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PANCE/EOC > EENT #1 > Flashcards

EENT #1 Flashcards

1
Q

Symptoms of an acoustic neuroma

A
  • Unilateral sensorineural hearing loss

- Tinnitus, vertigo, facial numbness, facial paresis

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2
Q

Diagnostic imaging for Acoustic Neuroma

A
  • MRI (imaging of choice)

- Audiometry is the lab of choice

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3
Q

Management of acoustic neuroma

A

Surgery or focused radiation therapy

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4
Q

Pathophysiology of acute angle closure glaucoma

A

Decreased drainage of aqueous humor via trabecular meshwork and canal of Schlemm in patients with pre-existing narrow angle or large lens

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5
Q

True or False: Acute angle closure glaucoma is the leading cause of preventable blindness in the US

A

True

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6
Q

Precipitating factors for acute angle closure glaucoma attack

A

Mydriasis (dilation), dim lights, sympathomimetics, anticholinergics

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7
Q

Symptoms of acute angle closure glaucoma

A
  • Sudden onsets of severe, unilateral ocular pain
  • Halos round lights and loss of peripheral vision
  • N/v, headache
  • Conjunctival erythema, cloudy cornea, mid-dilated and fixed pupil
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8
Q

Diagnostics for acute angle closure glaucoma

A
  • Increased IOP > 21 mmHg

- Fundoscopy: optic disc blurring or cupping

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9
Q

Treatment for acute angle closure glaucoma

A
  • Acetazolamide with Topical BB (Timolol) without affecting visual acuity
  • Definitive: Iridotomy
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10
Q

MCC of acute otitis media (SMH)

A

Strep Pneumo (MC); GABHS
Moraxella Catarrhalis
H. Influenzae

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11
Q

Symptoms of AOM

A
  • preceded by URI
  • Fever, otalgia, ear tugging in infants, conductive hearing loss
  • Bulging and erythematous TM with effusion
  • Decreased TM mobility (most sensitive)
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12
Q

What is the definitive diagnostic for AOM for recurrent cases

A

Tympanocentesis for a sample of fluid for culture

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13
Q

If the TM perforates, what symptoms present?

A

Rapid relief of pain + otorrhea (usually heals in 1-2 days)

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14
Q

Treatment for AOM

A

Amoxicillin (1st line) x 10-14 days

  • Augmentin or Cefaclor second line
  • Azithromycin if PCN allergy
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15
Q

Acute sinusitis, if bacterial, is caused by

A

Strep Pneumo

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16
Q

Acute sinusitis, if viral, is caused by

A

Rhinovirus, influenza, and parainflueza

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17
Q

Symptoms of acute sinusitis

A
  • Facial pain or pressure worse with bending or leaning forward
  • Headache
  • Purulent nasal discharge
  • Worsening symptoms after period of improvement
  • Malaise
  • Nasal congestion
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18
Q

Diagnostic of choice, if needed, for acute sinusitis

A

CT scan

19
Q

However, diagnostic that is gold standard for acute sinusitis is

A

Biopsy or aspirate

20
Q

If sinus radiographs are ordered for acute sinusitis, what view is most helpful?

A

Water’s View

21
Q

Treatment for acute sinusitis

A

Decongestants, analgesics, antihistamines, mucolytics, nasal lavage

22
Q

However, in acute sinusitis, if symptoms are present for _______, or if they have worsening symptoms, you can start ABX. What are the ABX that you can start?

A

10-14 days

  • Augmentin
  • Second line is Doxycycline
23
Q

What is the MCC of pharyngitis (acute tonsillitis)

A

Viral (Adenovirus, Rhinovirus, EBV)

However, bacterial is also a cause. Group A Strep (Strep Pyogenes) is the MC bacterial cause

24
Q

Treatment for acute tonsillitis

A

Symptomatic, warm fluids, saline gargles, topical anesthetics, lozenges

25
Q

If the acute tonsillitis is due to S. Pyogenes, you should use what ABX?

A

Amoxicillin

26
Q

MCC of permanent legal blindness and vision loss in older adults

A

Macular degeneration

27
Q

Symptoms of macular degeneration

A

Bilateral, progressive central vision loss.

  • Metamorphopsia (blurred lines)
  • Micropsia (objects are smaller in affected eye)
28
Q

Risk factors for Macular degeneration

A

Age > 50
Caucasians
Females
Smokers

29
Q

Fundoscopic exam for macular degeneration (dry and wet)

A

Dry: Drusen bodies (small yellow-white spots on retina)
Wet: New, abnormal vessels that cause retinal hemorrhaging and scarring

30
Q

Management of Dry Macular Degeneration

A
  • Zinc and Vitamins A & C

- Amsler grid monitoring at home

31
Q

Management of Wet Macular Degeneration

A

Intravitreal VEGF inhibitors (Bevacizumab)

-Laser photocoagulation

32
Q

Symptoms of allergic rhinitis

A
  • Clear, watery rhinorrhea
  • Pale or boggy turbinates
  • Nasal polyps
  • Cobblestone mucosa of conjunctiva
  • Allergic Shiner
  • Allergic Salute
33
Q

Treatment for allergic rhinitis

A
  • Intranasal corticosteroids
  • Intranasal glucocorticoids (Mometasone, Fluticasone) if nasal polyps
  • Decongestants
34
Q

What is the risk with decongestants?

A

Intranasal decongestants used > 3-5 days can cause rhinitis medicaments (rebound congestion)

35
Q

What is Amaurosis Fugax?

A

-Transient monocular vision loss with complete recovery due to retinal emboli or ischemia

36
Q

Symptoms of Amaurosis Fugax

A

Vision loss descending over visual field described as a curtain or shade, that lifts up and resolves within 1 hour

37
Q

Fissures at the side of the mouth

A

Angular Cheilitis

38
Q

bacterial conjunctivitis causes

A
  • Staph A (MC)
  • Strep Pneumo
  • H. Influenzae
  • M. Catarrhalis
39
Q

Symptoms of bacterial conjunctivitis

A

-Purulent discharge, lid crusting (eye stuck shut in the morning), conjunctival erythema, no visual changes

40
Q

Treatment for bacterial conjunctivitis

A

-Erythromycin ointment

41
Q

However, for a contact lens wearer for bacterial conjunctivitis, what should you cover for and what ABX should you use?

A

Pseudomonas

-Topical Ciprofloxacin or Ofloxacin

42
Q

with a bitemporal hemianopsia, where would you expect a lesion to be?

A

Lesion of optic chiasm

43
Q

Risk factors for cataracts (lens opacification/thickening)

A
  • Aging
  • Smoking
  • Glucocorticoid use
  • DM
  • Trauma
  • UV light
44
Q

Symptoms of cataracts

A
  • Absent red reflex, opaque lens
  • Painless, slow progressive vision loss over years
  • Difficulty driving at night, reading signs

PANCE/EOC (63 decks)

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