Ophtho/ENT/GU/MSK Flashcards by brandon lovin

Define Hordeolum

How are these Tx

Systemic ABX such as ? are used if ? Dx is present

Painful, hot stye d/t infected eye lid gland

Warm compress
Topical ABX

Cellulitis;
Doxy, Erythromycin

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Define Chalazion

Where are these MC found

How are these Tx

Painless lesions d/t noninfected obstruction of meibomian gland

Upper eyelid

Warm compress
Incision/curettage
CCX

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Defie Blepharitis

What two Dx are commonly assoicated w/ blepharitis’

What do Pts present complaining of

Inflammation of eyelids d/t dysfunctional meibomian gland or Staph infection

Seborrhea
Rosacea

Crusty eyelids in AM

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How is Blepharitis Dx

How are these Tx

? is the MC Ophtho c/c in ER

Slit lamp exam

Warm compress
Eyelid hygiene
Topical ABX

Corneal abrasion

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How are corneal abrasions Dx

How are these Tx

What are the 3 MCC of hearing loss

Fluorescein staining

Topical ABX:
Cipro
Ofloxacin
Polymyxin
Gentamicin
Erythromycin
Tobramycin

Presbycusis
Impaction
Eustacian dysfunction

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Define Conductive Hearing Loss

Define Sensorineural HL

Neural hearing loss is MC d/t ?

Lesions in EAC/TM/Mid ear preventing sound conduction

Lesion in inner eary/CN8

Cerebellopontine angle tumor

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Weber Test results

Rinne test results

All children under 7y/o have some form of ? ear issue

Lateralizes to affected ear w/ CHL;
Lateralizes to unaffected ear w/ SHL

CHL= bone > air
SNHL= air > bone

ET dysfunction

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How does Eustachian Tube Dysfunction present

This is a primary cause of ? two issues

How is this Dx

Ear fullness/popping w/ intermittent pain/tinnitus

AOM, OME

Tympanogram

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How is Eustachian Tube Dysfunction Tx

3 MC microbes causing AOM

Time frames for acute, chronic and recurrent

Pseudophedrine
Ibuprofen
Nasal steroids
Surgery- medical failure

Strep pneumo
H influenza
Moraxella catarrhalis

Acute: <3wks
Chronic: >3mon
Recurrent: 3 episodes in 6mon; 4 episodes in 12mon

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Time frame for COM

What will be seen in PE

What is a key finding for Dx

> 3mon

Clear serous fluid in middle ear w/out S/Sxs of infection

Limited mobility of TM w/ pneumotoscopy

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How is AOM Tx

What is used for 2nd line Tx

What is used for Pts w/ PCN allergy

Amox
Cefixime for PEds

Augmentin

Bactrim Azith Erythromycin

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How is COM Tx

How does Otitis Externa present on PE

What would tuning fork results look like

Myringotomy

Itching, Pain w/ manipulation

Weber lateralizes to blocked canal

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3 MC microbes causing Otitis Externa

? variant will DMs have

Fungal OM is caused by ?

Pseudomonas
Staph A
Proteus

Malignant OE

Aspergillus

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How is bacterial OE Tx if there’s a chance of perf

How is Fungal OE Tx

? is the MCC of CHL

Cipro and Dexameth
Ofloxacin

2% acetic acid
Clotrimazole
PO Itraconazole

Cerumen impaction

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What will Weber/Rinne look like during impaction

How can this be softened for removal

How long are Sxs needed for sinusitis Dx

W to affected side
R: A > B conduction

Carbamide peroxide
Trithanolamine

Worsen over 5-7d,
Fail to improve >10d

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How are adults w/ sinusitis Tx

How is this Tx in Pts w/ PCN allergy

What is done for second line therapy in Pts that fail to improve in 7d

Amoxicillin
Augmentin

Doxycycline
Cephalosporin w/ Clinda

Augmentin
Levo/Moxi-flox

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How is Chronic Sinusitis Tx

MC site for anterior nose bleeds to come from

Where do posterior bleeds come from

Augmentin
PCN-all: Clinda

Kiesselbachs/Little’s area

Woodruffs plexus: Shenopalatine artery

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How are nose bleeds Tx

What types of bleeds are admitted

Define Leukoplakia

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Pressure x 15min leaning fwd
Afrin x 2
Anterior packing w/ cephalosporin

Posterior w/ balloon packing

White patches on buccal surfaces that can’t be wiped off

Leukoplakia itself is benign but can lead to ?

? type of leukoplakia has a higher risk for dysplasia and Ca

? form of leukoplakia is not premalignant

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SCC

Erythroplakis

Hairy leukoplakia from EBV in HIV Pts

How is Leukoplakia Dx

How is it Tx

How is PO Hairy Leukoplakis Tx

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Biopsy

Excision
Cryosurgery

Zidovudine
Ganciclovir
Topical podophyllin or Isotretinoin

Difference between Leukoplakia and Hairy Leukoplakia

When do aphthous ulcers need to be considered for biopsy

What topical anesthetics can be used

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Hairy won’t progress into SCC

Lasting >3wks

Mg hydroxide
Dphenhydramine hydrochloride

Bacterial pharyngitis is MCC by ?

