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Clinical Medicine > ENT Opt > Flashcards

ENT Opt Flashcards

1
Q

what are the weber and rinne tests used for

A

to differentiate between senory and conductive hearing loss

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2
Q

medical prevention of barotrauma

A

decongestants, antihistamines

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3
Q

classic radical neck dissection removes what

A

internal jugular

SCM

CN XI

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4
Q

infectious vs non infectious causes of conjunctivitis

A

infectious (bacterial, viral)

noninfectious (allergic, nonallergic0

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5
Q

typical presentation of viral conjunctivitis

A

adenopathy

fever

pharyngitis

URI

mucous like drainage

profuse tearing

follicular tarsal conjunctiva

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6
Q

describe ´Topical glucocorticoid preparations in treating allergic conjuntivitis

A

used for patients with refractory symptoms

can suppress late phase reaction to alllergies

should be used for short therapy for patients who failed other Rx

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7
Q

complications associate with acute mastroidits

A

osteomylitis

epidural, subdural, brain abscess

meningitis

carotid artery involvement

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8
Q

Mrs. P is a 65 year old female who has become acutely ill in the waiting room. An ophthalmologic assistant had dilated her eyes in preparation for examination. She is now complaining of nausea, diaphoresis and pain in her right eye, which is now red and swollen.

probable Dx

A

closed angle glaucoma

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9
Q

central scotoma

A

a symptom of macular degeneration where the middle part of the visual field looks black

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10
Q

treatment for thyroid carcinoma

A

most require total thyroid

radioactive iodine

synthyroid

occasionally external beam

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11
Q

Acoustic Neuroma (Vestibular Schwannoma)

A

slow growing benigh tumor usually at the cerebelo-pontine angle

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12
Q

chronic rhinosinusitis defined

A

12 weeks or more with

mucopurulent drainage, nasal obstruction, facial pain/pressure, decreased sense of smell AND inflammation documented

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13
Q

treatment for traumatic, foreign body, or reccurrent erosion corneal abrasins

A

remove foreign body if needed

topical ABx with erythromycin or sulfacetamine

can use a patch

no topical steroids

no follow up needed unless the abrasion is >1/4 the corneal surface

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14
Q

late post operative complications for cataract surgery

A

endopthalmitis

retina dtachment

cystioud macular edema

lens displacement

persisting astigmatism

secondary glaucoma

posterior capsule opacification

anterior capusle phimosis

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15
Q

what causes Unilateral Vocal Cord Paralysis

A

unilateral RLN injury from malignancy, iatrogenic injury, ET tubes, trauma, degenerative disorders

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16
Q

Unilateral Vocal Cord Paralysis signs

A

weak, breathy voice

risk for aspiration

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17
Q

describe seasonal allergic conjunctivitis

A

less dramatic onset that is typically caused by outdoor airborne allergens and takes weeks to develop and produces a predicatable course based on the allergen

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18
Q

conjunctivitis visual acuity

pen light

fundoscopy

A

should be normal, if its not REFER

pupil reaction should normal (REFER)

pinpoint pupil (REFER)

white or spotty cornea (REFER)

fundoscopy is not very useful but it should be normal

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19
Q

blepharitis Dx

A

clinical, no labs

pink/irritated eyelid edges

crusting of the lashes or lid margins might be present

chronic inflammation may result in structural changes (entropon, ectropion)

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20
Q

accumulation of mucous around teh cricoid cartilage may cause what

A

stenosis

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21
Q

describe posterior subscapular cataracts

secondary causes

classically involves what age

A

opactities that appear in the posterior aspect of the lens that often causes flare and difficulty reading

diabetes, steroids, inflammation

occurs in patients under 50

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22
Q

talking points for patients about diabetic eye disease

A

most damage is assymptomatic

control is of the ut must importance

encourage them to take charge

DMII can be managed with diet and exercise

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23
Q

is Malignant (Necrotizing) (MOE) potenially fatal

A

yes, it can spread to the bones, nerves, and cranial contents

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24
Q

what is considered a normal IOP

A

between 10 and 20

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25
Q

what should be used to kill life insects in the ear

A

ethanol, mineral oil, lidocaine

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26
Q

indications for biopsy of a neck mass

A
  • Progressively enlarging nodes
  • Single, asymmetric nodal mass
  • Persistent nodal mass, Esp. if no prior signs of infection
  • Active infection not responding to conventional antibiotics with routine cultures indeterminate
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27
Q

what is the treatment for nasopharyngel carcinoma

A

chemo

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28
Q

inflammatory neck masses

A

lymphadenopathy, abscess

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29
Q

drainage from an ear tube during an active infect is normal TF

they can always be treated with topical ABX TF

A

true

true

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30
Q

Central Dizziness clinical presentation

A

sudden on set more consistent with vascular event such as stroke or infarct

progressive when paired with headache over weeks and months is indicative of a space occupying tumor

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31
Q

otosclerosis

A

process in which the stapes loses mobility by excessive bone growth at the oval window

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32
Q

Allergic rhinitis clinical presentation

A

paroxysms of sneezing, rhinorrhea, nasal itching, obstruction

post nasal drip, cough, fatigue

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33
Q

descrive viral conjunctivitis

A

a highly contagious form of conjunctivitis that incubates for 5 -12days, usually bilateral

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34
Q

characteristics of Meniere’s Disease

(Endolymphatic hydrops)

A

episodic vertigo that lasts several hours

sudden unilateral hearing decrease

fluctuating hearing loss

tinnitius (roaring)

unilateral aural fullness

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35
Q

Perilymph Fistula clinical presentation

A

vertigo

motion intolerance

N/V

sudden hearing loss or fluctuating hearing loss

aural fullness

tinnitis

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36
Q

Perilymph Fistula Dx

surgery?

treatment

A

no diagnosis bur fistual test is helpful

surgical exploration is not accepted

bed rest with feet up, avoid straninig, surgical pataching

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37
Q

SS macular degeneration

A

metamorphosia

central scotoma

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38
Q

Vestibular schwannoma (acoustic neuroma) presentation

diagnostic studies

treatment

A

unilateral SNHL accompanied by tinnitus

MRI is the standard for diagnosis

surgery, radiation, observation

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39
Q

what is the treatment of diabetic macular edema

advantages

A

focal laser

painless, mild side effects, reduces severe vision loss by half

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40
Q

neoplastic neck masses

A

benign (paraganglioma, schwannoma, hemangioma, lipoma)

malignant (lymphoma, sailvary, thyroid)

metastatic

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41
Q

treatment of mastoiditis

A

IV ABx directed against staph pneumo, h flu, strep pyo

myringotomy (incsion of the TM to drain fluid)

mastoid ectome if medical therapy fails

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42
Q

imaging for orbital fracture

A

coronal ct because plain Xray is not sensitive enough

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43
Q

Otomycosis Fungal Otitis externa treatment

A

frequent cleaning and debridement

alcohol and vinegar soluton

nystain

lotrim

betadine

gentian violet

stay away from water

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44
Q

T/F viral conjuncivitis is a chronic condition that requires treatment

treatment

A

false, it is self limiting and thre is no specific anti viral

antihistamines

warm or cool compreses

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45
Q

Otomycosis Fungal Otitis externa symptoms

A

itching, ear fullness, local irritation, otorrhea, pain

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46
Q

T/F macular degeneration is painless

A

true

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47
Q

management of an orbita fracture

A

protetion of the globe

elevation of the head

IV fluids

treat NV

pain control

augmentin or azithromycin

add corticosteroids for EOM entrapment

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48
Q

what is needed for treatment of Malignant (Necrotizing) (MOE)

A

oral/IV therapy based on culture and sensivities

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49
Q

what causes gonococcal conjunctivitis

A

gonorrhea from the genetialita to the hands then eyes often has an active STI

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50
Q

pars plana vitrectomy

A

surgical removal of part of the vitreous

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51
Q

treatment for EAC foreign object

presentation

what types of objects require immediate action

A

hearing loss, otalgia, otorrhea

penetrating foreign bodies, batteries, live insects

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52
Q

describe the use of ´Antihistamines with mast cell-stabilizing properties in treating allergic conjunctivits

A

Rx include: olopatadine (Patanol, Pataday), bepotastine (Bepreve)

antihistamines blocks degranulation

usually does BID or once daily

usuually takes effect immediately

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53
Q

Acute suppurative sialadenitis treatment

A

correct predisposing factors

warm compress

sour lozenges

ABx (augmentin)

parotiditis usuallly needs IV Abx

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54
Q

: Chondrodermatitis Nodularis Helicis indcidence and perinent HP

A

most are men

spontaneous onset

usually enlarges to a size then stays stable

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55
Q

why do you need to differentiate between simple and complicated eyelid lacerations

A

complicated lacerations will need surgical repair

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56
Q

complications from cerumen impaction

A

TM perforation

infection

abrasion

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57
Q

test for vertebro-bassilar insufficiency

A

tiltiong head back cause dizziness

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58
Q

staphylococcus anterior blepharitis

A

colonaization of the eye lids by staph that leads to fibrinous scales and crusts around the eyelashes

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59
Q

what are lymph node stages used for in head and neck surgery

A

certain primary cancers are know to spread to certain lymph nodes so those nodes can be targeted and removed

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60
Q

chronic laryngitis

A

laryngitis that lasts longer than 3 weeks

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61
Q

DDx of +2cm congenital neck mass in an adult

A

branchial cleft cyst, thyroglossal duct cyst

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62
Q

what is the use of fine needle aspiriation in the Dx of neck masses

A
  • Differentiates benign from malignant
  • Carcinoma vs. Lymphoid
  • Avoids open biopsy
  • Standard work-up for thyroid nodule
  • Can be used for culture
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63
Q

Otomycosis Fungal Otitis externa risk factors

A

moisture, prior use of topical ABx

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64
Q

cholestatatoma

A

a cystic mass of squamous epithelium in the middle ear or in the temporal bone that causes bondy destruction of the mastoid bon and ossicles

