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PANCE 2.0 > EENT #1 > Flashcards

EENT #1 Flashcards

1
Q

What is an ectropion?

A

-Eyelid and lashes turned outward (everted)

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2
Q

What muscle is relaxed in an ectropion?

A

Orbicularis oculi muscle

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3
Q

Risk factors for an ectropion?

A
  • Elderly
  • Congenital
  • Infectious
  • Cranial nerve 7 palsy
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4
Q

Symptoms of an ectropion

A
  • irritation
  • Ocular dryness
  • Tearing
  • Sagging of the eyelid
  • Increased sensitivity
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5
Q

Management for ectropion

A
  • Lubricating eyedrops

- Surgical correction if needed

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6
Q

What is an entropion?

A

-Eyelid and lashes are turned inward (inverted)

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7
Q

Pathophysiology of entropion

A

Spasms of orbicularis oculi muscle

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8
Q

What is dacrocystitis?

A

Infection of lacrimal sac due to obstruction of nasolacrimal duct

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9
Q

What are some common etiologies of dacryocystitis?

A

Staph Epidermidis
Staph Aureus
GABHS
Pseudomonas

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10
Q

Symptoms of acute dacryocystitis

A

Tearing and signs of infection: tenderness, erythema and warm to MEDIAL canthal NASAL side of lower lid area
Purulent discharge

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11
Q

However, symptoms of chronic dacryocystitis are

A

Mucopurulent drainage from puncta without other signs of infection

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12
Q

For acute dacryocystitis, what is the management?

A

Warm compresses

Antibiotics: Clindamycin, Vancomycin + Ceftriaxone

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13
Q

What is the treatment for chronic dacryocystitis?

A

Dacryocystorhinostomy

Topical ABX prior to surgery though

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14
Q

What is blepharitis?

A

Inflammation of the eyelid margin

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15
Q

Risk factors for blepharitis

A
  • Down Syndrome
  • Atopic dermatitis
  • Rosacea
  • Seborrheic Dermatitis
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16
Q

For blepharitis, posterior is MC due to ______ whereas anterior has two types, name them

A

Posterior: meibomnian gland dysfunction
Anterior: Infectious (Staph A or Staph Epidermidis) or Seborrheic

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17
Q

Symptoms of blepharitis

A
  • Burning, erythema, crusting, scaling and red-rimming of eyelid
  • Flaking on lashes or lid margins
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18
Q

Management for blepharitis

A
  • Eyelid hygiene is the mainstay of treatment: warm compresses, eyelid scrubbing, lid washing with baby shampoo, artificial tears
  • If severe or refractory, Azithromycin ointment, Erythromycin ointment), topical Cyclosporine, topical glucocorticoids
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19
Q

MCC of a hordeolum (stye)

A

Staph Aureus

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20
Q

There is increased risk for a hordeolum with what two things?

A

Rosacea and Seborrheic dermatitis

21
Q

What are the two types of hordeolums?

A

External: infection of eyelash follicle or external sebaceous glands
Internal: infection of meibomian gland

22
Q

Symptoms of a stye

A

-Erythematous, painful, warm nodule or pustule on the eyelid

23
Q

Management of a hordeolum

A
  • Warm compresses is the mainstay of treatment
  • Incision and drainage if no spontaneous drainage after 48 hours
  • May add topical Erythromycin or Bacitracin if actively draining
24
Q

What is a chalazion?

A

Painless indurated granuloma of the internal meibomian sebaceous gland away from the eyelid margin

25
Q

Symptoms of a chalazion

A

Non-tender localized, eyelid swelling (nodule) on conjunctival surface of the eyelid
-Often larger, firmer, and slower growing and less painful than hordeolums

26
Q

Treatment for a chalazion

A
  • Conservative: eyelid hygiene and warm compresses

- Refractory: incision and curettage at ophthalmologist if no resolution

27
Q

What is a pinguecula?

