Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PAM Semester 3 > Pharm HEENT Exam 1 > Flashcards

Pharm HEENT Exam 1 Flashcards

(106 cards)

Start Studying
1
Q

Eye steroids

A

Do not prescribe eye steroids

Refer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Viral treatment of eye

A

Eye lavage with saline BID 7-14 days

Vasoconstrictor - antihistamine drops may help

Warm to cool compresses reduce discomfort

ABX drops for secondary infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Bacterial Treatment of eye

A

Hygiene

Hand washing

ABX drops More effective than ointment

Rare pathogens may need concurrent systemic ABX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Allergic treatment of eye

A

Cold compress

Artificial tears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Empiric ABX for Bacterial conjunctivitis

A

Erythromycin ointment
4 times a day x 5-7 days

Trimethoprim -polymyxin B drops
1-2 drops 4 times a day 5-7 days

Ofloxacin drops
1-2 drops x 5-7 days (contacts)

Cipro drops
1-2 drops 4 times a day x 5-7 days (contacts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Viral conjunctivitis treatment

A

Antihistamine / decongestant drops OTC

1-2 drops 4 times a day for 3 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Allergic conjunctivitis treatment

A

Antihistamine / decongestant drops OTC
1-2 drops 4 times a day for 4 weeks

Mast cell stabilizer drops
1-2 drops 3 times a day

Eye lubricant drops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Antihistamine / decongestant drops

Class and MOA

A

anti histamine

inverse agonism of histamine H1 receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Mast cell stabilizer drops

Class and MOA

A

mast cell stabilizer

prevention of mast cell degranulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Vasoconstrictors

Class and MOA

A

Vasoconstrictors (decongestants)

Activation of Alpha adrenergic receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Leukotriene receptor antagonists

Class and MOA

A

Leukotriene receptor antagonist

Competitive binding to leukotriene receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

NSAIDS

Class and MOA

A

NSAID

prevention of prostaglandin production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Corticosteroids

Class and MOA

A

Corticosteroids

Broad anti-inflammatory action through prevention of proinflammatory mediator synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Single agent antihistamine - mast cell stabilizer

Class and MOA

A

Single agent antihistamine - mast cell stabilizer

Inverse histamine H1 receptor agonism plus prevention of mast cell degranulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Corneal ulcer treatment

A

Refer

Lesion should be stained and cultured to identify cause and guide treatment

Avoid topical steroids for risk of further tissue loss and increase risk of perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Infectious keratitis

A

Risk increased with contacts

extended wear lenses

poor prep and disinfection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

95% of bacterial keratitis is

A

contact lens infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In referral based institutions

bacterial infections are typically

A

Gram negative like Pseudomonas

Followed by

gram positive like staph and strep

These are the normal ocular surface flora

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Bacteria keratitis tx

A

4th gen fluoroquinolone

Moxifloxacin, gatifloxacin, besfloxacin

Close follow up in 24 hours

Do not use glucocorticoids

Do not patch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Acute dacrocystitis

most common organisms

A

Alpha hemolytic strep

Staph epidermis

Staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Acute dacrocystitis

Empiric Tx

A

Depends on age of child
severity of infection
presence and type of complications

Mild infections can be treated with oral clindamycin

Severe infections - IV Vanc with 3rd gen Cef

7-10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Blepharitis indications to refer

A 
Severe eye redness
Severe pain
Severe light sensitivity
impaired vision
corneal abnormalities (scarring, ulcers)
malignancy
refractory symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Blepharitis tx

A

Good lid hygiene

eliminate triggers
Allergens, smoking, contacts etc

goal is to minimize symptoms and limit exacerbations

Chronic condition

Can use ABX ointment is severe
(bacitracin, erythromycin)

Can use oral ABX if need further tx
(Doxy, tetra, azithro)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hordeolum

A

Sty (acute infection of oil gland)