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65
Q

the unknown primary

A

cancer in a cervical node with no detectable primary tumor

usually a squamous, undifferentiated tumor

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66
Q

History clues that can help Dx a neck mass

A

congenital (age, duration)

inflammatory (infection, pain, fever)

neoplastic (rapid growth, associated symptoms, risk factors, location)

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67
Q

treatment of bacterial keratitis

A

do not patch

being topical fluroquinolone

emergent evaluation by opthamalogist with close follow up

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68
Q

treatment for contact lens corneal abrasion

A

rule out infiltrate or opacity (refer if present)

topical ABx with cipro

no patch

no topical steroids

daily follow up

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69
Q

nasal foreign body dx

A

history or visualized foreign body

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70
Q

what will the swinging flashlight test look like

A

the consensual pupillary reflex will be diminshed in the good eye when the light is shined in the affected eye

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71
Q

lyre sign

A

a splayed appearance of the internal and external carotids indicative of carotid body tumor

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72
Q

Laryngopharyngeal Reflux symptoms

A

–dysphonia/hoarseness

–globus pharyngeus

–mild dysphagia

–chronic cough

–nonproductive throat clearing

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73
Q

vascular lesions associated with head and neck surgery

A

hemangioma, lymphangioma, vascular malformations

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74
Q

describe the use of mast cell stabilizers in treating allergic conjunctivitis

A

Rx includes cromolyn sodium (generic, Opticrom), nedocromil (Alocril)

full efficacy of therapy is reached 5-14 days

not useful for acumy symptoms

usually dose 4x daily

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75
Q

typical clincal course of viral conjunctivitis

A

symptoms get worse foe 3-5 days, very gradual resolution over 1-2w wth full recovery after 2-3 weeks

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76
Q

physical exam indications of an open eye injury

A

decreased visual acuity

affernyl pupillary defect

eccentric or teardrop pupul

increased anterior chamber depth

extrusion of vitrous

360 hemorrhage

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77
Q

how is a substernal goiter removed

A

transcerivcally, sometimes by sternotomy

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78
Q

Acoustic Neuroma (Vestibular Schwannoma) treatment

A

ecision or radiation

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79
Q

epistaxis diagnosis

A

HP with airway and CV assessment

work up for anemia and coagulopathy

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80
Q

clinical presentation of preseptal vs post septal cellulitis

eye pain/tenderness

A

pre: maybe
psost: yes, may cause deep eye pain

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81
Q

what levels of the spine will refer pain to the ear

A

C3-4

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82
Q

what will cause sensorineural hearing loss

A

dysfunction of the cochlea or neural components of the auditory system

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83
Q

causes of afferent pupillary defect

A

retinal detachment (total)

optic nerve damage

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84
Q

clinical presentation is tongue cancer

A

leukoplakia

erythroplasia

mass

ulceration

ill fitting dentures

pain

otalgia

neck mass

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85
Q

Presbycusis treatment

A

hearing aids

assistive listening devices

cochlear implants if hearing aids are ineffective

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86
Q

clinical presentation of preseptal vs post septal cellulitis

opthalmoplagia with diplopia

A

pre no

pro yes

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87
Q

ranula

A

a mucocele found on the floor of the mouth

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88
Q

acute mastoiditis is not a referal situation

A

false, it is

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89
Q

T/F Bilateral Vocal Cord Paralysis leaves the voice intact but has impaired respiratory function ranging from moderate stridor to respiratory distress

A

treu

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90
Q

benign paroxysmal positional vertigo treatment

A

particle reposition with the epley manuver

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91
Q

DDx for tinnitus: autoimmune

A

RA, SLE

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92
Q

complications of ETD

A

acute OM

OM with effusion

tympanic membrane retraction

conductive hearing loss

ear pressure and fullness

patulous estachian tubes

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93
Q

what is the most common type of glaucoma

A

open angle

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94
Q

Otitis media with effusion

A

presence of the fluid in the middle ear with/without SS of acute ear infection that can cauase conductive hearing loss

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95
Q

ciloretinal artery

A

a branch of the retinal artery that has left the optic nerve and found a different way into the retina

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96
Q

when in adenoidectomy indicated

A

children over the age of 4 with Hx of OME and nasal obstruction

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97
Q

pneumatic retinopexy

A

repair of a retinal tear on the superior portion of the retina tha tuses are an air bubble in teh vitreous chamber to tamp down the tear why whe pigemented retinal cells pump out eh vitreous

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98
Q

T/F Sudden Sensorineural Hearing Loss is a medical emergency

A

true

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99
Q

Central Vertigo
and Balance Disorders

A

central dizziness

vestibular equivalent migraine

vertebro-basilar insufficiency

stroke

space occupying lesion

hyper ventiallation

DM

MS

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100
Q

PE considerations for : Chondrodermatitis Nodularis Helicis

A

nodules are firm, tender, well demarcated, round to oval, central crust or ulcer

limited discoloration

commonly found on the right mre than the left

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101
Q

differentiate preseptal vs post septal cellulitis

severity

A

pre: generally mild
post: may cause vision loss or death

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102
Q

common cold etiology

A

rhinovirus

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103
Q

patient presents with a trauma that lacerates the retina

what might be sequela from this

A

some visual field lost from retinal artery occlusion

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104
Q

differentiate preseptal vs post septal cellulitis

location of infection

A

pre: anterior portion of the eyelid not involving the orbit
post: involves the content of the orbit but not the globe

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105
Q

when is immunotherapy used in allergic rhinitis

A

typically for refractory or severe cases

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106
Q

DDx of a +2cm congenital neck mass in kids

A

brachial cleft cyst, thyroglossal duct cyst

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107
Q

congenital neck masses

A

thyroglossal duct cyst, brachial cleft cyst, dermoid, laryngocele, thymic masses

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108
Q

vitrectomy

A

scope operation that fixes retinal detachment by draining the vitreous from behind the retina then putting an air bubble in the vitreous chamber to tamp down the retina

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109
Q

typical causes of conductive hearing loss in the outer ear

A

wax

otitis externa

trauma

exostosis

osteoma

squamous cell carcinoma

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110
Q

samters triad

A

asthma, aspirin sensitivity, nasal poyps

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111
Q

treatment of a corneal laceration with open globe injury

A

leave the object

place eye shield over affective eye

bed rest

avoid eye solutions

nacotics (no NSAIDs)

sedation if needed

emergent OP refereal with CT, IV vanco+ceph, NPO, tetanus booster

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112
Q

common clinical presentation of Cholesteatoma

A

hearing loss caused by pseudomonas

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113
Q

what can help decide whether or not to operate on a cataract

A

what degree of vision the person needs

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114
Q

most likely cause of Vestibular Neuritis

A

viral (herpes, epstein bar, flu, CMV)

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115
Q

Malignant (Necrotizing) (MOE) hallmark sign

A

infected granulated tissue on the flor of the cartilaginous each cannal near the bony junction that may have formed a defect under the skin

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116
Q

clinical presentation of oropharyngeal cancer

A

referred otalgia, trismus, throat pain, dysphagia, odynophagia

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117
Q

describe acute allergic conjunctivitis

how long to resolve

clinical presentation

A

sudden onset (within 30 mins) to hypersentitivty reaction cause by a known allergen

symptoms usually resolve within 24 hours after the allergen is removed

itching, hyperemia, tearing, chemosis, eyelid edema

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118
Q

how does HPV cause metastatic head and neck cancer

A

HPV causes occult tonsil cancer or base of tongue cancer

virus dies, but the tumor still grows

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119
Q

subdivisions of the larynx

A

supraglottis, glottis, subglottis

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120
Q

glaucoma

A

optic neuropathy that is the leading cause of irreversible blindness worldwide typically caused by increased inrtraocular pressure

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121
Q

when would augmentin be prescribed for treatment of Acute bacterial rhinosinusitis (ABRS)

what if they are cilin allegeric

A

likely ABx resistance (ABx use in the last month)

moderate to severe infection

presence of comorbidities (Diabetes)

use doxyclyclin

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122
Q

hordeolum

A

an accure purulent inflammation of the eyelid most commonly caused by staph

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123
Q

glaucoma treatment that will decrease aqueous pressure

A

beta blockers levobunolol, timolol, carteolol

alpha 2 adrenergic agonists apraclonidine, brimonidine

carbonic anhydrase inbitors acetazolmide, dorzolamide

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124
Q

Superior Canal Dehiscence Syndrome

A

a lesion in the superior semicircular canal

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125
Q

causes of SNHL

A

prebycusis

ototoxic drugs

meniere disease

acoustic neuroma

MS

autoimmune

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126
Q

what causes macular degeneration

A

vascular overgrowth in the retinal pigmented epithelium precipitated by an defect

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127
Q

arnolds nerve

what will it trigger

A

a branch of cranial nerve X in the ear that when stimulated causes a cough

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128
Q

pertinent HP and SS Exostosis

A

Hx of aquatic activty

more commn in males

usually assymtpomatic unless that are large enough to cause obstruction

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129
Q

what is the most common conjunctivtis in adults

what is the typical cause

A

viral conjunctivitis

adenovirus (cold)

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130
Q

describe ischemic optic neuropathy

A

usually optic nerve swelling

usually irrerverislbe

artheritic or non arteritic, both usually in the eldery

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131
Q

types of carotid body tumor

A

chemodectoma

paraganglioma

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132
Q

presentation of chlamydial conjunctivitis

A

unilateral, somtimes bilateral, follicular conjunctivitis that typucally affects the tarsal conjunctiva more so than the bulbar conjunctiva

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133
Q

clinical presentaiton of Ototoxicity

A

bilateral loss of cochelar funtion resulting in unstable gait and oscillopsia

can lead to senory hearing loss

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134
Q

what type of thyroid cancer has the best prognosis

A

papillary, it also is the most common

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135
Q

how does mastoiditis present on CT scan

A

loss of mastoid air cells and local bone destruction

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136
Q

describe the composition and location of the true vocal cords

A

bands of msucle, ligaments, mucosa that run from the arytenoids posterior to the midline of the thyroid cartilage posterior

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137
Q

pars plana

A

the area of the eye that can be incised without damaging other structures to allow access to the vitreous and retina

