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PNCE > EENT > Flashcards

EENT Flashcards

1
Q

MCC bacterial conjunctivitis

A

s. aureus
s. pneumo

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2
Q

bacterial conjunctivitis tx

A

warm compress
topical erythromycin

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3
Q

gonorrheal conjunctivitis tx

A

IM ceftriaxone, topical erythromycin

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4
Q

chlamydial conjunctivitis tx

A

PO doxy or azithromycin

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5
Q

neonatal conjunctivitis etiology by days

A

day 1: silver nitrate (chemical cause)
day 2-5: gonococcal
day 5-7: chlamydia
day 7-11: HSV

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6
Q

posterior uveitis

A

choroid inflammation assoc w/ HLAB27
sarcoidosis, MS
painless vision loss, floaters, dec/blurred vision
ophthalmic referral/ systemic CS

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7
Q

anterior uveitis sx

A

d/t underlying infx (AIDS, sarcoidosis)
unilateral vision loss, pain, redness, photophobia
constricted pupil, ciliary injection, painful eye movement
extra ocular sx: erythema nodosum, cough, lofgren syndrome

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8
Q

lofgren syndrome

A

sx of anterior uveitis
hx of sarcoidosis
erythema nodosum
bilateral hilar lymphadenopathy
polyarthralgia
fever

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9
Q

anterior uveitis test

A

CT: bilateral hilar adenopathy, pulmonary reticular infiltrates
hypercalcemia, hypercalcinuria
elevated ACE

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10
Q

anterior uveitis tx

A

ophthalmology referral
topical CS

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11
Q

nuclear vs peripheral cataract

A

nuclear: gray when seen by flashlight
peripheral: smoke like shadows, black against red

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12
Q

cataract test

A

SLIT lamp (yellow brown color)
fundoscopy: cataract is black on red background

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13
Q

cataract sx

A

painless blurred vision over months or years
halo around lights
absent red reflex
lens opacity

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14
Q

cataract tx

A

surgery

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15
Q

differential diagnosis for cataracts

A

retinoblastoma: absent red reflex + white pupil

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16
Q

corneal ulcer sx

A

pain, tearing, photophobia, gritty feeling
oval ulcer w/ ragged edges, severe conjunctival inflammation
white, hazy irregularity of cornea

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17
Q

corneal ulcer test

A

visual acuity
fluorescein staining

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18
Q

corneal ulcer tx

A

referral

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19
Q

herpes simplex infx in eye hallmark

A

dendritic ulcers, branching on fluorescein stain

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20
Q

herpes zoster opthalmicus etiology

A

varicella zoster- shingles

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21
Q

hypopyon

A

accumulation of pus in anterior chamber of eye
from severe keratitis infection

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22
Q

pterygium

A

fleshy triangular encroachment onto cornea

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23
Q

pinguecula

A

yellowish nodule on bulbular conjunctiva on nasal side

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24
Q

dacrocystitis vs dacroadenitis

A

dacrocystitis: lacrimal sac: medial canthos
dacroadenitis: lacrimal glands, above eyelid

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25
Q

dacrocystitis MCC

A

s. aureus

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26
Q

dacrycystitis or dacroadenitis tx

A

lid hygiene
acute: bacitracin and erythromycin or systemic tetracycline
chronic: obstruction –> dacryocystorhinostomy (DCR)

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27
Q

blepharitis MCC (anterior and posterior)

A

anterior: staph
posterior: meibomian gland dysfunction

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28
Q

anterior blepharitis sx

A

red rim

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29
Q

posterior blepharitis sx

A

hyperemic telangiectasias

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30
Q

blepharitis tx

A

supportive, lid scrub, warm compress
PO tetracycline, topical erythromycin
bactracin if refractory

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31
Q

chalazion vs hordeolum

A

chalazion: painless
hordeolum: painful

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32
Q

chalazion tx

A

initlal: warm compress
2nd: topical abx (erythromycin)
3rd: I&D

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33
Q

hordeolum tx

A

warm compress
erythromycin, bacitracin ointment
if no improvement in 2d, I&D

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34
Q

MCC optic neuritis

A

MS

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35
Q

med that causes optic neuritis

A

ethambutol

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36
Q

optic neuritis sx

A

unilateral central vision loss
periorbital pain
poor color perception
Marcus gunn pupil

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37
Q

optic neuritis tx

A

IV methylprednisolone –> oral CS

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38
Q

papilledema is a sign of

A

increased intracranial pressure

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39
Q

papilledema fundus exam

A

blurred disk margins
flame homorrhages
white cotton wool spots

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40
Q

papilledema tx

A

tx cause of increased intracranial pressure
keep bed elevated
diuretics (furosemide or acetazolamide)

