ENOT/Opthalmology

Question 1

how is chronic rhinosinusitis categorized

Answer 1

lasting 12 weeks or longer - despite attempts at medical management

Question 2

what is the common treatment for chronic rhinosinusitis

Answer 2

amox-clavulantate 875mg BID for at least 3 weeks and up to 10 weeks

Question 3

what are aphthous ulcers

Answer 3

single or multiple small, shallow ulcers with a yellow-grey fibroid center with red halos

Question 4

how are aphthous ulcers diagnosed

Answer 4

clinical presentation and history
consider biopsy if lasting for more than 3 weeks

Question 5

what is the treatment for apthous ulcers

Answer 5

viscous lidocaine 2-5%

Question 6

define blepharitis

Answer 6

chronic inflammation of lid margins - caused by seborrhea, staph or strep

Question 7

how is blepharitis diagnosed

Answer 7

slit-lamp examination

Question 8

what is the treatment for blepheritis

Answer 8

warm compresses, daily lid wash with diluted baby shampoo, lid massages and topical abx if infection is suspected

Question 9

what presents with painless otorrhea, brown/yellow dicharge with a strong odor

Answer 9

cholesteatoma

Question 10

what causes cholesteatomas

Answer 10

chronic eustachian tube dysfunction resulting in chronic negative pressure causing granulation tissue

Question 11

how is cholesteotoma diagnosed

Answer 11

otoscopic visualization of granulation tissue
confirm with CT and audiogram for hearing loss assessment

Question 12

how are cholesteotomas treated

Answer 12

surgical removal

Question 13

what are the different types of conjunctivitis

Answer 13

• viral
• bacterial
• allergic

Question 14

what type of conjunctivitis presents with copious watery discharge, scant mucoid discharge

what is the common etiology

Answer 14

viral

adenovirus

Question 15

what type of conjunctivitis presents with purulent discharge, crusting, usually worse in the morning

common etiologies

Answer 15

bacterial

S. pneumonia, S aurus for acute
M. catarrhalis and gonococcal/chlmydia

Question 16

what is Giemsa stain includsion bodies indicative

Answer 16

chlamydia conjunctivitis

Question 17

what type of conjunctivitis presents with red eyes, itching and tearing - typcially bilaterall

Answer 17

allergic

Question 19

what is the treatment of bacterial conjunctivits

Answer 19

gentamicin/tobramycin
erythromycin ointment
trimethoprim and plymyxin B

Question 20

if a patient has contacts what medications should be added to medication regimen

Answer 20

Fluoroquinolones - Ciprofloxacin/ciloxan drops

Question 21

what presents with sudden onset of eye pain, photophibia, tearing, FB sensation, blurring of the vision and/or conjunctival injection

Answer 21

corneal abrasion

Question 22

how are cornial abraisons diagnosed

Answer 22

fluoescen staining

Question 23

what is the treatment for corneal abraisons

Answer 23

abx ointment - NO PATCHING

Question 24

who commonly is affected by corneal ulcers

Answer 24

contact wearers

Question 25

what is a corneal ulcer

Answer 25

deep infection of cornia by bacteria, virus or fungi

Question 26

what is the presentation of corneal abrasion

Answer 26

white spot on the surface of the cornea that stains wtih fluorscein

Question 27

what is the treatment of corneal ulcer

Answer 27

immediate referral - if not possible start topcial opthalmic antibiotics

Question 28

define keratitis

Answer 28

inflammation of the cornia

Question 29

what is inflammation of the lacrimal gland called

Answer 29

dacryoadenititis

Question 30

what is the cause of dacryoadenitis

Answer 30

bacteria or virus

Question 31

what is an infectious obstruction of the nasolacrimal duct called

Answer 31

dacryocystitis

Question 32

what is the eversion of the eyelid called

Answer 32

ectropion

Question 33

what is inversion of the eyelid called

Answer 33

entropion

Question 34

what is the treatment for ectropion and entropion

Answer 34

tear supplements and ocular lubricants at night - definitive = surgery

Question 35

what is the common site for anterior nose bleeds

Answer 35

kiesselbachs plexus

Question 36

what is the common site for posterior nose bleeds

Answer 36

Woodruffs plexus - phenopalatine artery

Question 37

what needs to be given if anterior nasal packing is required

Answer 37

cephalosporin to prevent toxic shock syndrom

Question 38

what is the classic triad associated with acute narrow angle closure glaucoma

Answer 38

injected conjunctiva, steamy cornea and a fixed dilated pupil (opthalmic emergency)

Question 39

how are glaucomas diagnosed

Answer 39

tonometry showing increased IOP

Question 40

what is the treatment for acute narrow angle-closure glaucoma

Answer 40

acetazolaminde IV = first line agent topical BB (timolol) Miotics/cholinergics (pilocarpine)

