ENT Geriatrics Flashcards

1
Q

MC type of blepharitis

A

posterior

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2
Q

what is posterior blepharitis due to

A

meibomian gland dysfunction

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3
Q

sx blepharitis

A

eyelid crusting, scaling, red-rimming of the eyelid

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4
Q

tx blepharitis

A

eyelid hygiene

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5
Q

what is ectropion

A

eyelid and lashes are turned outward (everted)

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6
Q

tx ectropion

A

lubricating eye drops and moisture shields for sx relief

surgery if needed

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7
Q

what is entropion

A

eyelid and lashes are turned inward (inverted)

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8
Q

tx entropion

A

lubricating eye drops and moisture shields for sx

surgery is needed

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9
Q

what is pterygium

A

slow-growing thickening of the bulbar conjunctiva that may extend onto the corneal surface

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10
Q

RF pterygium

A

UV light exposure in sunny climates
sand, wind, dust

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11
Q

tx pterygium

A

observation for most
surgical removal if growth affects vision

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12
Q

what is the MCC of permanent legal blindness and vision loss in older adults in the US

A

macular degeneration

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13
Q

types of macular degeneration

A

dry - MC
wet - choroidal neovascularization

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14
Q

sx macular degeneration

A

bilateral progressive CENTRAL vision loss (includes detailed and colored vision)

metamorphopsia (straight lines appear bent)

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15
Q

funduscopic exam macular degeneration

A

dry - druse bodies - small, round yellow-white spots

wet - choroidal neovascularization

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16
Q

what grid can you use to help dx macular degeneration

A

amsler grid

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17
Q

tx macular degeneration

A

dry - zinc and vitamins C & E
wet - intravitreal VEGF inhibitors (Bevacizumab)

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18
Q

RF retinal detachment

A

myopia
previous cataract surgery

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19
Q

sx retinal detachment

A

photopsia (flashing lights)
floaters
progressive unilateral peripheral vision loss
shadow or curtain coming down

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20
Q

dx retinal detachment

A

funduscopy:
retinal tear - detached tissue flapping in the vitreous humor
positive shakers sign - clumping of brown-colored pigment resembling tobacco dust

21
Q

tx retinal detachment

A

emergency - keep pt supine with head turned toward side of detachment

22
Q

MCC blindness in the world

A

cataracts

23
Q

RF cataracts

A

aging
cigarette smoking
steroid use
DM

24
Q

sx cataracts

A

painless, slow, progressive blurred or vision loss over months to years

25
Q

PE cataracts

A

absent red reflex
opaque lens

26
Q

tx cataract

A

observe if mild
cataract surgery if visual changes affect ADL

27
Q

what is chronic open angle glaucoma

A

slow progressive painless bilateral peripheral vision loss

28
Q

RF chronic open angle glaucoma

A

AA
A > 40
FHx
DM

29
Q

sx chronic open angle glaucoma

A

asx until late
slow, progressive painless bilateral peripheral vision loss (tunnel vision)

30
Q

PE chronic open angle glaucoma

A

cupping of optic discs
increased cup to disc ratio
notching of disc rim

31
Q

tx chronic open angle glaucoma

A

prostaglandin analogs (latanoprost)

laser therapy

surgery

32
Q

tx cerumen impaction

A

3% hydrogen peroxide
6.5% carbide peroxide
irrigation

33
Q

what is BPPV

A

a type of peripheral vertigo MC due to displaced otolith particles within semicircular canals

34
Q

sx BPPV

A

sudden episodic peripheral vertigo (60 s or less); provoked with certain changes in head position

not associated with hearing loss or tinnitus

35
Q

dx BPPV

A

dix hallpike - produces nystagmus and vertigo

36
Q

tx BPPV

A

carnality repositioning - Epley maneuver

37
Q

vestibular neuronitis and labyrinthitis is due to

A

viral/postviral inflammation

38
Q

sx vestibular neuronitis and labyrinthitis

A

continuous peripheral vertigo

vestibular - no hearing loss
labyrinthitis - hearing loss

39
Q

dx vestibular neuronitis and labyrinthitis

A

clinical
MRI > CT

40
Q

tx vestibular neuronitis and labyrinthitis

A

steroids
sx relief - meclizine

41
Q

what is menieres dz

A

idiopathic distention of the endolymphatic compartment of the inner ear due to excess fluid

42
Q

sx menieres dz

A

episodic peripheral vertigo
unilateral fluctuating sensorineural hearing loss
tinnitus
ear fullness

43
Q

what should you rule out w menieres dz

A

syphilis

44
Q

tx menieres dz

A

sodium and caffeine restriction

can use HCTZ

45
Q

MCC sialadenitis

A

S aureus

46
Q

sx sialadenitis

A

sudden onset firm and tender gland swelling w purulent discharge (may be able to express pus if the duct is massaged)
dysphagia
trismus

fever and chills

47
Q

dx sialadenitis

A

CT scan

48
Q

tx sialadenitis

A

dicloxacillin or nafcillin
metronidazole can be added for anaerobic coverage

49
Q
A