can be associated with blepharitis

warm compress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Chalazion
firm non tender eyelid bump chronic sterile inflammation of oil gland results in granulomatous inflammatory reaction warm compress if needed can be surgically excised and intra-glucocorticoid injection
26
Nystagmus tx
Treatment is symptomatic meds depend on type of nystagmus 4 types of therapy medication Botox injections prism lenses and optical solutions surgery
27
Nystagmus medications
Gabapentin | memantine
28
Optic neuritis treatment
IV methylprednisolone for severe vision loss or two or more white matter lesions Oral prednisone is not recommended due to no affect on vison loss and due to possible increasing recurrent optic neuritis
29
Papilledema tx
Treat cause Neuro-surg consultation ``` Reduce ICP = mannitol CSF withdrawal Sedative (Propofol, barbiturate) Control hyperventilation Decompressive craniotomy Remove mass or lesion Hypothermia Steroids ```
30
Orbital cellulitis vs pre-septal cellulitis
Orbital = infection of soft tissue posterior to orbital septum Pre-septal = Infection of soft tissue anterior to the orbital septum
31
Orbital cellulitis tx
empiric ABX = Vanc plus Cef for staph, strep, MRSA, gram neg bacilli if concern for intracranial extension add metronidazole Should show improvement in 24-48 hours after proper therapy started if not imaging, surgery, biopsy, culture, histology
32
Age related macular degeneration
leading cause of legal adult blindness and severe visual impairment in industrialized countries
33
Dry macular degeneration
patients with: extensive intermediate drusen one large drusen or non central geographic atrophy be treated with daily oral vitamin eye supplement
34
daily oral vitamin eye supplement | AREDS2
``` Vit C 500 Vit E 400 Lutein 10 zeaxanthine 2 zinc 80 copper 2 ``` non smokers can use AREDS 1 which has beta carotene instead of lutein OTC
35
Bevaciumab
Avastin Vascular endothelial growth factor inhibitor (VGEFi) Interactions Increased risk of CHF and decline with LVEF with concomitant anthracycline based therapy
36
Retinal detachment Tx
Emergent consult laser surgery or cryosurgery Patient should remain supine with head turned to side of the retinal detachment 80-15-5% rule
37
Diabetic retinopathy tx
Initial therapy For most patients with diabetic macular edema (DME) and impaired visual acuity, we recommend intravitreal vascular endothelial growth factor inhibitors
38
Hypertensive retinopathy tx
Treat underlying condition
39
Blowout fracture
Emergent referral keep calm, avoid sneezing, coughing etc start nasal decongestants, ice packs and ABX right away Patients with orbital fractures that involve the sinus get prophylactic ABX (same ones as sinusitis)
40
Acute bacterial rhinosinusitis in children Mild/Moderate TX
Mild/Moderate Preferred: Augmentin PO 45mg/kg QD divided in 2 doses Alternate Amoxicillin PO 90mg/kg QD divided in 2 doses
41
Corneal abrasion tx
Refer Lesion should be stained and cultured to identify cause and guide treatment Avoid topical steroids for risk of further tissue loss and increase risk of perforation
42
CRVO Central retinal vein occlusion (eye DVT)
in patients with macular edema from BRVO or CRVO that cause visual loss, we recommend intravitreal anti-vascular endothelial growth factor inhibitor treatment as first line Second line Dexamethasone implant 0.7mg or intravitreal triamcinolone acetonide
43
Amaurosis Fugax
ESR and CRP should be checked in patients over 50 for giant cell arteritis with transient monocular or binocular vision loss
44
Amblyopia
It may be caused by strabismus (most common) uremia, Toxins (etoh, TOB, lead or others)
45
Amblyopia tx
Glasses Atropine drops Patching Patching atropine are equally effective in treating mild to moderate amblyopia Pathing usually first line and preferred by patients/parents atropine is reasonable first line when patching is expected to fail Visual outcome for most children with patching/atropine under 7 is good (most do not achieve normal vision)
46
Close angle Glaucoma acute attack
Emergency use of topical ophthalmic meds to reduce IOP Beta blockers alpha agonists miosis producing agents Systemic meds Oral or IV acetazolamide IV mannitol Once attack is controlled Laser peripheral iridotomy is definitive (small drainage hole through the iris or cataract surgery)
47
Meds that cause | Angle closure glaucoma
Anticholinergics Mydriatics eye drops: Atropine, homatropine, cyclopentolate, tropicamide Inhaled: Ipratropium Systemic: Atropine, scopolamine, other meds with anticholinergic effects Anti-histamines H1 receptor antagonists diphenhydramine, chlorpheniramine, loratadine H2 receptor antagonists cimetidine