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138
Q

structures in the supraglottis

A

structures above the true vocal cords

epiglottis, false vocal cords, arytenoglottal folds, arytenoids

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139
Q

Meniere’s Disease (Endolymphatic hydrops) causes

A

mostly idiopathic but can associated with trauma and auto immune disease

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140
Q

causes of infectious uveitis

A

both herpes can cause this, usually unilateral

CMV can also do this with concurrent HIV infection

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141
Q

Superior Canal Dehiscence Syndrome clinical presentation

A

vertigo and oscilopsia in response to loud noise, vibration, changes in middle ear pressure

can also include conductive hearing loss

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142
Q

typical visual field defect in open angle glaucoma

A

down the to the right

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143
Q

how is bacterial conjunctivitis spread

pathogens in adults

pathogens in children

A

direct contact with secretions or contaminated surfaces

staph aureus, MRSA

strep pneumoniae, haemophilus influenze, moraaella cotarrhalis

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144
Q

Meniere’s Disease (Endolymphatic hydrops) treatment

A

low sodium

diuretic

endolymphatic trunk

labrynthecomy

gentamycin (ototaxic)

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145
Q

Allergic rhinitis treatment

A

intranasal glucocorticoids

oral antihistamines

antihistamine sprays

decongestant/antihistamine combo

intranasal cromolyn sodium

montelukast

immunotherapy

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146
Q

curvature of the cornea will cause what

A

astigmatism if its not spherical

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147
Q

sequela from Malignant (Necrotizing) (MOE)

A

spread to temporal bone and cause osteomylitis, leading to cranila nerve damange, brain abscess, meningitis

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148
Q

what movement is detected by the urtricle

saccule

A

horizontal movement

vertical movement

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149
Q

hollenhort plaque

A

a piece of cholesterol or calcium from the carotid or heart valves that has lodged in a retinal artery

correlated with high risk of stroke

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150
Q

T.F maculopathy from plaquenil is reversible

A

false

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151
Q

DDx for tinnitus: ototoxic meds

A

aminoglycosides, cisplatin, aspirin, loop diuretics

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152
Q

what percent of parotid cancers are benign

what percent of submandubular cancer are benign

A

80% parotid

50% submandibular

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153
Q

PE considerations for conjunctivitis

A

the conjuntiva will be pink or red instead of clear

you can see injection (blood vessels)

can become opacified (look white, yellow, or fleshy)

affects both the palpebral and bulbar conjuctiva

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154
Q

modified neck dissection spares what

Type I

Type II

Type III

A

Type I CN XI

type II IJV and XI

Type III IVJ, SCM, XI

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155
Q

metamorphosia

A

a symptom of macular degeneration where a grid of straightlines will appear wavy and some parts of the grid will look black

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156
Q

first line treatment for nasal polyps

A

intranasal corticosteroids

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157
Q

Perilymph Fistula causes

A

barotrauma (common)

heas trauma

complications from middle ear surgery

excessive straining

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158
Q

what movements are detectted by the semicircular canals

A

pitch (yes), yaw (no), roll (side to side

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159
Q

what causes Benign Paroxysmal Positional Vertigo

A

a mechanical dysfunction caused by an otolith becoming dislodged and flating around the semicircular canals, most common the posterior

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160
Q

T/F fine needle biopsy is a last resort for aneck mass

A

false, open biopsy is a last resort

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161
Q

uveits

A

inflammation of the uvea (the middle portion of the eye)

can be atnerior (iris and cilliary body) or posterior (choroid)

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162
Q

Recurrent acute rhinosinusitis defined

A

4+ episodes of acute bacterial rhinosinusitis per year without signs or symptoms of rhinosinusitis between episodes

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163
Q

describe a brachial cleft cyst

A
  • Lateral neck
  • Increase in size with URI
  • Second cleft most common
  • First associated with parotid
  • Third may be associated with thyroiditis
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164
Q

what is the risk for the use of ´Vasoconstrictor/antihistamine combinations for longer than 2 weeks

A

it can cause rebound hyperemia

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165
Q

clinical presentation of an orbital fracture

A

periocular ecchymosis

tenderness

crepitus

diplopia

decreased sensation

NV

bradycardia

disconjugate gaze

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166
Q

what afferent pupillary defect look like

what does it mean

A

thee affected pupil doesn’t constrict symetrically when a light is moved from one eye to the other

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167
Q

to parts of the cupula

A

utricle

saccule

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168
Q

Vestibular Neuritis treatment

A

rest, antiemetics, vestibular suppresson, steroids, antivirals, PT

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169
Q

treament for lichenification OE

A

anti inflammatory (elocon, dexamethasone)

can need canalplasty sometimes

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170
Q

origins of vertigo

A

vestibular issues

CNS (stroke, brain tumor, multiple sclerosis)

orthostatic hypotension

anxieity

hyperventilation

ortho issues

visual

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171
Q

Alpha-2 Adrenergic Agonists [apraclonidine, brimonidine] for glaucoma

mechanisms

admin

side effects

A

decreases production of aqueous humor

drops

lethargy, fatigue, dry mouth

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172
Q

complications of acute chronic OM

A

hearing loss

ossicular disconinuety/fixation

labrynthitis

skull or brain abscess

meningitis

TM perforation

cholestatoma

tympanosclerosis

mastoiditis

facial paralysus

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173
Q

T/F Suspected perforation of the pars flaccida (TM attic) is a cholesteatoma until proven otherwise.

A

true

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174
Q

typical pathogenesis of Acute Otitis Externa

A

overgrowth of bacteria caused by skin breakdown caused by excessive ear cleaning, scratching, ear phones, moisture

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175
Q

issues that would cause chronic recurrant otitis externa

treament

A

bacteria, fungal, inflamatory

treated with dandruff shampoo and topical corticosteroids

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176
Q

when should bacterial conjunctivitis be cultured

can ABx be reduced in treatment

what if symptoms don’t get better

A

when it is severe, recurrent, or deals with a resistant strain

it can be reduced after 4 days with improvement

try another Dx, ABx, or refer

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177
Q

etiology of cataracts

A

age

trauma

medication toxicity (steroids, anticholinesterase, etc)

inflammation

radiation

systemic disase (DM, hypocalcemia, wilsons disease)

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178
Q

when to not irrigate an ear

A

Hx of chronic ear disease

HX of TM perforation

ear tubes

only hearing ear

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179
Q

Malignant otitis externa (Necrotizing) (MOE)

A

an aggressive, invasive, destructuve inflammatory process found in diabetics or the immunocompromised

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180
Q

DDx of +2cm inflammatory neck mass in an adult

A

HIV, TB

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181
Q

Dx of chlymdial conjuctivitis

A

confirmed with direct fluorescent antibody staiing of conjuctival smears or culture

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182
Q

orbital cellulitis treatment

A

admit for OP or ENT

begin IV vancomycin plus ceftiaxone

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183
Q

structures of the inner ear

A

cochlea, semicircular canal, internal auditory canals

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184
Q

treatments for PDR

A

laser

surgery

VEGF injections/steroids

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185
Q

common Ototoxic drugs

A

aminoglycosides (amikacin, gentamycin, vancomycin)

loop diuretics

chemo

high dose aspririn

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186
Q

how long does acute laryngitis last

what is it usually associared with

A

3 weeks (self-limiting)

usually a URI (rhinorrhea, cough, sore throat) or acute vocal strain

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187
Q

future treatments of DME

A

surgery

steroids

VEGF inhibitor

oral meds

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188
Q

montelukast

how it it used in treating allergic rhinitis

A

selective leukotriene receptor antagonist, less effecive than intranasal glucocorticoids

sometimes used for people with allegies and asthma or nasal polyps

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189
Q

sudden SNHL = ?

A

refer

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190
Q

what is the goal of the scleral buckle

A

to fix retinal detachment by indenting the posterior eye to remove traction on the retina from the vitreous

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191
Q

algorhythm for corneal abrasion down to subtype

A

rule out penetrating injury

exam with fluorescein consistent with corneal abrasion

Hx suggesting subtype

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192
Q

presbyopia

A

diminished power of accodation due to loss of elasticity of the lens, usualy starts after 40

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193
Q

Acute rhinosinusitis (ARS) defined

A

inflammation of the nasal passages and paranasal sinuses lasting up to four weeks combined with purulent nasal discharge, nasal obstruction, sinus pain and pressure

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194
Q

Vestibular schwannoma (acoustic neuroma) defined

A

Schwann cell-derived tumors-commonly originating from the vestibular potion of cranial nerve VIII

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195
Q

commonly associated immune mediated uveitis condtions

A

ankylosing spondyloarthritis

reactive arthritis

sarcoidosis

behcets deiease

psoriatic arthritis

IBS

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196
Q

immediate treatment for ocular chemical burns

A

remove the offending agent with irrigation

promote surface healing with artificial tears and topical ABx

elimating inflammation

preventing infection

controlling IOP

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197
Q

labyrinthitis etiology

A

unknown, maybe viral infection

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198
Q

Sialolithiasis treatment

A

hydration, warm compress, treat underlying infection

refer if treatment is ineffective or have severe symtpoms

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199
Q

VEGF inhibition

A

vascular enthothelial growth factor inhibition, treatment for macular degeneration

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200
Q

treatment of TM perforation

A

treat causative factor

most heal on their own, refere for surgical correction

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201
Q

what is the major risk of epiglottis

A

infection that will cause swelling and eventually result in airway obstruction

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202
Q

T/F quinolones are firstline therapy for bacterial conjunctivitis

exception?

