Exam One Flashcards
(30 cards)
Acute allergic conjunctivitis
Oral antihistamine
( fexofenadine and loratadine)
If symptoms persists, an antihistamine- vasoconstrictor may be used
( nephazoline- pheniramine) but no longer than 3-5 days
Vernal and Atopic conjunctivitis
Mast cell stabilizers
Cromolyn sodium
Lidoxamide tromethamine
Bacterial conjunctivitis
Trimethoprim-polymyxin B
Fluroquinolone drops qidx1wk ( topical)
H. Influenza amoxicillin- clavulante
Gonoccoal ceftriaxone iv or ciprofloxacin po
Chlyamidia azithro or doxy
Bacterial conjunctivitis
Sulfamyamide ointment or solution
Gentamicin
Erythromycin
Ciprofloxacin
Topical eye anesthetic
Tetracaine
Corneal abrasion
Atropine 1% or homatropine 2gtt to reduce pain from ciliary spasms
Topic antibiotics q2 hrs
No anesthetics or steroids
Repeat exam in 24 hrs
Cause of bacterial conjunctiva
Staph. Epidermis and aureus Strep pneumonia H. Influenzae Pseudomonas Moraxella
Allergic conjunctivitis
Vasoconstrictor Antihistamine- oral and topical Mast cell stabilizers NSAIDS oral Conticosteroids if no glaucoma or cataracts
Acute glaucoma
Sudden onset of photophobia and nausea Dilated pupils Red around cornea Unilateral visual loss EOM intact Peripheral vision WNL
Treatment of acute glaucoma
Immediate referral
Antiemetic
Pilocarpine or other possible drug
Chronic glaucoma
Gradual loss of peripheral vision Optic cup diameter greater than one half the optic disc diameter Halo around lights Optic nerve pallet No pain Visual change incidental
Chronic glaucoma medical management
Beta blockers - timolol maleate Miotics - pilocarpine Carbonic anhydrase inhibitor (Oral acetazolamine or dorozolamine) Sulfonamide Cholinesterase inhibitors (Echothiophate iodine)
Regular eye exam No steroids Bright light for reading Education regarding risk IP normally 10-21 mm hg Goal maintain vision
Macular degeneration
Loss of central vision No pain Can not read small print Visual acuity impaired Mottled appearance to macula Yellowish spots (Drusen) or hyperpigmentation on macula
Bacterial pharyngitis
Group A beta hemolytic streptococci
Creamy white tonsillar exudate
Tonsils enlarged
Positive throat culture
Treatment of bacterial pharyngitis
PCN
Ampicillin
Amoxicillin
If allergic to PCN then macrolides
Erythromycin
Azithro
Bacterial sore throat
PCN V
Viral rhinitis treatment
Analgesics and pseudoephedrine 30-60 every 4-6 hrs
Normal saline
No more then 3 days
( rhinitis medicamentosa)
Allergic rhinitis treatment
Oral antihistamine
Nasal topical steroids
Nasal irrigation with NS
Otitis external cause
Pseudomonas aeruginosa- green exudate
Staphylococcus pyogenes- yellow purulent exudate
Fungus- white fluffy or malodorous
Otitis external treatment
Pain control- topical and systemic
Domeboro otic or cortisporin otic qid
Fungal- lotrimin 1% 2 gtt tid
Pain control with topical anesthetic benzocaine, auralgan q 1-2 hr
Acute otitis media treatment
Systemic antibiotic with amoxicillin
Septra if local drug resistance
Acute bacterial rhino sinusitis cause
S. Pneumonia = adults
H. Influenza = children
Acute bacterial rhino sinusitis
Maxillary toothache Poor response to decongestants History of colored nasal discharge Purulent nasal secretion Abnormal transillumination after 10 days > 4 bacterial etiology
Differential for acute bacterial rhino sinusitis
Dental problems Trigeminal neuralgia Optic neuralgia Cold Migraine
