Walden

Question 1

Use macrolides, fluoroquinolones

Answer 1

Allergies to PCN

Question 2

Inflammation of eyelids TX baby shampoo, warm compresses

Answer 2

Blepharitis

Question 3

Stones within the salivary glands or the salivary gland ducts. Painful
lump on jaw that comes and goes, Sialolithiasis typically presents with pain and swelling in the involved gland; these symptoms are usually aggravated by eating or by anticipation of eating.

Answer 3

Sialolithiasis

Question 4

• Inflammation of middle ear/inner, erythema, decreased tympanic membrane mobility, distorted landmarks, displaced light reflex, moderate to severe bulging, mastoid pain,
• Dx pneumatic otoscopy
• TX analgesics acetaminophen, ibuprofen, narcotic with codeine, amoxicillin, Augmentin, omnicef, ceftin, otic drops ciprofloxacin with dexamethasone

Answer 4

Otitis media

Question 5

swimmers ear, P. aeruginosa, external canal producing inflammation, itching, pain, tragal/pinna pain, otorrhea, Dx culture, TX fluoroquinolone and polymyxin B cortisporin drops!

Answer 5

Otitis externa

Question 6

Weber test(top of head)no laterization, normal finding, does not lateralize to either ear, bilateral hearing loss, if hear better in left ear, right sensorineural loss

Answer 6

Sensorineural loss

Question 7

Rinne test (behind pinna)–normal finding if AC last longer than bone conduction, good ear= air conduction> bone conduction, bad ear BC>AC

Answer 7

Conductive loss

Question 8

decrease function of lacrimal and salivary glands

Answer 8

Sjogren’s syndrome

Question 9

Purulent (pus) exudate, initially unilateral, then often bilateral, self-limiting 5-7 days, delay treatment till 3rd day, TX eye drops or ointment polytrim, trimethoprim, polymyxin, macrolide

Answer 9

Bacterial conjunctivitis

Question 10

Profuse tearing, mucus discharge, burning, concurrent URI, enlarged preauricular node
- TX antihistamine, decongestant drops, Trifluridine in herpes conjunctivitis

Answer 10

Viral conjunctivitis

Question 11

Eye makes repetitive uncontrolled movements, decrease vision, depth perception, balance

Answer 11

Nystagmus

Question 12

Check for corneal abrasions, keratitis

Answer 12

Fluorescein strips

Question 13

Normal for eye to return to midline

Answer 13

Horizontal nystagmus

Question 14

Cover/uncover test

Answer 14

Strabismus

Question 15

screening test for strabismus, compare corneal light reflex

Answer 15

Hirschberg test

Question 16

Visual field by confrontation test

Answer 16

Test peripheral vision

Question 17

color vision test

Answer 17

Ishihara

Question 18

Responsible for sharpest vision

Answer 18

Fovea of macula

Question 19

Responsible for color vision

Answer 19

Cones

Question 20

Responsible for night vision

Answer 20

Rods

Question 21

Normally lymphocytosis, maculopapular rash, fever, fatigue, pharyngitis, cervical lymphadenopathy, limit sports/activity, monitor for splenomegaly hepatomegaly,

• Dx monospot screen for heterophil antibodies,
• TX ibuprofen/Tylenol, no virus infection, no Abx treatment, rehydrate, if with strep add Ceftin for 5 days

Answer 21

Mononucleosis

Epstein Barr virus

Question 22

Caused by Epstein Barr virus Pathognomonic for HIV infection.

Answer 22

Hairy leukoplakia

Question 23

• Strep pyongenes, cause of scarlet fever affects heart valves and
  kidneys, Criteria for strep tonsillar exudates, anterior cervical adenopathy, fever, sore throat, fatigue, NO cough
• TX PCN, amoxicillin, macrolide cephalosporin,
• Dx rapid strep test, CNC, monspot if mono suspected, increases mortality in community acquired pneumonia

Answer 23

Strep pharyngitis

Question 24

Clear discharge, blue tinged or pale and swollen (boggy) turbinate’s, sneezing itching nasal stuffiness
- TX single most effective treatment intranasal glucocorticosteroids, antihistamines, decongestants (raises BP)

Answer 24

Allergic rhinitis

Question 25

Inflammation of paranasal sinuses due to bacteria, viral fungal or allergic infection, Goal to promote drainage,

• Sx facial pain, tooth pain, purulent discharge, nasal congestion,
• TX wait 10 days then amoxicillin or Augmentin, if allergy, fluoroquinolones/ tetracyclines

Answer 25

Acute rhinosinusitis

Question 26

Epistaxis commonly occurs anterior, posterior nasal bleeds may hemorrhage, refer to ER

Answer 26

Kiesselbachs plexus

Question 27

Eye pain, photophobia, blurred vision in affected eye

- DX fluorescein stain, , may result in blindness, refer to ED, ophthalmology stat

Answer 27

Herpes keratitis

Question 28

Surfers eye, yellow triangular thickening of conjunctiva, web in eye, avoid light, glasses

Answer 28

Pterygium

Question 29

Opacity in lens, difficulty with glare, halos around light, blurred vision, gradual onset of decreased night vision, red reflex disappears (Red reflex is now opaque gray instead of orange red glow)

Answer 29

Cataracts

Question 30

Loss of center vision, loss of visual acuity, contrast sensitivity but still have peripheral vision, may find Drusen bodies,
- Dx Amsler grid to evaluate central vision changes

Answer 30

Macular degeneration

Question 31

Sudden onset of shower floaters with looking thru curtain with sudden flashes of light, refer to ED

Answer 31

Retinal detachment

Question 32

life threatening infection of epiglottis and surrounding tissue, cellulitis of the epiglottis, drooling, stridor, hoarseness, head is leaned back, can’t swallow because it hurts, big eyes scared, thumbs sign enlarged epiglottis protruding from anterior wall

Answer 32

Epiglottis

Question 33

Affected ear hearing loss, cauliflower like mass inside middle ear, can erode bones in face, damage facial nerve CN 7

Answer 33

Cholesteatoma

Question 34

white reflection in child’s pupil

Answer 34

Retinoblastoma

Question 35

Spinning or rotating common characteristic

- TX antivert

Answer 35

Vertigo