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PNCB2 > Eye, Ear, Nose, and Throat Issues and Disorders > Flashcards

Eye, Ear, Nose, and Throat Issues and Disorders Flashcards

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1
Q

What is blepharitis?

A

inflammation of eye lid (usually where eye lashes are)

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2
Q

What is dacryocystitis?

A

infection of lacrimal sac

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3
Q

What is a hordeolum?

A

stye–a common staph abscess on the upper or lower eyelid

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4
Q

What are the symptoms of a hordeolum?

A

abrupt onset
localized pain and edema
pain proportional to the amount of edema

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5
Q

What is the management of a hordeolum?

A

warm compresses
topical bacitracin or erythromycin ointment
refer to ophthalmologist for possible incision and drainage if doesn’t resolve in 48 hours

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6
Q

What is a chalazion?

A

a beady nodule on the eyelid–infection or retention cyst of meibomian gland

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7
Q

What are the signs and symptoms of a chalazion?

A

Differs from hordeolum in that it is usually PAINLESS
red conjuctiva
itching
visual distortion if cyst is large enough and can lead to astigmatisim
eyelid swelling
light sensitivity
increased tearing

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8
Q

What is the managment of a chalazion?

A

warm compresses

refer for surgical removal

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9
Q

When in a culture recommended for conjunctivitis

A

when gonococcal is suspected

in infants

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10
Q

What does the discharge look like and what is the management of allergic conjunctivitis?

A

stringy and increased tearing
oral antihistamines
referral to allergist or ophthalmologist
**steroids not ordered because of increased intraocular pressure and activation of herpes simplex virus

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11
Q

What does the discharge look like and what is the management of herpetic conjunctivitis?

A

bright red and irritated

Refer to ophthalmologist

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12
Q

What does the discharge look like and what is the management of viral conjunctivitis?

A

watery
symptomatic care:
1. mild: saline drops (refrigerated cool is best)
2. moderate: decongestents/antihistamines and NSAIDs
3. sulfacetamide 10% opthalmic solution for bacterial prophylaxis

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13
Q

What does the discharge look like and what is the management of chlamydia conjunctivitis?

A

erythromycin opthalmic ointment

oral: tetracycline, erythromycin, azithromycin, doxycycline, clarithromycin

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14
Q

What does the discharge look like and what is the management of gonococcal conjunctivitis?

A

THIS IS AN OPHTHALMIC EMERGENCY!
copious, purulent drainage
IV Pen G or ceftriaxone IM

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15
Q

What does the discharge look like and what is the management of bacterial conjunctivitis?

A

purulent drainage
Erythromycin 0.5% ophthalmic ointment
tetracycline 1%
polymyxin B ophthalmic solution or ointment

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16
Q

What does the discharge look like and what is the management of chemical conjunctivitis?

A

this is self-limiting

flush with normal saline

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17
Q

What are cataracts and what populations are they normally seen in?

A

abnormal, uniform, progressive opacity of the eye seen in children with down syndrome, diabetes, Marfan syndrome, and atopic dermatitis

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18
Q

What are causes of cataracts?

A 
congential
certain disorders
prolonged steroid use
infection
injury
radiation
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19
Q

What are symptoms of cataracts?

A 
painless
decreased vision acuity
clouded, blurred, dim vision
white fundus reflex
poor visual fixation
photophobia
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20
Q

What is the management of cataracts?

A

surgical removal

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21
Q

What is strabismus?

A

ocular misalignment as a result of uncoordinated ocular muscles
**If occurs after 6 months of age, then usually related to an underlying problem

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22
Q

Esotropia

A

eyes deviate inward

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23
Q

Exotropia

A

eyes deviate outward (exit)

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24
Q

hypertropia

A

eyes deviate upward (hyper=up)

