ENT/Ophthalmology Flashcards

1
Q

Most common pathogens for Bacterial Conjunctivitis

A

Staph Aureus and Strep.Pneumo. Less so H.Influenza and Moraxella

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2
Q

Sx for Bacterial Conjunctivitis

A

Purulent Discharge
Lid Crusting
No Visual Change

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3
Q

Treatment for Bacterial Conjunctivitis. What if they wear contacts?

A

Gentamicin Drops

Contacts: cover for pseudomonas so Fluorquinolones (Cipro, Levofloxacin, Ofloxacin)

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4
Q

Most common pathogens for Viral Conjunctivitis

A

Adenovirus

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5
Q

Sx for Viral Conjunctivitis

A

Super contagious
Associated with URI
Clear, Mucoid/Watery Discharge

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6
Q

Treatment for Viral Conjuncitivtis

A

Cool Compress
Artificial Tears
Antihistamines for Itching

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7
Q

Sx for Allergic Conjunctivitis

A

Itching, Tearing, Viral sx (rhinorrhea, fever, malaise, pharyngitis)

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8
Q

Tx for Allergic Conjunctivitis

A

Topical Antihistamines (Olopatadine)

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9
Q

Most common pathogen for Orbital Cellulitis

A

Strep. Pneumo. Less so GABHS, H.Flu, S.Aureus

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10
Q

Where is Orbital Cellulitis located

A

Post-Septal, 90% Ethmoid

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11
Q

Sx for Orbital Cellulitis

A

Usually spread for SINUS infection

Reduced Vision, Pain with ocular movement, Proptosis

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12
Q

Tx for Orbital Cellulitis

A

IV Abx (Vancomycin, Clindamycin, Cefotaxime)

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13
Q

Most common pathogen for Periorbital Cellulitis

A

Step. Aureus, S.Pneumo

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14
Q

Where is Periorbital Cellulitis located

A

Pre-Septal

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15
Q

Sx for Periorbital Cellulitis

A

Usually spread from URI

No pain with ocular movement, no vision change

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16
Q

Tx for Periorbital Cellulitis

A
Oral Abx (Dicloxacilin/Cephalexin)
If MRSA: Clindamycin/Cotrimoxazole
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17
Q

What is Strabismus

A

Eyes are not oriented straight

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18
Q

Sx of Strabismus

A

Cross-Eyed, Diplopia, Depth Perception Loss

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19
Q

Dx of Strabismus

A

Abnormal corneal light reflex, Drifting in cover/uncover test

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20
Q

Tx of Strabismus

A

Patch of “good eye”
Eyeglasses
Surgery between 6 months - 2 years

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21
Q

What is Conductive Hearing Loss

A

Block between external auditory canal and cochlear receptor cells - usually due to fluid in middle ear (middle ear effusion) or Cerumen

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22
Q

Tx for conductive hearing loss

A

Treat otitis media or remove cerumen, tubes if recurrent

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23
Q

What is Sensorineural Hearing Loss

A

Defect in Cochlear Hair Cells or Auditory Nerve (CN 8)

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24
Q

Tx for Sensorineural Hearing Loss

A

Cochlear Implants, Amplification

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25
Q

Most common pathogen for Otitis Externa

A

Pseudomonas. Less so, Staph and Strep, Aspergillus

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26
Q

Sx for Otitis Externa

A

Ear Pain, Pruritis, Auricular Discharge, Pain with movement of ear

27
Q

Tx for Otitis Externa

A

Dry with Isopropyl Alcohol or Aceitic Acid

Ciprofloxacin/Dexamethosone

28
Q

Most common pathogen for Acute Otitis Media

A

Strep. Pneumo. Less loss H.Flu, Moraxella

29
Q

Sx for Acute Otitis Media

A

Fever, Otalgia, Ear Tugging, TM with effusion

30
Q

Tx for Acute Otitis Media

A

Amoxicillin. Augment in 2nd line.

31
Q

Most common pathogen for Mastoiditis

A

Usually an extension of middle ear infection. Strep. Pneumo.

32
Q

Sx of Mastoiditis

A

Non-Resolving otitis media, hearing loss, postauricular swelling, TM perforation

33
Q

Tx of Mastoiditis

A

IV Abx (Ceftriaxone and Cefotaxime)

34
Q

Where is the most common site for an anterior epistaxis

A

Kiesselbach’s Plexus

35
Q

Treatment for Epistaxis

A

Direct pressure and lean forward while sitting.
Topical Decongestant (Cocaine, Phenylephrine, Oxymetazoline nasal)
Cauterization or nasal packing

36
Q

Most common pathogen for Acute Sinusitis

A

Same as for acute otitis media!

