EENT

Question 1

Dx. Unilateral/Bilateral vocal cord paralysis?

Answer 1

Fiberoptic laryngoscopy (NOT EMG)

Question 2

Central retinal a. occlusion

Tx

Answer 2

Sudden, painless monocular vision loss
Afferent pupillary defect
Pale retina with cherry red fovea

Tx: Ocular massage

Question 3

Open/Wide angle Glaucoma keywords

Answer 3

peripheral then central vision loss d/t IOP
optic disc atrophy/cupping
painless

Question 4

Closed/Narrow angle Glaucoma keywords

Answer 4

obstruction of aqueous flow

painful, sudden, halos, rock-hard eye

Question 5

CN 3 Damage S&S

Answer 5

down and out eye
ptosis
mydriasis
loss of accomodation

Question 6

CN 4 Damage S&S

Answer 6

upward eye, especially with contralat gaze and head tilt

“problems going down stairs”

Question 7

CN 6 Damage S&S

Answer 7

eye cannot abduct

Question 8

Marcus Gunn Pupil

Dx?

Answer 8

afferent pupillary defect (d/t optic n. damage or retinal detachment)
- decrease bilateral constriction when line is shone in affected eye

Dx: Swinging flashlight test

Question 9

Tx: Glaucoma (open)

Answer 9

Decrease aqueous humor:
Epinephrine (causes vasoconstriction)
Timolol
Acetazolamide

Increase outflow:
Pilocarpine
Physostigmine
Latanoprost

Question 10

1st line for Tonic clonic seizures

Answer 10

Phenytoin (Dilantin)
Carbamazepine (Tegretol)
Valproic Acid (Depakote)

Question 11

1st line for Status Epilepticus tx?

prophylaxis?

Answer 11

Benzodiazepine

Phenytoin

Question 12

MOA Phenytoin

Answer 12

blocks Na, inhibits glutamate release

Teratogenic (Fetal Hydantoin syndrome) and gingival hyperplasia

Question 13

MOA Barbiturates (duration)

Answer 13

Increase duration Cl- channel opening to facilitate GABA-A action

Question 14

MOA Benzodiazepine (frequency)

Answer 14

Increase frequency Cl- channel opening to facilitate GABA-A action