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41
Q

orbital cellulitis causes

A

sinusitis (ethmoid)
dental infection
skin infection

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42
Q

orbital cellulitis sx

A

dec vision, warm to touch
fever, eyelid redness
dec EOM, pain w/ EOM
proptosis

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43
Q

preseptal cellulitis sx

A

fever
respiratory infection
sepsis
EOM normal

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44
Q

orbital cellulitis dx

A

high res CT for dx

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45
Q

periorbital cellulitis tx

A

augmentin

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46
Q

orbital cellulitis tx

A

hospital
IV abx (ceftriaxone and vancomycin)

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47
Q

macular degeneration dry vs wet

A

dry: MC, gradual, atrophic cause
wet: neovascularization, rapid progression

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48
Q

macular degeneration sx

A

leading cause of permanent vision loss in elderly
central vision loss only
drusen (yellow deposit of debris)
scotomas

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49
Q

macular degeneration tests

A

amsler grid for dry central vision loss
fluorescent angiography for wet

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50
Q

macular degeneration tx

A

wet: laser photocoagulation, ranibizumab. optical tomography for monitoring
dry: zinc, vitamin A/C/E

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51
Q

MC location retinal detachment

A

superior temporal area

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52
Q

retinal detachment sx

A

unilateral painless central vision loss
shadow/curtain descending
floaters, flash of light
+shafers sign
tobacco dust

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53
Q

retinal detachment tx

A

emergency: refer to ophthalmology
supine position
photocoagulation, cryosurgery

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54
Q

retinopathy screening

A

57 if DMT1 then annually
if DMT2, annually

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55
Q

retinopathy tx

A

pan retinal laser photocoagulation

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56
Q

diabetic retinopathy sx for diabetic

A

hard exudates
cotton wool spots
flame shaped blot and dot

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57
Q

retinopathy sx proliferative (late)

A

neovascularization

58
Q

hypertensive retinopathy sx

A

copper wiring, silver wiring, AV nicking

59
Q

hypertensive retinopathy sx stages

A

I: arterial narrowing (copper wiring –> silver wiring)
II: AV nicking
III: flame shaped hemorrhages, cotton wool spots (soft exudates)
IV: papilledema (malignant HTN)

60
Q

retinopathy vitreous hemorrhage

A

bevacizumab

61
Q

cotton wool spots + optic disk edema =

A

HTN emergency

62
Q

open globe fracture hallmark

A

gush of fluid
eccentric or teardrop shape

63
Q

blowout fracture sx

A

orbital emphysema
restriction of upward eye movement
vertical diplopia
crepitus, step off deformity
anesthesia of anterior medial cheek

64
Q

blowout fx anesthesia of anterior medial cheek which nerve

A

infraorbital nerve

65
Q

blowout fracture entraps which muscle

A

inferior rectus

66
Q

blowout fx test

A

CT TOC

67
Q

blowout fracture tx

A

nasal decongestant
CS, Abx
surgery

68
Q

corneal abrasion w/ contact wearer tx

A

FQ drops

69
Q

corneal abrasion test

A

1st: visual acuity
fluorescein stain: ice rink/ lines abrasions

70
Q

corneal abrasion tx

A

polymyxin-bacitracin ointment
tetanus shot if FB
rust ring: remove w/in 24h w/ rotating burr

71
Q

chemical burn eye tx

A

prophylaxis: moxifloxin topical abx drops
severe: topical CS and topical VitC

72
Q

globe rupture hallmark test

A

+ seidels test: parting of fluorescent dye by clear stream of aqueous humor from anterior chamber

73
Q

child with hyphema, suspect

A

child abuse until proven otherwise

74
Q

condition w/ increased with of hyphema

A

sickle cell anemia

75
Q

hyphema which chamber

A

anterior chamber

76
Q

hyphema tx

A

measure IOP
fox shield
ophthalmology referral
cycloplegic for pain control
glucocorticoid eye drops to prevent rebelled

77
Q

avoid what med for hyphema

A

ASA
NSAIDs

78
Q

complications hyphema

A

rebleeding
permanent vision loss
intraocular HTN
optic nerve atrophy –> glaucoma

79
Q

MCC CRAO

A

atherosclerosis

80
Q

CRAO sx

A

sudden painless monocular loss of vision
preceded by amaurosis fugax
retinal whitening and cherry red spot
box car appearance

81
Q

CRAO tx

A

emergency ophthalmology referral
acetazolamide
supine + orbital massage

82
Q

amaurosis fugax sx

A

painless unilateral vision loss
curtain descending then goes back up, lasts minutes

83
Q

amaurosis fugax MCC

A

carotid artery dz

84
Q

amaurosis fugax tx

A

tx underlying
heparin

85
Q

CRVO hallmark

A

blood and thunder appearance
no effective tx

86
Q

open angle glaucoma sx

A

inc IOP, gradual peripheral vision loss
increased cup to disk ratio
halo around lights

87
Q

closed angle glaucoma sx

A

steamy cornea, fixed mid dilated pupil
decreased visual acuity
sudden eye pain, ocular halos
vision loss
dark movie theater

88
Q

glaucoma screening

A

RF: AA, +FHx
20-29: at least once in this period, RF every 3-5yr
30-39: at least twice in this period, RF q 2-4yrs
40-64: q 2-4yrs
65+: q 1-2yrs