Strep.Pneumo, GABHS, H.Flu, Moraxella

37
Q

Sx for Acute Sinusitis

A

Sinus Pain/pressure
Headache
Purulent sputum or nasal discharge

38
Q

Tx for Acute Sinusitis

A

Amoxicillin

39
Q

What is Allergic Rhinitis

A

An IgE mediated histamine release response

40
Q

Sx of Allergic Rhinitis

A

Sneezing, nasal, ocular, or palatal itching

Clear rhinorrhea, nasal congestion, pale bluish nasal mucosa

41
Q

Tx for Allergic Rhinitis

A

Fluticasone (Flonase)

42
Q

Most common pathogen for Oral Thrush

A

Candida Albicans

43
Q

Sx of Oral Thrush

A

White curd-like plaques that when scrape leave an erythematous base behind and often bleed

44
Q

Dx of Oral Thrush

A

KOH Smear = Budding Yeast, Hyphae

45
Q

Tx of Oral Thrush

A

Nystatin or Clotimazole

Fluconazole PO

46
Q

Most common pathogen for Epiglottitis

A

H.Influenza

47
Q

Sx of Epiglottits

A

Fever, Drooling, Dysphagia, Distress (Tripod/Sniffing Dog Position)

48
Q

Dx of Epiglottits

A

Don’t put anything in their mouth!
X-Ray: Thumb Sign
Laryngoscope is definitive = Cherry red epiglottis

49
Q

Tx of Epiglottitis

A
Secure the airway and intubate the kid.
IV Abx (Ceftriaxone)
50
Q

Most common pathogen for Peritonsillar Abscess

A

Group A Strep (Strep.Pyogens)

51
Q

Sx for Peritonsillar Abscess

A

Dysphagia, Pharyngitis, Muffled Voice, Trismus (limited mouth opening), Drooling

52
Q

Tx for Peritonsillar Abscess

A

IV Clindamycin or Penicillin

53
Q

Most common pathogen for Acute Pharyngotonsillitis

A

VIRAL is 90%! (Adenovirus)

Group A Strep (Strep Pyogens)

54
Q

Sx for Acute Pharyngotonsillitis

A
Fever
Tonsillar Exudates
Tender Anterior Cervical Lymphadenopathy
Petichea on soft palate
No Cough
Scarlet Fever = Flushed cheeks, Strawberry tongue, erythematous blanching rash that is rough
55
Q

Tx for Acute Pharyngotonsillitis

A

Penicillin G

Amoxicillin, Augmentin

56
Q

Tx for Otitis Externa

A

Dry the ear with isopropyl alcohol and use Fluoroquinolones like Ofloxacin/Ciprofloxacin drops

57
Q

Most common pathogen for Mastoiditis

A

Remember, it’s an extension of Otitis Media
Strep. Pneumo, then Strep Pyogens, then Staph and H.Flu
Strep. Pneumo is #1

58
Q

Tx for Hearing Impairment

A

Manage with hearing screen at birth
Early Detection and Intevention Program with Auditory Branstem Response and Otoacoustic Emmision Testing
Intervene by 6 months
Cochlear Implants for sensorineural hearing loss
Amplification for sensorienueral correction

59
Q

Sx of Cleft Palate

A

Note a translucent zone in middle of soft palate
Palpation of hard palate reveals absence of posterior bony protrusion
During feedings: Nasal regurgitation of food
Abnormal Speech

60
Q

Cause of Cleft Palate

A

Congenital Malformation

61
Q

Tx for Otitis Externa

A

Dry ear with isopropyl alcohol and use Fluoroquinolones (Ofloxacin/Ciprofloxacin) DROPS

62
Q

Cause of Conjunctivitis

A

Bacterial: H.Flu, S.Pneumo, Moraxella, Staph Aureus. Spread via contact
Viral: Adenovirus. Very Contagious

63
Q

Dx for Epiglottis

A

Clinical, Note Rapid Progression
Drooling, Hoarseness, High Fever, Sore Throat, Tripod Position (sniffing dog).
Remember: Caused by H.Influenza so immunization hx important (if kids ages 2-7 missed, they are prone in winter months)

64
Q

Cause of Oral Candidiasis

A

Common in babies, people with immune deficiency and those who use steroid sprays for asthma. Can result from anything that throws off balance (Abx)
Caused by Fungus: Candida Albicans (normally found in mouth)