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EENT > Final Exam > Flashcards

Final Exam Flashcards

1
Q

What is amblyopia?

A

Lazy eye

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2
Q

Why should you not press on the eye with a pt presenting with eye trauma?

A

Extrusion of vitreous humor into cheek

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3
Q

When should you refer a pt with eye trauma to an ophthalmologist?

A

Diminished vision
Disturbed or asymmetric pupils
Evidence of retinal damage
Ocular misalignment (diplopia)
Hyphema (can precipitate acute glaucoma)

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4
Q

Homeopathy for eye trauma

A

Acontite - trauma, abrasions; scratched cornea, severe pain
Symphytum - blunt trauma to GLOBE
Arnica - orbit injuries, typical arnica pic

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5
Q

What is a Subconjunctival hemorrhage?

A

Spontaneous appearing patch of hemorrhage over sclera; painless, normal vision

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6
Q

Causes and RF Subconjunctival hemorrhage

A

Usually follow minor trauma, coughing, sneezing
Inc incidence with HTN, bleeding disorders

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7
Q

If you have a patient complaining of gradual loss of vision, difficulty driving at night; what is your ddx?

A

Cataracts

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8
Q

Ophthalmoscopic exam findings with cataracts

A

Red light reflex dec or absent
Difficult to see in the eye

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9
Q

Pathogenesis mechanisms for glaucoma

A

Mechanical (IOP related)
Vascular (HTN)
Glutamate toxicity

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10
Q

Signs/sx acute angle closure glaucoma

A

Red eye, N/V, diminished vision
Can come on after exposure to dark environment
Perilimbal injection, cloudy cornea, ant angle narrow, pupil fixed and dilated
Tactile tonometry firm

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11
Q

Wet v dry ARMD

A

Dry - gradual loss of vision in one/both eyes, difficulty reading or driving, using lights/magnification, slow onset with intact peripheral vision

Wet - new vessels form and break easily; occurs acutely, difficulty with seeing straight lines or central vision, usually one eye

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12
Q

What is a cholinergic medication?

A

Meds that ach through Ach, either by binding to its receptors or changing its concentration

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13
Q

What are muscarinic agonists also called?

A

Parasympathomimetic meds ; Muscarinic agonists will mimic parasympathetic nervous system stimulation.

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14
Q

What EENT conditions use muscarinic agonists?

A

Acute angle-closure glaucoma
Maintenance med in primary open-angle glaucoma
Dry mouth and dry eyes in sjogrens

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15
Q

for what EENT conditions are muscarinic antagonists used?

A

Topically for pupil dilation during ophthalmic procedures

Used as cycloplegics for uveitis, iritis, UV keratitis

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16
Q

what patient population should avoid muscarinic antagonists?

A

Elderly due to risk of confusion, sedation, dry mouth and eyes, constipation, and urinary retention

Patients with glaucoma and those at risk of acute angle-closure glaucoma

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17
Q

What are adrenergic medications?

A

Act by binding to adrenergic receptors or by changing the concentration of norepinephrine and epinephrine.

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18
Q

What are adrenergic agonists also called?

A

Sympathomimetics

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19
Q

For what EENT conditions are alpha 1 agonists used?

A

Nasal congestion and red eyes

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20
Q

For what EENT conditions are Alpha 2 agonists used?

A

Glaucoma

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21
Q

For what EENT conditions are Beta blockers used?

A

Glaucoma

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22
Q

What patient population should avoid alpha 1 agonists?

A

HTN/CVD
Angle closure glaucoma
Urinary retention
Bowel obstruction

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23
Q

What patient population should avoid Beta blockers?

A

Pts with asthma or obstructive airway disease

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24
Q

What are the effects of histamine in the allergic response?

A

Vasodilation and inc vascular permeability (edema, redness, inc mucosal secretions)

Stimulation of afferent neurons, leading to pruritis and pain

Contraction of bronchial smooth muscle, leading to bronchoconstriction

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25
Q

Role of H1 histamine receptors

A

Allergic response

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26
Q

Role of H2 histamine receptors

A

Regulation of acid secretion by gastric mucosa

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27
Q

What EENT conditions are treated with H1 antagonists?

A

Reduce itching, sneezing, rhinorrhea, and congestion of allergic rhinitis

Itching, redness, and watery eyes of allergic conjunctivitis

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28
Q

Which pt populations should avoid antihistamines?

