EENT Flashcards
(140 cards)
1
Q
MCC bacterial conjunctivitis
A
s. aureus
s. pneumo
2
Q
bacterial conjunctivitis tx
A
warm compress
topical erythromycin
3
Q
gonorrheal conjunctivitis tx
A
IM ceftriaxone, topical erythromycin
4
Q
chlamydial conjunctivitis tx
A
PO doxy or azithromycin
5
Q
neonatal conjunctivitis etiology by days
A
day 1: silver nitrate (chemical cause)
day 2-5: gonococcal
day 5-7: chlamydia
day 7-11: HSV
6
Q
posterior uveitis
A
choroid inflammation assoc w/ HLAB27
sarcoidosis, MS
painless vision loss, floaters, dec/blurred vision
ophthalmic referral/ systemic CS
7
Q
anterior uveitis sx
A
d/t underlying infx (AIDS, sarcoidosis)
unilateral vision loss, pain, redness, photophobia
constricted pupil, ciliary injection, painful eye movement
extra ocular sx: erythema nodosum, cough, lofgren syndrome
8
Q
lofgren syndrome
A
sx of anterior uveitis
hx of sarcoidosis
erythema nodosum
bilateral hilar lymphadenopathy
polyarthralgia
fever
9
Q
anterior uveitis test
A
CT: bilateral hilar adenopathy, pulmonary reticular infiltrates
hypercalcemia, hypercalcinuria
elevated ACE
10
Q
anterior uveitis tx
A
ophthalmology referral
topical CS
11
Q
nuclear vs peripheral cataract
A
nuclear: gray when seen by flashlight
peripheral: smoke like shadows, black against red
12
Q
cataract test
A
SLIT lamp (yellow brown color)
fundoscopy: cataract is black on red background
13
Q
cataract sx
A
painless blurred vision over months or years
halo around lights
absent red reflex
lens opacity
14
Q
cataract tx
A
surgery
15
Q
differential diagnosis for cataracts
A
retinoblastoma: absent red reflex + white pupil
16
Q
corneal ulcer sx
A
pain, tearing, photophobia, gritty feeling
oval ulcer w/ ragged edges, severe conjunctival inflammation
white, hazy irregularity of cornea
17
Q
corneal ulcer test
A
visual acuity
fluorescein staining
18
Q
corneal ulcer tx
A
referral
19
Q
herpes simplex infx in eye hallmark
A
dendritic ulcers, branching on fluorescein stain
20
Q
herpes zoster opthalmicus etiology
A
varicella zoster- shingles
21
Q
hypopyon
A
accumulation of pus in anterior chamber of eye
from severe keratitis infection
22
Q
pterygium
A
fleshy triangular encroachment onto cornea
23
Q
pinguecula
A
yellowish nodule on bulbular conjunctiva on nasal side
24
Q
dacrocystitis vs dacroadenitis
A
dacrocystitis: lacrimal sac: medial canthos
dacroadenitis: lacrimal glands, above eyelid
25
dacrocystitis MCC
s. aureus
26
dacrycystitis or dacroadenitis tx
lid hygiene
acute: bacitracin and erythromycin or systemic tetracycline
chronic: obstruction --> dacryocystorhinostomy (DCR)
27
blepharitis MCC (anterior and posterior)
anterior: staph
posterior: meibomian gland dysfunction
28
anterior blepharitis sx
red rim
29
posterior blepharitis sx
hyperemic telangiectasias
30
blepharitis tx
supportive, lid scrub, warm compress
PO tetracycline, topical erythromycin
bactracin if refractory
31
chalazion vs hordeolum
chalazion: painless
hordeolum: painful
32
chalazion tx
initlal: warm compress
2nd: topical abx (erythromycin)
3rd: I&D
33
hordeolum tx
warm compress
erythromycin, bacitracin ointment
if no improvement in 2d, I&D
34
MCC optic neuritis
MS
35
med that causes optic neuritis
ethambutol
36
optic neuritis sx
unilateral central vision loss
periorbital pain
poor color perception
Marcus gunn pupil
37
optic neuritis tx
IV methylprednisolone --> oral CS
38
papilledema is a sign of
increased intracranial pressure
39
papilledema fundus exam
blurred disk margins
flame homorrhages
white cotton wool spots
40
papilledema tx
tx cause of increased intracranial pressure
keep bed elevated
diuretics (furosemide or acetazolamide)
41
orbital cellulitis causes
sinusitis (ethmoid)
dental infection
skin infection
42
orbital cellulitis sx
dec vision, warm to touch