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25
Hypotropia
eyes deviate downward (hypo= down)
26
How could you diagnose strabismus?
hirschberg papillary light reflex is unequal
27
What is the management of stabismus?
Refer to ophthalmology: if fixed or continuous at 6 months or more immediately for hypertropia or hypotropia signs of underlying cause
28
What is otitis externa?
inflammation of the external auditory meatus (also known as swimmers ear)
29
What are signs/symptoms of otitis externa?
otalgia (ear pain) pruritus (itching purulent discharge
30
What are the physical exam findings of otitis externa?
erythema of the ear canal edema of the ear canal purulent exudate (sometimes with odor) pain upon manipulation of auricle lateral surface of tympanic membrane may be erythematous **TYMPANIC MEMBRANE IS NORMAL--with normal mobility
31
What is the management of otitis externa?
remove purulent debris keep from moisture/injury Bacterial, topical ear medication: acetic acid with/without hydrocortisone cortisporin (neomycin, polymyxin B) Fungal: antifungal drops such as clotrimazole 1% solution
32
What is acute otitis media and what are the typical causes?
bacterial infection of the mucosally lined air-containing spaces of the temporal bone, most commonly caused by s. pneumoniae (30%) and h. influenzae (20%)
33
What are signs/symptoms of acute otitis media?
``` decreased hearing otalgia fever aural presure vertigo nausea/vomiting ```
34
What are the exam findings of acute otitis media?
``` erythematous (not diagnostic) edematous purulent exudate!!! tympanic membrane rarely bulges **impaired mobility of TM ```
35
What is the management of acute otitis media?
**Watchful waiting for 48-72 hours in healthy, asymptomatic children tylenol, benzocaine otic drops amoxicillin 80-90 mg/kg/day 2x daily x10 days TO prevent: Hib, PCV13, annual flu vaccines; avoid second hand smoke (those exposed with have 4x more often than peers)
36
What is serous otitis media/otitis media with effusion?
presence of fluid in middle ear without s/sx of acute otitis media
37
What are the signs/symptoms and exam findings of serous otitis media?
hearing loss, popping sensation when pressure altered, fullness in ear air bubbles behind TM, decreased mobility, weber/rinne tests suggestive of conductive hearing loss
38
What is the management of serous otitis media?
watchful monitoring- 3 months reevaluate in 3-6 months **antibiotics and antihistamines/decongestants are not effective
39
Weber test
strike tuning fork and place in middle of head and state where sound is coming from (L, R, or both) * "W" looks like bow on top of head so W=weber determines whether there is conductive or sensorineural hearing loss
40
What are normal findings of a weber test?
should be heard equally in both ears and not laterlize
41
Rinne test
strike tuning fork and put near base of mastoid bone (bone); then when no longer can hear move fork near ear canal (air) and state when you can no longer hear. Then compare the time. determines bone and air conduction hearing
42
What are normal findings of a rinne test?
air conduction should last twice as long as bone conduction
43
What are causes of conductive hearing loss?
``` something is blocking ear cerumen impaction/foreign body hematoma otitis media perforated tympanic membrane ```
44
What are causes of sensorineural hearing loss?
Impaired transmission of sound through the nervous system from diseases ex) meningitis (treated with ototoxic meds-gent/vanc, causing more problems) acoustic neuroma syphilis central nervous system disease medication toxicity
45
Diagnosis of conductive hearing loss
Weber test: hearing better in affected ear | Rinne test: abnormal in affected ear (bone conduction is heard better than air conduction)
46
Diagnosis of sensorineural hearing loss
Rinne test is is normal | Weber test: hear better in normal ear
47
Labs/diagnostic tests of hearing loss
``` Rinne/weber otoscopic exam neurologic exam audiometric screening CT scan if neurologic condition is suspected serum blood tests as needed ```
48
Management of hearing loss
remove foreign body/ear wax refer for audiogram refer for further eval/hearing aid
49
When can you give OTC cold preparation such as decongestants/antihistamines/antitussives etc.?
Do not give until age of 6
50
How to manage epistaxis?
to manage nosebleeds--put pressure at kiesselbach's triangle (where nose goes from hard to soft). Hold for 10 minutes and apply ice
51
What clinical features are must suggestive of group A beta-hemolytic streptococci (GABHS)?
``` FLEA: F: fever (100.4+/38) L: lack of cough E: exudate of pharyngo-tonsillar A: anterior cervical adenopathy OR F: fever L: lymph node swelling E: exudate A: absent cough ``` **Strep test is recommended for 1 or more of these
52
Management of strep infection:
supportive cares antibiotics: Penicillin VK 250 mg orally 3x/day x10 days If allergic to penicillin--erythromycin 250 mg 4 x daily x 10 days
53
What are the most common pathogens that cause epiglottitis?
streptococci, pneumococci, and h. influenzae | **Bacterial infection
54
When is the peak incidence of epiglottitis?
between ages 6 and 10
55
What are s/sx of epiglottitis?
``` sudden onset high fever drooling choking sensation restless, fearful hyperextension of the neck rapidly progressive signs of resp distress ```
56
What diagnostic sign is indicative of epiglottitis?
thumb sign (thumb shaped patch, appearing on radiograph of neck)
57
What is the management of epiglottitis?
``` immediate hospitalization DO NOT PERFORM PHARYNGEAL EXAM keep child calm intubation capabilities ASAP IV third generation cephalosporin until pathogen identified ```
58
Who does croup most commonly affect?
3 month year olds to six years olds more common in males most common occurrence in fall or winter
59
What are s/sx of croup?
``` symptoms of URI barky cough low grade fever vital signs consistent with infection dyspnea stridor if severe clear lung sounds ```
60
What diagnostic tests help confirm croup?
pulse oximetry will show hypoxia in severe croup | radiograph will show a steeple sign (narrowing of trachea) of the neck
61
What is the management of croup?
mild: supportive care moderate: hospitalize for resp support/IV fluids and possible racemic epi Short course of corticosteroids
62
Who does sinusitis affect and what is it caused by?
Occurs in those 9 years of age and older most commonly in the maxillary and ethmoid sinuses Caused by same organisms of otitis media: s. pneumoniae, h. flu, m. catarrhalis
63
What is the treatment of sinusitis?
augmentin for 10 days--change to levaquin if no improvement in 3 days *decongestants and antihistamines are not useful in acute sinusitis, but possibly work in chronic sinusitis Chronic sinusitis can be referred to oto
64
Signs/symptoms of mono?
posterior cervical lymphadenophathy and generalized lymphadenopathy White exudate on tonsils splenomegaly maculopapular or petechial rash
65
Laboratory tests indicative of mono?
lymphocytic leukocytosis, neutropenia positive heterophil and monospot early rise in IgM EBV permanent rise in IgG

PNCB2 (18 decks)

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