A

Children <2
Elderly (fall down ouch ouch)

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29
Q

MOA of antihistamines vs mast cell stabilizers

A

Antihistamines: block histamine receptors

Mast cell stabilizers: prevent release of histamine from mast cells

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30
Q

What EENT conditions are treated with mast cell stabilizers?

A

IN for allergic rhinitis
Eye drops for allergic conjunctivitis
Topically for allergic conjunctivitis

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31
Q

What are the 2 eicosanoid synthetic pathways and what eicosanoids are made by each?

A

cyclooxygenase (COX) pathway - prostaglandins and thromboxane

Lipoxygenase (LOX) pathway - leukotrienes

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32
Q

How are NSAIDs used to treat EENT conditions?

A

fever and pain

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33
Q

How are prostaglandins used to treat EENT conditions?

A

Glaucoma

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34
Q

How are leukotriene antagonists used to treat EENT conditions?

A

Allergic rhinitis
Chronic rhinosinusitis

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35
Q

What is Episcleritis?

A

Inflammation of CT under conjunctiva

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35
Q

What is Episcleritis?

A

Inflammation of CT under conjunctiva

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36
Q

Episcleritis vs scleritis

A

Episcleritis - sudden onset, no vision changes, blanches with topical phenylephrine

Scleritis - more intense, red eyes, blurred vision, photophobia, intense eye pain, dec visual acuity

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37
Q

RF senile cataracts

A

Ocular disease, injury, surgery
DM
Galactosemia
UV light
Smoking
Genetics
Statin use

38
Q

Cataract PE findings

A

Red light reflex dec or absent

39
Q

Sx of acute closure glaucoma

A

Red eye
N/V
Diminished vision
Sx may begin after exposure to dark environment

40
Q

PE/signs acute angle glaucoma

A

Perilimbal injection
Cornea cloudy, ant angle narrow, pupil fixed and dilated
Tactile tonometry firm

41
Q

Mechanisms of primary open angle glaucoma

A

Mechanical
Vascular
Glutamate toxicity

42
Q

Primary open angle glaucoma sx/signs

A

Loss of peripheral vision > loss of central visual acuity

Loss of peripheral fields
Inc cup to dis ratio
Inc IOP

43
Q

____ makes up 80-95% of cases of ARMD

A

DRY ARMD

44
Q

the presence of _____ indicates age related macular degeneration

A

Drusen bodies

45
Q

Signs/sx of retinal detachment may be preceded by:

A

Dark, large, irregular floaters
Flashes of light and blurred vision
Curtain or veil in field of vision

46
Q

PE findings retinal detachment

A

Irregular, folded, darkened BVs

47
Q

euphrasia officinalis common name and parts used

A

Eyebright, leaf and flower

48
Q

Euphrasia/eye right actions

A

Decongestant
Antiinflammatory
Astringent
Antiseptic
Expectorant

49
Q

Euphrasia/eyebright indications

A

Conjunctivitis and nasal congestion

50
Q

What types of conditions is euphrasia/eyebright specific for?

A

Acute disorders of the nasal mucus membranes, esp with kids

Accompanied by watery dc, earache, headache, eye distress in acute catarrhal affections > direct action on lachrymal apparatus

51
Q

Amoracia rusticana common name and parts used

A

Horseradish
Fresh, Raw, grated roots

52
Q

Amoracia/horseradish actions

A

Decongestant
Mucolytic
Stimulant
Diaphoretic
Rubefacient
Digestive stimulant

53
Q

Amoracia/horseradish Indications

A

Sinusitis
Topically for neuralgia and chilblains

54
Q

allium sativum common name/parts used

A

Garlic
Cloves

55
Q

Allium/garlic actions

A

Antimicrobial
Anthelmintic
Antiparasitic
Antifungal
Immune support
Spares lactobacillus
Synergistic to antibiotics
Circulatory stimulant
Mucolytic

56
Q

Urtica/nettle actions

A

Antihistamine
Antiinflammatory

57
Q

Urtica/nettle indications

A

Allergic rhinitis

58
Q

Tanacetum parthenium common name and parts used

A

Feverfew, leaf and flower

59
Q

Tanacetum/feverfew Energetics

A

Drying and warming

60
Q

Tanacetum/feverfew Actions

A

Antimicrobial
Antiinflammatory
Febrifuge
Reduces inflammatory mediators
Inhibits prostaglandin synthesis
Vascular stabilizer - prevents dilation/contraction, inhibits release of histamine from mast cells