fever, eyelid redness
dec EOM, pain w/ EOM
proptosis
43
preseptal cellulitis sx
fever
respiratory infection
sepsis
EOM normal
44
orbital cellulitis dx
high res CT for dx
45
periorbital cellulitis tx
augmentin
46
orbital cellulitis tx
hospital
IV abx (ceftriaxone and vancomycin)
47
macular degeneration dry vs wet
dry: MC, gradual, atrophic cause
wet: neovascularization, rapid progression
48
macular degeneration sx
leading cause of permanent vision loss in elderly
central vision loss only
drusen (yellow deposit of debris)
scotomas
49
macular degeneration tests
amsler grid for dry central vision loss
fluorescent angiography for wet
50
macular degeneration tx
wet: laser photocoagulation, ranibizumab. optical tomography for monitoring
dry: zinc, vitamin A/C/E
51
MC location retinal detachment
superior temporal area
52
retinal detachment sx
unilateral painless central vision loss
shadow/curtain descending
floaters, flash of light
+shafers sign
tobacco dust
53
retinal detachment tx
emergency: refer to ophthalmology
supine position
photocoagulation, cryosurgery
54
retinopathy screening
57 if DMT1 then annually
if DMT2, annually
55
retinopathy tx
pan retinal laser photocoagulation
56
diabetic retinopathy sx for diabetic
hard exudates
cotton wool spots
flame shaped blot and dot
57
retinopathy sx proliferative (late)
neovascularization
58
hypertensive retinopathy sx
copper wiring, silver wiring, AV nicking
59
hypertensive retinopathy sx stages
I: arterial narrowing (copper wiring --> silver wiring)
II: AV nicking
III: flame shaped hemorrhages, cotton wool spots (soft exudates)
IV: papilledema (malignant HTN)
60
retinopathy vitreous hemorrhage
bevacizumab
61
cotton wool spots + optic disk edema =
HTN emergency
62
open globe fracture hallmark
gush of fluid
eccentric or teardrop shape
63
blowout fracture sx
orbital emphysema
restriction of upward eye movement
vertical diplopia
crepitus, step off deformity
anesthesia of anterior medial cheek
64
blowout fx anesthesia of anterior medial cheek which nerve
infraorbital nerve
65
blowout fracture entraps which muscle
inferior rectus
66
blowout fx test
CT TOC
67
blowout fracture tx
nasal decongestant
CS, Abx
surgery
68
corneal abrasion w/ contact wearer tx
FQ drops
69
corneal abrasion test
1st: visual acuity
fluorescein stain: ice rink/ lines abrasions
70
corneal abrasion tx
polymyxin-bacitracin ointment
tetanus shot if FB
rust ring: remove w/in 24h w/ rotating burr
71
chemical burn eye tx
prophylaxis: moxifloxin topical abx drops
severe: topical CS and topical VitC
72
globe rupture hallmark test
+ seidels test: parting of fluorescent dye by clear stream of aqueous humor from anterior chamber
73
child with hyphema, suspect
child abuse until proven otherwise
74
condition w/ increased with of hyphema
sickle cell anemia
75
hyphema which chamber
anterior chamber
76
hyphema tx
measure IOP
fox shield
ophthalmology referral
cycloplegic for pain control
glucocorticoid eye drops to prevent rebelled
77
avoid what med for hyphema
ASA
NSAIDs
78
complications hyphema
rebleeding
permanent vision loss
intraocular HTN
optic nerve atrophy --> glaucoma
79
MCC CRAO
atherosclerosis
80
CRAO sx
sudden painless monocular loss of vision
preceded by amaurosis fugax
retinal whitening and cherry red spot
box car appearance
81
CRAO tx
emergency ophthalmology referral
acetazolamide
supine + orbital massage
82
amaurosis fugax sx
painless unilateral vision loss
curtain descending then goes back up, lasts minutes
83
amaurosis fugax MCC
carotid artery dz
84
amaurosis fugax tx
tx underlying
heparin
85
CRVO hallmark
blood and thunder appearance
no effective tx
86
open angle glaucoma sx
inc IOP, gradual peripheral vision loss
increased cup to disk ratio
halo around lights
87
closed angle glaucoma sx