A

false, they are expensive and there is a concern about resistance

contact wears get first line treatment because of high incidence of pseudomonas

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203
Q

Acoustic Neuroma (Vestibular Schwannoma) clinical presentation

A

unilatearl sensory hearing loss

tinnitus

vestibular hypofunction

dysequilibrium

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204
Q

clinical presntation of allergic conjunctivitis

A

ocular pruitis is the most common symptom

blurred vision

redness

eyelid edema

usual bilateral symptoms

watery, non purulent discharge

NO eye pain

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205
Q

causes of senorineural hearing loss

A

presbycusis

noise exposure

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206
Q

epistaxis etiology

A

trauma

neoplasm

hereditary hemorrhagic telangectasia (osler-weber-rendu)

wegeners

coagulopathy

blood thiners

infection

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207
Q

how many episodes of acute OM indicate the placement of tympanostomy tubes

A

6 or more in one yera

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208
Q

clinical presentation of conjunctivitis

A

gritty feeling in the eye

itching/burning

excessive tearing

clear or yellow discharge

morning crust

swollen eyelids

increased sensitivity to light

signs of an upper respiratory infection

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209
Q

sialadenitis bacterial cause

viral

A

infection of the salivary glands cuased by staph, strep, h flu though to be caused by retrograde contamination from the oral cavity

mumps

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210
Q

DDx for tinnitus: neurologic

A

MS, Tumor

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211
Q

midline head and neck cancers

A

thyroglossal duct cyst

level I lymph nodes

dermoids

thyroid masses

level IV pathology

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212
Q

allergic cascade that causes allergic conjunctivitis

A

mast cell is exposed and sensitized to an allergen

subsequent exposure to the allergen causes massive degranulation

degranulation releases histamine which causes the majority of the symptoms

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213
Q

Otomycosis Fungal Otitis externa Dx

A

direct visualization or ear culture

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214
Q

typical symptoms of open angle glaucoma

A

progressive loss of vision from the periphery to center

disc cupping due to retinal cell death

open anterior angle chamber

assymptomatic with IOP >21mmHG

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215
Q

DDx of a +2cm neoplastic neck mass in kids

A

lymphoma, thyroid, sacroma

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216
Q

location and structures in the glottis of the larynx

A

true vocal cords and the area adjecent extending 1 cm below

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217
Q

benign paroxysmal positional vertigo etiology

A

most commonly associated with calcium debris of the posterior semicircular canal (canalthiasis)

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218
Q

Eustachian tube dysfunction

etiology

presentation

A

commonly associated with edema of the URT (viral URI or allegery)

earfullness, popping or cracking when swallowing, mild to moderate hearing loss, retraction or decreased mobility on pneumatic otoscopt

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219
Q

Exostosis

A

a benign, slowly growing, dome shaped area of bony hypertrophy that comes from the medial surface of teh temporal bone

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220
Q

signs of background diabetic retinopathy

A

dot/blot hemorrhages

hard exudate

cotton wool spots

intraretinal microvascular abnormalities

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221
Q

diseases that cause fibrosis or fixation of teh cricoarytenoid cartilage

A

RA, trauma

222
Q

treamtne of dacryocysitis

A

mst be fast

get blood culture and drainage

begin emipiric ABx therapy

223
Q

central RVO

A

central retinal vein occulsion that can cause blindness of varying severity with no real treatment

caused by compression around teh optic nerve

224
Q

Branch retinal artery occusion

A

blockage of the artery associated with carotid/cardiac dieases

may be considered emergent

225
Q

DDx of a +2cm inflammatory neck mass in children

A

atypical TB, lymphadenitis

226
Q

meniere disease presentation

A

episodic vertigo

SNHL that fluctuates and typically affects lower frequencies

tinnitis

aural fullness

227
Q

complication of nasoethmoid fracture

A

disruption of the medial canthal ligament and lacrimal duct system

can trap medial rectus

228
Q

Acute Otitis Externa furuncle

A

a staph abcess that come from a hair follicle (usually called a boil) that only happen in the outer part of the ear where hair is present

229
Q

Vestibular Neuritis Dx

A

calorics that will show hypofunction on the affected side

fakuda stepping

230
Q

posterior uvetitis

A

most likely to be apinless and may result in nonspecific visual changes such as floats or reduced acuity

redness of the eye is not a prominent feature unless there is anterior uveitis

you can see posterior inflammmation and or WBCs in the vitreous

231
Q

structure of the inner ear (periperal vestibular system) that can cause vertigo

A

semi circullar canals

cupulas of the semi circular canal

otolith structures

232
Q

factors associatd with chronic laryngitis

referral?

A

inhaled irritants (smoke, GERD, alcohol)

yes, requires laryngoscopy

233
Q

acute otitis media

A

inflammation of the middle ear that causes pain, hearing loss, red and bulging TM most common between 4 months and 4 years old

234
Q

reccomendations for allergic conjunctivits

A

dont rub eyes (exacerbates mast cell degranulation)

cool compresses can help

refridgerated articial tears are useful

stop contact lens use while symptomatic

limit exposure to allergens

235
Q

nasal polyps

A

pale, edematous, mucosa covered masses that form in the nasal cavity or paranasal sinuses

236
Q

Allergic rhinitis treatment with oral antihistamines

issues with first generation (benedryl)

issues with second (claritin)

A

lots of side effects (drowsiness)

cause less sedation and useful with patients who need relief from intermittent symptoms

237
Q

DDx for tinnitus; infection

A

rubella, neurosyphylis, lymdisease

238
Q

what is the function of the eustachian tube

A

regulates pressure

drains mucus

aerates the middle ear

239
Q

blepharitis treatment

A

warm compress

lid massage

lid washing

240
Q

classifications of allergic rhinitis

A

temporal pattern (seasonal)

perennial

episodic

determined by frequency and severity of symptoms

241
Q

T/F HTN is a direct cause of vision loss

A

false, it can cause many eye issues indirectly

242
Q

otitis externa lichenification

A

thickened, leathery epidermis caused over time by scratching, rubbbing that can lead to obsruction

243
Q

Laryngopharyngeal Reflux reccomendation

A

avoid foods that strip mucous from the esophagus (coffee, tea, peppermit(

avoid acidic foods

no smoking

eat smaller meals

avoid exercise for 2 hours after eating

244
Q

meniere disease acute treatment

A

vestivbular suppressants and antiemetics

245
Q

Perilymph Fistula

A

abnormal communication beween the inner and middle ear

246
Q

risk factors for developmental difficulties for children with OME

A

permanent hearing loss

suspected or confirmed speech and language delay

ASD and othe developmental disorders

down syndrome

craniofacial disordesr

blindness or uncorrectable visual impairment

cleft palate

developmental delay

247
Q

Allergic rhinitis treatment with Intranasal glucocorticoids

onset of action

continuous vs intermittent use?

adverse drug reactions

A

3-5 to 36 hours after first dose

continuous is better than intermittent

headache, throat irriation, epistaxis, nasal dryness

248
Q

common cause of blindness related to HIV

A

CMV retinitis

249
Q

what will happen in a rinne test with normal hearing

CHL

SNHL

A

air condicution will be better than bone

bone conduction will be equal or better than air

ac conduction will be better than bone

250
Q

function of the vocal chords

A

phonation

airway patency

valsalva

251
Q

ramsay huny syndrome (herpes zoster oticus)

definition

presentation

A

an otologic complication of the herpes zoster virus

ipsilateral face paralysis, ear pain, vesicles in the auditoy canal and auricle

252
Q

dacryocystitis

A

an infection of the nasolacrimal system

253
Q

Otomycosis Fungal Otitis externa PE

A

lumen will have cotton whie growth or debris wtih creamy white exudate

254
Q

whatis the function of the arytenoid cartilage

A

allow for attachment of intrinsic muscles of the neck that perfrom complex movements of the larynx

255
Q

T/F squamous cell parotid tumors require nothing post op

A

false, they need aggressive surgical managment and post operative radiation

256
Q

typical cause of barotrauma

A

usually flying or scuba diving, in conjuction with an ET dysfunction that prevents equalization

257
Q

Post op care for cataract surgery

A

steroid drops

topcical mydriatics

IOP reducers

refraction testing

use glasses

258
Q

two types of astigmaism

A

regular (light is always bent the same way)

irregular (distorted images caused by warps surfaces)

259
Q

what causes retinal detachment

A

tears that allow the vitreous humor to escape the posterior chamber and flow behind the retina

260
Q

lab test for corneal lesions, foreign bodies, abrasions

A

fluorscein staining on he corneal epithelium that will turn defects bright green

261
Q

mastoiditis defined

presentation

A

common complication of acute otitis media that is associated with mastoid bone destruction

fever, post auricular erythema/tenderness, ear proptosis, acute otitis media on otoscopy

262
Q

Mal De Barquement Syndrome

A

spontaneous rocking sensation that comes with spending a lot of time on a boat that usually resolves in a few days

263
Q

in central retinal artery occulsion, why would the fovea be red

causes

treatment

A

because the fovea doesn’t get much blood from the arteries of the eye

thrombosis, embolism

usually untreatable

264
Q

etiology of : Chondrodermatitis Nodularis Helicis

A

dermal inflammation, edema, necrosis, pressure probably intiatie the disease

may be assocaited with CTD, autoimmune, thyrod issues, SLE, scleroderma

265
Q

clinical presentation of bacterial keratitis

A

pain in the eye usually sudden

unusual eye redness

reduce visual acuity

photophobia

excessive tearing

corneal opacity of infiltrate

discharge

can present with hypopyn

266
Q

types of cataracts

A

nuclear sclerosis

cortical

posterior subscapular

267
Q

drugs that increase aqueous flow

A

Nonspecific Adrenergic Agonists [epinephrine, dipivefrin]

Parasympathomimetics [pilocarpine, carbachol, echothiophate]

Prostaglandins [latanoprost, lumigan, travatan]

268
Q

Sudden Sensorineural Hearing Loss chance of restorng hearing in the first 2 weeks

A

50%

269
Q

Bilateral Vocal Cord Paralysis caauses what

why

A

stridor

beccause the non functrional vocal cords cause glottal stenosis

270
Q

labs for severe epistaxsis

A

CBC for anemia and thrombocytosis

coagulation (PT, INR, PTT)

blood type

271
Q

typical causes of bacterial keratitis

A

pseudamonas, staph a, strep

272
Q

uvetitis diagnoses and treatment

A

refereral to OP

topical, intravitral or system corticosteroids

systemic immunosuppression

anti microbial therapy

273
Q

when is urgent removeal for a nasal foreign body required

treatment

when to refer

A

button batteries or paired magnets

positive pressure or direct instrumentation

when the object is posteriorly located, impacted, or penetrating

274
Q

T/F bacterial conjunctivitis needs treatment

A

false, it typically is self limiting but ABx will decrease the clinical course if given before day 6

