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Flashcards in ENT Deck (131):
1

s/s of herpes keratitis

sever eye pain, photophobia, and blurred vision in one eye

2

herpes keratitis is diagnosed with

fernlike lines on corneal surface using flourescein dye

3

complication of herpes keratitis

corneal blindness

4

exam with acute angle-closure glaucoma reveals

mid-dilated pupil that's oval shaped, cloudy cornea

5

treatment for acute angle-closure glaucoma

medical emergency

6

s/s of acute vision loss

sudden onset of floaters or black dots, scotoma (retinal detachment), blurred vision, eye pain

7

s/s of cholesteatoma

"cauliflower-like" growth with foul-smelling discharge to ear; hearing loss

8

those with cholesteatoma often have a hx of

chronic otitis media infections

9

complication of cholesteatoma

can damage CN VII (facial)

10

treatment for cholesteatoma

atbx and surgical debridement, refer to ENT

11

acute onset of bruise behind ear over the mastoid area after recent trauma

Battle's sign

12

Battle's sign indicates

fracture of basilar skull

13

s/s of basilar skull fracture

Battle's sign, clear golden fluid discharge from ear or nose (CSF)

14

rare complication where a patient with a hx of sinus or facial infection will present with severe headache and high fever

cavernous sinus thrombosis

15

s/s of peritonsillar abscess

severe sore throat, difficulty swallowing, trismus, "hot- potato" voice, fever, one-sided swelling with uvula displaced

16

trx for peritonsillar abscess

refer to ED for I&D

17

sore throat, fever, swollen neck "bull neck", hoarsness, dysphagia with gray-yellow colored pharynx

diphtheria

18

the macula is responsible for

central vision

19

the area of the eye that determines 20/20 vision

fovea

20

cobblestoning inner conjunctiva can be seen in patients with

atopy, allergic rhinitis, allergic conjunctivitis

21

age-related vision change that causes difficulty focusing and ability to read print at close range

presbyopia

22

thickened, white patches inside of mouth that may be cancerous

leukoplakia

23

management for avulsed tooth

store in cool milk see refer to dentist ASAP

24

this kind of nystagmus is always abnormal

vertical

25

optic disc swelling with blurred edges d/t increased ICP

papilledema

26

finding with hypertensive retinopathy

copper and silver wire arterioles

27

finding with diabetic retinopathy

microaneurysms caused by neovascularization

28

chronic steroid use can cause

cataracts

29

"grain of salt" papules in the buccal mucosa

Koplik spots, appear with measles

30

mucosal lining inside eyelids

palpebral conjunctiva

31

mucosal lining covering the eyes

bulbar conjunctiva

32

farsightedness

hyperopia

33

nearsightedness

myopia

34

abnormal Snellen chart result

two-line difference between each eye; less than 4 out of 6 letters correct

35

interpretation of 20/60

a person can see at 20 feet what the patient can see at 60 feet

36

legal blindness is characterized as

20/200

37

Weber test

placed on forehead, sound should not lateralize

38

Rinne test

placed on mastoid process, then front of ear. Normal is AC> BC

39

fluorescein dye with corneal abrasion

linear lines on cornea

40

s/s of corneal abrasian

severe eye pain with tearing; will keep affected eye shut.

41

treatment for corneal abrasion

check vision, flush with NS, if unable to remove, refer. Treat with erythromycin or polytrim x3-5 days.

42

Do not do this for corneal abrasion

do NOT patch eye

43

F/U for corneal abrasion in

24 hours, if not improved, refer

44

painful acute bacterial infection of hair follicle on eyelid

hordeolum (stye)

45

trx of stye

sulfa or erythromycin drops, warm compress bid-tid

46

chronic inflammation of the meibomian gland

chalazion

47

different between hordoleum (stye) and chalazion

hordoleum is painful and itchy; chalazion is not painful

48

yellow triangular thickening of bulbar conjunctiva caused by UV damage

pinguecula and pterygium

49

difference between pinguecula and pterygium

pinguecula will not cover the cornea; pterygium can cover cornea and affect vision

50

treatment for pinguecula and pterygium

weak steroid eye drops, sunglasses, surgery if pterygium starts affecting vision

51

subconjunctival hemorrhage can be caused by

coughing, sneezing, heavy lifting, vomiting, on ASA or anticoagulants

52

subconjunctival hemorrhage usually resolve within

1-3 weeks

53

normal intraocular pressure

8-21 mmHg

54

risk factors for primary open-angle glaucoma

elderly, African Americans, diabetes

55

In primary open-angle glaucoma, gradual changes occur in ____ first, then ____

peripheral vision; central

56

caused by gradual onset on increased intraocular pressure

open angle glaucoma

57

treatment for open angle glaucoma

Betimol beta blocker eye drops

58

contraindications for betimol beta-blocker eye drops for open angle glaucoma

asthma, COPD, heart block, heart failure

59

sudden blockage of aqueous humor causing increased intraocular pressure

primary angle closure glaucoma

60

s/s of primary angle closure glaucoma

acute onset of severe frontal headache with eye pain, decreased vision, halos around lights N/V

61

high risk of anterior uveitis in those with

autoimmune disease

62

s/s of anterior uveitis

red sore eyes with increased tearing

63

which form of macular degeneration is most common and less severe?

atrophic (dry form)

64

The exudative (wet form) of macular degeneration is responsible for

vision loss

65

s/s of macular degeneration

painless central vision loss; peripheral vision not affected

66

Treatment for macular degeneration

refer to opthalmologist, Amsler grid (focus eye on center dot daily).