48
IOP of | Close angle glaucoma
40 - 70 mmhg Normal is 8 -21
49
Close angle glaucoma Tx
Timolol 0.5% one drop wait one minute Apraclonidine 1% one drop wait one minute pilocarpine 2% one drop wait one minute give acetazolamide 500mg IV (can be PO)
50
Scleritis
Up to 50% of patients with scleritis have an underlying systemic illness Most often a rheumatic disease
51
Scleritis tx | Less severe
NSAIDS are intial treatment for diffuse nodular forms of anterior scleritis (this is the less severe form) Indomethacin 25 - 75mg PO TID
52
Scleritis Tx
Prednisone 1 mg/kg QD max of 80mg Prednisone is usually tapered over a period of 6 months, often closure to 9-12 months
53
Strabismus tx
Eye exercises Patch therapy Surgery If left untreated after 2 years of age, amblyopia will occur
54
Foreign Bodies | Small corneal abrasions
Small corneal abrasions (less than or equal to one fourth of corneal surface area) (eg. circular abrasion 4mm in diameter) Oral analgesia - Ibuprofen, APAP/Oxy combo With or without nonsteroidal anti inflammatory ophthalmic drops (ketorolac, diclofenac)
55
Foreign Bodies | Large corneal abrasions
Oral opioid analgesia (APAP/Oxy combo) cycloplegic drops and in select patients with abrasions >50% of cornea, eye patching
56
Corneal abrasion heal time
Most small corneal abrasion heal within 24-48 hours
57
Cycloplegics
These drugs cause mydriasis like mydriatics, but they also cause cycloplegia Paralysis of ciliary muscle Used to dilate pupils to examine fundus Prevent ciliary spasm and pain in iritis patients this stops the patient from constantly accommodating when the Dr. is trying to refract the patient and determine the prescription
58
Ciliary Muscle
Ciliary muscle controls focusing of the light rays entering the eye by changing the shape of the crystalline lens
59
Cycloplegic / Mydriatic drugs
``` Atropine Homatropine scopolamine cyclopentolate Tropicamide ```
60
Drugs that can cause cycloplegia
``` Chloroquine Phenothiazine Anticholinergics Antihistamines Anti-anxiety Tricyclic anti-depressants ```
61
When to have daily follow ups for abrasions
Larger abrasions Abrasions from contact lens Abrasions associated with decreased vision Abrasions in young children
62
Which of the below class of eye drops have the MOA of activation of alpha-adrenergic receptors? Antihistamines Mast cell stabilizers Decongestants Corticosteroids
Decongestants
63
What are the most common pathogens associated with bacterial keratitis? Anaerobes Spirochetes Gram-negatives Gram-positives
Gram-negatives
64
What is the most common antibiotic medication used to treat mild infections of dacryocystitis with children? Azithromycin Amoxicillin Doxycycline Clindamycin
Clindamycin
65
What is the best antibiotic therapy for the initial empiric treatment of orbital cellulitis? Metronidazole plus amoxicillin Vancomycin plus ceftriaxone Doxycycline plus gentamycin Ciprofloxacin plus metronidazole
Vancomycin plus ceftriaxone
66
Which of the following medications is not used for bacterial conjunctivitis empiric therapy? Azithromycin drops Erythromycin ointment Ofloxacin drops Trimethoprim-polymyxin drops
Azithromycin drops
67
Which of the below medications is best used for the treatment of mild otitis externa? acetic acid-hydrocortisone ciprofloxacin-hydrocortisone azithromycin-hydrocortisone clindamycin-hydrocortisone
acetic acid-hydrocortisone
68
What is the best therapy for patients with mild acute bacterial rhinosinusitis? clarithromycin azithromycin trimethoprim-sulfamethoxazole amoxicillin
amoxicillin
69
What is the best therapy for patients with mild otitis media in adults? clarithromycin azithromycin trimethoprim-sulfamethoxazole amoxicillin
amoxicillin
70
What is the best therapy for patients with GAS pharyngitis? clarithromycin azithromycin trimethoprim-sulfamethoxazole amoxicillin
amoxicillin
71
Which of the following pathogens is not one of the more common pathogens for a patient with a peritonsillar abscess? S. pyogenes (group A streptococcus),  Streptococcus anginosus Fusobacterium necrophorum Staphylococcus aureus
Staphylococcus aureus
72
3 components of managing Otitis Externa
Cleaning the ear canal Treating the inflammation and infection Pain control
73
Otitis externa tx | Mild Disease
Mild Disease non antibiotic topical preparation containing an acidifying agent and a glucocorticoid (acetic acid - hydrocortisone) Moderate disease
74
Otitis externa tx | Moderate disease
Moderate disease | Topical preparation that is acidic and contains an antibiotic, antiseptic an a glucocorticoid Cipro HC, Cortisporin
75
Otitis externa tx | Severe disease