275
Q

PDR laser treatment

considerations

A

a more extensive laser treatment

more extensive, treats peripheral retina, can be painful, reduces side/night vision

276
Q

Acoustic Neuroma (Vestibular Schwannoma) Dx

A

MRI-IAC with contrst

277
Q

DDx for tinnitus

A

SNHL (most common)

neuro

ototoxic meds

infection

metabolic disorders

autoimmune

vascular disorders

278
Q

DDx of +2cm neoplastic neck mass in an adult

A

SCCA, thyroid, salivary gland, lymphoma

279
Q

what is the most common of periodontal disease

it is a precursor to what

how can it be reversed

A

gingivits

periodontitis

can be reversed withgood dental hygiene

280
Q

differentiate preseptal vs post septal cellulitis

blood work

A

pre: bactricemia is rare
post: blood cultures are more often positive in children than adults

281
Q

laryngopharyngeal reflux

A

retrograde movemnt of gastric contents into the laryngopharnyx

282
Q

Ototoxicity

A

ingestion or exposure to an ototoxic subsance that kills the hair cells in the cochlea

283
Q

prevention an education for conjunctivitis

A

practive good hygeine

dont touch your eyes with your hands

wash your hands often

change towels and wash cloths

return to sport, school, work after 24 hours of treatment and drainage as resolved

284
Q

what is the larynx suspended from

A

the hyoid bone

285
Q

typical causative organisms of dacryocystitis

A

alpha hemolytic strep

staph epi

staph a

286
Q

treatment for otitis externa

are ABx always nessasry

A

Aural toliet

topical therapy with steroids

analgesics

no ABx unless there is an extenstion out side the ear canal or comorbities that raise concern (diabetes, immune deficiency

287
Q

types of imaging used for neck masses

A

US

CT

MRI

PET

nuc med

288
Q

cause closed angle glaucoma

A

apposition of the iris and the trabecular meshwork

increases risk with age due to increase in lens volume

can be brought on by parasympatholytics (pupilary dilation)

289
Q

clinical presentation of oral cavity cancer

A

non-healing ulcer, dysarthria, bleeding, pain, loose teeth

290
Q

eye length

myopia

hyperopia

A

myopia long

hyper short

291
Q

History for unknow primary cancer

A
  • Risk Factors
  • Prior Malignancy
  • Prior Surgery (including skin or neck)
  • Head and Neck Symptoms
  • Oromandibular and Dental
  • Dysphagia/Odynophagia/Voice complaints
  • Epistaxis, Nasal Congestion/obstruction
  • Otalgia, Hearing Loss
  • Weight Loss
  • Fever, Chills, Sweats
292
Q

describe cortical cataracts

A

radial or spoke like opacities in the lens perphery that expand to involve the anterior and posterior lens (often asymptomatic until the defect is centrally involved)

293
Q

if epistaxis doesn’t stop with convervative measures

if that doesn;t work then what

if that doesn’t work then what

A

nasal packing with ABx

ENT consult, pack the oppostive nasal cavity

consider posterior source

294
Q

retinal side effect of plaquenil

screening

A

toxicity that can cause bullseye maculopathy

need to have eye exam yearly

295
Q

clinical presentation of Acute localized otitis external
Furuncle

A

severe pain that is agrrevated by movement of the pinna, pressure on the tragus, chewing

hearing loss is present if the ear canal is occluded

296
Q

typical presentation of an Overly patent eustachian tube (a.k.a. patulous eustachian tube)

treatment

A

autophony (exaggerated ability to hear ones breathing and voice)

directed at treating an underlying condition

297
Q

Parasympathomimetics [pilocarpine, carbachol, echothiophate] for glaucoma

mechanism

admin

side effects

A

increases contractile force of the ciliary body muscle to increase out flow of aqueous

topical drops or gel

headache, myopia

298
Q

leukoplakia often indicates what

how often will it progress to carcinoma

when should it be biopsied

A

hyperkeratosis from chronic infection

1-20% within 10 yrs

indurated or enlarged lesions

299
Q

clinical presentation of preseptal vs post septal cellulitis

pain with eye movements

A

pre no

post yes

300
Q

differentiate preseptal vs post septal cellulitis

agents

A

staph, strep, anaerobes

post: strep anginosus, staph a, strep pyo

301
Q

SS cerumen impaction

A

tinnitis

conductive hearing loss

feeling plugged

302
Q

Rx considerations for bacterial conjunctivitis

A

ointment is prefered for children, those with poor compliance, or people who are hard to administer drops to because the ointement stays on the eye longer

303
Q

what is the goal of imaging studies in diagnosing orbital cellulitis

when is a CT recommended

A

look for an abcess or complication that needs surgery

proptosis, limitation of movement or pain, double vision, vision loss, edema beyound the eyelish, signs og CNS involvement

304
Q

T/F HPV positve oropharyngeal cancers have a worse prognosis than those who have cancer realted to tobacco

A

false, HPV has a better prognosis

305
Q

treatment of Sudden Sensorineural Hearing Loss

A

high dose steroids

intratympanic steroid injetions

antiviral med

306
Q

HTN related signs of poor retinal health

A

arterial narrowing

AV nicking

exudate

optic nerve swelling

307
Q

why is afferent pupillary defect diagnostically valuable

A

because you can assess the function of the afferent and efferent nerves in both eyes from one

308
Q

globus

A

feeling like there is something in the throat

309
Q

chronic rhinosinusitis ways to document inflammation

A

purulent mucus and edema in the middle meatus or anterior ethmoid

polyps in the nasal cavity or middle meatus

radiographs showing inflamation of the sinuses

310
Q

elements to include during exam of a corneal abrasion

A

measure visula acuity

exclsusion of open globe and hyphema

fluorescein

lid eversion to asses conjunctival foreign body

311
Q

typical presentation of gonococcal conjunctivitis

A

profuse discharge within 12 hours of innoculation that rapidly progresses to irritation, redness, tenderness

has prearicular adenopathy

312
Q

T/F christmas tree cataracts are typically congenital

A

true

313
Q

auricular hematoma

presentation

treatment

complications

A

tender, fluctuant collection of blood floowling a blunt trauma

drainage, pressure to keep the hematoma from forming, ABx

infection, recurrance, hematoma, cauliflower ear

314
Q

symptoms of retinal detachment

A

new floaters

flashing lights (photopsia)

visual field loss

315
Q

what type of neck masses are most common in children

young adults

adults

A

inflammatory

congenital or inflammatory

neoplasia

316
Q

secondary sources of ear pain

A

C spine

TMJ

temporal arteritis

GERD

neuralgia

poor dentition

tonsilitis

317
Q

gonococcal conjuctivitis lab test

treatment

referal

A

can be gramstained G- diplococci

ceftriaxone IM + azithromycin oral + topical

admit for monitoring, treatment

318
Q

most common pathogens for acute OM

A

strep pneumo

Haemophilus

moraxella catarrhalis

group A strep

319
Q

clinical presentation ocular chemical burns

A

decrease vision

moderate of severe eye pain

blepharospasm (inability to open eyes)

conjuctival redness

photophobia

alkaline burns turn the eye white

320
Q

when should hoarseness be refered to ENT

A

when there are no URI symptoms, lasts more than 2 weeks

accompanied by risk factors for head and neck cancer, severe cough, hemoptysis, unlateral ear or throat pain, dysphagia, unexplained weight loss

321
Q

Acute bacterial rhinosinusitis (ABRS) complications

A

orbital cellulitis and abcess

osteomyelitis

intracranial extension

cavernous sinus thrombosis

322
Q

benign paroxysmal positional vertigo presentation

A

recurrent episodes of vertigo lasting one minute or less provoked by sudden head movement

positive dix hallpike manuver with characteristic nystagmus

323
Q

causes of refractive errors

A

eye length

curvature of the cornea

curvature of the lens

324
Q

barotrauma

presentation

prevention

referral?

A

ear pressure, hearing loss, otalgia, tinnitus

avoid activities that might cause injury

if there is SNHL or dizziness, but most will heal on their own

325
Q

what will happen during the weber test if there is CHL

SNHL

normal

A

CH - sound lateralizes to the bad ear

SNHL - sound lateralizes to the good ear

normal hearing - sound hear equally in both ears

326
Q

atrophoic glossitis

causes

A

inflammation of the tonhe that makes the tongue look glossy

iron, b12, folic acid deficient

low protein diet

infection

sjogrens

celiac

327
Q

presentation of otosclerosis

treatment

A

slowly progressive conductive hearing loss that is usually bilateral and assymetric

tinnitus, SNHL

refer to ENT for hearing amplification or surgery

328
Q

describe allergic conjunctivitis

A

inflammation caused by airborne allergens in the eye that is comonly associated with other allergic disease (asthma, allergic rhinitis, atopic dermatitis)

329
Q

corneal abrasion Hx subtypes

A

tramuatic

foreign body

recurrent erosion

contact lens

330
Q

Intranasal cromolyn sodium

how effective of a treatment is it for allergic rhinitis

A

mast cell stabilizer that inhibits mast cell degranulation

frequently less effective than intranasal glucocorticoids or 2nd gen antihistamine

331
Q

T/F there are many things that can present as a cyst, so it is important to not assume things are a cystic

A

true

332
Q

pleiomorphic adenoma

A

a benign tumor of the parotid gland that can convert into a more serious issue if allowed to grown

333
Q

factors that are cocerning for proliferative diabetic retinopathy

A

can cause true blindness, esp in DM I

important to look for uncontrolled DMI as teens

334
Q

causes of acute vision loss

A

macular disease

retinal detachments

vein occlusions

arterial onclusions

vitreous hemorrhage

optic nerve trauma

“functional vision loss”

335
Q

proliferative diabetic retinopathy

A

neovascularization of the retina that causes the secretion of VEGF and infiltration of the vitreous

336
Q

seborrheic anterior blepharitis

A

dandruff like skin changes around the base of the eyelids, resulting in greasy scalse around teh eye lashes

