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ENT Oral cavity/Pharynx, Condition - Coggle Diagram

- - - - System
      - Prevention
      - Treatment
        
        Clindamycin
        
        IV Ampicillin/Sulbactam
        if complicated/severe
        
        Penicillin VK
        
        Augmentin
      - Physiology
        
        Pathogen
        
        Average of 4-6 different bacteria
        
        Transmission/Causation
        
        Complications
        
        Ludwig Angina
        
        Symptoms
        
        Localized Pain
        
        Hot/Cold sensitivity
        
        Facial Swelling
        
        Halitosis
      - Diagnosis
        
        Lab Tests
        
        CBC/culture
        
        Aspiration, I&D
        
        Imaging
        
        CT
        
        soft tissue neck (A/P and lateral)
        
        History
        
        PE
        
        Gingival erythema, warmth, induration
        
        Dental Erosion
        
        Trismus
        
        Neck/Face edema
        
        Ludwig Angina
    - - System
        
        Cellulitis of sublingual/submaxillary space
        
        MC "Neck space infection"
      - Prevention
      - Treatment
        
        emergent ENT/surgery consult
        
        ABX
        
        PCN & Metronidazole
        
        Clindamycin
        
        Aggressive airway management (intubate)
      - Physiology
        
        Pathogen
        
        Polymicrobial
        
        Transmission/Causation
        
        Complications
        
        Airway bstruction
        
        Sepsis
        
        Spread to mediastinum
        
        Symptoms
        
        Severe swelling
      - Diagnosis
        
        Lab Tests
        
        CBC & C&S
        
        Imaging
        
        CT
        
        Neck, chest
        
        History
        
        PE
        
        Bilateral submandibular swelling
    - - System
      - Prevention
      - Treatment
        
        Warm Peroxide rinse
        
        Metronidazole 500mg PO TID OR
        Augmentin 875 MG PO BID
      - Physiology
        
        Pathogen
        
        Variety of bacteria
        
        Transmission/Causation
        
        MC in young adults under stress
        
        Malnourishment
        
        Complications
        
        Symptoms
        
        Grey membrane on gums
        
        Halitosis
        
        Fever, malaise,
        cervical lymphadenopathy
      - Diagnosis
        
        Lab Tests
        
        Imaging
        
        History
  - - - Herpetic Gingivostomatitis
        
        System
        
        Prevention
        
        Treatment
        
        Acyclovir
        
        Physiology
        
        Pathogen
        
        HSV 1 or 2
        
        Transmission/Causation
        
        Immunosuppression
        
        Trauma
        
        Fever
        
        stress
        
        Complications
        
        Herpetic Keratitis (eye lesion)
        
        Symptoms
        
        Widespread lesions
        
        Diagnosis
        
        Lab Tests
        
        Imaging
        
        History
      - Oral Candidiasis
        
        System
        
        Prevention
        
        Treatment
        
        Infants:
        Nystatin "Swish and swallow"
        
        Adults
        
        Treat underlying causes
        
        Fluconazole
        
        ketoconazole
        
        Clotrimazole
        
        HIV
        
        Fluconzaole
        
        PO Itraconazole
        
        ART
        
        Physiology
        
        Pathogen
        
        Candida Albicans
        
        Transmission/Causation
        
        Dentures
        
        Immunocompromise
        
        Recent ABX
        
        Corticosteroid use
        
        HIV
        
        Chemo
        
        Diabetes
        
        Anemia
        
        Poor hygiene
        
        Complications
        
        Symptoms
        
        Painful
        
        White patches on mucosa
        that CAN BE scraped away
        
        Diagnosis
        
        Lab Tests
        
        KOH prep
        
        Spores
        
        "Non-septate Mycelia"
        
        Imaging
        
        History
      - Hairy Leukoplakia
        
        System
        
        Prevention
        
        Treatment
        
        Physiology
        
        Pathogen
        
        Epstein-Barr Virus
        
        Transmission/Causation
        
        Immunocompromise
        
        Complications
        
        Does NOT predispose to cancer
        
        Symptoms
        
        White plaques that CANNOT be rubbed off
        
        Vertical Striations
        
        Diagnosis
        
        Lab Tests
        
        Imaging
        
        History
        
        Appearance changes daily
    - - Aphthous Ulcer
        (canker sore)
        
        System
        
        Prevention
        
        Remove irritants
        
        Salty/acidic foods
        
        chemical in toothpaste
        
        Treatment
        
        Corticosteroids
        "sticky" orobase
        
        Triamcinolone 0,1% + orabase
        
        Clobetasol 0.05% Gel
        
        Peridex rinse
        
        Topical Benzocaine 20%
        (Orajel OTC)
        