67

chronic autoimmune disorder where there is decreased function of the lacrimal and salivary glands

Sjogren's syndrome

68

s/s of Sjogren's syndrome

dry eyes and dry mouth for > 3 months

69

trx for Sjogren's syndrome

artificial tear gtts, check ESR/CRP, refer to ophthalmologist and rheumatologist.

70

chronic red inflammation to eyelids that causes itching

blepharitis

71

trx for blepharitis

johnson's baby shampoo with warm water scrub eyelids;

72

Treatment for allergic rhinitis

nasal steroid sprays, decongestants, antihistamine

73

prolonged use of nasal decongestants for more than 3 days causing rebound nasal congestion

rhinitis medicamentosa

74

First line trx for strep throat

penicillin; Zpack if allergic to PCn

75

An acute type of AOM that causes more pain; presence of blisters on red/bulging TM.

bullous myringitis

76

AOM will lead to this kind of hearing loss

conductive

77

If AOM does not start resolving in 48-72 hours then,

switch to either Augmentin or (cefuroxime) Ceftin

78

first line trx for AOM

amoxicillin 875 mg x 10-14 days

79

first line trx for AOM if allergic to PCN

Zpack x 5 days, Bactrim DS

80

s/s of otitis media with effusion

bulging TM with fluid level

81

trx for otitis media with effusion

oral decongestants, steroid nasal spray

82

organisms that cause otitis externa

Pseudomonas aeruginosa (-), Staph aureus (+)

83

s/s of otitis externa

ear pain, swelling, green purulent discharge

84

trx for otitis externa

cortisporin otic QID x 7 days; or ciprofloxacin + hydrocortisone bid x 7 days

85

triad of mononucleosis

fatigue, pharyngitis, posterior cervical lymphadenopathy

86

avoid this drug if allergic to PCN

cephalosporins

87

difference b/t stye and chalazion

stye is painful, chalazion is not painful

88

medication for angular cheilitis

topical nystatin

89

common cause of angular cheilitis

C. albicans

90

first line trx for acute bacterial rhinosinusitis (ABRS)

augmentin

91

a characteristic of H. influenza is

may have some antimicrobial resistance to beta-lactamase

92

when sound gets better in a noisy enviornment

conductive hearing loss

93

Rinne test in conductive hearing loss

BC>AC

94

Weber test in conductive hearing loss

lateralizes to impaired ear

95

when hearing worsens in noisy enviornment

sensorineural hearing loss

96

Rinne test in sensorineural hearing loss

AC> BC

97

Weber test in sensorineural hearing loss

sound lateralizes to good ear

98

diphenhydramine is cautiously given in those with

BPH, COPD, glaucoma

99

most common cause of epiglottiitis

H influenza type b

100

s/s of epiglottitis

sore throat, stridor, sniffing posture, drooling, fever

101

Do not attempt to visualize pharynx if this is suspected

epiglottitis

102

rotavirus is given at

2 and 4 months

103

PCV13 is given at

2, 4, 6, 12-15 months

104

MMR is given at

12-15 months, 4-6 years

105

Hib is given at

2, 4, 12-15 months

106

DTap is given at

2, 4, 5, 15-18 months, 4-6 years

107

TdaP is given at

11-12 years, college freshmen, booster ever 10 years

108

varicella vaccine is given at

12-15 months, 4-6 years

109

s/s of acute rhinosinusitis

purulent nasal discharge, nasal congestion, tooth discomfort, facial pressure (esp when bending forward)

110

s/s suggestive of bacterial sinusitis

fever, purulent drainage; symptoms for more than 10 days

111

trx for rhinosinusitis

promote drainage

112

trx for bacterial sinusitis if allergic to PCN

doxycycline or quinolone

113

how long to trx for bacterial sinusitis

5-7 days

114

when should noticeable improvement occur after atbx for ABRS

3-5 days

115

complication of ABRS

periorbital cellulitis

116

diagnostic for periorbital cellulitis

CT with contrast

117

complications of GABHS

peritonsillar abscess, rheumatic fever, glomerulonephritis

118

Centor criteria for GABHS

absence of cough, fever greater than 100.4F, anterior lymphadenopathy, tonsillar exudate and swelling, age 3-14
RADT if greater than 2 points

119

If GABHS is not treated within 24-48 hours, then

symptoms will spontaneously resolve in 2-5 days. Can sequelae into rheumatic fever, glomerulonephritis.

120

Mononucleosis is caused by

Epstein-barr virus

121

s/s of mono

fever, pharyngitis, fatigue, posterior adenopathy, splenomegaly

122

diagnostic for mono

monospot (likely to be positive on 2-3rd week); EBV titers, CBC shows atypical lymphocytes

123

how long those with mono need to avoid direct contact sports

3-4 weeks

124

treatment for rhinitis medicamentosa

nasal steroid

125

first choice trx for allergic rhinitis

nasal steroid: diminishes allergic response overtime

126

4 step assessment of all eye complaints

1. assess visual acuity
2. examine with lamp or penlight
3. fluourescein staining
4. lid eversion

127

if patient only c/o scratchy and gritty sensation in eyes without visual changes, then suspect

viral conjunctivitis

128

best predicting s/s of AOM

cloudy, bulging TM with impaired mobility

129

causes of AOM in children

viral, streptococcus pneumonia

130

AOM in those less than 6 months old

always treat with atbx

131

f/u with AOM

in 48-72 hours