\\|| ||//\\|| ||//\\||
Oropharynx Pharyngitis clinical presentation Viral ||//\\|| ||//\\|| ||//\\|| ||//\\||
most common, self limiting- sore throat, fever, malaise, headache, myalgias, and fatigue,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
rhinitis, and conjuctivitis, congestion, and cough with sputum. p438
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Oropharynx Strep throat clinical presentation bacterial ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
, most prevalent in children under 15 y.o incubation period of 2 to 5 days. S&S onset of sore
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
throat, painful swallowing, fever (higher than 101.3F), chill, headache, vomiting, and
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
abdominal pain. GAS may present with erythema of the throat and tonsils, patchy, discrete||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
white or yellowish exudate, pharyngeal petechiae, and tender anterior cervical adenopathy.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
p439
Oropharynx Strep throat diagnostics ||//\\|| ||//\\|| ||//\\||
throat culture, a rapid antigen detection test (RADT), and sometimes an antistreptolysin
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
(ASO) titer. ||//\\||
Oropharynx Strep throat treatment ||//\\|| ||//\\|| ||//\\||
antibiotics: penicillin or amoxicillin for 10 days, penicillin is low cost, safe, and efficacy. If
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
allergic to PCN clindamycin or Clarithromycin for 10 days is given. Another option is
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Azithromycin for 5 days. ||//\\|| ||//\\|| ||//\\||
Mononucleosis clinical presentation ||//\\|| ||//\\||
more common in adolescents and young adults. S&S headache, malaise, fatigue, and
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
anorexia before the sore throat occurs. Hepatosplenomegaly may be noted during
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
examination. p439 ||//\\||
Mononucleosis clinical diagnostics ||//\\|| ||//\\||
CBC reveals leukocytosis with a right shift of atypical lymphocytes. A positive monospot test
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
reveals heterophil antibodies, this test may take 2 to 3 weeks of illness to produce a positive
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
test result. Patients should start to feel better 24 to 48 hours after antibiotic therapy has
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started. p440 ||//\\||
Sinusitis
Symptomatic inflammation of the mucosal surface of the paranasal sinuses. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
acute (ARS) resolves in less than 4 wks
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subacute- resolves in 4 to 12 wks ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
chronic (CRS)- continues beyond 12 wks ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Acute Rhinosinusitis (ARS) clinical presenation
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often confused with URIs. S&S nasal congestion, purulent nasal discharge, headache that
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becomes more intense when pt bend forwards, fever, and fatigue. onset is abrupt, halitosis,
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postnasal drip, ear fullness, otalgia, and decreased lack of smell p411 ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Acute Rhinosinusitis (ARS) diagnostics
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