        Physiology
        
        Pathogen
        
        Unknown, possibly viral (HSV) related
        
        Transmission/Causation
        
        Trauma
        
        Acidic foods
        
        Bad toothpaste
        
        Vitamin deficiency
        
        stress
        
        Complications
        
        May be confused for herpangina
        
        Enterovirus/coxsackie A presentation
        
        Febrile illness
        
        Symptoms
        
        Isolated lesion on buccal or labial mucosa
        
        Diagnosis
        
        Lab Tests
        
        Imaging
        
        History
        
        Rule out herpes virus
        (HSV, CMV, Varicella, Coxsackie)
        
        Large differential. What's left over?
      - Leukoplakia
        
        System
        
        Prevention
        
        Treatment
        
        Physiology
        
        Pathogen
        
        Transmission/Causation
        
        Complications
        
        Symptoms
        
        Diagnosis
        
        Lab Tests
        
        Imaging
        
        History
      - Glossodynia
        
        Glossitis
        
        Prevention
        
        Treatment
        
        Physiology
        
        Pathogen
        
        Inflammation
        
        Transmission/Causation
        
        Nutritional deficiency
        
        Iron, Vitamin B, Vitamin E
        
        Autoimmune
        
        Dehydration
        
        Complications
        
        Symptoms
        
        "Smooth, red tongue"
        
        Diagnosis
        
        Lab Tests
        
        Imaging
        
        History
        
        System
        
        Prevention
        
        Treatment
        
        Physiology
        
        Pathogen
        
        Transmission/Causation
        
        Complications
        
        Unilateral Symptoms:
        Neuro pathology
        
        Symptoms
        
        With or without glossitis
        
        Diagnosis
        
        Lab Tests
        
        Imaging
        
        History
    - - Erythroplakia
        
        Prevention
        
        Treatment
        
        Physiology
        
        Pathogen
        
        Transmission/Causation
        
        Complications
        
        Symptoms
        
        Diagnosis
        
        Lab Tests
        
        Imaging
        
        History
        
        System
      - Peutz Jegherz syndrome
        
        System
        
        Prevention
        
        Treatment
        
        Physiology
        
        Pathogen
        
        Transmission/Causation
        
        Complications
        
        Symptoms
        
        Diagnosis
        
        Lab Tests
        
        Imaging
        
        History
      - Addison's disease
        
        System
        
        Prevention
        
        Treatment
        
        Physiology
        
        Pathogen
        
        Transmission/Causation
        
        Complications
        
        Symptoms
        
        Diagnosis
        
        Lab Tests
        
        Imaging
        
        History
  - - - System
        
        Parotid and Submandibular glands
      - Prevention
        
        I&D if abscess formed
        
        Stay hydrated
      - Treatment
        
        Nafcillin 1g IV q6h
        
        Mild/Moderate:
        Dicloxacillin or Cephalexin
        PO QID
        
        Promote salivation
        
        Warm compress
        
        Massage
        
        Hydration
        
        sour candy
      - Physiology
        
        Pathogen
        
        MOST COMMONLY staph Aureus
        
        Transmission/Causation
        
        Dehydration
        
        Sjogren Syndrome
        
        Sarcoidosis
        
        Complications
        
        Stones
        
        Symptoms
        
        Acute pain, swelling
        
        Tenderness
        
        Drainage
        
        Fever
      - Diagnosis
        
        Lab Tests
        
        Imaging
        
        Ultrasound or CT
        
        History
        
        Physical exam
        
        Worsened around meals
    - - System
        
        Most common in Wharton's Duct
        
        Mostly Calcium Phosphate
      - Prevention
      - Treatment
        
        Remove stone
        
        Sialoendoscopy
        
        Shock-wave-lithotripsy
        
        Gland Excision if recurrent
      - Physiology
        
        Pathogen
        
        Transmission/Causation
        
        Complications
        
        Infection
        
        Symptoms
      - Diagnosis
        
        Lab Tests
        
        Serum Amylase
        
        Imaging
        
        Non-Contrast CT (neck or face)
        
        Ultrasound
        
        History
        
        More common in men
        
        Most frequent between 30 and 60
  - - - Aerobic and Anaerobic
      - Strep and Actinomyces MC
      - Abscess always polymicrobial
- - - - Rheumatic fever
      - Rheumatic myocarditis
      - glomerulonephritis
      - Abscess
      - Abx resistant S. pneumoniae
      - cost
  - - - System
      - Prevention
        
