HEENT Flashcards
(262 cards)
1
Q
Leukoplakia Etiology
A
Inflammatory/Autoimmune
2
Q
Leukoplakia Presentation
A
Adherent white patches/plaques on oral mucosa or tongue.
3
Q
Erythroplakia Presentation
A
Type of Leukoplakia that presents with erythema
4
Q
Leukoeruthroplakia Presentation
A
Type of leukoplakia that is white and speckled
5
Q
Leukoplakia Treatment
A
Pre-cancerous. Biopsy. ENT referreal
6
Q
Oral Hairy Leukoplakia Etiology
A
epstein-berr virus. Almost exclusively HIV patients.
7
Q
Oral Hairy Leukoplakia Presentation
A
Vertically Corrugated white lesions on the lateral side of the tongue.
8
Q
Oral Squamous Cell Carcinoma Presentations
A
Ulcers/masses that don’t heal. Can be painful if ulcerated. Dental changes. Exophytic.
9
Q
Oral Squamous Cell Carcinoma Treatment
A
ENT for biopsy and surgical resection.
10
Q
Oral Melanoma Presentation
A
Painless, bleeding mass. Discolored. Ulceration. Dental changes. ABCDEs.
11
Q
Oral Melanoma Treatment
A
ENT for biopsy, CT, endoscopy. Surgical resection and radiation.
12
Q
Amalgam Tattoo presentation
A
blue/black macule seen in area adjacent to amalgam dental filling. benign.
13
Q
Melanosis
A
common pigmentation change in darker skin types. Appears symmetrically.
14
Q
Oral Melanotic Macules
A
Dark benign macules that are symmetric with sharp borders
15
Q
Mucoceles Etiology
A
Mild/minor trauma
16
Q
Mucoceles Presentation
A
fluid-filled cavities in mucous membranes lining the epithelium. pink/blue soft papule/nodule. gelatinous fluid.
17
Q
Mucoceles Treatment
A
Resolves on their own.
18
Q
Oral Herpes Simplex Virus Etiology
A
HSV 1
19
Q
Oral Herpes Simplex Primary Presentation
A
Herpetic Gingivostomatitis. Painful grouped vesicles on an erythematous base on buccal mucosa. Can have fever.
20
Q
Oral Herpes Simplex Recurrent Presentation
A
Prodrome with pain/burning/tingling 24 hours before lesion appears. usually occurs withing keratinized areas.
21
Q
Oral Herpes Simplex Diagnosis
A
Clinical. viral culture. Tzanck prep will show multinucleated larger cells.
22
Q
Oral Herpes Simplex Treatment
A
Antivirals (acyclovir, valacyclovir, famiclovir) within first three days. Miracle mouthwash, analgesics.
23
Q
Coxsackie Virus prodrome
A
fever, malaise, sore throat
24
Q
Coxsackie virus presentation
A
Small, painful, aphthae lesions that usually spare the lips and gingiva. Pale papules also present on hands and feet.
25
Coxsackie Virus Treatment
Supportive. Resolves within 5-6 days.
26
Oropharyngeal Candidiasis Etiology
Candida Albicans. Opportunistic Infection.
27
Oropharyngeal Candidiasis Presentation
Sore mouth/throat. Beefy red tongue. Creamy white patches with erythematous mucosa. "Thrush with Brush"
28
Oropharyngeal Candidiasis Diagnosis
KOH prep shows budding yeast.
29
Oropharyngeal Candidiasis Treatment
Topical. Nystatin suspension/troche or clotrimazole troche.
30
Erythema Multiforme Major Etiology
Acute, immune-mediated condition. Induced by HSV or Mycoplasmic pneumonia.
31
Erythema Multiforme Major Presentation
Target-like lesions on the skin. Diffuse areas of mucosal erythema with erosions/bullae. Also effects genitals and eye.
32
Erythema Multiforme Major Treatment
Resovles within 2 weeks. Topical corticosteriods for relief. miracle mouthwash, antihistamines. Can use oral glucocorticoids for severe mucosal involvement.
33
Stevens-Johnson Syndrome Etiology
Medication induced.
34
SJS Prodrome
Fever, flulike symptoms. conjunctivitis/photophobia.
35
SJS skin Lesions
Tender erythematous purpuric macules leading to vesicles leading to skin sloughing.
