5. ENT Flashcards
- Otoscopy shows cerumen impacted - type of hearing loss/Tx?
- Perforated TM - Tx?
- MC Conduction hearing loss
- Tx: Hydrogen peroxide 3%, Carbamide peroxide
- Heal its own
- Avoid water/mositure/aminoglycosides if TM rupture
- only abx is ofloxacin can be use
- Surgery may need if past two month
Pt complains Pain on traction of the ear canal/tragus
ID/Pathogen/Patient/Presentation/PE/Tx/Complication
Name: OE (Otitis externa)
Pathogen: Pseudomonas
Patient: Swimming or exposure moisture
Presentation: malodorous discharge and pruritus
PE: tenderness with tragus or pinna
Tx: Cipro (ofloxacin safe to use TM perforation), Hydrocortisone
Complication: Osteomyelitis at skull (Necrotizing)
- often cause due to DM or immunocompromised
- Tx: IV piperacilin or ceftazidime + FQ
Pt’s ear cartilage thickening which looks like cauliflower ear. Pt had hx of blunt trauma.
ID/Patho/Tx
ID: Auricular hematoma
Patho: blunt trauma
Tx
- Evacuate blood < 7days, abx (cephalexin)
- ENT referral >7days
Pt complains of Gradually Unilateral sensorineural hearing loss and Tinnitis over months. Other result pending at this time.
ID(other name)/Involve nerve/Dx/Tx
ID: Acoustic neuroma (CN8) - other name: Vestibular schwannoma
Involve nerve
- hearing loss - cochlear nerve
- ataxia - vestibular nerve
- facial - Facial nerve
Dx: MRI
Tx: Surgery
Pt recently had airplane trip. Pt complains of ear fullness after get off airplane.
ID/Patho/Patient/Tx
ID: Barotrauma
Patho: rapid pressure change due to eustachian tube closer -> inability of ET to equalize pressure
Patient: diver or flying
Tx: Autoisufflation (swallowing, yawning), decongestant or antihistamine
Vertigo
- No hearing loss + episodic vertigo - ID/Patho/Dx/Tx
- hearing loss + episodic vertigo - ID/Patho/Extra sx/Tx
- No hearing loss + Cont’ Vertigo - ID/Patho/Tx
- Hearing loss + Cont’ Vertigo - ID/Patho/Patient/Extra sx/Tx
- BPPV (benign paroxymal positional vertigo
- Patho: displaced otolith
- Dx: Dix-hallpike test - Place 30 degree head -> quick move 90 degree of one side -> check delayed nystagmus (POSITIVE)
- Tx: Epley maneuver (reposition to put otolith back to normal)
- Meniere
- Patho: Inner ear distention by excessive fluid
- Extra sx: Tinnitus
- Tx: vestibular rehabilitation(Main), Low salt diet and diuretic, Meclizine(vertigo)
- Vestibular neuronitis
- Patho: inflammation of vestibular (MC after viral infection)
- Tx: Corticosteriod + Meclizine (for vertigo)
- Labyrinthitis (라베리나이티스)
- Patho: cochlear hearing loss
- Patient: recent URI
- Extra sx: Tinnitus
- Tx: Corticosteriod + Meclizine (for vertigo)
Central vs Peripheral vertigo
Onset/effect position/direction nystagmus/Neurologic
Central
- Onset: gradual or sudden
- Head position: Do not effect
- Direction nystagmus: bidirection horizon or vertical
- Neruologic finding: yes
Peripheral
- Onset: Sudden
- Head position: worsened by position
- Direction nystagmus: Unidirection (never vertical)
- Neurologic finding: No
Pt complain of painless brown/yellow discharge with strong order and granulation tissue
ID/Patient/Dx/Tx
ID: Cholesteatoma
Patient: MC has hx of Chronic ET
Dx: Otoscopy (granulation tissue)
Tx: Tympanomastoid surgery
Pt had hx of URI few days ago. Pt complain of ear pain. PE reveals bulging and red TM w/ effusion
ID/Pathogen/PE/Dx/Tx
ID: AOM (acute otitis media)
Pathogen: S. Pneumo, H.flu, Moraxella catarrhalis, Strep pyogenes
Presentation: URI sx
PE: Bulging, red TM (decreased TM mobility)
Dx: Otoscopy
Tx:
- One time - AMOX, if PCN allergy Cefixime or cefidinir
- recurrent - Augmentine, if PCN allergy -> Clinda + cefixime or cefidinir
- acetic acid drops - someone who can’t afford medication
Sensory vs conduct hearing loss
Result of hearing test/MC cause
Sensory normal ear to lateralization + AC >BC
- Presbyacusis(Aging) MC
Conduct: Affected ear to lateralization + BC >AC
- Cerumen impaction MC
Pt had hx of OM. Pt present mastoid tenderness and deep ear pain
ID/Patient/Dx/Tx
ID: Mastoiditis
Patient: hx of Otitis Externa
Dx: CT scan
Tx: IV abx + drainage + admission
- Refractory - mastoidectomy
Pt states his ear continues Perforated TM and recurrent purulent otorrhea for months
ID/Pathogen/Tx
ID: Chronic otitis media
Pathogen: Pseudomonas, S. Aureus
Tx: Oflaxacin
- no water, aminoglycosides in the ear if TM rupture
Pt had Ear fullness, poping of ears. But PT reveals normal otoscopy exam. No pain.