What criteria is used for Dx//ABX

Gold standard for Dx

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GAStrep

Centor:
Fever >100.4
Anterior adenopathy
Cough, no
Exudate
3 of 4= rapid

Rapid then Culture

Why are ABX used in the Tx of bacterial pharyngitis

MCC of viral pharyngitis

How is this form Dx

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PCN, Macrolide

Adenovirus

Atypical lymphocytes; monospot test

How is fungal pharngitis Tx

How is this Dx Tx in Pts w/ HIV

How long after sickness can Pts w/ Mono return to sports

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Clotrimazole troches
Miconazole
Nystatin

Fluconazole

3wks from Sx onset

How is ghonorrhea pharyngitis Tx What two PE findings are highly suggestive of tonsilar abscesses These are AKA ? abscess

Ceftriaxone Deviated palate Asymmetric uvula rise Quincy's

? are the MC aerobic and anaerobic microbes causing tonsilar abscesses How are these Tx non-surgically Infections of upper airway/epiglottitis is MC from ?

Staph, Strep Bacteroides Augmentin, Clindamycin H Influenza b

What will be seen on PE of epiglottitis What position do Pts adopt How is it Dx

Drooling Dysphagia Distress Sniffing dog- neck hyperextended, chin protrusion Xray- thumbprint sign

What ABX are used for epiglottitis after admission When is throat Ca a DDx from pharyngitis If PO/IM steroids are going to be used for Tx, what must be done first

IV Ceftriax and Clinda Hoarse >2wks w/ Hx of ETOh/Tobacco Vocal cord eval prior to start

Renal artery stenosis is MCC by ? What presentation signals this Dx What imaging is used for Dx How is this Tx

Atherosclerosis, Fibromuscluar dyplasia Pt Tx w/ ACEI and develops kidney failure First: US GS: renal ateriography Percutaneous transluminal angiography

What causes Syphilis After 3wk incubation, what are the three phases What is seen if acquired congenitally

Treponema pellidum (spirochette) Primary: painless chancre Secondary: erythematous rash, condyloma lata Tertiary: latent; systemic, mucosal growth- gummas Hutchinson teeth Saddle nose deformity ToRCH syndrome

How is syphilis Dx How isneurosyphilis Dx ? conditions can cause a false pos result

Monospot w/ reactive treponemal test Lumbar puncture Lyme Malaria Pregnancy TB

How is syphilis Tx What is usd for PTs w/ allergy to mainstay Tx What is the hallmark PE finding for trichomonas vaginitis

PCN G: Primary/Secondary: IM Congenital/late: IV Doxy or Tetracycline Strawberry cervix Mobile, pear shaped protozoa w/ flagella on wet mount

How is Trichomonas Vaginitis Tx What causes condyloma acuminate How are these prevented How are they Tx

Metronidazole HPV 6, 11 Gardasil- protects from 6, 11 and two most Ca types: 16, 18 Podofilox, Cryo

How does HSV present on PE Where do these reside in for life What are HHV 3-8 names

Grouped vesicles on erythematous base, all in same stages of development Trigeminal, Sacral ganglia 3: Varicella Zoster 4: EBV 5: CMV 6: Roseolovirus, 6th dz 7: similar to 6 8: rhadinovirus called Kaposi sarcoma associated HSV

? is the MC virus passed from mother to unborn baby How are HSV cases Dx How are they Tx

CMV Tzanck prep- multinucleated gian cells FAV-cyclovir

What kind/shape is N gonorrhoeae ? biliary-hepatic dz can gonorrhea mimic How is it Dx

Gram neg diplococci Fitz-Hugh-Curtis syndrome NAAT: women: vaginal swab men: first catch UA Persistent after ABX= culture

How is gonorrhea Tx What is used for PTs allergic to mainstay Tx ? is the MC STI

Ceftriaxone, + doxy for chlamydia Gentamicin + Azith Chlamydia

Gold standard to Dx chlamydia How is chlamydia Tx How is gonorrhea Tx How is chlamydia Tx during pregnancy

NAAT Azithromycin, Doxy Ceftriaxone Azith, Amox

# Define Chancroid What microbe causes this How is it Dx How is it Tx

STD w/ painful ulcers and inguinal adenpoathy/bulbo Haemophilus ducreyi: gram neg rod Serologic testing Gram stain, culture Ceftriax or Axithromycin

AIDS is defined as a ? three criteria? How is this Dx made What is used to monitor infectivity and Tx effectiveness

CD4 <200 Opportunistic infections Malignancies Immunoassay ELISA (screen) and Western Blot (confirm) HIV RNA viral load

When is HAART therapy initiated for HIV What are the HAART regiments for naive Pts

CD4 <350 or Viral load >55K NNRTI + 2 NRTIs or PI + 2 NRTI or INSTI+2 NRTI

Opportunistic infections at CD4 count of <250 Opportunistic infections at CD4 count of <200 Opportunistic infections at CD4 count of <150 Opportunistic infections at CD4 count of <100 Opportunistic infections at CD4 count of <50

Coccidiomycosis Pneumocystis Histoplasmosis Toxoplasmosis/Crypto Mycobacterium avium complex

Post-HIV exposure prophylaxis needs to be started w/in ?hrs of exposure How can this infection be passed to infants

<72hrs Breast milk

Ophtho/ENT/GU/MSK Flashcards

(43 cards)