36
SJS mucosal involvement
Erythema, edema, bullae that rupture. Can also effect genitals and eyes.
37
SJS treatment
biopsy, discontinue offending med, corticosteroids, hospital admission (hydration and secondary infections: S. aureus and P. aeruginosa).
38
Pemphigus Vulgaris Etiology
Chronic Auto-immune disorder
39
Pemphigus Vulgaris Presentation
Flaccid bullae in oropharynx that spread to the scalp/face/axillae. Nikolsky sign.
40
Nikolsky Sign
gentle application of lateral pressure in uninvolved area causes the superficial layer to slough off. Diagnostic for Pemphigus.
41
Pemphigus Vulgaris Diagnosis
Nikolsy Sign. 2 biopsies (lesion and perilesional) for direct immunofluorescence.
42
Pemphigus Vulgaris Treatment
Systemic corticosteroids, immunosuppressants, Topical lidocaine or oralone. Derm referral.
43
Pemphigoid Etiology
Chronic auto-immune disorder
44
Pemphigoid prodrome
pruritic eczematous, papular/uticaria-like lesions
45
Pemphigoid Presentation
Tense bullae that remain intact. erythematous plaques in mucosal membrances.
46
Pemphigoid Diagnosis
2 biopsies (lesion and perilesional) for direct immunofluorescence.
47
Pemphigoid Treatment
Topical or oral corticosteriods. Derm referral.
48
Apthous Ulcers Etiology
Idiopathic. Predisposing factors: infection, HIV, genetic, vitamin/mineral deficiencies.
49
Apthous Ulcers Presentation
single/multiple oral lesions. Shallow round/oval, painful with grey base and ring of erythema. on buccal and labial mucosa.
50
Apthous Ulcers Treatment
Resolve within 10-14 days. Topical steroids for symptomatic relief.
51
Bechet's Syndromd Etiology
Neutrophilic Inflammatory disease.
52
Bechet's Syndrome Presentation
Recurrent oral/genital ulcers. Painful, deep, central yellow necrotic base. Often multiple.
53
Bechet's Syndrome Diagnosis
Recurrent oral ulcers >3 times per year with 2 other clinical findings (genital ulcers, eye or skin lesions).
54
Bechet's Syndrome Treatment
Refer to Rheumatology
55
Oral Lichen Planus Etiology
Chronic inflammatory disorder
56
Oral Lichen Planus presentation
Reticular: Lacy white plaque on buccal mucosa (wickham's straie)
Erythematous: Painful, red patches due to atrophy.
Erosive: painful erosions and ulcers
57
Oral Lichen Planus Diagnosis
biopsy and ENT
58
Oral Lichen Planus Treatment
pain relief, high potency corticosteroids (clobetasol proprionate).
59
Black Hairy Tongue Etiology
antibiotic use, candida albicans, poor oral hygeine.
60
Black Hairy Tongue Presentation
Elongated filliform papillae. Yellow/white/brown. Drosal aspect of tongue.
61
Black hairy tongue Treatmen
better oral hygeine. brush the tongue.
62
Geographic tongue presentation
Erythematous patches on dorsal tongue with circumferential white borders. Transient. Asymptomatic.
63
Geographic Tongue Treatment
Reassurance.
64
Atrophic Glossitis Etiology
Nutritional deficiencies (VB12), dry mouth, celiacs, candida. Inflammatory disorder causing atrophy of the filliform papillae.
65
Atrophic Glossitis Presentation
smooth, glossy, erythematous tongue. Burning sensation.
66
Atrophic Glossitis Treatment
Address the underlying condition.
67
Otitis Externa Etiology
Psuedomonas, S. Epidermis, S. Aureus, aspergillus, candida.
68
Otitis Externa Causes
Heat and moisture leading to swelling and maceration of the EAC.
69
Otitis Externa Presntation
Ear pain that worsens with movement of the external ear. pruritc especially with fungal. Decreased conductive hearing. Erythematous and edematous.
70
Otitis Externa Green Discharge
pseudomonas
71
Otitis Externa yellow discharge
S. Aureus
72
Otitis Externa black/white fluffy growth
Fungal
73
Otitis Externa fungal treatment
clotrimazole 1% BID x 14 days. Acidifying solution (acetic acid). Keep EAC dry.