steamy cornea, fixed mid dilated pupil
decreased visual acuity
sudden eye pain, ocular halos
vision loss
dark movie theater
88
glaucoma screening
RF: AA, +FHx
20-29: at least once in this period, RF every 3-5yr
30-39: at least twice in this period, RF q 2-4yrs
40-64: q 2-4yrs
65+: q 1-2yrs
89
acute glaucoma tx
definitive: laser trabeculoplasty/ peripheral iridotomy
acetazolamide (PO or IV) to lower IOP
topical BB (timolol)
topical alpha agonist (apraclonidine)
topical pilocarpine: facilitate outflow of aqueous humor
90
acute glaucoma test
tonometry: elevated IOP (>30)
gonioscopy: gold standard
91
CI in acute glaucoma
atropine
pseudoephedrine
ipratropium
albuterol, antihistamines
92
open angle glaucoma sx
AA, gradual loss over years
peripheral vision loss (tunnel vision), bilateral
cupping of optic disk
constricted peripheral vision
93
open angle glaucoma tx
definitive laster trabeculoplasty
BB (timolol)
1st line: latanoprost
acetazolamide
94
MCC sensorineural hearing loss
presbyacusis
95
MCC conductive hearing loss
cerumen impaction
96
Hirschberg test
look at flashlight, observe reflection location on corneal surface
used for strabismus
97
strabismus in infants
should be aligned by 2-3mo
98
weber test checks CN
CN8
99
MCC OE
pseudomonas
100
OE tx
cipro or neomycin/polymycin
severe: ear wick
if infx past EAC or immunocomp: PO FQ
101
malignant OE MCC
pseudomonas
102
malignant OE sx
immunocomp
severe ear pain, otorrhea
facial nerve palsy
103
malignant OE tx
high dose IV cipro
104
acoustic neuroma sx
unilateral sensorineural hearing loss
tinnitus, dizzy
105
acoustic neuroma can compress
CN 5, 7, 8
106
acoustic neuroma tests
BIT: audiometry
weber: lat to normal ear
rinne: AC>BC
confirm: MRI w/ contrast (tumor)
107
bilateral acoustic neuroma
neurofibromatosis type 2
108
acoustic neuroma tumor CN
CN 8 (vestibulocochlear)
109
acoustic neuroma tx
surgery
110
labrynthitis sx
hx of URI
vertical rotational vertigo + hearing loss
nystagmus
continuous
111
labyrinthitis tx
self limiting
CS first line
112
BPPV test
dix hall pike maneuver
113
BPPV tx
employ maneuver
114
cholesteatoma tx
mastoidectomy
115
OM MCC
S. pneumo
M. catarrhalis
H. flu
116
OM tx
child TOC: cefixime
1st line: amoxicillin
allergy: azithromycin
2nd line: augmentin
117
mastoiditis test
1st test CT
118
mastoiditis tx
IV vancomycin
tympanostomy + drain
119
meniere disease sx
gradual unilateral recurrent hearing loss
tinnitus, >2 episodes of vertigo >20m
aural fullness
triad: episodic vertigo, dec frequency sensorineural hearing loss, tinnitus
120
meunière disease test
caloric/vestibular testing: horizontal nystagmus
121
menière disease tx
meclizine
zofran
HCTZ or acetazolamide
122
retinoblastoma sx
absent red reflex
white pupil
refer to ophthalmology, emergency
123
MC location sinusitis
maxillary
124
sinusitis TOC
CU
125
sinusitis abx first line
augmentin or amoxicillin after 7 days no resolve
126
chronic sinusitis from aspergillus
MC fungal sinusitis
black eschar on palate/face
tx w/ amphociterin B
127
gingival hyperplasia can be caused by
phenytoin
CCB
cyclosporine
phenobarbital
128
Vincents angina tx
trench mouth
PCN VK, clindamycin
129
dental abscess tx
I&D
IM ceftriazone + amoxicillin
130
Ludwig angina
cellulitis of submandibular space
CT TOC
131
oral thrush tx
nystatin
PO fluconazole
132
epiglottitis MCC
HiB
133
MCC tonsillitis
viral or group A strep
134
tonsilitis tx
GAS: PCN V
135
MCC peritonsillar abscess
S. pyogenes (GABHS)
136
tx bacterial pharyngitis
PCN V or amoxicillin
137
pharyngitis bacterial cause
GABHS
138
complication of bacterial pharyngitis (strep)
rheumatic fever/ heart disease
139
sialadenitis tx
IV (nafcillin + flagyl or clindamycin)
140
silver sulfasalazine CI
sulfa allergy
pregnancy
<2mo old
on the face