        Tonsilectomy for recurrent
      - Treatment
        
        Penicillin VK or Amoxicillin PO
        500mg PO BID x10 days
        
        Cephalexin 500mg PO BID x10 days
        
        Penicillin G 1.2 million units
        IM once
        
        Symptomatic
        
        Hydration
        
        Tylenol/NSAIDs
        
        Viscous lidocaine
        
        One time Dexamethasone
        for tonsillar swelling
      - Physiology
        
        Pathogen
        
        Transmission/Causation
        
        Complications
        
        Symptoms
      - Diagnosis
        
        Lab Tests
        
        Imaging
        
        History
        
        PE
    - - System
      - Prevention
      - Treatment
        
        Fluids, rest
        
        Self-limiting
      - Physiology
        
        Pathogen
        
        Transmission/Causation
        
        Viral more common than bacterial
        
        Complications
        
        Symptoms
        
        Sore throat
        
        Rhinorrhea
        
        Non-productive cough
        
        +/- fever
      - Diagnosis
        
        Lab Tests
        
        Imaging
        
        History
        
        PE
  - - - System
      - Prevention
      - Treatment
        
        ENT consult
        
        Surgical drainage
        
        Needle aspiration
        
        I&D
        
        no deeper than 1 cm (major vessels)
        
        ABX
        
        Ampicillin/sulbactam 3g IV QID
        
        Clindamycin 600mg IV TID & Levofloxacin 750mg IV QD
        
        Metronidazole 500mg IV TID & Ceftriaxone 2g IV QD
      - Physiology
        
        Pathogen
        
        Strep, usually
        
        Transmission/Causation
        
        Complication of Strep pharyngitis
        
        Complications
        
        what caused it?
        
        Lot of major vasculature nearby
        
        Symptoms
        
        Odynophagia
        
        Trismus
        
        "hot potato" voice
      - Diagnosis
        
        Lab Tests
        
        Imaging
        
        CT neck +/- contrast
        
        Ultrasound
        
        History
        
        PE
    - - System
      - Prevention
      - Treatment
        
        admit, consult ENT/surgery
        
        Aggressive airway management
        
        ABX
        
        Ampicillin/sulbactam 3g IV QID
        
        Clindamycin 600mg IV TID & Levofloxacin 750mg IV QD
        
        Metronidazole 500mg IV TID & Ceftriaxone 2g IV QD
      - Physiology
        
        Pathogen
        
        Transmission/Causation
        
        Complications
        
        Symptoms
        
        odynophagia
        
        trismus
        
        hot potato voice
        
        Respiratory distress
      - Diagnosis
        
        Lab Tests
        
        Imaging
        
        Lateral neck X-ray
        
        History
        
        Usually in pt under 5 yo
        
        PE
        
        "Sick" - ill appearing
        
        neck stiffness
        
        Cervical lymphadenopathy
  - - - System
      - Prevention
      - Treatment
        
        aggressive airway management
        
        Ceftriaxone & Vancomycin IV
        
        IV corticosteroids
      - Physiology
        
        Pathogen
        
        about a thousand of them
        
        Transmission/Causation
        
        viral or bacterial
        
        More common in diabetics
        
        Complications
        
        Rapidly developing; airway compromise risk
        
        Symptoms
        
        "Pain out of proportion to PE findings"
        
        +/- respiratory distress
      - Diagnosis
        
        Lab Tests
        
        Imaging
        
        CXR: "Thumb Sign"
        
        History
        
        "Very anxious"
        
        "I feel like my airway is closing"
        
        PE
        
        Tripoding
        
        Stridor
        
        Oral exam may cause laryngospasm
        esp. in children
    - - System
        
        Acute
        
        Chronic
      - Prevention
        
        stop smoking
        
        Address underlying causes
      - Treatment
        
        ENT referral for chronic
        checking for tumor/etc
        
        supportive
        
        time, rest, avoid irritants
      - Physiology
        
        Pathogen
        
        Usually viral
        
        Transmission/Causation
        
        Irritation
        
        Chemical
        
        Vocal "misuse"
        
        Strain? or nodule/tumor?
        
        GERD
        
        Infection
        
        Complications
        
        Symptoms
        
        Fever
        
        Hoarseness
        
        Cough
      - Diagnosis
        
        Lab Tests
        
        Imaging
        
        History
        
        PE
        
        Mostly normal
  - - - supportive
        
        Corticosteroids for swelling
        
        NSAID, tylenol
      - consider acyclovir
    - - Pathogen
        
        EBV
      - Transmission/Causation
        
        long incubation
        
        Saliva transmission
        
        4-6 month infectious period
      - Complications
        
        Bacterial coinfection
        
        splenic rupture
      - Symptoms
        
        Fever, malaise, sore throat
    - - Lab Tests
      - Imaging
      - History
      - PE
        
        Palatal petechiae
        
        Posterior cervical lymphadenopathy
        
        Splenomegaly
        
        Rash
        
        10% happen natively
        
        reaction with ampicillin admin