74
Otitis Externa Bacterial Treatment
cortisporin otic suspension (polymyxin B, neomycin, hydrocortisone). Keep EAC dry. Resolves within 5-7 days.
75
Malignant Otitis Externa Etiology
Pseudomonas. Seen with DM and immunocompromised.
76
Malignant Otitis Externa Presentation
Intense ear pain (out of proportion), otorrhea, red granulation, lymphadenopathy, edema, trismus, elevated inflammatory markers in the blood.
77
Malignant Otitis Externa Treatment
Admission. IV ciprofloxacin. Debridement.
78
Acute Otitis Media Etiology
Streptococcus pneumoniae, Haemophilus influenzae, moraxella cararrhalis
79
AOM Pediatric Presentation
Irritability, decreased apetite, +/- Fever, ear pain, discharge, vomiting, diarrhea, conjunctivitis (H. Influenzae).
80
AOM Adult Presentation
Otalgio without fever.
81
AOM exam findings
opaque/reddend, bulging TM. Decreased TM mobility. Conductive hearing loss. Can have blisters. Type B tympanogram.
82
AOM Antibiotics indicated for...
102.2, or bilateral AOM
| >24 months: severe symptoms
83
AOM antibiotics NOT indicated for...
6-23 months with unilateral and non severe AOM
| >24 months with uni/bilateral and non severe AOM
84
AOM Antibiotic Treatment
Amoxicillin (80-90 mg/kg/day) for 7-10 days.
85
AOM first line antibiotic Treatment contraindicated
antibiotics in last 30 days, purulent conjunctivitis or recurrent AOM. Instead use Augmentin (amoxicillin and clavulanate).
86
AOM Treatment with Penicillin Allergery
cefdinir, cefuroxime, cefpodoxine
87
AOM treatment failure
IM rocephin (ceftriaxone) 50 mg.
88
Recurrent AOM
more than 3 in the last 6 months or more than 4 in the last 12 months. Treat with ceftriaxone or augmentin. Consider ENT consult.
89
Chronic Otitis Media Etiology
Recurrent AOM, trauma or cholesteatoma.
90
Chronic Otitis Media Presentation
Drainage from middle ear for longer than 2 weeks with a painless TM perforation. Conductive hearing loss.
91
Chronic Otitis Media Treatment
Refer to ENT
92
Otitis Media with Effusion Etiology
Viral URI, AOM, allergic rhinitis.
93
OME Presentation
painless, ear fulness and decreased hearing. Amver colored fluid behind TM. Type B tympanogram.
94
OME Treatment
Watchful waiting. intranasal steroids for allergeris. ENT for T tubes if longer than 3 months.
95
Eustachian Tube Dysfunction Presentation
Retracted TM. Type C tympanogram. Ear fullness, recurrent OME, hearing loss.
96
Eustachian Tub Dysfunction Treatment
Steroid nasal spray (afrin/neo-synephrine for ONLY 3 days), allergy management, decongestants, T tubues.
97
Ear Barotrauma Presentation
Discomfort or drainage with pressure changes. Ear fullness. Hemotympanum.
98
Ear Barotrauma Treatment
supportive
99
Labrynthitis Etiology
Viral URI causing acute inflammation/infection of the vestibular system.
100
Labrynthitis Presentation
Acute onset of vertigo, N/V, balance problems, tinnitus, hearing loss. Positive head thrust (can't maintain visual fixation). Horizontal nystagmus.
101
Labrynthitis Treatment
Bed rest, hydration, Meclizine (antivert) 25mg TID for vertigo.
102
Allergic Rhinitis Etiology
Hyper-responsiveness to allergens. IgE (basophils/mast cells). Increase in histamine, cytokines, leukotrienes, prostaglandins.
103
Allergic Rhinitis symptoms
Rhinorrhea, sneezing, itchy eyes/nose, congestion, PND (clear), cough.
104
Allergic Rhinitis Signs
pale/blue boggy nasal mucosa, clear discharge, palpebral conjunctival injection, allergic shiners, denier morgan lines.
105
Allergic Rhinitis Diagnosis
Skin test or Immunoassays (less risk but more expensive)
106
Allergic Rhinitis Treatment
Remove allergen, intranasal glucocorticosteroids (flonase), antihistamines, decongestants (sudafed), leukotriene antagonists (singulair), immunotherapy.