A

Slow growing thickening of the bulbar conjunctiva

-Yellow, slightly elevated nodule on nasal side of sclera that does NOT grow onto cornea

28
Q

What three things does a pninguecla consist of?

A

Fat, protein, calcium

29
Q

Risk factors for a pinguecula?

A

Often develop when the eye is irritated (dry, windy, sunny conditions, ocular trauma)

30
Q

Treatment for a pinguecula?

A

No treatment is needed

-May be resected if chronically inflamed or cosmetic reasons

31
Q

Risk factors for a pterygium

A

Associated with ultraviolet exposure in sunny climates (tropics)
Sand, wind and dust exposure

32
Q

Symptoms of a pterygium

A
  • Elevated, superficial fleshy, triangular-shaped growing fibrovascular mass that usually starts medially (nasal side of eye) and extends laterally
  • May cause irritation, erythema, or foreign body sensation
33
Q

Treatment for a pterygium

A
  • Observation for most
  • Artificial tears for irritation and erythema
  • Removal only if affects vision (if grows over cornea or causes astigmatism)
34
Q

Globe rupture is considered an

A

Ophthalmologic emergency: immediate consult

35
Q

What are some findings on a globe rupture examination?

A
  • Visual acuity: markedly reduced, diplopia.
  • Orbits: exophthalmos (proptosis) or enopthalmos (posterior displacement of eye/pushed in). Severe conjunctival hemorrhage (360 degrees)
  • Cornea/Sclera: teardrop or irregularly-shaped pupil, Positive Seidel’s Test (parting of fluroscein dye by a clear stream of aqueous humor). Hyphema (blood in anterior chamber)
36
Q

Management of a globe rupture

A
  • Rigid eye shield
  • Impaled objects left undisturbed
  • IV ABX
  • Tetanus prophylaxis if needed
  • Emergent consult by ophthalmology
  • Avoid any procedures that applies pressure to eyeball (tonometry, eyelid retraction, etc.)
37
Q

What bones make up the orbital floor?

A

Zygomatic
Palatine
Maxillary

38
Q

MC type of orbital floor (blowout) fractures

A

-Inferior (floor, blowout)

39
Q

What muscles are affected when there is an inferior orbital floor fracture?

A

Orbital fat and inferior rectus muscle may prolapse into maxillary sinus

40
Q

Symptoms of an orbital floor fracture

A
  • Decreased visual acuity
  • Diplopia with upward gaze (inferior rectus muscle entrapment)
  • Orbital emphysema from air in maxillary sinus (eyelid swelling after blowing nose)
  • Epistaxis
  • Anesthesia to anteromedial cheek (due to stretching of infraorbital nerve)
41
Q

What is the diagnostic of choice for an orbital fracture?

A

CT scan: Teardrop sign (inferior herniation of orbital fat inferiorly)

42
Q

Treatment for orbital floor fracture

A
  • Nasal decongestants (decreases pain)
  • Avoid blowing nose or sneezing
  • Corticosteroids (reduce edema)
  • Antibiotics (Ampicillin-Sulbactam or Clindamycin)
  • Surgical repair: if enophthalmos or persistent diplopia
43
Q

What is the MC primary intraocular malignancy in childhood?

A

Retinoblastoma

44
Q

Most retinoblastoma are diagnosed by what age and are found almost exclusively in children?

A

3 years old

45
Q

What gene is affected with a retinoblastoma?

A

RB1

46
Q

Symptoms of a retinoblastoma

A
  • Leukocoria (presence of an abnormal white reflex instead red reflex)
  • May develop strabismus or nystagmus
47
Q

How do you diagnose a retinoblastoma besides an ocular examination?

A

-Ocular ultrasound: intraocular calcified mass

48
Q

What is the management for a retinoblastoma?

A
  • Radiation therapy, chemotherapy, enucleation

- Fatal if untreated, but survival > 95% if treated promptly

49
Q

What is the MCC of permanent legal blindness and vision loss in older adults?

A

Macular degeneration

PANCE 2.0 (62 decks)

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