EENT

Question 1

What are the sx of strep throat?

Answer 1

• Fever > 38 C
• tender cervical adenopathy
• lack of cough
• tonsillar exudate

Question 2

What 2 meds are used for tx of strep throat?

Answer 2

• PCN

- Erythromycin

Question 3

PCN: What should you monitor?

Answer 3

• Signs of anaphylaxis during 1st dose

- Opportunistic infection

Question 4

What med can enhance the anticoagulant effect of warfarin?

Answer 4

PCN

Question 5

What are the causes of acute laryngitis?

Answer 5

• Usually viral

- M. catarrhali, H. influenzae

Question 6

What 3 meds are used for tx of acute laryngitis?

Answer 6

• Erythromycin
• Cefuroxime
• Augmentin

Question 7

What are the signs & sx of HSV?

Answer 7

• Prodrome = burning, pain, tingling

- Erythematous papules –> vesicles rupture –> SF ulcers –> scabs

Question 8

What labs should you monitor in HSV?

Answer 8

• Urinalysis

- BUN, Cr, liver enzymes, CBC

Question 9

What 3 abx should you use for bacterial conjunctivitis?

Answer 9

• Macrolides
• Aminoglycosides (Tobramycin)
• Polymixin-Trimethoprim

Question 10

What abx should you use for bacterial conjunctivitis?

Answer 10

• Macrolides
• Aminoglycosides (Tobramycin)
• Polymixin-Trimethoprim

Question 11

What organism causes blepharitis?

Answer 11

S. aureus

Question 12

How do you tx preseptal (periorbital) cellulitis?

Answer 12

• If MSSA:
  1. Augmentin
  2. Cefpodoxime
  3. Cefdinir
• If CA-MRSA:
  1. Trimethoprim
  2. Clindamycin
  3. Doxycycline

Question 13

How do you tx a corneal abrasion?

Answer 13

• Erythromycin
• Sulfacetamide
• Polymixin/trimethoprim
• Ciprofloxacin

Question 14

How do you tx corneal abrasion?

Answer 14

• Erythromycin
• Sulfacetamide
• Polymixin/trimethoprim
• Ciprofloxacin

Question 15

How do you tx a corneal ulcer?

Answer 15

Fluoroquinolones

Question 16

How do you tx HSV keratitis?

Answer 16

• Topical antivirals: Ganciclovir gel, trifluridine solution
• Corticosteroids (ONLY via ophthalmologist)

Question 17

How do you tx herpes zoster?

Answer 17

• Antivirals & abx

- Corticosteroids (ONLY via ophthalmologist)

Question 18

Bacterial conjunctivitis: What method of tx is preferred for children?

Answer 18

Ointment

*Also good for those w/ poor compliance & whom it is difficult to administer eye meds

Question 19

In pts w/ bacterial conjunctivitis, when should they respond to the med?

Answer 19

1-2 days

Question 20

What is the tx for viral conjunctivitis?

Answer 20

None, but…
Can relieve sx via:
- Antihistamine/decongestants
- Lubricating agents

Question 21

For acute conjunctivitis, what med should NOT be prescribed by primary care clinicians?

Answer 21

Glucocorticoids

Question 22

How do you tx otitis externa?

Answer 22

• Decrease moisture
• Aminoglycoside
• Fluoroquinolones

Question 23

How do you tx otitis externa?

Answer 23

• Decrease moisture
• Aminoglycosides
• Fluoroquinolones

Question 24

How do you tx otitis media?

Answer 24

• Amoxicillin (empiric tx)
• Erythromycin + sulfonamide
• Cefaclor
• Augmentin

Question 25

In otitis media, how should you disperse augmentin to a child w/ severe illness?

Answer 25

90mg every 12 hrs for 10 days

Question 26

In otitis media, how should you disperse augmentin to a child w/ severe illness?

Answer 26

90mg every 12 hrs for 10 days

Question 27

How do you tx otitis media in pts w/ PCN allergy?

Answer 27

- Azithromycin - Clarithromycin - Erythromycin-sulfisoxazole - Clindamycin (max = 1.8mg) - Trimethoprim

Question 28

Describe sinusitis

Answer 28

- Most often viral | - Inflammation of > 1 of the paired paranasal sinuses (maxillary = most common)

Question 29

What organisms are seen in bacterial sinusitis?

Answer 29

S. pneumo > H. influenzae > M. catarrhalis

Question 30

How do you tx sinusitis?

Answer 30

- Fluids - Humidity - Saline irrigation

Question 31

When can you administer abx for tx of sinusitis?

Answer 31

Only if sx worsen after 5-7 days or sx persist > 10-14 days

Question 32

What can decrease one's risk of acute otitis media?

Answer 32

Vaccination against flu & pneumo

Question 33

What is the empiric med for acute sinusitis?

Answer 33

Amoxicillin

Question 34

What is the empiric med for acute pharyngitis?

Answer 34

PCN

Question 35

What does of amoxicillin is recommended in pts w/ otitis media who have a high risk for a PRSP infection?

Answer 35

High dose (80-90mg/day)

Question 36

What are the characteristics of primary open-angle glaucoma?

Answer 36

- 95% of cases - Insidious, peripheral vision loss - Excavation (“cupping”) & pallor of the optic disk - Elevated IOP due to reduced drainage of aqueous fluid through the trabecular meshwork

Question 37

How do you decrease IOP in open-angle glaucoma?

Answer 37

- Increase aqueous drainage - Decrease aqueous production - Surgery (if unresponsive to meds)