107
First Generation Antihistamines
Chlorpheniramine (chlor-trimeton) or diphenhydramine (benadryl). Can cause dry mouth, sedation and constipation.
108
Second Generation Antihistamines
Loratadine (claritin), fexoxedadine (allegra), cetrizine (zyrtec). Less sedating, same effect as first generation.
109
Sympathomimetics
Decongestants. Vasoconstriction decreases edema and secretions. Psuedoephredrine (sudafed). Contraindicated in patients with HTD and cardiac disease.
110
Immunotherapy
Hypersensitizes IgE. Takes about 6 months to start working.
111
Perennial Non-allergic (vasomotor) Rhinitis Etiology
Abnormal autonomic response triggered by stress, temperature changes, sexual arousal and blood pressure meds.
112
Vasomotor Rhinitis Presentation
Congestion and rhinorrhea without itching or sneezing. Nasal mucosa and IgE levels are normal.
113
Vasomotor Rhinitis Treatment
Avoid triggers, topical steroids, topical antihistamines (azelastine), topical antichollinergics (ipratropium) and first generation oral antihistamine.
114
Nasal Polyps Etiology
Associated with allergic rhinitis, vasomotor rhinitis, chronic sinusitis and smatter's triad.
115
Smatter's triad
Asthma, nasal polyps and NSAID sensitivity.
116
Nasal Polyp presentation
pedunculated, non-tender, soft, grey tissue growths.
117
Nasal polyp Treatment
intranasal glucocorticoids. ENT referral if obstruction occurs.
118
Rhinitis Medicamentosa Etiology
Tachyphylaxis with overuse of topical decongestants like afrin.
119
Rhinitis Medicamentosa Presentation
Erythematous mucosa
120
Rhinitis Medicamentosa Treatment
discontinue the intranasal glucocorticoid.
121
Common Cold Etiology
Rhinovirus, Parainfluenza and Respiratory Syncytial Viruses in pediatric patients
122
Common Cold Symptoms
Rhinitis, congestion, sore throat, cough, malaise, +/- fever, HA (mild), Myalgias (mild).
123
Common Cold Signs
Mucosal edema, congestion, pharyngeal erythema, +/- lymphadenopathy, conunctival injection.
124
Common Cold Treatment
Rest, Hydrate, NAIDS, anti-tussive, decongestant. 1-2 week duration.
125
Influenza Etiology
Influenza virus A and B
126
Influenza Symptoms
Abrupt onset, HA, Fever (100-104), chills, myalgias, malaise, cough, sore throat, conjunctival injection.
127
Influenza Signs
Flushed, hot, dry skin. Mucosal membrane injection, mild lymphadenopathy.
128
Influenza Diagnosis
Rapid antigen test, immunofluorescense (A from B), Viral culture (gold standard), Polymerase chain reaction.
129
Influenza Treatment
Antivirals (within 24-48 hours of onset). Oseltamivir, Zanamivir.
130
Oseltamivir Dosing
Tamiflu. For influenzae. 70mg BID for 5 days. Can cause delirium, N/V.
131
Zanamivir Dosing
Relenza. For influenzae. 10mg BID for 5 days. indicated for pregnancy. Can cause bronchospasm.
132
Pharyngitis/tonsilitis Symptoms
sore throat, fever, HA, malaise, lymphadenopathy, URI symptoms.
133
Pharyngitis/tonsilitis signs
pharyngeal erythema, tonsilar hypertrophy, purulent exudate, tender/enlarged anterior cervical nodes, palatal petechiae.
134
Group A strep Presentation
Pharyngeal exudate, cervical lymphadenopathy, fever, lack of a cough.
135
Group A strep Diagnosis
Rapid antigen detection. Even if negative follow up with a throat culture.
136
Herpetic Pharyngitis Presentation
ulcerations in the throat.
137
Herpetic pharyngitis treatment
acyclovir or famcyclovir
138
Diptheria Presentation
gray membrance in the pharynx with significant bleeding.
139
Diptheria treatment
antitoxin plus penicillin or erythromyocin.
140
HIV Presentation
If pharyngitis sxs aren't improving in 5-7 days or are worsening.
141
Group A strep Treatment
Penicillin V. 500mg BID-TID for 10 days.
142
Group A Strep Treatment alternatives
amoxicillin, penicillin G benzathine (IM), cephalexin.