ID/Patient/Dx/Tx
ID: Eustachian tube dysfunction
Patient: hx of URI or allergy rhnitis
Dx: Normal otoscopy exam
Tx: Decongestants
bugs in ear
ID/MC risk/Tx
ID: Foreign body in the ear
MC risk: 6y> children
Tx: kill bug first by using mineral oil -> remove
Pt present with nose area tenderness. PE revealed Sinus pain with pressure and worse with bending down & leaning forward
ID/Pathogen/MC site/Duration/PE/Dx/Tx
ID: Acute Sinusitis
Pathogen: S. Pneumo, H flu, GABHS, M catarrhalis
MC site: Maxillary
Duration: 1-4 weeks (if more than 10-14 days bacterial)
PE: Opacification with transillumination, tenderness nose area
Dx: CT scan
Tx: Symptomatic therapy (1st)
- Abx use only if presistant more than 10 days or faicial swelling - AMOX, augmentin
Pt has long hx of facial pressure pain x 12wks. Upon PE, revealed black eschar on palate, face.
ID/Complication/Tx
ID: Chronic sinusitis
Complication: Mucormycosis
Tx: IV amphotericin
Pt complain of Clear rhinorrhea and Nasal polyps. Pt states nasal congestion worse in the morning
ID/Patho (2 type)/Patient(triad)/PE/Dx/Tx
ID: Rhinitis
2 type
- Allergy - MC type - IgE mediated mast cell histamine release
- Infection - Rhinovirus MC infection
Patient: hx of asthma, dermatitis and rhinitis altogether make up atopy
PE
- Transverse nasal crease/infraorbita edema/cobblestone - allergy
- Erythmatous turbinates - viral
Dx: elevated IgE
Tx
- Intranasal steriod (flonase) Best option for seasonal allergic rhinitis
- If Failed Flonase then use antihistamine - Azaletine
- Decongestant - 3-5 days use only (rebound congestion)
- DO not use it for allergic rhinitis monotherapy
Pt present for annual exam. PE shows nasal polyp but otherwise normal exam
ID/Patient/Triad/Tx
ID: Nasal polyps
Patient: allergic MC
Triad: Samter Triad: asthma + allergy/NSAID/ASA sensitivity + nasal polyps
Tx: Flonase
Nasal bleeding
ID/2 type/Risk/Tx/Prevention/Special consideration
Name: Epistaxis
2 type
- Anterior - Kiesselbach’s plexus MC site
- Posterior - Palatine artery MC site
Risk
- Anterior - nasal trauma MC
- Posterior - HTN, atherosclerosis
Tx
- Direct pressure (1st) - Compress the Kiesselback plexus with the child in an upright position and head tilted forward
- Decongestant or cocain 4% helpful
- Continue bleeding posterior - may consider hospitalization
Prevention: avoid exercise, spicy food
Special consideration: Septal hematoma - consider loss of cartilage if hematoma not removed
Children + foul odor in nose
Name/Dx/Tx
Name: Nasal Foreign body
Dx: Rigid or flexible fiberoptic endoscopy
Tx: Remove
Strep throat
Pathoge/4 sx/Criteria interpretation/Dx/Tx/Complication
Pathogen: GAS
Strep throat 4 sx
- Fever (101.5)
- Lymadenopathy (neck)
- Absent of cough
- Pharyngotonsillar exudate
Criteria interpretation
- 0-1 point - No abx No culture
- 2 - Rapid test(1st) if Neg do culture
- 3-4 - Rapid test(1st) and culture + Abx
Dx
- Rapid strep test (1st screening) if negative should do culture
- Culture (Definitive)
Tx
- PCN
- Macrolide if PCN allergy
Complication: Glomerulonephritis, Rheumatic fever
Muffle (hot potato voice) + Uvula deviation to contralateral side
Name/Pathogen/Dx/Tx
Name: Quinsy (peritonsillar abscess)
Pathoge: GAS
Dx: CT
Tx: I&D followed by augmentin,
