EENT Flashcards
Common symptoms for bacterial conjunctivitis?
Discharge, usually unilateral, no pain, crusted over eyes
Common symptoms for viral conjunctivitis?
Foreign body sensation, tearing, burning, bilateral preauricular node involvement
Common symptoms of allergic conjunctivitis?
bilateral red eys, severe pruritis, moderate tearing,
Differential diagnosis for conjunctivitis?
Iritis- marked conjunctival injection around cornea, unilateral, photophobia, blurred vision
When do you refer conjunctivitis?
No improvement in 24 hours, decreased visual acuity, possibility of herpes or zoster
Treatment of bacterial conjunctivitis
Gentamycin 2 gtts q 4 hours x 5 days
two types of blepharitis?
ulcerative and nonulcerative
Differential diagnosis of blepharitis?
Horleolum, conjuncitivits, chalazion
Treatment for ulcerative blepharitis?
erythromycin or bacitracin ophthalmic ointment, or sulfactamide sodium solution
What is a chalazion?
Meibmian gland obstruction that is nontender
What is a hordeleum?
Stye, on eye lashes. Reoccur often with diabetes
Assessment for corneal abrasion
Corneal staining
Treatment of corneal abrasion
Antibiotic ointment for 5 days; tetanus shot if indicated
When to refer corneal abrasion?
If not improved in 24 hours
What is hypema?
Blood in anti chamber of eye, usually related to trauma. Refer. 25% have ruptured globe.
Symptoms of Uveitis?
Iritis- conjunctival injection, red, slow pupil response, blurry vision, photophobia. REFER!
What is scleritis?
Inflammation of sclera, localized on sclera. Benign, seen in collagen disease. May be tender, irritated, or red
What is Pinguecula or pterygium
ter-ih-gee-um. May need surgical removal
Usual IOP?
10-20
What medications to avoid in glaucoma?
Steroids
Fundoscopic exam for glaucoma?
increased cup to disk ratio
Classic triad for glaumoca?
Increased IOP, peripheral vision loss, and optic nerve atrophy
What type of glaucoma is acute?
closed angle glaucoma
Symptoms of closed angle glaucoma?
rapid, painful, head ache, fixed non reactive pupil, photophobia, halos around lights at night
Signs of otitis external?
Pain in ear, itching, fullness, discharged, diminished hearing
Differential diagnosis of otitis externa?
furunculosis, mastoiditis, foreign body, OM, herpes zoster
Topical therapy of otitis external?
Oxifloxicin, steroid, neomycin, Tobradex, or lotrimine if fungal
Exam findings for ottitis media?
red, bulging, no landmarks, decreased mobility of TM
What happens when tympanic membrane ruptures?
There sudden relief of pain
What medication should you avoid with OM?
antihistamines
Medication for otitis media?
Amoxicillin 1g TID for adults. Wait 48-72 hours in children
Treatment for OM with effusion?
Watchful waiting because most clear in after 3 months. Or give Augment or clarithromycin
Treatment for ruptured tympanic membrane?
Oxifloxacin gtts BID. Don’t use auralgan
Red flags for sinusitis?
orbital swelling or pain, swelling of the forehead, or diplopia
Pertinent history for sinusitis?
Previous URI, duration of symptoms (initially better, then worse after 5 days), dental pain
Significance of transillumination in sinus infection?
If it transilluminates, there’s no active infection. For those that do, there’s only a 1/4 chance that there’s an infection
Differences in ambulation with frontal and maxillary sinuses?
Frontal is worsened by laying down, maxillary is worsened by standing up
What medication should you avoid in sinusitis and OM?
Antihistamines
General treatment for bacterial sinusitis?
Agumentin 875 BID x 10 days
Different causes for coryza?
Allergic, vasomotor, mechanical chronic inflammatory, infections, hromonal
What is a saddle nose?
a symptom of the nose in Wegener’s granulomatosis
What orbital symptom can you look for for perennial allergies?
cobblestone like in palpebral conjunctieva
Classic allergic nasal objective assessment?
Pale and boggy
1st choice medication for rhinitis?
Fluticasone
What intranasal drug can you give for prophylaxis for rhinitis for seasonal allergies?
Cromlyn, intranasal
Other medications for rhinitis?
Singulair 10 mg po QD, decongestants, antihistamines
Clues to EBV/Mono pharyngitis?
petechiae, posterior chain lymphadenopathy, abdominal pain
Clues to Group A Strep? (4 main ones)
Fever >100.5, exudate, no cough, and lymphadenopathy; also strawberry tongue
What to do if patient is drooling?
Refer to ED emergently
Sign of glomerulonephritis?
hematuria
What else to do when patient dx with strep?
Throw away toothbrush.
What’s an important differential diagnosis in sinusitis?
Tooth Abscess
When should a patient with a corneal abrasion follow up?
In 24 hours
What’s the treatment for a corneal abrasion?
Oxifloxicin gtts