337
Q

what causes vision loss in background diabetic retinopathy

A

macular edema

338
Q

hyopyon

A

layer of white cells in the anterior chamber of the eye assocated with fulminiant cases of bacterial keratitis

339
Q

T/F sublingula tumors are rare

A

true

340
Q

treatment for Laryngopharyngeal Reflux

A

full strength PPI for 3 months

341
Q

what age is most likely to present with a foreign body in the EAC

A

6

342
Q

Beta-Blockers [levobunolol, timolol, carteolol, betaxolol] for glaucoma

mechanism

adminstration

three side effects

A

acts on the ciliary body to decrease production fo aqueous humor

topical drops to minimize side effects

bradycardia, syncope, bronchonconstrction

343
Q

Vestibular Neuritis

A

sudden onset of vertigo without an associated auditory symptoms, lasts more than 24 hours, postural instability, and nystagmus

344
Q

Otomycosis Fungal Otitis externa defined

A

superficail fungal infection of the ear

345
Q

mild dacryocystitis should be treated with what

severe

A

oral clindamycin

IV vancomycin with cephalosporin

referal

346
Q

etiology of Otomycosis Fungal Otitis externa

identification based on discharge

A

aspergilis, candida are common

aspergilus: black, yellow, gery

candida white

347
Q

what does a head and neck oncologist do

A

management of cerival lymph nodes, salivary glands, thyroid malignancy, otologic maliganancy, paranasal sinus malignancy, cranial base malignancy

348
Q

what is the most common eye exam in kids

A

conjunctivitis

349
Q

what is detected by the otoliths

A

movements where the head stay in the same positon but the body moves as awhole

350
Q

clinical presentation of cancer below the pharynx

A

dysphagia, odynophagia, hoarseness, otalgia, neck mass, sore throat

351
Q

causes of Sudden Sensorineural Hearing Loss

A

idiopathic

viral

meniere disease

trauma

stroke DM

352
Q

treatment methods for glaucoma

A

lower IOP by decreasing production aqueous humor or increasing out flow of aqueous humor

353
Q

DDx of lymphadenopathic neck masses

A

infection (bacterial, abscess)

caseating granuloma

reactive

sarcoidosis

354
Q

what is the only definitive therapy for closed angle glaucoma

A

trabeculectomy

355
Q

intact confrontational visual fields with poor vision is indicative of what

A

central scotoma from macular degeneration

356
Q

dix hallpike manuever

A

turn patient head to the right, lay them down fast, look of rotary nystagmus and dizziness

if the right side doesnt work try the left

the side that has a positive test is the location of the dysfunction

357
Q

T/F Cholesteatoma should be refered

A

true

358
Q

treatment for cerumen impaction

A

wax removal kits

irrigation with warm water and alcohol

359
Q

SS optic neuritis

gender bias

imaging

A

MS

pain with eye movement

APD

usually makes a complete recovery

more young women

MRI is advisable

360
Q

diagnostic categories of neck masses

A

inflammatory

congenital

neiplastic

traumatic

361
Q

what would cause a bitempral visual field defect

A

lesion at the optic chiasma

362
Q

four types of refractive errors

A

myopia

hyperopia

astigmatism

presbyopia

363
Q

Common Cold presentation

A

rhinitis, congestion, sore throat, cough, sometimes conjunctivitis

typically NOT fever

364
Q

structures of the outer ear

A

auricle and ear canal

365
Q

topical treatment for allergic conjunctivitis

A

antihistamine/vasoconstrictor product

anti histamines with mast cell stabilizing properties

mast cells stabilizers

NSAIDs

topical glucocortcoids

366
Q

describe arteritic ION

A

elderly women

related to PMR (tender scalp, headache, fever, jaw pain)

can progress to giant cell arteritis

367
Q

why is nasopharyngeal cancer unique

A

EBV is the carcinogen

368
Q

Acute Otitis Externa defined

A

inflammtion of the skin of the outer ear

369
Q

unilateral purulent discharge in a young patient suggests what

A

a foreign body of organic nature

370
Q

less familiar with signs of acquired cataracts

A

retina appears indistinct on fundoscopy

dim red reflex

increased myopia that previously noted

cataract does not cause an afferent pupil defect

371
Q

evaulation for vertigo

A
  • History, History, History
  • Physical Exam with Orthostatic blood pressures
  • Audiogram
  • ENG (electrovestibular nystamogram) or VNG
  • Labs
  • Imaging studies
372
Q

labyrinthitis presentation

A

vertigo lasting for several days to a week accompanied by hearing loss

373
Q

what is the primary risk factor for head and neck cancer

A

tobacco use

374
Q

T/F eye ointment doesn’t affect vision

A

false, it will cause blurred vision for 20 minutes

375
Q

Acute Otitis Externa typical bacterial agents

A

pseudomonas

staph

376
Q

what gets treated first, eye lid laceration or globe injury

A

globe

377
Q

describe the use of ´Vasoconstrictor/antihistamine combinations in treatment of allergic conjuctivitis

A

OTC drugs (naphazoline, phenariamine)

dosing up to four times daily for accute symptoms

reversibly blocks histamine

vasoconstricts (alpha-adrenergic agonist)

appropriate for short term use

378
Q

Acute bacterial rhinosinusitis (ABRS) must fit one of what three presentations

A

acute rhinosinusitis lasting for 10 days after the onset of URI

acute rhinosinusitis worsening within 10 days after initial improvement

onset of sever symptoms of signs of high fever (+102F), purulent discharge or facial pain, lasting for at least 3-4 days at the beginning of illness

379
Q

meniere disease etiology

A

possible fluid in the ear due to abnormal ion homeostasis

380
Q

where is the arytenoid cartilage

A

on the upper border of the posterior cricoid cartilage

381
Q

middle ear causes of conductive hearing loss

A

otitis media

cholesteatoma

otosclerosis

TM perforation

Eustachian tube issue

middle ear barotrauma

382
Q

: Chondrodermatitis Nodularis Helicis

A

common, benign, painful condition of the helix or anti helix

383
Q

risks of a deep lobe tumor in the parotid gland

A

more likely to have a facial nerve insult that causes facial paralysis

384
Q

clinical presentation of nasopharyngeal cancer

A

epistaxis, nasal obstruction, unlateral hearing loss, SOm, Neck mass, cranial nerve palse

385
Q

caution for vestibular suppresants in Vestibular Neuritis treatment

A

meclizine can cause decreased central compensation

386
Q

positive fakuda stepping for Vestibular Neuritis

A

marching in place for 100 steps causes movement greater than 1m or rotate more than 45deg

387
Q

Exostosis PE

A

usualy multiple nodules

circumscribed or diffuse

small hard, shiny, sometimes penduculated

overlying skin is sometimes more pale an thin

can be differentiated from a foreign body on palpation

388
Q

Prostaglandins [latanoprost, lumigan, travatan] for glaucoma

mechanism

adminstration

side effects

A

may increase uveoscleral outflow by relaxing ciliary body

topical

iris color change

389
Q

patient presents with hard exudate but no DM or HTN

what might be the cause

A

hyper lipidemia

390
Q

what causes open angle glaucoma

A

obstruction of trabecular meshwork that allows the flow of fluid between the intermediate and anterior chambers of the eye

391
Q

T/F pediatric epiglottitis can be confirmed with a through oral exam

A

false, adults can be examined but children can gag and completely close their glottis

392
Q

clinical presentation of preseptal vs post septal cellulitis

proptosis

A

pre no

post usually may be subtle

393
Q

euphimisms for dizzy

A

spinny

unsteady

staggering

lightheaded

disequilbirum

disoriented

woozy

floatin

394
Q

Carbonic Anhydrase Inhibitors [acetazolmide, dorzolamide] for glaucoma

mechanism

admin

side effects

A

blocks enzyme that produce HCO3 that carry osmotic water, therby decreaseing the production of aqueous humor

oral or topical

malaise, kidney stones, aplastic anemia

395
Q

symptoms of acquired cataracts

A

slowly progressive visual loss or blurring

glare

reduced color perception

396
Q

hall mark presentaton of prebycusis

other symptoms

A

progressive, systemic loss of hearing over many years (SNHL)

tinnitus, vertigo

397
Q

Allergic rhinitis treatment with Oral antihistamine/decongestant combinations

why use them?

adverse drug reactions

A

nonsedating antihistamines combined with pseduoephedrine provide better relief than antihistamine alone

limit us, include HTN, insomnia, irritability, headache

398
Q

what is the only complete ring of cartilage in the larynx

A

the cricoid cartilage, below the thyroid cartilage

399
Q

clinical presentation of preseptal vs post septal cellulitis

vision impairment

A

pre no

post maybe

400
Q

what usually causes corneal abrasion

A

trauma or foreign body

401
Q

how does HTN affect the eye

A

worsens DR

vein/artery occlusions

aneurysyms

optic nerve issues

macular degeneration

402
Q

Acute suppurative sialadenitis presentation

A

pain and swelling of the affected gland

induration, edema, tenderness

possible expression of pus

403
Q

Acute bacterial rhinosinusitis (ABRS) treatment

A

ABx (amoxicillin or augmentin)

NSAIDs and tylenol

intranasal saline irrigation

intranasal corticosteroids

404
Q

erythroplakia

is this more or less indicative of malignancy compared to leukoplakia

A

red mucosal plaques

more likely to be malignant, should be biopsied

405
Q

DDx for tinnitus: metabolic disorders

A

thyroid, chronic renal failure

406
Q

what determines the presentaion of hearing loss with TM perforation

A

depends on the size and location of the perforation

407
Q

Meniere’s Disease (Endolymphatic hydrops) dx

A

usually clinical

audometric evaluatation for low frequency sensory loss

vestibular evaluation with nystagmus toward the hypofunctioning side

calorics will usually be hypofunctioning on the affected side

more common in women bewteen 30and 60

408
Q

practice guidlines for OME

A

screen at risk kids

discourage antihistamines and intranasal steroids

fluld present for 3 months warrants tubes

observation of children without risk for development disability for 3-6 months

if hearing loss is >20dbs put in tubes

409
Q

Meniere’s Disease (Endolymphatic hydrops) hearing loss

A

early stage only has low frequency loss

as the disease progresses the heaing loss will flatten

usually results in poor word recongition

410
Q

what is often the presenting symptom of spondyloarthropthy

A

uveitis

411
Q

descrive perennial allergies

A

mild, chronic, waxing and waning related to environmental exposure to year round indoor allergens (dust mites, animals, molds)

