5 ENT, eye

Question 1

Glaucoma tx

meds

Answer 1

Think: keep pupils constricted

1. beta blocker–timolol
2. pilocarpine (cholinergic)
3. acetazolamide, mannitol (not in renal fail)

q1h IOP check

Question 2

pinguecula vs pterygium

Answer 2

‘callus’ on eye conjunctiva

pterygium can develop from a pinguecula, can interfere with vision

Question 3

CRAO tx

Answer 3

CRAO: emergent ophtho consult

Can try these (no evidence):

• eye massage (to disloge clot)
• timolol
• breathe into paper bag (increase PCO2 for vasodilation)

ALSO:

consider POCUS, and hyperbaric therapy

Question 4

Vertigo:

5 Ds for central vertigo

Answer 4

dizzy, dysphagia, dysmetria, dysarthria, diplopia

Question 5

Vertigo sxs:

meclizine doesn’t seem to help. What next med to use

Answer 5

can try BZD, scopolamine

Question 6

You see gingival hyperplasia,

and diagnose acute necrotizing ulcerative gingivitis (trench mouth)

also think what other ddx (2)

Answer 6

also think :

1. phenytoin toxicity
2. acute leukemia

Question 7

tooth layers

Answer 7

enamel, dentin, pulp

Question 8

sialolithiasis tx

Answer 8

sialogogues, eg lemon drops

abx if it’s infected–you see surrounding erythema