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HEENOT Flashcards

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1
Q

Lichen Planus

- overview

A

T-cell mediated

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2
Q

Lichen Planus

- assoc with what

A

Hep C exposure

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3
Q

Lichen Planus

- Clinical

A
  • oral or cutaneous lesions
  • polygonal, purple, pruritic papules
  • Wickham’s striae: lacy, white oral mucosa
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4
Q

Lichen Planus

  • dx
  • mgmt
A
  • clinical and biopsy

- Steroids first line, calcineurin inhibitors second line, avoid irritants

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5
Q

Dacryocystitis

- overview

A
  • infection of lacrimal sac

- dt obstruction: congenital or acquired

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6
Q

Dacryocystitis

- acute bugs

A

Staph aureus

beta-hemolytic strep

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7
Q

Dacryocystitis

- clinical

A
  • rapid onset
  • pain, red, swelling
  • inner eye near tear duct
  • possible purulent material
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8
Q

Dacryocystitis

- mgmt

A
  • mild: oral clinda

- severe: IV vanc + 3rd gen ceph

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9
Q

Dacryocystitis

- risk without tx

A
  • preseptal/orbital cellulitis
  • sepsis
  • meningitis
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10
Q

Croup

- bug

A

parainfluenza virus

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11
Q

Croup

- mgmt

A
  • supportive
  • steroid: dexamethasone usu
  • stridor at rest: racemic epi to open airway
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12
Q

Croup

- type of stridor

A

inspiratory

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13
Q

when to start fluoride supplementation if not on fluorinated water

A
  • 6 months
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14
Q

Open Angle Glaucoma

- overview

A
  • atrophy of optic nerve head

- Most often due to increased IOP

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15
Q

Open Angle Glaucoma

- RF

A
  • age
  • aa
  • hispanic
  • DM
  • HTN
  • CVD
  • myopia
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16
Q

Open Angle Glaucoma

- vision loss

A
  • insidious

- tunnel vision: lose periphery

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17
Q

Open Angle Glaucoma

- dx

A
  • fundoycopic exam: cupping of optic disc and increased cup to disc ratio
  • inc IOP
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18
Q

Open Angle Glaucoma

- mgmt

A
  • Prostaglandin analog drops: latanoprost

- 2nd line: timolol/bb drops

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19
Q

MCC bulls myringitis in children

A

Strep pneumonia

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20
Q

Acute bacterial sinusitis

- mgmt

A
  • oral decongestants
  • NSAIDS
  • Abx: amoxicillin, augmentin if risk for pneumococcal resistance
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21
Q

Sialolithiasis

- MC location

A

Wharton duct: anterior floor of mouth under tongue, drains submandibular gland

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22
Q

Pinna cartilage damage

- what type of closure best

A

first intention

  • if <12 hours old
  • no sign infection/contamination
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23
Q

How to close bite wounds, why

A
  • clean and leave open, treat with abx: assume contaminated with oral flora…
  • Once cleaned, close with secondary or tertiary intention
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24
Q

