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Flashcards in Ophthalmology/ENT Deck (30):
1

What is amblyopia? Most common cause?

A child risks becoming cortically blind due to an impairment of visual processing during the years 0-7. Strabismus.

2

A child who is cross eyed has? What are they at risk of developing if not corrected?

Strabismus. Amblyopia.

3

A baby presents with a white pupil. What is the most dangerous diagnosis? What is a less dangerous one? Complication if not repaired?

Retinoblastoma. Congenital cataract. Amblyopia.

4

A patient complains of severe eye pain and a frontal headache adter watching a few hours of television at night. They notice seeing halos around lights? Pathophysiology? Physical exam findings (3)? Treatment?

Acute angle closure gluacoma. Excess fluid trapped in anterior chamber.Mid-dilated pupil that is unresponsive to light, greenish cloudy cornea, and eye feels hard as a rock. Diamox (carbonic anhydrase inhibitor) and topical beta blockers/alpha2 adrenergic agonists - followed by emergency drainage with a laser.

5

A febrile patient presents with hot, tender, red, and swollen eyelids, when pried open, the pupil is dilated and fixed? Tests? Treatment?

Orbital cellulitis. CT scan. Drainage of pus.

6

How to treat chemical burns.

Massive irrigation with water for at least 30 minutes ASAP. Irrigate with saline once at hospital, and check pH before sending them home.

7

A patient complains of dozens of floaters in their eyes? Treatment?

Retinal detachment. Laser spot welding.

8

A patient complains of a a "dark cloud"in the top of their visual field? Treatment?

Retinal detachment. Laser spot welding.

9

An elderly patient with HTN describes acute loss of vision from one eye? What should be done to mitigate the damage?

Embolic occlusion of the retinal artery. Have the patient breath into a bag and have someone press hard on their eyes on the way to the ER (move the clot into a more distal location).

10

Recently diagnosed Type 2 diabetics need urgent opthalmologic evaluation. How long do patients diagnosed with T1D have until they develop eye problems?

~20 years.

11

A young patient presents with a midline neck mass (had it for years) at the level of the hyoid bone, that retracts when the tongue is extended? Tests? Treatment?

Congenital Thyroglossal cyst. Radionucleide scan. Surgical removal of cyst, middle segment of the hyoid bone, and the track that leads to the tongue.

12

A young patient presents with a three centimeter neck mass (had it for years) anterior to the sternomastoid muscle. Treatment?

Congenital Branchial cleft cyst. Drainage.

13

A patient presents with a large, mushy neck mass * had it for years) that occopies the entire supraclavicular area? Tests? Treatment?

Congenital cystic hygroma. CT scan (to assess spread into the mediastinum). Surgical removal.

14

A young patient presents with multiple enlarged nodes throughout the body complaiing of weeks of fever and night sweats? Tests? Treatment?

Lymphoma. FNA or nodal removal for biopsy. Chemotherapy.

15

An elderly patient with poor dentitia, and a history of smoking and drinking presents with a metastatic node in the jugular chain of the neck? Tests? Treatment?

Squamous cell carcinoma of the mucusae. Triple endoscopy (laryngoscopy, endoscopy and bronchoscopy), CT scan. Resection, radial neck dissection, radiotherapy and platinum based chemotherapy.

16

An AIDS patient presents with persistent hoarsensss, perisistent painless ulcer in the oral floor, and perisistent unilateral earache? Tests? Treatment?

Squamous cell carcinoma of the mucusae. Triple endoscopy (laryngoscopy, endoscopy and bronchoscopy), CT scan. Resection, radial neck dissection, radiotherapy and platinum based chemotherapy.

17

A patient notices an enlarged lymph node and immediately heads to the hospital? What should be their work up?

Complete H&P, with an appointment in a month. See if the mass is still there and act accordingly.

18

A patient complains of sensory hearing loss in only one ear? Tests?

Acoustic nerve neuroma. MRI.

19

A patient presents with gradual unilateral facial paralysis of the forehead and lower face? Tests?

Facial nerve tumor. Gadolinium-enhanced MRI.

20

A patient presents with a large palpable mass in front of the ear. What is the most likely diagnosis? What sign suggests a more dangerous diagnosis? Tests and Treatment? Contraindicated Tests?

Parotid pleomorphic adenoma. If the mass is hard, painful, or has produced paralysis -- Partoid cancer. Superficial partoidectomy. Open biopsy (damage the facial nerve).

21

If a young child presents with unilateral earache, rhinorrhea, or wheezing? Treatment?

He shoved something up there. Endoscopy under anesthesia.

22

A patient with poor dentitia presents with an abscess in the floor of the mouth, and a swollen and hot mouth? Source of infection?Complications? Treatment?

Ludwig's angina. Infected tooth. Airway obstruction. Incision and drainage, potentially intubation and tracheostomy.

23

A patient presents with sudden unilateral facial paralysis of the forehead and lower face? Treatment?

Bell's Palsy. Anti-virals and steroids.

24

A patient develops diplopia after being diagnosed with sinusitis? Tests? Treatment?

Cavernous sinus thrombosis. CT and MRI. IV antibiotics and drainage of infected sinuses.

25

A 5 year old compains of frequent epistaxis. Cause? Treatment?

Nose picking. Phenylephrine spray.

26

An 18 year old complains of frequent epistaxis, exam notes a septal perforation. Cause? Treatment?

Cocaine abuse. Posterior packing.

27

An 18 year old complains of frequent epistaxis. Which neoplasm might be the cause? Treatment?

Juvenile nasopharyngeal angiofibroma. Mandatory surgical resection.

28

A patient complains that the room is spinning around them. Where is the problem? Treatment?

Inner ear. Meclizine (antihistamine), promethazine, or diazepam.

29

A patient complains that they are unsteady but the room is stable. Where is the problem? Treatment?

Brain problem. Neurologic work up required.

30

A patient that suffers intense facial trauma presents develops paralysis. Treatment?

No treatment needed, swelling will eventually subside.