Severe disease | Topical preparation that is acidic and contains an antibiotic, antiseptic an a glucocorticoid Cipro HC, Cortisporin
76
Otitis externa Antibiotics First line
Coverage of most common pathogens Staph aureus and pseudomonas Quinolones are good first line options with few side effects against both pathogens (Cipro, Ofloxacin) If infection is outside auditory canal or malignant OE, refer urgently Combined systemic and topical antibiotics are also indicated in patients who are immunosuppressed
77
Ear pain
Oral NSAIDS
78
Otitis externa Antibiotics Second line
Aminoglycosides Tobramycin, gentamycin both are good against Staph aureus and pseudomonas Beware ototoxicity with aminoglycosides Tobramycin, gentamycin, neomycin
79
Cipro HC Otic
ABX + Steroid Contra Perforated tympanic membrane Viral otic infections (herpes, varicella)
80
Cholesteatoma | Surgical determinants
The extent of disease Size and pattern of mastoid pneumatization Eustachian tube dysfunction
81
Otitis Media S/S
``` Pain Pressure Popping / Cracking Drainage Hearing Loss Tinnitus Feels like "water in ear" Feels like "Ear needs to pop" ```
82
Otitis Media S/S | by age
Neonates / infants Change in behavior, irritability, ear tugging, decreased appetitive, vomiting Children 2-4 Otalgia, fever, noise in ears, cant hear properly, changes in personality Children over 4 Complains of ear pain, changes in personality
83
Acute otitis media bacteria
Most common are: Strep pneumo H Flu Less common are: Group A strep Staph aureus M Cat
84
Acute otitis media in adults
Drug must work against Strep pneumo, H Flu, M Cat Augmentin over amoxicillin Better against beta lactamase 2nd/3rd gen cef are alternates for Pen allergy next is doxy
85
Acute otitis media in adults | who don't respond in 48-72 hours
Should be reexamined Then give high dose Augmentin (if not initial drug) or 2nd/3rd gen cef (if not initial drug)
86
Acute otitis media in children | Pain tx
Ibuprofen or APAP for ear pain in AOM Topical benzocaine, procaine, or lidocaine can be used as an alternate in children over 2 (not with TM perf) Do not use decongestants or antihistamines
87
Acute otitis media in children | ABX tx
Children under 6 months should get ABX Children 6mo - 2yrs should get ABX Amoxicillin is first line in children 90mg/kg QD divided in to 2 doses (3g max) Macrolides or clindamycin are alternatives
88
Penicillin reactions
``` Immediate hypersensitivity reactions anaphylaxis angioedema bronchospasm urticaria ``` Severe delayed reactions SJS, TEN, Hemolytic anemia,
89
Acoustic neuroma
Surgery or radiation
90
Eustachian tube functions
Protection of the middle ear pressure regulation mucociliary clearance
91
Eustachian tube dysfunction
in the absence of an underlying cause of obstructive dysfunction systemic decongestants such as pseudoephedrine or phenylephrine may be helpful for congestive symptoms (ear fullness, pressure) Do not exceed 3 days of nasal decongestants to avoid mucosal dependency and rhinitis medicamentosa
92
Labrinthyitis
Vestibular stimulants and antiemetics to limit symptoms in 24-48 hours
93
Vertigo treatments
Treatments aimed at Underlying vestibular disease Symptoms of vertigo Promoting recovery
94
Antihistamines
Dimenhydrinate Diphenhydramine Meclizine
95
Benzodiazepines
Alprazolam Clonazepam Diazepam Lorazepam
96
Antiemetics
Metoclopramide ondansetron Prochlorperazine promethazine
97
Drugs that can cause Vertigo
Anti-inflammatories Ibuprofen, indomethacin Antihypertensive HCTZ, atenolol, propranolol, f=nifedipine, verapamil prazosin, terazosin Anxiolytics Alprazolam, chlordiazepoxide, clonazepam, diazepam, lorazepam, oxazepam
98
Meclizine
Antivert (antihistamine) Motion sickness prophylaxis vertigo of vestibular origin Warnings Asthma, glaucoma, GI/GU obstruction, Hepatic/renal impairment, elderly, pregnancy, nursing Interactions Alcohol, tranquilizers Adverse Drowsiness, dry mouth, HA, fatigue
99
Antiemetics | receptor sites for vomiting reflex
M1 - Muscarinic D2 - dopamine H1 - Histamine 5 HT-3 (5-hydroxytryptamine) - Serotonin Neurokinin-1 NK1 receptor - Substance P
100
Sudden sensorineural hearing loss (SSNHL)
with idiopathic SSNHL Glucocorticoids within 2 weeks of onset Can use systemic or intratympanic this is preferred first line
101
Neurokinin 1 antagonists
Aprepitant
102
Antimuscarinincs
Atropine Hyoscine M1 receptors
103
Antihistamines
Hydroxyzine H1 receptors
104
Prokinetics
Metoclopramide Domperidone Prochlorperazine D2 Receptors
105
Serotonin antagonists
Ondansetron Granisetron Ramosetron Palonosetron 5HT-3 receptors
106
Acute mastoiditis
Strep pneumo Strep pyrogens Staph aureus Consider pseudomonas in children with recurrent AOM

PAM Semester 3 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions