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

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