EENT #3 Flashcards
MCC of nasal polyps
Allergic rhinitis
What do nasal polyps look like?
Pale boggy mass on nasal mucosa
Treatment of choice for nasal polyps
Intranasal glucocorticoids
With neonatal hearing loss, if not identified before _____, may get delays in speech and language.
6 months
How to screen newborns for hearing loss
-Auditory brain stem response (ABR)
What is optic neuritis?
Acute inflammatory demyelination of the optic nerve
Causes of optic neuritis
Ethambutol
MS
Symptoms of optic neuritis
Painful loss of vision Decrease in color vision Central scotoma Unilateral Ocular pain worse with movement
With optic neuritis, what is a Marcus-Gunn Pupil?
During swinging light flashlight test from the unaffected eye into the affected eye, the pupils seem to dilate
Treatment for Optic Neuritis
IV Methylprednisolone
Oral Lichen Planus is associated with
Hepatitis C infection
Appearance of oral lichen planus
-lacy, reticular (Wickham Striae)
Treatment for oral lichen planus
Local glucocorticoids (Clobetasol, Betamethasone)
Symptoms of orbital cellulitis
- Ocular pain with movement
- Ophthalmoplegia (EOM muscle weakness)
- Proptosis
- Eyelid edema
Diagnostic of choice for Orbital Cellulitis
-High resolution CT scan
Treatment for Orbital Cellulitis
Admission + IV Antibiotics (Vancomycin + Ceftriaxone)
MCC of Otitis Externa
Pseudomonas Aeruginosa
Otitis Externa is also called
Swimmer’s Ear
Symptoms of Otitis Externa
- Ear pain, pruritus, discharge, pain on traction of ear canal/tragus
- Purulent discharge
Treatment for otitis externa
- Ciprofloxacin-Dexamethasone, Ofloxacin
- Protect ear against moisture (alcohol, remove debris and cerumen)
Mastoiditis is a complication of
Acute otitis media
Symptoms of mastoiditis
- Deep ear pain (worse at night), fever, Mastoid tenderness, edema, erythema
- Protrusion of auricle
Diagnostic for mastoiditis
CT scan with contrast
Treatment for mastoiditis
- IV Vanco + Ceftazidime
- Middle ear or mastoid drainage (Myringotomy)
What differentiates preseptal (periorbital) cellulitis from orbital (septal) cellulitis?
-Absence of proptosis, ophthalmoplegia, and ocular pain with EOM movements
Treatment for periorbital cellulitis
- Outpatient management if > 1 year old
- MRSA coverage: oral Clindamycin
Risk factors for retinal detachment
- Myopia
- Previous cataract surgery
- Age
- Trauma
MC type of retinal detachment
Rhegmatogenous: separation from choroid plexus
Symptoms of retinal detachment
- Photopsia (flashing lights)
- Floaters
- Unilateral peripheral vision loss: shadow or curtain coming down
- No ocular pain or redness
Diagnostic for retinal detachment
-Fundoscopy: Positive Shafer Sign: clumping of brown-colored pigment vitreous cells in anterior vitreous humor like “tobacco dust”
Treatment for retinal detachment
- Emergency!
- Keep patient supine, head turned toward side of detachment
- Laser or ocular surgery
Risk factors for Pterygium
- UV exposure in sunny climates
- Sand, wind, dust exposure
Symptoms of Pterygium
-Elevated, triangular-shaped growing fibrovascular mass starts medially and extends laterally
Treatment for pterygium
- Observation
- Removal if affects vision
Common etiology of peritonsillar abscess
-Group A Strep (S. Pyogenes)
Symptoms of peritonsillar abscess
- Muffled “hot potato” voice
- Drooling
- Trismus (lockjaw)
- Swollen or fluctuant tonsil
- Uvula deviation to contralateral side
Diagnostics for peritonsillar abscess
-CT scan
Treatment for peritonsillar abscess
- Needle aspiration, incision and drainage
- Augmentin or Clindamycin Oral ABX
Most retinoblastoma are diagnosed before what age?
3 years old
Retinoblastoma is associated with what gene mutation
Mutation in RB1 gene on chromosome 13
Symptoms of retinoblastoma
- Leukocoria (abnormal white reflex instead of red reflex)
- Nystagmus or Strabismus
MCC of Sialadenitis
S. Aureus
Symptoms of Sialadenitis
- Sudden onset of tender gland swelling with purulent discharge, pus if the duct is massaged
- Dysphagia
- Trismus
- Fever and chills if severe
Diagnostics for sialadenitis
-CT scan
Treatment for Sialadenitis
- Sialagogues
- Dicloxacillin or Nafcillin, Clindamycin
Sialolithiasis (Salivary Gland Stones) are MC in where?
Wharton’s Duct (Submandibular gland) or Stensen’s Duct
Symptoms of Sialolithiasis
Sudden onset of salivary gland pain and swelling with eating or in anticipation of eating
-Stone may be palpated in salivary gland
Treatment for Salivary Gland Stones
Sialagogues, hard candy, lemon drops
-Dicloxacillin, Nafcillin, Clindamycin if severe (Staph)