412
Q

conditions related to nasal polyps in adults

in kids

A

chronic sinusitis, ashtma, aspirin sensitivty

cystic fibrosis

413
Q

Acute localized otitis external Furuncle on physical exam

A

a extremely tender, erhytmatous, localized swellling on the out ear

adenopathy between the mandible and mastoud

pain

414
Q

how would a lesion in the optic tract behind the optic chiasm manifest

A

contralateral homogogenous hemianopsia (vision lost on the nasal ipsilateral and the temporal contralateral side)

415
Q

epiglottis

A

Infectious epiglottitis is a cellulitis of the epiglottis and adjacent tissues that can result from bacteremia and/or direct invasion of the epithelial layer by the pathogen

416
Q

Acute localized otitis external Furuncle treatment

A

I&D

oral Abx (keflex, clindamycin, bactim)

topical ABx

warm compress

417
Q

indications for removal of a substernal goiter

A

airway obstruction or dysphagia

418
Q

Central Dizziness

A

dizziness causd by a lesion in the cerebellum, brain stem or central vestiblar pathway

419
Q

patient education associated with blepharitis

A

it is a chronic condition with no definitive cure

good lid hygiene is important

have reasonable expectation

420
Q

early post opp complications of cataract

A

endopthalmitis

uveitis

retained lens matter

corneal edema

hyphema

astigmatism

exacerbation of diabetic retinopathy

421
Q

clinical presentation of laryngeal cancer

A

muffled voice, hoarseness, sore throat, otaligia, airway obstruction

422
Q

diabetic screening for retinal health

A

DM I, yearly dilated exams starting a puberty or within 5 years of diagnosis

DM II, at diagnosis and yearly after

Gestational: in the first trimester, each trimester as indicated

423
Q

types of thyroid carcinoma

A
  • Papillary
  • Follicular
  • Medullary
  • Anaplastic
  • Lymphoma
  • Metastatic (melanoma, renal and others rarely)
424
Q

what must be done when lymphoma is suspected

A

fine needle biopsy to exclude carcinoma

425
Q

what is a common presentation of uveitis relating to behcet disease

A

wide spread intraretinal hemorrhage that is secondary to retinal vasculitis

426
Q

hyperopia

corrected by

A

far sighted ness caused by light rays focused behing the retina because the cornea/lens is too flat or the eye is too short

corrected by a convex lens to converge light

427
Q

what is one tool that can help localize the location of a stroke

A

central visual field defect

428
Q

strucutres of the middle ear

A

tympanic membrane, ossicles, middle ear space

429
Q

causative factors for TM perforation

A

barotrauma, foreign body injury, infection

430
Q

blood under the retina is indicative of what

A

macular degeneration

431
Q

common causes for otitis externa

what bacteria are the most common vectors in otitis externa

A

infection, allergy, dermatological reasons

pseudmonas and staphylococcus

432
Q

causes of eustachain tube diysfunction

A

youth

URI

chronic sinusitis

allergic rhinitis

adenoid hypertrophy

tobacco smoke

reflux

radiation

433
Q

DDx for tinnitus

when to suspect a vascular cause

lab studies?

A

when the tinnitus is pulsatile

contrast CT, MRI, and angiography

434
Q

T/F Laryngeal Growths tend to be bilateral

A

false, they tend to be unilateral with a contralateral friction lesion, though some “screamer nodes” can occur that are bilateral

435
Q

differentiate between a hordeolum and a stye

A

an internal hordeolum is an inflammed meibomian gland under the conjuctival side of the lid

a stye is an external hordoleum that comes from an eyelash or a lid margin gland

436
Q

etiology of uvetis

A

systemic infections

inflammatory disease

immune conditions

437
Q

anterior blepharitis

A

a less common form that involves inflamtion of the base of eye lashes

usually seen in youner women

can be staphylcoccal or seborhheic

438
Q

describe chlamydial conjuctivitis

A

a chronic case of conjunvtivitis that usually concurrent with GU infection

439
Q

what happens during panendoscopy

A
  • Palpation of the base of tongue facilitated
  • Evaluation of the pyriform sinuses
  • Biopsy of inaccessible regions
  • Telescopic Mapping
  • Screening for multiple primaries
440
Q

Lip-Splitting Incisions

A

Straight

Curved around mental sulcus and chin

“Z” and “V”

Stepped approaches

441
Q

what is the most important part of evaluating a patient with uveitis

A

you need to ask questions about underlying causes

spondyloarthrtis (LBP before age 45)

joint pain or swelling

FHx of spondyloarthritis

risk fators for HIV

442
Q

Exostosis Dx and treatment

A

usually clinical

no unless obstructive

443
Q

T/F the otoliths house the cupulas

A

false, the cupulas house the otoliths

444
Q

treatment for hordelum/stye

A

warm compresses on off for about 10-15 minutes

ABx has little evidence

if treatment doesn;t reduce size in 2 weeks or a chlazion forms, refer for incision and curretage

445
Q

Unusual Presentations of Head and Neck Cancer and Sinonasal and Skull Base Tumors

A
  • Trismus
  • Proptosis (unilateral)
  • Cheek swelling
  • Facial numbness
  • Facial Pain
  • Intermittent epistaxis
  • Facial nerve paralysis
  • Nasal obstruction
446
Q

chalazion clinical presentation

A

firm, pea sied swelling that can happen after internal hordeolum

usually one at a time

usually no signs of inflammation externally

minimal pain

447
Q

best treatment for carotid body tumor

A

surgical removal, but conservative can be used in ellderly patient

448
Q

problems assocaited with laryngeal dysfunction

A

hoarseness (often with weakness, fatigue, strained voice)

stridor

449
Q

Benign Paroxysmal Positional Vertigo dx

A

dix hallpike manuver

450
Q

SS acute OM

A

otaliga

hearing loss

fussy

poor sleep

nausea

fever

red bulging TM

451
Q

what percent of neck masses in kids are benign vs malignant

what about adults

A

80% benign, 20% malignany

8-% maliganant, 20% benign

452
Q

typical causes of hoarseness

A

acute/chronic laryngitis

benign vocla cord lesion

maliganacy

neuro dysfunction

systemic condition

453
Q

what is the most common cause of epiglottis in kids

A

H flu, but also associated with strep, staph, mrsa

454
Q

describe blepharitis

A

chronic eye condition that is characterized by inflammation of the eye lid with intermittent exacerbation

455
Q

clinical presentation of corneal abrasion

A

severe pain

photophobia

foreign body senstation

456
Q

T/F presence of a fovea reflex indicates diabetic macular edema

A

false, it indicates good retainal health

457
Q

two categories of causes leading to vertigo

A

peripheral (benign paroxsysmal positional vertigo)

central (MS)

458
Q

clinical presentation of otitis externa

A

otalgia, itching, ear fullness, possible hearing loss

tenderness at the tragus or pinna

diffuse ear canal edema, erythema

purulent otorrhea

459
Q

what do cotton wool spots indicate in terms of progression in diabetic retinal edema

A

very davanced disease

460
Q

what nerve innervates all the intrinsic muscles of the larynx

A

the reccurrent laryngeal nerve

461
Q

corneal vs lenticular astimatism

A

abnormal cornea vs abnormal lens

462
Q

what is the most common cause of epiglottis in adults

A

viruses, but can be bacterial, fungal, or a combination

463
Q

Acute rhinosinusitis (ARS) presentation

A

drainage, clogged nose, sinus pain or pressure, fever, fatigue, cough, ear pressure

464
Q

calorics

A

pouring cold water into the ear to cause dizziness

465
Q

typical presentation of dacryocystitis

A

erythema, swelling, warm, tender lacrimal sac with/without discharge

typically associated with congenital NLD obstruction

466
Q

Benign Paroxysmal Positional Vertigo

A

a fatiguable spinning senation that lasts less than one minute often triggered by laying down, rolling in bed, tilting the head back

467
Q

describe thyroglossal duct remnants

A
  • Midline
  • Move with swallowing, tongue protrusion
468
Q

DDx difuse Acute Otitis Externa

A

necrotizing otitis externa

furunculosis

trauma

carcioma

atopic dermatttis

foreign body

impaction

469
Q

nasopharyngeal carcinoma is related to what virus

A

epstein bar

470
Q

considerations when prescribing for glaucoma

A

most drugs require several agents deliveryed frequently

slow release delivery devices are useful

laser treatment and surgical treatment is an option

treatment is focused on decreasing IOP but issues can exist without IOP

471
Q

Acute Otitis Externa treatment

A

clean or debride ears

topical cleaner (alcohol, vinegar, boric acid)

ABx ear drops (otafloxacin, cipro, vasocidin)

472
Q

when are mast cell stabilizers most often used

A

when patients don’t tolerate other medications and can anticipate their onset

473
Q

three typical orbital fractures

A

zygomatic

nasoethmoid

orbital floor

474
Q

T/F vertigo is a diagnosis

A

false vertigo is a symptom and the trigger of the vertigo might lead to Dx

475
Q

three types of allergic conjunctivitis

A

acute

seasonal

perennial

476
Q

labyrinthitis treatment

A

vestibular suppressants

anti emetics

corticosteroids

477
Q

critical sign of acquired cataract

A

opacification of the normal clear lens

478
Q

treatment for herpes keratitis

A

DON’T use topicla glucocorticoids

if there is vision loss, refer

topical antivirals

479
Q

consideration of treatment for cerumen impaction

A

treat symptomatic patients

keep in mind you don’t know what is behind the wax

sometimes a patient cannot adequately express their symptoms

480
Q

treatment of chlamydial conjunctivitis

A

azithromycin 1g po once

or doxycyline 100 mg bid or erythromycin 500mg po gid for 7b days

481
Q

useful empiric ABx for bacterial conjunctivitis

A

erythromycin ointment

azithromycin drops

ciprofloxacin drops (prefered for contact wearers)