89
Q

acute glaucoma tx

A

definitive: laser trabeculoplasty/ peripheral iridotomy
acetazolamide (PO or IV) to lower IOP
topical BB (timolol)
topical alpha agonist (apraclonidine)
topical pilocarpine: facilitate outflow of aqueous humor

90
Q

acute glaucoma test

A

tonometry: elevated IOP (>30)
gonioscopy: gold standard

91
Q

CI in acute glaucoma

A

atropine
pseudoephedrine
ipratropium
albuterol, antihistamines

92
Q

open angle glaucoma sx

A

AA, gradual loss over years
peripheral vision loss (tunnel vision), bilateral
cupping of optic disk
constricted peripheral vision

93
Q

open angle glaucoma tx

A

definitive laster trabeculoplasty
BB (timolol)
1st line: latanoprost
acetazolamide

94
Q

MCC sensorineural hearing loss

A

presbyacusis

95
Q

MCC conductive hearing loss

A

cerumen impaction

96
Q

Hirschberg test

A

look at flashlight, observe reflection location on corneal surface
used for strabismus

97
Q

strabismus in infants

A

should be aligned by 2-3mo

98
Q

weber test checks CN

A

CN8

99
Q

MCC OE

A

pseudomonas

100
Q

OE tx

A

cipro or neomycin/polymycin
severe: ear wick
if infx past EAC or immunocomp: PO FQ

101
Q

malignant OE MCC

A

pseudomonas

102
Q

malignant OE sx

A

immunocomp
severe ear pain, otorrhea
facial nerve palsy

103
Q

malignant OE tx

A

high dose IV cipro

104
Q

acoustic neuroma sx

A

unilateral sensorineural hearing loss
tinnitus, dizzy

105
Q

acoustic neuroma can compress

A

CN 5, 7, 8

106
Q

acoustic neuroma tests

A

BIT: audiometry
weber: lat to normal ear
rinne: AC>BC
confirm: MRI w/ contrast (tumor)

107
Q

bilateral acoustic neuroma

A

neurofibromatosis type 2

108
Q

acoustic neuroma tumor CN

A

CN 8 (vestibulocochlear)

109
Q

acoustic neuroma tx

A

surgery

110
Q

labrynthitis sx

A

hx of URI
vertical rotational vertigo + hearing loss
nystagmus
continuous

111
Q

labyrinthitis tx

A

self limiting
CS first line

112
Q

BPPV test

A

dix hall pike maneuver

113
Q

BPPV tx

A

employ maneuver

114
Q

cholesteatoma tx

A

mastoidectomy

115
Q

OM MCC

A

S. pneumo
M. catarrhalis
H. flu

116
Q

OM tx

A

child TOC: cefixime
1st line: amoxicillin
allergy: azithromycin
2nd line: augmentin

117
Q

mastoiditis test

A

1st test CT

118
Q

mastoiditis tx

A

IV vancomycin
tympanostomy + drain

119
Q

meniere disease sx

A

gradual unilateral recurrent hearing loss
tinnitus, >2 episodes of vertigo >20m
aural fullness
triad: episodic vertigo, dec frequency sensorineural hearing loss, tinnitus

120
Q

meunière disease test

A

caloric/vestibular testing: horizontal nystagmus

121
Q

menière disease tx

A

meclizine
zofran
HCTZ or acetazolamide

122
Q

retinoblastoma sx

A

absent red reflex
white pupil
refer to ophthalmology, emergency

123
Q

MC location sinusitis

A

maxillary

124
Q

sinusitis TOC

A

CU

125
Q

sinusitis abx first line

A

augmentin or amoxicillin after 7 days no resolve

126
Q

chronic sinusitis from aspergillus

A

MC fungal sinusitis
black eschar on palate/face
tx w/ amphociterin B

127
Q

gingival hyperplasia can be caused by

A

phenytoin
CCB
cyclosporine
phenobarbital

128
Q

Vincents angina tx

A

trench mouth
PCN VK, clindamycin

129
Q

dental abscess tx

A

I&D
IM ceftriazone + amoxicillin

130
Q

Ludwig angina

A

cellulitis of submandibular space
CT TOC

131
Q

oral thrush tx

A

nystatin
PO fluconazole

132
Q

epiglottitis MCC

A

HiB

133
Q

MCC tonsillitis

A

viral or group A strep

134
Q

tonsilitis tx

A

GAS: PCN V

135
Q

MCC peritonsillar abscess

A

S. pyogenes (GABHS)

136
Q

tx bacterial pharyngitis

A

PCN V or amoxicillin

137
Q

pharyngitis bacterial cause

A

GABHS

138
Q

complication of bacterial pharyngitis (strep)

A

rheumatic fever/ heart disease

139
Q

sialadenitis tx

A

IV (nafcillin + flagyl or clindamycin)

140
Q

silver sulfasalazine CI

A

sulfa allergy
pregnancy
<2mo old
on the face

PNCE (33 decks)

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