Vocal abuse (singers, screaming) + hoarseness
Name/Patho/MC cause/Tx
Name: Laryngitis
Patho: Inflammation of the larynx
MC cause: Viral infection MC
Tx: Supportive
White curd like plaque able to scrape and bleeding after scrape
Name/Pathogen/Risk/Dx/Tx
Name: Oral Candidiasis (thrush)
Pathogen: Candida albicans
Risk: often hx of DM (check glucose)
Dx: KOH smear (budding yeast/pseudohyphae)
Tx: Nystatin liquid, Oral fluconazole
Painless white patchy lesion that cannot scraped off
Name/Patho/Dx/Tx
Name: Oral leukoplakia
Patho: Precancerous hyperkeratosis
Dx: Biopsy
Tx: Cryotherapy, laser ablation
Painless white plaque along the lateral tongue borders or buccal mucosa (irregular hairy or feathery)
Name/Risk/Tx
Name: Oral hairy leukoplakia
Risk: Epstein-Barr virus, HIV related
Tx: No specific tx, Acyclovir
Yellow centered surrounded by red halo
Name/Tx
Name: Aphthous ulcers (Canker sore, ulcerative stomatitis)
Tx: Viscous Lidocaine 2-5%, topical oral steriod
Postprandial(after food) salivary gland pain & swelling + No trismus + No ductal discharge
Name/Gland duct/Tx
Name: Sialolthiasis
Gland duct: Wharton (submandibular), Stensen (parotid)
Tx: sialogogues (tart, hard candies, lemon drop)
Postprandial gland swelling and pain + tenderness at the duct opening + Trismus + ductal discharge
Name/Pathogen/patho/Dx/Tx
Name: Sialadenitis
Pathogen: S. Aureus
Patho: Infection of parotid or submandibular (salivery gland)
Dx: CT scan
Tx
- Sialogogues (Tart hard candies or lemon drop)
- IV dicloxacillin or nafcillin + Metronidazole or Clindamycin if severe
Lacy leukoplakia of the oral mucosa (Wickham striae)
Name/Risk/Tx
Name: Oral lichen planus
Risk: Hep C infection
Tx: Corticosteroids
Sudden onset fever and gum swelling or bleeding (gingivitis)
Name/Risk/Tx
Name: Acute herpetic gingivostomatitis
Risk: HSV 1 infection children (6month - 5y)
Tx: self limited
vesicles that rupture and become ulcerative lesion with grayish exudates + fever
Name/Tx
Name: Acute herpetic pharyngotonsillitis
Risk: HSV 1 children
Tx: Oral hygiene - resolve within 7-14 days
Swelling & erythema of the upper neck & chin with PUS on the floor of the mouth + Phonation is muffled and tongue protrusion
Name/Patho/PE/Dx/Tx
Name: Ludwig’s angina
Patho: cellulitis of the sublingual & submaxillary spaces in the neck
PE
- upwardly displaced tongue as cellulitis and pus gather in the floor of the mouth
- Phonation is muffled and tongue protrusion
Dx: CT
Tx: AMP/sulbactam, pen + Metro or clinda
swelling angle of mendible + Trismus
Name/Pathogen/Risk/Tx
Name: Pariotitis
Cause: S Aureus
Risk: hx of dehydration or intubation
Tx: IV abx
Stridor + Trismus + neck rigidity + muffle voice
Name/Patho/Risk/Pathogen/Dx/Tx
Name: Retropharyngeal abscess
Patho: infection and thickened prevertebral space
Risk: 3-5 y children
Pathogen: S. Aureus, GAS
Dx: Lateral neck x-ray (widened retropharyngeal space twice the size of the vertebral body in C2-4)
Tx: IV Abx, I & D
- Shine on unaffected eye both constrict but shine on affected eye both dilate = Name/MC cause
- Accomodation but does not react to light = Name/MC cause
- Bitemporal heteronymous hemianopsia = MC cause
- Vision curtain lift up usually within 1 hour called as?
