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Seminar 2 Notes

The seminar notes cover various medical topics, focusing on respiratory conditions, HEENT disorders, and treatment guidelines for COPD and asthma. Key points include the importance of individualized patient care, appropriate use of medications, and referral to specialists when necessary. Case studies illustrate diagnostic considerations and treatment plans for conditions such as periorbital cellulitis and allergic reactions.

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Barbara Jermyn
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18 views3 pages

Seminar 2 Notes

The seminar notes cover various medical topics, focusing on respiratory conditions, HEENT disorders, and treatment guidelines for COPD and asthma. Key points include the importance of individualized patient care, appropriate use of medications, and referral to specialists when necessary. Case studies illustrate diagnostic considerations and treatment plans for conditions such as periorbital cellulitis and allergic reactions.

Uploaded by

Barbara Jermyn
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Seminar 2 notes

 Eent: PowerPoint
 Respiratory PowerPoint
 Question regarding COPD/asthma guidelines: Use the most up-to-date
data. Look at your patient and develop something specific and
individualized for your patient.
 Ask if your patient is symptomatic: add something or a combination.
Look at the treatment plan. Refer to a specialty if the baseline
treatment isn’t working. Make sure you refer to rehab while waiting for
a specialist appointment.
 HEENT: typical disorders-URIs, cerumen impaction, serous otitis, OM,
OE, stye, pink eye, conjunctivitis, rhinorrhea. Use an otoscope for ear
examination. Decongestant-Zyrtec D or Claritin D every morning 10mg
for 5 days. Follow-up in five days continues during the pollen season.
Conjunctivitis is 70% viral and contagious for 3 days. Dry up nasal
conjunctivitis. Look at drainage to decide if it is matted shut or
purulent. Warm, moist compress (wash rag). Wet cold tea bag, tannins
help with inflammation. Wash eye BID baby shampoo for three days.
Don’t recommend Visine. Use Systane. Throw eye makeup away. Look
at throat for postnasal drip- red pharynx-decongestant. Look for
tympanic membrane light reflex-om, bulging dull. Pull pinna up and
back. If pain is on pinna OE, acidifying ear drops. Steroid drops.
Ciprodex. Debrox 5gtts bid for 5 days. Epistaxis-do they have
uncontrolled HTN-blurred vision and headache. Run a humidifier, nasal
saline, AYR. Avm-ask family Hx-did they start in childhood, medication
hx? Overuse of nasal spray. CBC to watch for shifts, throat cultures,
and CMP vomiting. Allergy testing? Wear a mask outside. Salt water-
sniff it in and blow it out. Question on nasal aspirators for babies-they
are ok, need to be cleaned, watch cross-contamination. If nasal fx is
suspected, check patency and look at turbinates. Send them to ER for
xray-may need ENT. Chronic sinusitis-ENT, deviated septum, tonsil
stones, strep throat a lot, hearing-ent. Flonase/Follow-up call in 5 days.
 Quiz questions- strep negative, send for culture.
 Avoid hot liquids after nosebleed.
 Adequate fluid hydration-rest the voice.
 Rinne Test-air conduction weber is bone conduction.
 Ear pain, pinna tenderness-OE, om is bulging, menieres is balance

Question on decongestant-Claritin D and Zyrtec D.


Respiratory ppt-HPI-get through history. Travel, weather change, copd, ear
pain

 80% of DX is in the History. Eczema and asthma go hand in hand.


 Social hx, smoke, vape, hookah, snuff, plug tobacco, smoking, do
parents smoke?
 Inhalers? Nebulizers. ROS 12 points. Chest pain, dyspnea?
 Physical retractions? Walk them, delay, confusion, walker, furniture
cruising, purse lip breathing. Anxious, blue, clubbing, smells like
smoke. Diff dx-copd, asthma, blue (hypoxia)bloater vs pink puffer
(asthma). Bronchitis every year? Change in exposure: do you have
chickens?
 Walking pneumonia: the person is functioning, coughing, and
mycoplasma. Lower resp infection-cxr-reevaluate if wrong.
 List all medications

Quiz

 Asthma: chronic airway inflammation with superimposed


bronchospasm
 ICS in COPD-reduction of airway inflammation
 Moderate persistent asthma therapy-ICS
 Chronic cough- 8 weeks
 Immunizations with COPD-inactivated flu vaccine

Case study-Chicken

 Questions asked: why taking antibiotic injections? Is the bump tender?


Yes, fever-no, but verbalizes fevers at home. Std concerns. Husband
seeing other women. Any previous injuries? No. runny nose and ear
pain, yes. Rashes-no. maybe gonorrhea. Where on the eye? Swollen
shut

DDX:

 Periorbital cellulitis-iv abx to prevent ocular cellulitis


 Staph Blepharitis-azithromycin ointment, then oral.-ER
 Allergic reaction-contact dermatitis-antihistamines, Benadryl 50mg.
 Gonorrhea infection-sent culture and treat penicillin-get treatment for
all the chickens.
Infectious coryza.

We can have different dx but get to the same treatment plans.

Case study-don’t order any more diagnostics

Lyseine-oral herpes

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