ENT

Question 1

irritation, burning and itching of eye lids. red rimmed eyes/scaly/frothy tears

Answer 1

blepharitis

Question 2

tx blepharitis

Answer 2

hot wash cloth and baby shampboo, bacitracin to apply to lid margins. if posterior, try tetracyline po bid

Question 3

tx bacterial conjunctivitis

Answer 3

topical sulfonamide TID

Question 4

topical tx for allergic conjunctivitis

Answer 4

H1 antagonist levocabastine hydrochloride .05% or mast cell stabilizer cromolyn sodium 4%

Question 5

you suspect corneal abrasion. dx and tx?

Answer 5

dx with slit lamp or fluorescein staining and check acuity. then topical anesthetic, antibiotic ointment bacitracin/polymyxin and acetaminophen for pain relief. patch and follow up in 1-2 days

Question 6

dacryoadenitis

Answer 6

inflammatory conditions affecting lacrimal system of eye…cystitis is an infection within lacrimal drainage system.

Question 7

tx dacryoadenitis

Answer 7

systemic antibiotic therapy, can prob duct if chronic

Question 8

tx dacryocystitis

Answer 8

warm compress and massage, look for orbital cellulitis then need to admit for IV antibiotics

Question 9

sxs dacryocystitis

Answer 9

sudden pain, erythema, edema overlying lacrimal sac, tearing, mattering, may have cellulitis

Question 10

fever, proptosis, restriction of extraocular movements, swelling and redness of lids

Answer 10

orbital cellulitis

Question 11

orbital cellulitis tx

Answer 11

hospitalize for IV nafcillin with metronidazole or clindamycin to cover anaerobes. if trauma, use cephalosporin to cover staph/strep. vanco or clinda if MRSA

Question 12

cherry red spot, persistent painless loss of monocular vision

Answer 12

retinal artery occlusion

Question 13

sudden blurring or vision loss in all or part of eye….common from HTN, diabetes, glaucoma, atherosclerosis

Answer 13

RVO. refer right away

Question 14

painful focal abscess on eyelid

Answer 14

hordeolum

Question 15

painless cyst of eyelid

Answer 15

chalazion

Question 16

tx hordeolum

Answer 16

warm compresses, lid hygiene, massage, systemic cefalexin

Question 17

blood in anterior chamber. next step?

Answer 17

CT of orbit to r/o orbital fracture or foreign body. screen for sickle cell and do a Hgb electrophoresis and refer to opthalmologist

Question 18

curtain over eye…painless sudden appearance of floaters or flashes of light

Answer 18

retinal detachment

Question 19

tx retinal detachment

Answer 19

refer emergently

Question 20

blurry vision, halos, cloudy/steamy cornea, nausea and vomiting

Answer 20

acute angle closure glaucoma

Question 21

tx AACG

Answer 21

reduce IOP with acetazolamide. can do osmotic diuretics such as oral glycerin and IV mannitol. refer

Question 22

progressive bilateral loss of peripheral vision..tunnel vision..preserved visual acuity…cupping of optic disc

Answer 22

chronic / open-angle glaucoma

Question 23

tx chronic glaucoma

Answer 23

prostaglandin analogs (latanoprost/bimatoprost), topical b adrenergic blockers such as timolol (CI in pts with reactive airway disease and heart failure)…definitive treatment is laser therapy and surgery

Question 24

painless loss of central vision

Answer 24

macular degeneration

Question 25

drusen

Answer 25

mac degen

Question 26

tx mac degen

Answer 26

antioxidants, VEGF

Question 27

microaneurysms, retinal hemorrhages, exudates/ischemia, neovascularization and vitreous hemorrhage

Answer 27

diabetic retinopathy

Question 28

tx diabetic retinopathy

Answer 28

VEGF, tx diabetes. vitrectomy.

Question 29

AV nicking, flame hemorrhages and cotton wool spots…stellate macula

Answer 29

HTN retinopathy

Question 30

AV nicking, flame hemorrhages and cotton wool spots…stellate macula

Answer 30

HTN retinopathy

Question 31

optic disc swelling secondary to increased ICP

Answer 31

papilledema

Question 32

blurring, diplopia, visual disortions, may be asymptomatic…symptoms 2ndary to increased ICP such as HA and N&V

Answer 32

papilledema

Question 33

tx papilledema

Answer 33

acetazolamide, prednisone, refer immediately

Question 34

bone conduction over air conduction and louder in affected ear

Answer 34

conductive hearing loss

Question 35

air conduction over bone, louder in unaffected ear

Answer 35

sensorineural hearing loss