- Marcus gunn pupil - MC Optic neuritis (MS)
- argyll-robertson pupil - MC neurosyphilis
- Pituitary adenoma
- Amaurosis fugax
Prulent and yellow discharge + Worst in the morning, hard to open eye due to cursting.
Name/Patho(2 case)/PE/TX (2 case)
Name: Bacterial conjunctivitis
Patho
- MC case: infection (Staph A)
- Lens wearers: Pseudomonas
PE: Prulent, yellow discharge
Tx
- General infection: Erythromycin, Polymix B meds
- Lens wearer: FQ (moxifloxacin)
Pt complaining of itch eye and tearing. No prulent discharge.
ID/Presentation/PE/Tx
ID: Allergic conjuctivitis
Presentation: itching
PE: Cobblestone mucosa
Tx: H1 blocker (olopatadine)
Pt complaining of Copious watery discharge and bilateral pink or red eye.
ID/Patho/Presentation/PE/Tx
ID: Viral conjunctivitis
Presentation: red or pink eye
PE: Corpious watery discharge, preauricular lymphadenopathy
Tx: Cool compress, artificial tear, antihistamine if itch
New born baby less than 14 days comes with eyelid swelling and discharge
ID/Patho/Patient/PE/Dx/Tx
ID: Chlamydial conjunctivitis
Patho: Chlamydia trachomatis
Patient: Neonate 5-14 days
PE: Eye swelling and mucoprulent discharge
Dx: Culture
Tx: Oral erythromycin
New born baby less than 5 days comes with swelling and discharge
ID/Patho/Patient/Dx/Tx
ID: N. Gonorrhoea conjunctivitis
Patho: N. Gonorrhoea
Patient: Neonate 0-5 days
PE: Eye swelling and mucoprulent discharge
Dx: Culture
Tx: Ointment erythromycin
61 y pt present to clinic for gradual blurre vision over few months
ID/Patho/Patient/Presentation/PE/Tx/Differential
ID: Cataract
Patho: Lens opacification (thicken)
Patient: OLD
Presentation: Gradual blurreness or double vision
PE: Clouding lens (NO red light reflex)
Tx: Surgical removal
Differential: Retinoblastoma - white pupil + Absent red reflex
Pt used extensive contact lens uses. Oval ulcer with ragged edge reveals upon test. Patient complain of pain and foreign body senation.
ID/Patho/Patient/PE/Dx/Tx
ID: Corneal ulcer
Patho: Staph A (if lens - Pseudomona)
Patient: hx of lens use or trauma
PE: Oval ulcer with ragged edges
Dx: Fluorescein dye test
Tx: Emergent ophthalmo consult
Pt who is welder comes to clinic for bilateral decreased vision acuity and pain.
ID/Patient/Presentation/PE/Dx/Tx
ID: Ultraviolet Keratitis
Patient: Welder or skier
Presentation: bilateral vision acuity decreased
PE: Multiple punctate lesion
Dx: fluorescein staining
Tx: NSAID
Pt present to clinic for foregin body sensation. Upon exam, revealed dendritic lesion on cornea.
ID/Colonized/Presentation/PE/Dx/Tx
ID: Herpes simplex keratitis
Colonized: trigeminal ganglion (V1)
Presentation: Unilateral pain, Foregin body sesation
PE: Cillary flush
Dx: Slit lamp (dendritic)
Tx: Acyclovir
Pt has hx of prolong exposure to sunlight. PE reveals triangular-shaped growth on medial aspect of eye.
ID/Patient/Presentation/PE/Tx
ID: Pterygium
Patient: prolong exposure of sunlight, Sand wind
Presentation: foreign body sensation
PE: Triangular-shaped growth on medial aspect of eye (Corneal involved)
Tx: Artificial tear, sunglasses, surgical excision
Pt has yellow, brown fleshy mess on the conjunctiva. Do not involve corneal.
ID/PE/Tx
ID: Pinguecula
PE: Nasal side of Sclera (No involve Corneal)
Tx: Observe
Pt present with Unilateral tender and swelling at inframedial of eye.
ID (2 case)/Involved gland/Presentation(2 case)/Complication/Tx
ID: Dacryocystitis vs dacryoadenitis
Involve gland: lacrimal
Presentation
- Cystitis (infection) - inframedial, overflow tearing
- Adenitis (inflammation) - supratemporal
Complication: preseptal or orbital cellulitis
Tx:
- Mild - clindamycin
- Severe - Vanco
Pt woke up in the morning with crusting, scaling, red-rimming of eyelid. Also able to see eyelash flaking.
