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Flashcards in 2) EENT Deck (47)
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1

Tx of blepharitis

Lid scrub w/ baby shampoo on q-tips
(topical abx if infection is suspected)

2

Blowout fx presentation

(fx of orbital floor max, pal, zygo)
-inability to look up (entrapment of infraorbital nerve and musculature)
-swelling and misalignment of eyes
-double vision
Tx: Ophthalmology (decongest, ice packs, cold compresses, abx)

3

Cataract presentation

-insidious onset of decreased vision
-dbl vision, fixed spots, reduced color perception
-ext = discoloration of lens
-int = cataract appears black on red background
tx: intracapsular or extracapsular extractions of cataract w/ lens replacement

4

Viral conjunctivitis cause

Adenovirus type 3, 8, 19
**can be transmitted in swimming pools**
-tender lymphadenopathy & watery d/c
Tx: eye lavage w/ normal saline bid; compresses

5

Bacterial conjunctivitis cause

s. pneumo, s. aureus, h. aegyptius and moraxella species
-copious purulent d/c
Tx: topical abx (ex: ciprofloxacin)

6

Rare pathogens in bacterial conjunctivitis

Chlamydia (no organism on stain) & gonorrhea (gram neg diplococci)
-sever conjunct and keratitis w/ develo perm vision loss
-tx: systemic abx (ceftriaxone/doxy)

7

Follow up on corneal abrasions

within 1-2 days is essential

8

Corneal ulcer tx

Eye specialist immediately
(HSV=dendritic, s. aureus)

9

Hyphema tx

refer to optham asap (risk for more hemorrhage)

10

how long is it ok to patch an eye for?

up to 24h

11

What is glaucoma?

Increased IOP w/ optic nerve damage

12

Open Angle Glaucoma

Chronic, asymptomatic potentially blinding dz
-defects in PERIPHERAL vision
-increased disc to cup ratios
tx: refer to optham (topical or systemic rx to decrease IOP)

13

Angle Closure Glaucoma

Painful eye, loss of vision
circumlimbal injection, steamy cornea, fixed mid-dilated pupil
-nausea, vomiting, diaphoresis
Tx: opthalmic emergency (start IV carbonic anhydrase inhibitor, topical beta blocker and osmotic diuresis)

14

Leading cause of irreversible central visual loss

Macular Degeneration

15

Macular Degeneration

-Causes: age related, choloroquine or phenothizine
-Drusen on buch's membrane
-Mottling, serous leaks, hemorrhages on the retina
-NO EFFECTIVE TX

16

Central Retinal ARTERY occlusion

-sudden, painless, marked unilateral loss of vision
-emoblic, thrombotic, vasculitides
-arteriolar narrowing, box-carting, retinal edema, perifoveal atrophy (cherry red spot), gangioloinc seat heads to optic atrophy and pale retina
Tx: Opthalm Emergency w/ poor prognosis regardless if tx immediately

17

Central Retinal VEIN occlusion

-sudden, U/L, painless blurred vision or complete vision loss
-Causes: secondary to thrombic event
-afferent pupillary defect and bood and thunder retina
AKA: dilated veins, hemorrhages, edema, exudates
-vision is typical resolved w/ time, at least partially

18

Retinal Detachment

Causes: spontaneous, secondary to trauma, extreme myopia
-acute onset of blurred or blackened vision that occurs over several hours and progress to complete or partial monocular blindness (curtain being drawn over eye)
-floaters or flashing lights at initiation of sump
-relatively afferent pupillary defect
-rgous retina flapping in the vitreous humor
Tx: opthalm emergency

19

Leading cause of blindness in adults in US

Diabetic retinopathy (yearly dilate eye exam)

20

Prolif diabetic retinopathy

-neovascularization, vitreous hemorrhage

21

Non prolif diabetic retinopathy

-venous dilation, microaneurysms, retinal hemorrhages, retinal edema, hard exudates

22

Tx of diabetic retinopathy

Optimized clusoe control, regulation of BP, laser photocoag, vitrectomy

23

Optic Neuritis

Occurs in 15-40 y/o
-idiopathic but 20-50% develop MS
-globe is tender, visual field defects, altered color vision

24

Orbital cellulitis

More common in kids than adults (7-12y/o)
-sinusitis, dental infections, facial infections, infection of the globe or eyelids, ing of lacrimal system)
-s. pneumo, s. aureus, h. influ, gram neg bact
-PTOSIS, EYELID EDEMA, EXOPTHALMOS, PURULENT D/C AND CONJUNCTIVITIS
-FEVER, DECREASE ROM OF EYE MUSCLES AND SLUGGISH PUPILLARY RESPONSE
tx: medical emergency (hospitalization and IV abx)

25

Amblyopia

reduce VA not correctable by refractive means (most common cause is strabismus not tx by age 2)

26

Bullae in AOM suggests

mycoplasmal infection

27

Cholesteatoma

Complication of OM; chronic neg pressure creastes sac which may dil w/ desquamated keratin and become chronically infected
Tx: marsupialization of the sac or complete removal

28

Tx of eustachian tube dysfunction

Systemic or intranasal deoncgestatnts

29

Causes of Conductive hearing impairment

(dysfunction of the external or middle ear)
1) obstruction (cerumen impaction)
2) Mass loading (middle ear effusion)
3) Stiffness (otosclerosis)
4) Discontinuity (ossicular disruption)
-conductive hearing disorders in adults are commonly due to cerumen impaction or transient eustachian tube dysfunction associated w/ viral URI
-persisitnent conductive losses susually result from chronic ear infection, trauma, or otosclerosis
-Tx: Often correctable w/ medical or surgical therapy

30

Causes of Sensorineural Hearing impariement

-sensory hearing loss = deterioration of the cochlea due to loss of hair cells from organ of corti
-presbyacusis = most common (gradual; predominantly high freq loss)
-others: excessive noise exposure, head trauma, systemic dz

-neural hearing loss = lesions involving the eight nerve, auditory nuclei, ascending tracts or auditory cortex
-Causes: acoustic neuroma, multiple sclerosis, auditory neuropathy