Strabismus

- overview

A
  • often infants <6 months
  • unclear etiology, genetics?
  • can lead to amblyopia
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25
Strabismus | - mgmt
- Small angle deviation: prism lens and corrective lens +/- patch - Angle >40: unlikely to have spontaneous resolution, require surgical realignment, early better
26
Open globe rupture | - dx
- clinical findings - teardrop pupil - Seidel test: fluorescein testing
27
Open globe rupture | - mgmt
- visual acuity - pupillary response to light - rigid protective patch - urgent ophthalmology referral
28
Labyrinthitis | - overview
- inflammation inner ear | - assoc bacterial/ viral infections
29
Labyrinthitis | - presentation
- acute onset, severe vertigo - assoc with tinnitus and hearing loss - aural fullness, otorrhea - otalgia - n/v - fever
30
Labyrinthitis - dx - mgmt
- clinical (r/o stroke, brain tumor) - bed rest, hydration - meclizine, diazepam ST to suppress vestibular system - Steroids, abx, antivirals
31
Aphthous stomatitis - RF - treatment
- genetics :) | - topical steroids
32
Rhinitis medicamentosa | - common med
Oxymetazoline | - don't use for more than 3 days in a row
33
Normal IOP
8-21 mmHg
34
Acute angle-closure glaucoma | - dx
Gonioscopy: gold standard. Special lens on slit lamp
35
Acute angle-closure glaucoma | - mgmt
- alpha-agonist: apraclonidine - bb: timolol - Cholinergic: pilocarpine - Acetazolamide - osmotic diuretics: mannitol
36
Diabetic retinopathy | - proliferative dx
- fundoycopic exam: neovascularization | - Fluorescein angiography: GS.
37
Diabetic retinopathy | - nonproliferative dx
fundoycopic exam: hard exudates, cotton wool spots, macular edema, etc.
38
Retropharyngeal abscess - location - overview
posterior to pharynx - complication of URI/oral infections or trauma - high mortality rate
39
Retropharyngeal abscess | - clinical
- sore throat - fever - painful swallow - pain opening mouth - neck pain/stiff - diff breathing - +/- airway compromise
40
Retropharyngeal abscess | - dx
- lateral neck XR | - CT neck with contrast: best
41
Retropharyngeal abscess | - mgmt
- broad spectrum abx - 2nd/3rd gen ceph + clinda - Vanc in high risk groups - I&D in operating room in some cases
42
AOM | - Most specific clinical finding
- bulging TM
43
AOM | - mgmt
``` Pain: acetaminophen or ibuprofen Abx: - amoxicillin first line - cefdinir, etc for mild PCN reaction - macrolide/clinda for severe PCN allergies ```
44
Herpes simplex keratitis | - mgmt
- topical/oral antiviral: trifluridine drops, ganciclovir ointment, acyclovir ointment or PO
45
Blepharitis | - RF
- rosacea - psoriasis - eczema - seborrheic dermatitis (chronic inflammatory conditions)
46
Blepharitis | - mcc
meibomian gland dysfunction (posterior)
47
Dental carries | - mc pathogen
- strep. mutans
48
Gingostomatitis due to herpes simplex | - mgmt
acyclovir
49
Chemical Eye burn - worst type of agent - mgmt
- alkaline: liquefactive necrosis | - copious eye irrigation, target pH 7-7.4
50
Sampters Triad
- ASA/NSAID allergy - Nasal polyps - Asthma
51
Orbital cellulitis | - RF
- rhinosinusitis - orbital trauma - dacryocystitis
52
Orbital cellulitis | - bugs
- s. aureus | - s. anginosus
53
Orbital cellulitis | - clinical
- eye pain, swelling - fever - deceased vision - painful eye movement - proptosis - chemosis - ophthalmoplegia
54
Orbital cellulitis | - dx
- CT / MRI
55
Orbital cellulitis | - mgmt
- IV vanc + 3rd gen ceph (ceftriaxone)
56
Presbycusis | - overview
- symmetric, progressive hearing loss - high frequency then lower - elderly pts - sensorineural disorder: damage to cochlear hard cells - M > F
57
Weber
- goes to Wax: conductive will lateralize to affected side | - sensorineural will lateralize to normal side
58
Rinne
- Normal AC > BC | - Conductive Loss: BC > AC
59
Vestibular Schwannoma / acoustic neuroma | - overview
- Benign tumor of CN VIII | - usu unilateral
60
Vestibular Schwannoma / acoustic neuroma | - presntation
- unilateral sensorineural hearing loss - vestibular sx - CONTINUOUS disequilibrium (not episodic) - Can cause disturbance of trigeminal nerve = facial paresthesia/pain or facial nerve
61
Vestibular Schwannoma / acoustic neuroma | - dx
- clinical testing | - MRI: definitive
62
Scarlet Fever | - overview
- diffuse erythematous rash assoc with strep pharyngitis | - delayed cutaneous reaction to toxins
63
Scarlet Fever | - rash
- diffuse erythema - sandpaper - papular elevations - armpit to trunk and extremities, spears palms and soles
64
Scarlet Fever | - clinical
- strep throat findings | - assoc with circumoral pallor and strawberry tongue
65
Scarlet Fever | - complications
- progression to rheumatic fever
66
Scarlet Fever | - dx
- clinical | - strep test/cuture
67
Scarlet Fever | - mgmt
- pcn, amoxicillin, cephalexin, macrolide
68
Infectious mononucleosis | - virus
EPV
69
Infectious mononucleosis | - dx
- labs: lymphocytosis | - heterophiles antibody test

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