ID/Patho/Presentation/PE/Dx/Tx/Associated with other Dz
ID: Blepharitis
Patho: MC caused by dysfuntional of meibomian gland
Presentation: eyelash flaking
PE: Crusting, scaling, red-rimming of eye
Dx: Slit exam
Tx
- Supportive: warm compress
- Abx for flare up: erythromycin
Associated with other Dz: seborrhea, and Rosacea
Hordeolum vs Chalazion
Patho/Presentation/Location/Tx
Hordeolum
- Patho: infection
- Presentation: Tender
- Location: Near follicle
- Tx: warm compress + I&D
Chalazion
- Patho: Obstruction of meibomian gland
- Presenation: nontender
- Location: upper lid
- Tx: Warm compress (if prolong I&D)
Entropion vs Ectropion
Patho/Presentation/PE/Tx
Ectropion
- Patho: caused by aging
- Presentation: Dry eye
- PE: eyelid outward
- Tx: Surgical correction
Entropion
- Presentation: foreign body sensation
- PE: eyelid inward
- Tx: Surgical correction
- eye rapidly moves called as?
- if eye movement up and down caused by what?
- if eye movement horizontal caused by what?
- Gaze-evoked caused by what?
- Nystagmus
- CNS dysfunction
- Labyrinth or vestibular
- MC and benign
Pt complains of monocular vision loss and pain worse with eyemovement
ID/Patho/Associated Dz/Medication/Presentation/PE/Dx/Tx
ID: Optic Neuritis
Patho: Demyelinating inflammation of the optic nerve
Associated dz: Multiple sclerosis
Medication: Ethambutal
Presentation
- Monocular vision loss
- eye pain with move
- loss of color vision
- Transient vision loss due to increased body temp (uhthoff’s phenomenon)
PE: Marcus-gunn pupil
Dx: MRI (confirm)
Tx: IV methylprednisolone (will return if tx)
Pt present to urgent care for acute onset of HA and blurred vision. PE revealed ICP increased and optic disc swelling.
ID/Patho/Presentation/PE/Dx/Tx
ID: Papilledema
Patho: ICP increased
Presentation: Acute onset of HA, blurred vision
PE: Optic disc swelling
Dx: Fundoscopy
Tx: Acetazolamide
Pt presents with painful eye swelling and limited extraocular movement.
ID/Patient/Presentation/PE/Dx/Tx/Comparable dz
ID: Orbital cellulitis
Patient: Children, bacterial rhinosinusitis
Presentation: swelling eye
PE: Painful eye and limited extraocular movement, proptosis
Dx: Clinically
Tx: Vanco + piperacillin
Comparable dz: pre-orbital cellulitis (eye movement doesn’t cause pain)
70 y pt present with gradual central field vision loss with Scotoma (blind spot) and Metamorphopsia (line bent)
ID/Patient/Presentation/PE/Dx/Tx
ID: Macular degeneration
Patient: 50y< (MC blindness in elderly)
Presentation
- Dry - Drusen - accumulation of waste products(breakdown of retina) from the retinal pigment
- Wet - Sudden Abnormal vessel
PE: Dry (Gradual vision loss), Wet (Sudden vision loss)
Dx: Amsler grid (dry), Fluorescein angiography (wet)
Tx
- Dry - Zinc, Vitamin A,C,E (slow down progression)
- Wet - - Zumab meds
Pt complain with Flash light, floater, and Unilater vision loss (curtain down)
ID/Patho/Presentation/Dx/Tx/Avoid/Confused w/ other
ID: Retinal detachment
Patho: Retinal tear
Presentation: Painless loss of vision, floaters, flashing light, curtain down
Dx: Funduscopy - flapping (haze gray w/ white fold)
Tx: Ophtho Emergency
Avoid: DO NOT USE MIOTIC DROP
Confused with other: Amaurosis fugax - Curtain lifts up
Pt reports progressive central vision loss. Pt has hx of DM.
ID/Patient/Presentation/PE/Tx
ID: Diabetic retinopathy
Patient: DM
Presentation: Progressive central vision loss, Red spot and floaters
PE: Microaneurysms (cotton-wool spot, hemorrhages)
Tx: DM control (1st), Laser surgery or Vitrectomy
Children loss of red reflex upon exam.