Question 41

what is the definitive treatment for acutre narrow-angle glaucoma

Answer 41

peripheral iridotomy

Question 42

what is the treatment for chronic open-angle glocoma

Answer 42

prostaglanding analogs - first line (latanoprost) topical BB (timolol)

Question 43

what is a painful, warm, swollen red lump on the eyelid called

Answer 43

hordeolum

Question 44

what is the treatment for hordeolum

Answer 44

warm compress and topical abx

Question 45

what is a hyphema

Answer 45

trauma causing bleeding in the anterior chamber of the eye (between cornea and iris)

Question 46

what is the tx for hyphemas

Answer 46

usually the blood is reabsorbed over days/weeks - elevate head at night to 30 degrees

Question 47

how does labrynthitis present

Answer 47

acute onset, continuous vertigo + hearing loss, tinnitus lasting several days to week.

Question 48

what is the treatment of labrynthitis

Answer 48

vestibular suppressants (meclizine) and antiemetics (zofran/promethazine) to limit symptoms 10 day course of prednisone taper

Question 49

what is the treatment of laryngitis

Answer 49

vocal rest and supportive therapy

Question 50

what is gradual painless of central vision called

Answer 50

macular degeneration

Question 51

what is seen with dry macular degeneration

Answer 51

DRUSEN - yellow retinal deposits

Question 52

what is seen with wet macular degeneration

Answer 52

hemorrhage, neovascularization

Question 53

what is the treatment for wet macular degeneration

Answer 53

VEGF inhibiors photodynamic therapy Zinc and antioxidant vitamins

Question 54

what is the treatment of dry macular degeneration

Answer 54

zinc and antioxidant vitamin

Question 55

what disease is characterized by excessive endolymph fluid in the cochlea that causes overstimulation of the hairs - causing vertigo and sudden hearing loss

Answer 55

meniere disease

Question 56

what is the treatment of meiere disease

Answer 56

low salt diet and diuretics to reduce the aural pressure

Question 57

What is Samter's Triad

Answer 57

asthma ASA sensitivity nasal polyps ## Footnote often seen in conjunction with allergic rhinitis

Question 58

what pathogen is the common cause of bacterial otitis externa

Answer 58

Pseudomonas aeruginosa (swimmers ear) or S. aureus (digital trauma)

Question 59

what is the treatment for bacterial otitis exeterna wtih chance of or perforated TM

Answer 59

Cipro and dexamethasone drops

Question 60

what are diagnostic criteria for otitis media

Answer 60

1. bulging of TM 2. other signs of acute inflammation (erythema, fever, pain) 3. middle ear effusion

Question 61

what is the treatment options for otitis media

Answer 61

first line = amoxicillin second line = augmentin (macrolides if PCN allergic)

Question 62

what is pailledema

Answer 62

optic disc swelling that is caused by increased ICP

Question 63

what causes papilledema

Answer 63

malignant HTN brain tumor/abscess meningitis cerebral hemorrhage encephalitis

Question 64

what is the presentation of a patient with parotitis

Answer 64

fever/chills periauricular, mandibular pain and swelling dysphagia

Question 65

what is the treatment of parotitis

Answer 65

self limiting - treat with hydration and rest vaccination is effective for prevention

Question 66

what is the treatment of peritonsillar abscess

Answer 66

aspiration, incision and drainage and/or ABX

Question 67

what is the most common etiology of pharyngitis

Answer 67

viral - adenovirus or mononucleosis

Question 68

what is the Centor Score

Answer 68

for streph pharyngitis 1. absence of a cough 2. exudates 3. fever (>100.4) 4. cervical lymphadenopathy (3 or 4 (+) means strep test)

Question 69

what is the treatment for GAS pharyngitis

Answer 69

PCN = first line azithro if PCN allergic

Question 70

what is the treament of gonorrhea pharyngitis

Answer 70

ceftriaxone 500mg IM as a single dose

Question 71

what is a Pterygium

Answer 71

elevated, superficial, fleshy, tiragular-shaped "growing" fibrovascular mass - m/c in inner corner/nasal side of the eye

Question 72

what is the treatment of pterygium

Answer 72

only surgically removal when vision is affected

Question 73

what is the presentation of retinal detachment

Answer 73

curtain coming down across vision may sense floaters or flashes at onset

Question 74

what is myopia

Answer 74

nearsightedness

Question 75

what is the treatment of retinal detachment

Answer 75

opthalmologic emergency

Question 76

what is the presentation of retinal vascular occlusion

Answer 76

sudden, painless, unilateral and usually sever vision loss

Question 77

what is sialadenitis

Answer 77

bacterial infection of salivary gland

Question 78

how is sailadenitis diagnosed

Answer 78

CT, US or MRI can confirm if pus - gram stain and culture

Question 79

how is sialolithiasis

Answer 79

clinical dx is usually adequate

Question 80

what are the only type of antibioitcs that are non-ototoxic

Answer 80

floxin drops