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Flashcards in FNP-ENT Deck (54)
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1

Herpes Keratitis

Symptoms, causes, treatment, complication(s).

  • severe eye pain, photophobia, blurred vision in one eye. May have crusty rashes on ophthalmic branch (CN V, trigeminal)
  • use fluorescein dye to dx FERN-LIKE lines on corneal surface
  • Causes: herpes simplex or herpes zoster (shingles)
  • Refer to ED
  • Complication: corneal blindness

2

Acute Angle-Closure Glaucoma:

Symptoms, signs, tx/disposition

  • Symptoms: acute onset severe eye pain, headache, n/v, halos around lights, decreased vision.
  • Signs: mid-dialted OVAL-SHAPED pupil 
  • Refer to ED

 

3

Multiple Sclerosis-Eyes

Symptoms, disposition

  • young female
  • Symptoms: new or intermittent loss of vision in one eye, nystagmus, (neuro symptoms: aphasia, paresthesia, ab. gait, spasticity, etc.). Dai;y fatigue upon awakening, worsening. Heat increases symptoms
  • Refer to neuro

4

Orbital cellulitis

S/S, causes, disposition

More common in young children than adults. Hx recent rhinosinusitis or URI.

  • Symptoms: acute onset erthymatous, swollen eyelid with poptosis (bulging eye), eye pain, limited ROM
  • Cause: acute bact. infxn of orbital contents
  • Refer to ED

5

Retinal Detachment

Symptoms, disposition

  • Sudden onset of shower of floaters, "feeling like you're looking through a CURTAIN or UNDER WATER", sudden flashes of light (photopsia)
  • Refer to ED

6

Cholesteatoma

S/S, tx, disposition

  • CAULIFLOWER-like growth
  • foul-smelling ear discharge
  • hearing loss
  • unable to visualiz tm, d/t destruction by tumor (not cancerous)
  • Tx: abx and surgical debridment
  • Refer to otolaryngoloist

7

Battle Sign

What is it?

What do you do?

Could be a sign of skull fracture.

  • "RACCOON EYES" (periorbital ecchymosis)
    • with brusing behind ear (mastoid area)
    • appears 2-3 days post trauma
  • Look for clear, golden fluid (CSF)
  • Refer to ED 

 

8

CSF fluid from skull

panic or chill?

how to test.

  • Panic (but don't actually). Indicative of basiliar skull fracture.
  • Refer to ED
  • test with urine dipstick to check for glucose (mucropurulent fluid will be negative)

 

9

Peritonsillar Abscess

S/S, dispostion

  • Symptoms: severe sore throat, pain on swallowing (odynophagia), trismus (muscale spasm in jaw), HOT POTATO voice
  • Signs: UNILATERAL swelling of peritonsillar area and soft palate, bulging red mass, UVULA DISPLACED away from mass, fever.
  • Refer to ED

10

Diptheria

S/S, dispostion

Notes: very contagious. Contact precautions

  • Symptoms: sore throat, fever, BULL NECK
  • Signs: post. pharynx, uvula, and soft palate are coated with GRAY to YELLOW PSEUDOMEMBRANE that is difficult to displace
  • Refer to ED

11

Presbyopia

  • Normal finding, age related
  • decreased ability to read small print
  • d/t stiffening of the lenses
  • usual onset around 40 y.o.

12

How many sinuses are there?

  • 4 in adults
    • ethmoid, maxillary, frontal, sphenoid
  • Children have ethmoid and maxillary at birth, frontal by 5 yo and sphenoid by 12 yo

13

Leukoplakia

  • White to light-grey patch (plaque) on tongue or inside of cheek. 
  • caused by chronic irritation, r/o CA
  • risk factors=smoking, chewing tabacco, EtOH use
  • Consider hairy leukoplakia if on lat. aspect of tongue

14

Diabetic Retinopathy

signs

  • cotton wool spots
  • microaneuryms

15

Cataracts

S/S

  • Symptoms: complain of glare, halos aroud lights, blurred vision
  • OPACITY of the lens
  • up to 20% of adults are affected (65-74)

16

Allergic Rhinitis

s/s

  • Blue-tinged or pale and swollen (boggy) nasal turnbinates
  • Clear nasal discharge
  • itchy nose
  • congestion

17

Koplik's Spots

describe. indicative of what?

  • clusters of sm. red papules with wht. centers inside the buccal mucosa (inside the cheeks) near the lower molars.
  • Measels (!)

18

Hairy Leukoplakia

describe, cause, indicative of?

  • version of leukoplakia
  • elongated papilla on lateral aspects of the tongue
  • difficult to remove
  • EBV infxn
  • Consider HIV infxn 

19

Cheilosis 

(Angular Cheilitis, Perleche)

describe, causes, etiology, tx

  • painful skin fissures at CORNER of mouth
  • Causes: excessive moisture, Candida albicans, Staph. aureus
  • mult. etiologies: dentures, pacifier use, oversalvation, lupius, autoimmune...
  • tx: remove underlying cause
    • if yeast infx topical azole
    • is staph, culture/spec. mupiricin BID
  • Prevent with petroleum jelly or zinc barrier cream

20

Visual Test Results:

What does it mean when someone has 20/60 vision?

They have to be 20 ft away from an object in order to see it, compared to a person with 20/20 (perfect vision) who can see the same item from 60 ft away.

  • (always use 20 as the first number)

21

What are the cones in the eye responsible for?

  • Color (COnes=COlor)
  • 20/20 vision
  • sharp vision

22

What are rods in the eye responsible for?

  • Detecting light and shadow
  • night vision

23

What are some characteristics of the fundus of the eye?

  • Veins are larger than arteries
  • Veins appear darker in color than arteries

24

What are the macula and fovea resposible for?

Macula

  • responsible for central vision

Fovea

  • set in the middle of the macula
  • responsiblew for sharp, 20/20 vision
  • contains a large # of cones

25

What is a typanogram used for?

  • Most objective measure to test for fluid in the middle ear
  • Acute otitis media and serious otitis media will show a straight line upon testing (as opposed to a peaked shape)

26

Bluish, pale and/or boggy turbinates are often indicative of what?

Allergic rhinitis

27

Optic disc with blurred edges is called __________ and may be due to?

  • Papilledema
  • ICP (Intracranial pressure)
    • secondary to bleeding, brain tumor, abscess, pseudomotor cerebi

28

Hypertensive retinopathy hallmarks

  • copper and silver wire arterioles
  • artereovenous nicking
  • retinal hemorrhages

29

Diabetic retinopathy hallmarks

  • microaneuryms
  • neovscularization
  • cotton wool spots

30

What causes arteriovenous nicking?

when an arteriole crosses a retinal vein, it indents the vein.