482
Q

typically presentation of herpes simplex keratitis

A

infection of the superfical layer of the cornea with a puncate or diffuse branching lesion in the epithelium

usually fom viral latency rather than primary infection

usually unilateral

483
Q

anterior nose bleeds most typically comes from what

posterior comes from what

A

up to 90% area of kiesselbach’s plexus

originate most cmmonly from the posterolateral branches of the sphenopalatine artery

484
Q

branch retinal occulsion

A

ischemia in the retina related to HTN caused by a blockage int he retinal veins that releases VEGF`

485
Q

T/F labyrinthtis will recover completely with with time

A

false, patients my have sporadic vertigo and might never regain hearing

486
Q

where are the false vocal cords

what separates them from the true vocal cords

A

above the true vocal cords

the laryngeal ventricle, that contains mucous producing glands that produce lubrication for the true vocal cords

487
Q

T/F blood cultures are often useful in diagnosing preseptal cellulitis

who should be admitted

who should be outpatietn

A

false, since the sight of infection is hard to get to

adults and children over 1 with mild symptoms and no toxicity

children under on who cannot cooprerate or who are severly il

488
Q

T/F cataracts are almost always unresponsive to medical treatment except when due to a correctable cause like DM, steroid use

A

true

489
Q

causes of conductive hearing loss

A

AOM

OME

otosclerosis

ETD

490
Q

what type of cancerous cells are found in parotid tumors

are they primary or mets

A

squamous cell carcinoma.

usually mets from a cutaneous lesion, but rarely is a primary lesion

491
Q

management and treatment of epiglottis

A

intubation

epiglottal culture

ABx

492
Q

causes of Bilateral Vocal Cord Paralysis

A

iatrogenic

ALS, diabetic neuropathy, myasthenia gravis, organophosphate pesticide toxicity, stroke, head injury

493
Q

what is the goal of laser treatment of diabetic edema

but

A

it coagulate microaneurysms

only 1 in 7 will regain vision

494
Q

what is considered head and neck cancer

what type of cell is usually effected

A

generally cancer of the upper aerodigestive tract

usually squamous cells

495
Q

Superior Canal Dehiscence Syndrome treatment and Dx

A

CT without contrast

surgical plugging

496
Q

common side effects of ´Antihistamines with mast cell-stabilizing properties

A

stinging and burning

headache

increased occular dryness

497
Q

Laryngeal Growths are manifestations fo what

A

irritation caused by smoking, reflux, muscle tension, trauma

498
Q

T/F no single medication can be used to treat glaucoma in all patients

A

true

499
Q

Allergic rhinitis diagnosis

A

HP consistent with allegic cause

nasal congestion, rhinorrhea, itchy nose, sneezing

500
Q

Nonspecific Adrenergic Agonists [epinephrine, dipivefrin] for glaucoma

mechanism

admmin

side effects

A

increase uveoscleral out flow

topical

can precipitate acute attacks in patients with narrow angle, head aches, tachycardia

501
Q

epiglottis in immunocompromised hosts can be caused by wha

A

pseudomonas aeruginosa or candida

502
Q

complication of the orbital floor fracture

A

entrapment of the inferior rectus

503
Q

what CN innervates the laryngopharynx

A

the vagus

504
Q

curvature of the lens

myopia

hyperopia

A

too steep, myopia

too flat, hyper

505
Q

vestbular ocular reflex

A

reflexive eye movement in response to head movement that allows for stable gaze while the head is moving

506
Q

Acute rhinosinusitis (ARS) common cause

A

viral etiology along with URI or common cold

507
Q

common cold treatment

A

symptomatic therapy

508
Q

periodonitis

A

gingival inflammation that leads to loss of connective tissue and alvolar bone that causes tooth loss

509
Q

T/F inorganic foreing bodies cause more severe symptoms

A

false, they are typically assymptomatic

510
Q

meniere disease long term therapy

A

avoid triggers (high salt, caffiene, alcohol, stress)

diuretics with lifestyle control is ineffective

vestibular rehab with hearingaids

511
Q

most common cause of orbital fracture

because of this, what will need to do

A

assault, MVA, sports

30% will have globe injury

evaluate for CNS injury (epidural hemtoma, subdural, subarachnooid)

512
Q

typical vectors that can cause acute laryngitis

treatment

A

M cat, H flue, strep pneumo

usually resolves with conservative treatment
ABx not needed
sterds can be given if there is a pressing need to use their voice

513
Q

etiology of exostosis

A

cold water exposure in susceptible individuals

514
Q

what is the most common kind of vertigo

A

benign proxysmal positional vertigo

515
Q

epistaxis treatment

A

ABC’s

conservative (squeeze your nose, bend at the waist

2 sprays of oxymetazoline

chemical or electrocautery for anteriot nose bleed

if the bleeding stops and no source is visualized, observe for recurrance

516
Q

thumb sign

A

a radiographic sign of epiglottis where it is so inflammed it looks like a thumb in the neck

517
Q

common presentation of unknown primary cancer

A

painless unilateral mass, typically in a non smoking white male

518
Q

describe ´Nonsteroidal anti-inflammatory drugs (NSAIDs) for allergic conjunctivitis

A

block prostaglandin formation

less effective than topical antihistamines but are clincally efficacious compared to placebo

519
Q

how does anterior uvetits present

A

redness around the limbus

cillary flush

no discharge

constricted pupil with pain

have have WBC int he anterior chamber

a haze/flare can be seen on slit lamp that indicated protein accumulation

520
Q

chalazion

A

an inflammatory granular lesion that forms around obstructed meibomian glands that can be sequla to internal hordeolum

521
Q

Mr. S presents to you with diminished peripheral vision. He complains that he feels like the world is closing in on him. He also notes that he has trouble looking at lights as they all appear to be surrounded by halos.

probable Dx?

A

open angle glaucoma

522
Q

T/F most people are aware of Laryngopharyngeal Reflux and easy to diagnose

A

false, they are often assymptomatic so all other conditions must be ruled out then confirmed with laryngoscopy

523
Q

PE for Acute Otitis Externa

A

flaking, infammation, erythema, edema, discharge, granulation, narrowing of the external meatus

524
Q

describe the drainage caused by bacterial conjunctivitis

A

thick, white/yellow/green, continally produced and respawns quickyl when wiped

525
Q

describe nuclear sclerosis

A

yellow or brown discoloration of the central part of the lens that tends to blur distance more than near vision

526
Q

common clinical presentation Acute Otitis Externa

A

itching

pain

hearing loss

swelling

dranage

527
Q

Sialolithiasis

A

salivary stones, presents with pain and swelling exacerbated by eating

can be imaged if suspected but PE doesn’t reveal an obvious probelm

528
Q

when should an eye lid laceration be refered

A

if there is fat in the lac

it goes throug the margin of the eyelid

involves the tear ducts

poor alignment or avulsion

529
Q

baterial keratitis

A

a bacterial infection of the cornea

530
Q

T/F Unilateral otitis media in an adult, without a preceding URI or a URI that fails to resolve, is a nasopharyngeal carcinoma until proven otherwise.

A

true

531
Q

posterior blepharitis

A

more common form that involves inflammation of the inner eye lid at the level of the meibomian glands (also know as meibomian gland dysfunction)

can be associated with rosacea or seborrheic dermatitis

532
Q

treatment for acute OM

A

amoxicilin

augmentin

omnicef

if allergic use quinolones (levo, mexo, cipro)

533
Q

differentiate preseptal vs post septal cellulitis

source of infection

A

pre: local trauma, insect bites, dacryocytitis, sinusitis
post: paranasal sinuses

534
Q

complications associated with glucocortocoid treatment of allergic conjunctivitis

A

cataracts, elevated intraocular pressure, glaucoma, secondary infection

535
Q

Benign Paroxysmal Positional Vertigo treatment

A

canalith repositioning manuver (epley), need referal to PT

536
Q

clinical findings associated with epiglottis in kids

A

respiratory distress (stridor, tachypnea, tripod breathing)

sore throat

dysphasia

muffled voice

retractions

537
Q

what will cause conductive hearing loss

A

dysfunction of the EAC, TM, or ossicles

538
Q

types of head and neck neoplasia

A
  • Carcinoma
  • Salivary Gland
  • Lymphoma
  • Thyroid
  • Carotid Body
  • Sarcoma
  • Melanoma
539
Q

typical prsentaion of closed angle glaucoma

A

acute onset of headache, nausea, malaise that requires immediate treatment

540
Q

location and structures of the subglottis

A

the region of the larynx extending from the inferior edge of the glottis down to the inferior edge of the cricoid cartilage

541
Q

clinical presentation of preseptal vs post septal cellulitis

eye lid swelling with or without erhthema

A

yes to both

542
Q

what causes myopia

corrected by

A

light rays focused in front of the retina caused by an eye that is too long, or the cornea/lens are too steep

coorrected by a concave lens to divergle light

543
Q

differentiate preseptal vs post septal cellulitis

incidence

A

pre: much more cmmon
post: much less common

544
Q

ABx treatment of preseptal cellulitis

A

oral clinday mycin

oral sulfa + amoxicillin

545
Q

describe the course of the reccurrent laryngeal nerve

A

on the left it passes under the aortic arch, on the right it passes under the subclavian, then it reenters the ekc at the thoracic inlet

546
Q

types of hearing loss

A

conductive, sensorineural, mixed

547
Q

treatment for arteritic ION

A

stat esr, CRP

immediate referral

start high dose steroids

schedule biopsy

548
Q

what causes sunflower catartact

A

wilsons disease

549
Q

describe non arteritic ION

A

No GCA symptoms

small disc cup

other involved 25-50%

might be related to nocturnal hypotension

550
Q

two major types of glaucoma

A

open angle and closed angle

551
Q

vestibular sedeatives

A

—Meclizine (Antivert)

—Promethazine (Phenergan)

—Dimenhydrinate (Dramamine)

—Diphenhydramine (Benadryl)

—Anticholinergics (Scopolamine)

Clinical Medicine (11 decks)

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