61
Q

Tanacetum/feverfew Indications

A

Migraine headache with internal heat
RA pain and inflammation
Febrile illnesses

62
Q

Petasites hybridus common name and parts used

A

Butterbur
Rhizomes, roots and leaves

63
Q

Petasites/butterbur actions

A

Smooth muscle antispasmodic
Antiinflammatory
Anti allergy

64
Q

Petasites/butterbur Indications

A

Respiratory conditions such as asthma, bronchitis, hay fever
Migraine headache

65
Q

What herb was found to be equally effective as cetrizine (Zyrtec) but without sedation, just as effective as Allegra, and more effective than desloratadine (Claritin)?

A

Petasites hybridus (butterbur)

66
Q

Ganoderma lucidum common name and parts used

A

Reishi, ling zhi
Fruiting body

67
Q

Ganoderma/reishi actions

A

Anti allergic
Antihypertenive
Dec platelet aggregation, LDL, arrythmia, insomnia, angina
Protects against ionizing radiation

68
Q

Ganoderma/reishi Indications

A

In allergy to dec histamine response
Cancer treatment to inc immune function and help treat fatigue
HTN
Immune deficiency
Insomnia
Hepatitis

69
Q

Scutellaria baicalensis part used

A

Root

70
Q

Scutellaria actions

A

Anti allergic
Antiinflammatory
Antineoplastic
Antioxidant
Cardioprotective
Antimicrobial

71
Q

Scutellaria indicatinos

A

Regulation of sleep cycle
Anxiety
Synergistic relationship with eleutherococcus with blocking allergic mediators/cytokines

72
Q

Phytolacca Americana common name and part used

A

Poke root

73
Q

Phytolacca/poke root energetics

A

Cooling

74
Q

Phytolacca/poke root Actions

A

Lymphagogue
Antiviral
Emetic
Purgative
Laxative

75
Q

Phytolacca/poke root Indications

A

Hard, painful glandular swellings
Mastitis

76
Q

Phytolacca/poke root CI

A

Pregnancy
Toxic at high dose
Can cause dermatitis when collected

77
Q

Stillingia sylvatica common name and part used

A

Queens root

78
Q

Stillingia/queens root actions

A

Lymphagogue
Emetic
Cathartic

79
Q

Stillingia/queens root indications

A

Dry, red, irritated mucous membranes of larynx, pharynx, bronchi
Croup cough

80
Q

Stillingia/queens root Caution/CI

A

Sylvacrol in fresh root tincture may cause GI burning, diarrhea, N/V, tachycardia, muscular weakness, prostration

81
Q

HEMP formula for pharyngitis

A

Hydrastis
Echinacea
Myrrh
Phytolacca

82
Q

Herb for conjunctivitis

A

Euphrasia/eyebright compresses for relief of redness, swelling and visual disturbances in eye inflammations and injuries and corneal ulcers

83
Q

Herbs to treat/prevent cataracts

A

Cineraria maritima
Trigonella foenum-graecum
Ginkgo

84
Q

Cineraria maritima common name

A

Dusty miller

85
Q

Cineraria/dusty miller uses

A

Juice dropped into eyes to treat cataracts, prevention of cataract formation

86
Q

Trigonella foenum graecum common name

A

Fenugreek

87
Q

Trigonella/fenugreek uses

A

Prevention of cataracts - restoration of antioxidant enzymes

88
Q

Ginkgo cataract MOA

A

EGb761 -
Reduced intensity of oxidative stress
Dec aldose reductase activation and AGEs
Suppressed transforming growth factor B2
Inc the expression of E cadherin
Dec alpha smooth muscle actin

89
Q

Herbs for macular degeneration and glaucoma

A

Ginkgo
Vaccinum

90
Q

Vaccinum myrtillus part used

A

Berry

91
Q

Vaccinium myrtillus actions

A

Inflammation modulator
Antioxidant
Improves circulation
Stabilizes collagen
Inhibits platelet aggregation
Prevention of release and synthesis of pro inflammatory compounds such as histamine, prostaglandins, leukotrienes

92
Q

Vaccinium myrtillus indications

A

Dry eyes
Eye fatigue
Diabetic retinopathy
Macular degeneration
Glaucoma

EENT (6 decks)

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