143
Group A strep treatment with penicillin allergy
macrolides or clindamycin.
144
Scarlet fever rash
sand papery feeling. complication of strep.
145
Emergent Acute Pharyngitis disorders
epiglottitis, peritonsilar abscess, submandibular space infection, retropharyngeal space infection.
146
Epiglottitis Presentation
severity of sore throat is out of proportion to exam findings. stridor, respiratory distress.
147
Peritonsilar abscess Etiology
Group A strep, S. aureus.
148
Peritonsilar abscess Symptoms
severe, unilateral sore throat. muffled voice, drooling, trisumus, fever, neck swelling/pain, ipsilateral ear pain, fatigue.
149
Peritonsilar abscess Signs
swollen, fluctuant tonsil. Uvula deviation towards opposite side. soft palate with palpable fluctuance. Lymphadenopathy.
150
Peritonsilar abscess diagnosis
CBC, throat culture, Ct with contract to rule out spread to parapharyngeal space.
151
Pharyngitis/tonsilitis signs
pharyngeal erythema, tonsilar hypertrophy, purulent exudate, tender/enlarged anterior cervical nodes, palatal petechiae.
152
Group A strep Presentation
Pharyngeal exudate, cervical lymphadenopathy, fever, lack of a cough.
153
Group A strep Diagnosis
Rapid antigen detection. Even if negative follow up with a throat culture.
154
Herpetic Pharyngitis Presentation
ulcerations in the throat.
155
Herpetic pharyngitis treatment
acyclovir or famcyclovir
156
Diptheria Presentation
gray membrance in the pharynx with significant bleeding.
157
Diptheria treatment
antitoxin plus penicillin or erythromyocin.
158
HIV Presentation
If pharyngitis sxs aren't improving in 5-7 days or are worsening.
159
Group A strep Treatment
Penicillin V. 500mg BID-TID for 10 days.
160
Group A Strep Treatment alternatives
amoxicillin, penicillin G benzathine (IM), cephalexin.
161
Group A strep treatment with penicillin allergy
macrolides or clindamycin.
162
Scarlet fever rash
sand papery feeling. complication of strep.
163
Emergent Acute Pharyngitis disorders
epiglottitis, peritonsilar abscess, submandibular space infection, retropharyngeal space infection.
164
Epiglottitis Presentation
severity of sore throat is out of proportion to exam findings. stridor, respiratory distress, drooling.
165
Peritonsilar abscess Etiology
Group A strep, S. aureus.
166
Peritonsilar abscess Symptoms
severe, unilateral sore throat. muffled voice, drooling, trisumus, fever, neck swelling/pain, ipsilateral ear pain, fatigue.
167
Peritonsilar abscess Signs
swollen, fluctuant tonsil. Uvula deviation towards opposite side. soft palate with palpable fluctuance. Lymphadenopathy.
168
Peritonsilar abscess diagnosis
CBC, throat culture, CT with contrast to rule out spread to parapharyngeal space.
169
Peritonsilar abscess treatment
Drainage via aspiration/incision. IV ampicillin-subactan or clindamycin. Oral amoxicillin-clavulanate or clindamycin for 14 days.
170
Trismus
Spasm of the internal pterygoid muscle so can't open mouth.
171
Submandibular space infection (ludwig's angina) Presentation
elevated oropharyngeal floor, protruding tongue, double chin
172
Retropharyngeal space infection Presentation
difficulty swallowing/breathing, neck stiffness. can follow intubation or trauma.
173
Abscess of parapharyngeal space
bulging behind tonsilar pillars
174
Acute Laryngitis Causes
Viral, bacterial or vocal abuse, trauma, GERD, carcinoma.
175
Acute Laryngitis Viral
rhinovirus, influenze and parainfluenza
176
Acute Laryngitis Bacterial
Strep, M. cattarrhalis, H. influenzae, S. Aureus.
177
Acute Laryngitis Symptoms
Hoarseness, URI symptoms
178
Acute Laryngitis Signs
Laryngoscopy can reveal erythema, edema, vascular ingorgment, nodules and ulcerations.
179
Acute Laryngitis Treatment
Address underlying cause, humidification, resolves within 3 weeks.
180
Acute rhinosinusitis Causes
Usually viral URI followed by a secondary bacterial infection.