ID/Patho/PE/Special comment
ID: Retinoblastoma
Patho: MC loss function of the retinoblastoma gene
PE: white pupil (leukocoria)
Special comment: MC eye tumor in children
Pt had hx of trauma to the orbit. Upon PE, revealed that pt unable to upward gaze and enophthalmos (eyeball socket inward)
ID/Presentation/PE/Mc site/Muscle entraped/Dx/Tx
ID: Orbital floor fx
Presentation: Limited upward gaze
PE: Enophthalmos
MC site: Maxillary
Muscle entrapt: inferior rectus
Dx: CT scan (tear drop)
Tx
- Nasal decongestants (decrease pain)
- Avoid blowing nose
- Corticosteriod (reduce edema)
- Abx
- Surgical repair
Pt recently had penetrating eye injury.
ID/Patho/Patient/PE/Dx/Tx
ID: Globe rupture
Patho: Full thickness injury to the sclera
Patient: Recent penetrating injury or trauma, blunt trauma
PE: teardrop pupil, seidel sign (aqueous flows on fluorescain test)
Dx: CT
Tx: Emergency ophthalmology consult + eye shield + elevated head 45 degree
Pt had hx of blunt trauma. Pt complains of blurre vision and PE revealed blood in the anterior chamber.
ID/Patient/Presentation/PE/Tx
ID: Hyphema
Patient: hx of trauma
Presentation: blurred vision
PE: Blood in the anterior chamber
Tx: eye protection + rest with head elevated 30-45 degrees all the time + opthalmology consultation
CRAO vs CRVO
Risk/Presentation/Dx/Tx
CRAO
- Risk: Atherosclerotic disease (Ophtho ER)
- Sx: sudden Mono vision loss + amurosis fugax
- Dx: fundoscopy - Cherry red macula (red spot)
- Tx: Lower IOP (mannitol IV) + ophtalmology consult
CRVO
- Risk: DM, HTN
- Sx: sudden Mono vision loss
- Dx: fundoscopy - Thunder & blood appearance (extensive retinal hemorrhage) + tortorus vein seen
- Tx: Opthalmology consult
Pt has Foregin body sensation, tearing, and painful eye
ID/Presentation/Dx/Tx (1st thing first)
ID: Ocular foreign body & Corneal abrasion
Presentation: foreign body sensation
Dx: Fluorescein staining
Tx: visual acutiy check 1st
- If foreign body - remove with irrigation + ABX
- if abrasion - small no patch, larger then 5mm Patch it but no longer than 24hours + ABX
- if contact lens - NO PATCH, use CIPRO drop
- if Rust ring - remove rust ring at 24 hour
Chemical burn
Type/Tx
Ophtho Emergency
Type
- Alkali burn - worse than acid, denature protein
- Acid burn - coagulative necrosis
Tx
- Irrigation with Lactaed ringers or Normal saline
- PH & visual acuity after irrigation
- ABX - moxifloxacin
Acute closed vs open Glaucoma
Sx/PE/Dx/Tx/Contraindication (closed only)
Acute (closed)
- Sx: Sudden painful unilateral eye (halo around light)
- PE: Cloudiness + fixed nonreactive pupil
- Dx: Tonometry (IOP high 30
- Tx: Timolol (reduce IOP, 1st) + Pilocarpine +Acetazolamide (severe case)
- Dilation of the pupils is contraindicated in acute closed-angle glaucoma.
Chronic (open)
- Sx: Painless bilateral peripheral vision loss (tunnel vision)
- PE: Cupping of optic disk
- Tx: Prostaglandin
- Laser therapy if failed meds
Esotropia vs exotropia
ID/Patho/Dx/Tx
ID: Strabismus
Patho: misalignment of the eyes (Newborn - stable ocular alignment not present until 2-3month of life)
- Esotropia - Deviated inward
- Exotropia - Deviated outward
- Hypertropia - Upward
- Hypotropia - Down
Dx: Hirschberg Corneal light reflex test (cover/uncover test)
Tx: Patchy therapy, corrective surgery
Pt has hx of HLA-B27. PE reveals cilliary injection and inflammatory cells & flare
ID/Patient/Location/Tx
Name: Uveitis (iritis)
Patient: hx of HLA B27
Location
- Anterior - unilater eye pain + redness
- Posterior - decreased vision
Tx
- Anterior - topical corticosteriod (scopolamine)
- Posterior - systemic corticosteriod
