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EENTO - 15% Flashcards

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1
Q

MC pathogen involved in viral conjunctivitis

A

adenovirus

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2
Q

who is most likely to get viral conjunctivitis

A

kids, swimming pool

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3
Q

presentation of viral/bacterial/allergic conjunctivitis

A

VIRAL:
preauricular LAD
watery/scant-mucoid discharge
bilateral

BACTERIAL:
purulent discharge w lid crusting, no visual changes (mild pain), no ciliary injection

ALLERGIC:
conjectural erythema, other allergic sx, cobblestone mucosa, itching, tearing, redness, stringy discharge, usu bilateral

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4
Q

tx of viral/bacterial/allergic conjunctivitis

A

VIRAL: cool compress, artificial tears, antihistamines

BACTERIAL: e-micin (topical)

ALLERGIC: topical antihistamines (olopatadine, pheniramine/naphazoline), topical ketorolac, topical corticosteroids

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5
Q

MC pathogen in bacterial conjunctivitis + others

A

S.aureus
S.pneumo
H.flu

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6
Q

how is bacterial conjunctivitis transmitted

A

direct contact + autoinoculation

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7
Q

which types of conjunctivitis are usu bilateral

A

viral + allergic

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8
Q

if pt is contact wearer and has bacterial conjunctivitis, how do you treat and why?

A

fluoroquinolone or AMG because of pseudomonas

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9
Q

if pt has chlamydia conjunctivitis how do you treat

A

azithro

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10
Q

if pt has gonorrhea conjunctivitis how do you treat

A

ceftriaxone

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11
Q

what is the MC type of orbital cellulitis

A

ethmoid

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12
Q

what is orbital cellulitis usu 2ry to

A

sinus infxn; also can be dental/facial infix or bacteremia

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13
Q

what are the MC organisms to cause orbital cellulitis

A

s.aureus, s.pneumo, GABHS, h.flu

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14
Q

what are the sx of orbital cellulitis

A

dec vision
pain w EOMM
proptosis
eyelid erythema + edema

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15
Q

dx of orbital cellulitis

A

high resolution CT scan

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16
Q

tx of orbital cellulitis

A

IV vanco, clinda, cefotaxime, amp/sulbactam

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17
Q

what is perceptual cellulitis, how is it different from orbital cellulitis and how do you treat it?

A

infix of eyelid + periocular tissue- may have ocular pain/swelling but NO VISUAL CHANGES OR PAIN W EOMM
amoxicillin

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18
Q

what is a strabismus

A

misalignment of the eyes- stable ocular alignment isn’t normal until 2-3mo

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19
Q

how do you dx a strabismus

A

hirschberg corneal light reflex testing (screening)

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20
Q

how do you tx a strabismus

A

patch tx, corrective surgery if severe

no tx before 2yo

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21
Q

why can’t you treat strabismus before 2yo

A

amblyopia may occur- dec visual acuity not correctable by refractive means

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22
Q

MC pathogens involved in OM

A

S.pneumo (MC)
H.flu
M.cat
S.pyo

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23
Q

if there are bullae on the TM, what should you suspect

A

M.pneumo infection

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24
Q

tx of OM

A

amox (DOC- azithro/e-micin if allergic), cefixime

2nd line- augmentin or cofactor

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25
MC cause of rhinitis
allergic- IgE
26
what is the MC infectious cause of rhinitis
rhinovirus
27
sx of rhinitis
sneezing, itching, congestion, clear rhinorrhea allergic- nasal polyps, worse in AM, pale/violaceous boggy turbinates, cobblestone mucosa of conjunctiva viral- erythematous turbinates
28
tx of rhinitis
PO antihistamines decongestants (oxymetazoline, phenylephrine, naphazoline, pseudophed) intranasal corticosteroids if allergic
29
what usu precedes mastoiditis
inadequately tx or prolonged OM
30
presentation of mastoiditis
deep ear pain, worse at night, fever | mastoid tenderness, may have cutaneous abscess
31
dx of mastoiditis
CT scan
32
tx of mastoiditis
IV abx + middle ear/mastoid drainage | mastoidectomy if complicated/refractory
33
complications of mastoiditis
hearing loss, labyrinthitis, vertigo, CN VII paralysis, brain abscess
34
what causes otitis externa
swimmers ear- excess H2O or local trauma changes acidic pH of ear --> bacterial overgrowth
35
what is the MC pathogen in otitis externa
pseudomonas
36
indicating PE finding for otitis externa
pain on tragal traction
37
tx of otitis externa
keep dry- isopropyl alcohol, acetic acid topical cipro, ofloxacin can use AMG (neomycin/polytrim) only if no perf suspected (ototoxic)
38
what is malignant otitis externa
osteomyelitis @ skull base 2ry to pseudomonas
39
who most commonly gets malignant otitis externa
diabetics, immunocompromised
40
tx of malignant otitis externa
IV ceftazidime or piperacillin + FQ/AMG | pseudomonas coverage
41
what can TM perfs lead to
cholesteatoma development
42
what type of hearing loss do you see with TM perforation
conductive
43
what is the MC type of epistaxis
anterior
44
what are the causes of anterior epistaxis
``` nasal trauma low humidity + hot environment rhinitis ETOH antiplt meds ```
45
what is the MC site of anterior epistaxis
kiesselbach's plexus
46
what causes posterior epistaxis
HTN | atherosclerosis
47
what is the MC site of posterior epistaxis
palatine artery
48
how to tell difference btw anterior + posterior epistaxis
posterior- there is blood in posterior pharynx
49
tx of epistaxis
direct pressure 10-15min, seated + leaning FORWARD | topical decongestants/vasoconstrictors (phenylephrine, oxymetazoline, cocaine), cauterization, nasal packing
50
what is septal hematoma associated with
loss of cartilage if hematoma isn't removed
51
what is the MC cause of acute pharyngotonsillitis
viral- adeno, rhino, enero, EBV, RSV, flu a+b, herpes zoster
52
what is the MC bacterial cause of acute pharyngotonsillitis
GABHS
53
what do you treat bacterial pharyngotonsillitis with?
PCN, amox (E-micin or clinda if allergic)
54
what is the MC pathogen involved in epiglottis
H.flu
55
what age group is highest risk for epiglottitis
3mo-6yo
56
what gender is highest risk for epiglottitis
males
57
what is the definitive dx for epiglottitis
laryngoscopy- cherry red epiglottis w swelling
58
what do you see on cervical XR in pt w epiglottis
thumb print sign
59
if you suspect epiglottis what should you avoid
tongue depressors + agitating pt!
60
tx of epiglottitis
maintain airway, dexamethasone, intubation if severe | ceftriazone or cefotaxime +/- PCN/ampicillin
61
what do you see on KOH smear if candidiasis
budding yeast + pseudohyphae
62
tx of oral candidiasis
nystatin liquid DOC | clotrimazole, PO fluconazole
63
pathophysiology of peritonsilar abscess
tonsillitis --> cellulitis --> abscess
64
MC pathogen involved in peritonsilar abscess
s.pyo (GABHS)
65
1st line dx test for peritonsilar abscess
CT scan
66
tx of peritonsilar abscess
amp/sul, clinda or PenG+flagyl | + aspiration or I&D

Pediatrics (9 decks)

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