181
Acute rhinosinusitis Viral
rhinovirus, influenza, parainfluenza
182
Acute rhinosinusitis Bacterial
H. influenzae or S. pneumonia.
183
Acute rhinosinusitis Symptoms
Congestion, purulent discharge, facial pain, fever, fatigue, cough, HA, ear pressure.
184
Acute rhinosinusitis treatment 1-9 days
analgesics, irrigation, decongestants.
185
Acute rhinosinusitis indication for antibiotics
symptoms >10 days or a fever (102) with purulent discharge for 3 days. Or worsening symptoms following a viral URI.
186
Acute rhinosinusitis antibiotics
Amoxixillin-clavulanate (augmentin) 500mg TID or 875mg BID. for 5-7 days
187
Acute rhinosinusitis with penicillin allergy
Doxycycline, levofloxacin or moxifloxacin for 5-7 days.
188
Chronic Rhinosinusitis Presentation
Mucopurulent discharge, congestion, facial pain/pressure and loss of smell (cough for pediatrics) for longer than 12 weeks with treatment.
189
Chronic Rhinosinusitis Treatment
Saline lavages, intranasal corticosteriods, oral corticosterious/antibiotics, antihistamines, antifungals, sinus surgery.
190
Infectious Mononucleosis Etiology
Epstein-Barr virus
191
Mono Prodrome
1-2 weeks with fatigue, fever and malaise.
192
Mono Presentation
cervical lymphadenopathy, fever, sore throat (resembles strep), malaise, splenomegaly.
193
Mono diagnosis
CBC, elevated LFT, Monospot (weeks 2-3), antibody testing.
194
Mono antibody testing
IgM and absence of IgG indicates an acute infection.
195
Mono Treatment
Supportive. Can last up to 6 months. Sports restrictions for 4 weeks.
196
Cataracts
Any opacity of the lens, usually age-related.
197
Cataracts Presentation
gradual, chronic, painless loss of vision. Glare at night. yellow/opalescent lenses.
198
Cataract Treatment
Refer. Intraocular lens implant has good prognosis.
199
Glaucoma
Increase in intraocular pression leading to optic nerve damage causing visual field loss.
200
Closed Angle Glaucoma
Emergency. Crescent shadows. Acute. Painful. Aqueous fluid can't flow outwards at all.
201
Glaucoma Presentation
Peripheral vision loss. Increased intraocular pressure. increased cup/disc ratio.
202
Rhegmatogenus Retinal Detachment
associated with myopia
203
Tractional Retinal detachment
Associated with diabetes.
204
Retinal detachment Symptoms
Floaters, photopsias (flashes of light), Acute loss of vision "curtain-like"
205
Retinal Detachment Signs
decreased vision, raised, whitish retina. posterior vitreous detachment.
206
Macular Degeneration (ARMD)
number one cause of blindness. Degeneration of the phororeceptors.
207
ARMD Symptoms
gradual or acute blurred vision, metamorphopsia (wavy lines), central scotoma.
208
ARMD Signs
Decreased visual acuity, amsler grid distortion. Dry then Wet ARMD.
209
Dry ARMD
Drussen bodies (dead cells), pigment mottling, geographic atrophy.
210
Wet ARMD
Subretinal fluid/blood, neovascularization.
211
ARMD Treatment
Referral. Stop smoking. Vitamins (omega 3, antioxidants, zinc).
212
Central Retinal Artery Occlusion (CRAO).
Embolic
213
CRAO symptoms
Acute, painless, total loss of vision.
214
CRAO signs
no light perception, afferent pupil defect, white retina with cherry red spot.
215
Central retinal Vein Occlusion (CRVO)
Thrombotic
216
CRVO Presentation
acute, painless, variable vision loss. Afferent Defect. "blood and thunder"
217
CRVO Treatment
Referral and aspirin.
218
Hypertensive Retinopathy Presentation
Usually asymptomatic. Copper wiring (narrowing), sliver wiring (sclerosis), A-V nicking, cotton-wool spots, disc edema.
219
HTN retinopathy Treatment
Control systemic BP. Referral if severe or any vision loss.
220
Diabetic retinopathy
number one cause of blindness in people younger than 50.
221
Non-proliferative DM retinopathy
microaneurysms, cotton-wool spots, venous bleeding
222
Proliferative DM retinopathy
neovascularization, traction retinal detachment.
