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AANP FNP: Adult > EENT > Flashcards

EENT Flashcards

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Family Nurse Practitioner (FNP) flashcards
1
Q

What can “AV nicking” on fundoscopic exam signify?

A

Hypertension

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2
Q

Inspection of the macula

A
  • patient should look directly into the light if macula is difficult to visualize
  • Centered 2-2.5 disc diameters temporal to the optic disc; avascular
  • Fovea centralis is a reflective area that looks darker and lies in the middle of the macula (Fovea centralis controls one’s sharpest vision)
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3
Q

Hyperopia

A

“Farsightedness”

Hard to see close

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4
Q

Myopia

A

“Nearsightedness”

Hard to see far away

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5
Q

Presbyopia

A

Common after age 40; difficulty maintaining clear focus at a near distance due to weakening and less flexibility in the lens

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6
Q

Arcus sinilis

A

Cloudy appearance of cornea with gray/white/blue arc or circle around the limbis due to deposition of lipid material; no effect on vision
Check lipid panel

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7
Q

Ptergyium

A

Raised, wedge-shaped growth of thin, noncancerous tissue over the conjunctiva
Often occurs with repeated exposure to wind, dry air

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8
Q

Hordeolum vs Chalazion

A

Usually caused by staph aureas
Hordeolum- acute, painful
Chalazion- beady nodule, painless, insidious

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9
Q

Blepharitis

A

Red, scale, greasy flakes
Thickened, crusted lid margins
Burning, itching, tearing
Hot compresses, topical abx (bacitracin, EEC), vigorously scrub lashes with eyes closed and rinse

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10
Q

Bacterial conjunctivitis

A

Purulent; self-limiting usually 72 hours max
Abx drops: levofloxacin, ofloxacin, ciprofloxacin, tobramycin, gentamycin

For copious green mucopurulent, consider gonococcal or chlamydial conjunctivitis
Tx: Ceftriaxone 250mg IM x1, 1gm azithromycin PO x1

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11
Q

Allergic conjunctivitis

A

Stringy, increased tearing

Tx: Oral antihistamines

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12
Q

Viral conjunctivitis

A

Watery

Symptomatic care

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13
Q

Does conjunctivitis present with pain?

A

No: May be burning or itching but no pain.

If PAINFUL red eye, consider corneal abrasion.

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14
Q

Inspection of the optic disc

A

Donut-like shape with orange/pink neuroretinal rim and central white depression
Cup should note be more than 1/2 size of the disc diameter (if larger, papilledema, consider glaucoma)

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15
Q

Glaucoma: open-angle

A

chronic increased IOP
cupping of disc, constriction of visual fields (tunnel vision)
Tx: refer, eye drops

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16
Q

Glaucoma: closed-angle

A

acute increased IOP
extreme PAIN, blurred vision, halo around lights, pupil dilated or fixed
Tx: refer, surgery

17
Q

Tonometry

A

Annual screening for glaucoma

Start for all patients by age 40, all diabetics annually

18
Q

Cataracts

A

Highest cause of treatable blindness
Causes: aging, trauma, drugs, alchohol, smoking, congenital, diabetes, AV sunlight exposure
S/sx: painLESS, clouded/blurred vision, halos around lights, difficulty with night vision, photosensitivity, diplopia in one eye, no red reflex, clouding/opacity of lens
Tx: Refer, surgery

19
Q

Retinal detachment

A

Flashes of light (photopsia), especially in peripheral vision
Floaters in eye
Blurred vision
Shadow/blindness in part of visual field in one eye
Immediate referral for surgery

20
Q

Otitis Externa

A

Acute localized furunculitis
Bacterial (usually Staph aureas), chronic, fungal, eczema, etc.
Tx: Clean/debride ear, topical otic drops (cortisporin), pain control (NSAIDs, topical corticosteroids)

21
Q

Acute otitis media

A

most common: viral URI
most common bacterial pathogens: Strep pneumoniae, H. influenzae, M. catarrhalis
Erythema alone of TM is NOT diagnostic
Most uncomplicated cases resolve spontaneously; antibiotics only for suspected bacterial cases (Amoxicillin; if doesn’t work in 3 days, change to Augmentin)

22
Q

Cholesteatoma

A

Chronic otitis media; may erode middle ear leading to nerve damage and deafness
S/sx: chronic infection, painless otorrhea, hearing loss, TM perforation
Tx: refer for surgery

23
Q

Vertigo: causes

A

Most common: BPPV
Common causes: brain tumor, medications, OM, Meniere’s disease, acoustic neuroma, head or neck trauma, migraines, cerebellar hemorrhage

24
Q

Vertigo: S/sx, Dx, Management

A

S/sx: positive Dix-Hallpike, n/v, sweating, nystagmus, tinnitis
Dx: CT scan, VDRL/RPR, serum medication levels, hearing exam, blood glucose/EKG may be useful
Tx: Diazepam, Meclizine, Diphenhydramine, Scopolamine, Antiemetics

25
Q

Meniere’s disease

A

Sensorineural hearing loss + vertigo + tinnitis

26
Q

Conductive hearing loss

A

Causes: Foreign body/cerumen, Perforated TM, Otitis media/externa
Weber: Sound lateralizes to AFFECTED ear
Rinne: Abnormal in affected ear (AC

27
Q

Sensorineural hearing loss

A

Causes: damage to hair cells and/or nerves that sense sound waves: acoustic trauma, barotrauma, head trauma, ototoxic drugs, Meniere’s disease, Acoustic neuroma, infections
Weber: Sound lateralizes to UNAFFECTED ear
Rinne: Normal in affected ear (AC>BC)

28
Q

Viral rhinitis

A

Common cold
self limiting 5-10 days
Rhinovirus, coronavirus, RSV, adenovirus

29
Q

Pharyngitis/Tonsillitis: causative organisms

A

Viruses: RSV, flu A/B, Epstein Barr virus
Bacteria: Strep (only 10 percent of adult sore throats), gonorrhea

30
Q

Strep throat: Centor criteria

A 
Fever greater than 100.4F
Lack of cough
Exudate
Anterior cervical adenopathy
If strep +, treat with Penicillin V or erythromycin
31
Q

Mononucleosis (Epstein Barr Virus)

A

fever, chills, MALAISE, severe pharyngitis, exudates, POSTERIOR cervical adenopathy, splenomegaly
Tx: prednisone taper for severely enlarged tonsils, avoid contact sports 3 weeks to 3 months, supportive care

32
Q

Influenza

A

Fever, HA, myalgias, coryza, malaise, cough
Flu swab
Tx: antipyretics, neuraminidase inhibitors (Tamiflu)

33
Q

Rhinosinusitis: causative organisms, Dx, Tx

A

Cause: Strep pneumonia, H. influenzae
Dx: culture as needed, CT scan, decreased transillumination
Tx: Antibiotics- Augmentin, clarithromycin (Biaxin)

AANP FNP: Adult (14 decks)

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