223
Macular edeam with DM retinopathy
graying/opacification, microaneurysms.
224
DM retinopathy treatment
Sugar control. Ophthalmology dilated exam once a year.
225
Blepharitis Symptoms
Eyelid inflammation. chronic itching, burning, scratchy. Worse in the AM.
226
Blepharitis Signs
Erythema, scales, debris, meibomian gland disease, chalazion.
227
Blehparitis treatment
warm compresses, baby shampoo. antibiotics/steroid topical if severe.
228
Pingueculum
yellow bump on the sclera associated with aging.
229
Pterygium
Triangular thickening of the bulbar conjunctiva. Grows from nasal side to the surface of the cornea. Can interfere with vision.
230
Cellulitis Symptoms
acute onset of pain, swelling, +/- systemic sxs.
231
Cellulitis Signs
+/- vision decrease, warm erythematous, edema, tenderness. Loss of EOMS with orbital cellulitis.
232
Cellulitis Treatment
referal. and systemic antibiotics.
233
Dry eye Sxs
chronic, itching, burning, scratching, tired eyes especially at night.
234
Dry eye signs
vision fluctuation, poor tear film, punctate epithelial erosions.
235
Viral conjunctivitis Presentation
Acute, bilateral, itching/burning/soreness, mild-severe injection, watery discharge, URI symptoms, preauricular lymphadenopathy.
236
Viral conjunctivitis Treatment
Tears, compresses, vasoconstictors.
237
Bacterial conjunctivitis Presentation
Acute, unilateral, burning, irritation, moderate-severe injection, mucopurulent discharge, adherent lids.
238
Bacterial conjunctivitis Treatment
topical antibiotics
239
Allergic Conjunctivitis Presentation
Chronic, bilateral, itching, mild-moderate injection, stringy mucoid discharge, chemosis.
240
Chemosis
swelling of the conjunctiva
241
Allergic conjunctivitis treatment
tears, topical antihistamines/mast cell stabilizers
242
Subconjunctival Hemorrhage Presentation
Acute, asymptomatic diffuse red patch on the sclera. Usually results from trauma. No treatment neccessary.
243
Episcleritis/Scleritis Etiology
Can be associated with systemic autoimmune diseases.
244
Epi/scleritis Presentation
Subacute. Feeling of foreign body, pain. Focal injection, inflammation of episclera/scleral tissue, scleritis is a deep bluish hue.
245
Corneal Abrasion presentation
Acute onset of pain and foreign body sensation. Epiphora. +/- vision.
246
Epiphora
overflowing tears.
247
Corneal abrasion diagnosis
epithelial defect seen with flourescein drops and blue light.
248
Corneal abrasion treatment
lubricants, antibiotics, pain meds, NO anesthetic drops.
249
Chemical Injury Presentation
Acute pain, burning, decreased vision, red/pink/white eye.
250
Chemical injury treatment
irrigate and refer.
251
Corneal Foreign Body Presentation
Acute onset of foreign body sensation. Can sometimes see the foreign body with or without rust rings.
252
Corneal Foreign Body Treatment
Irrigation or use of cotton-tip applicator to remove the foreign body.
253
Keratitis/corneal ulcer Etiology
Usually from contact lense abuse. Or use of anesthetic drops with a corneal abrasion.
254
Keratitis/corneal ulcer Presentation
acute onset of pain, mucous discharge, decreased vision, white infiltrate can have a hypopyon. Treated with topical antibiotics.
255
Keratitis HSV Presentation
Dendritic pattern. Treated with topical anti-viral. Referral.
256
Iritis/uveitis Presentation
Acute onset of photophobia, ciliary flush, +/- vision decrease. Hypopyon.
257
Hyphema Etiology
Blood in the anterior chamber usually due to trauma.
258
Hyphema Presentation
Acute onset of pain and photophobia, +/- vision, layered heme in anterior chamber.
259
Hyphema Treatment
Eyeshield and immediate referral.
260
Angle Closure Glaucoma Etiology
Acute rise in intraocular pressure die to outflow obstruction.
261
Angle closure glaucoma symptoms
Acute, decreased vision, halos, nausea, pain, feeling of pressure in the eye.
262
Angle closure glaucoma Signs
Crescent shadow, ciliary flush, decreased vision, steamy cornea.
