EENT Flashcards
1
Q
Centor Criteria
A
anterior cervical lymphadenopathy, fever >38, exudate, no cough
2
Q
GABHS tx
A
Oral penicillin or amoxicillin.
3
Q
allergic conjunctivitis tx
A
topical antihistamine
avoid allergen
cool compress
artificial tears
4
Q
allergic rhinitis tx
A
intranasal corticosteroids (esp if nasal polyps) avoid allergen mast cell stabilizer, anticholinergics
5
Q
gonorrheal conjunctivitis tx
A
admit for IV ceftriaxone and topical abs
no steroids
emergency
6
Q
viral conjunctivitis MC cause
A
adenovirus
MC acquired from swimming pool
7
Q
viral conjunctivitis tx
A
warm compress artificial tears topical antihistamines decongestant stay home from school/work
8
Q
otitis media with effusion tx
A
asymptomatic
observe
promote Eustachian tube drainage
9
Q
TM perforation tx
A
avoid water/moisture/topical aminoglycosides
follow up to ensure healing (may need surgery)
10
Q
chronic otitis media MC causes
A
complication of AOM, trauma, or cholesteatoma.
MC pseudomonas, S aureus
11
Q
chronic otitis media w/ rupture tx
A
topical oflaxacin or ciprofloxacin
avoid water/moisture/topical aminoglycosydes
surgical repair
12
Q
mastoiditis tx
A
IV amoxicillin
middle ear/mastoid drainage by myringotomy +/- tympanostomy tube placement
13
Q
barotrauma tx
A
autoinsufflation
decongestants or antihistamines
14
Q
acute serous otitis media cause
A
Eustachian tube dysfunction, often follows viral or allergic rhinitis
15
Q
acute sinusitis signs
A
symptoms present > 1 week sinus pain/pressure headache purulent sputum or nasal discharge opacification w/ transillumination
16
Q
acute sinusitis tx
A
if > 10-14 days or if facial swelling or fever –> oral amoxicillin x 10-14 d
17
Q
otosclerosis tx
A
stapedectomy with prosthesis
hearing aid
18
Q
conductive hearing loss causes
A
cerumen impaction (MC)
damage to ossicles (otosclerosis, cholesteatoma)
mastoiditis
otitis media
19
Q
sensorineural hearing loss causes
A
presbyacusis (MC) chronic loud noise exposure CNS lesion (acoustic neuroma) labyrinthitis meunière syndrome
20
Q
cholesteatoma signs
A
painless otorrhea with strong odor
conductive hearing loss
+/- vertigo/dizziness
21
Q
peripheral vertigo causes
A
BPPV (MC) Meniere vestibular neuritis labyrinthitis cholesteatoma
22
Q
episodic vertigo, no hearing loss
A
BPPV
23
Q
episodic vertigo, + hearing loss
A
meniere’s disease
24
Q
continuous vertigo, no hearing loss
A
vestibular neuritis
25
continuous vertigo, + hearing loss
labyrinthitis
26
peripheral vertigo signs
horizontal nystagmus
beats away from affected side
fatigues with fixation
sudden onset & associated w/ hearing loss & tinnitis
27
central vertigo causes
```
cerebellopontine tumors
migraine
CVD
MS
Vestibular neuroma
```
28
central vertigo signs
vertical nystagmus
nonfatigable
gait problems (Romberg +)
gradual onset
29
BPPV tx
Epley maneuver
antihistamines for N/V
benzodiazepines for acute N/V
30
Meniere's disease tx
symptom management (antiemetics, antihistamines)
low salt diet
diuretics
31
Meniere's disease 4 signs
episodic vertigo (minutes to hours)
tinnitus
ear fullness
hearing loss (fluctuating, low tones)
32
Acoustic neuroma / CN 8 Schwannoma signs
UNILATERAL sensorineural hearing loss
tinnitus
continuous vertigo
33
Acoustic neuroma / CN 8 Schwannoma signs
UNILATERAL sensorineural hearing loss
tinnitus
continuous vertigo
34
chronic sinusitis MC bacterial cause
S. aureus
35
chronic sinusitis fungal causes
1st MC: Aspergillus
| 2nd MC: Mucormycosis
36
chronic sinusitis fungal tx
IV amphotericin B
| surgical debridement
37
chronic sinusitis bacterial tx
amoxicillin/clavulanate x 3-10 weeks
38
viral rhinitis tx
supportive
oral antihistamine
decongestants (intranasal should not be used >3-5 days to avoid rhinitis medicaments)
39
pale/violaceous, boggy turbinates +/- nasal polyps
allergic rhinitis
40
erythematous turbinates
viral rhinitis
41
epistaxis MC location
Keisselbach's plexus
42
acute viral pharyngitis/tonsillitis tx
NSAIDs, saline gargle, other sx mgmt
43
candidiasis tx
topical nystatin liquid
| oral fluconazole
44
oral hairy leukoplakia cause & location
EBV
| on lateral tongue and buccal mucosa
45
acute herpetic gingivostomatitis tx
HSV-1 in children
none
acyclovir in severe cases
46
acute herpetic pharyngotonsillitis tx
oral hygiene
| HSV-1 in adults
47
crusting, scaling, red rimming, eyelash flaking
blepharitis
crusting = bacterial
scaling/flaking = seborrheic
(not necessarily infected, systemic underlying cause)
48
tearing, tenderness, edema & erythema to medial cantonal of lower lid
dacrocystitis
49
eyelid and lashes turned inward
| corneal abrasion, erythema, tearing
entropion
50
eyelid and lashes turned outward
| dry eye + tearing, irritation
ectropion
51
painful, warm, swollen red lump on eyelid (internal meibomian gland or external hair follicle)
hordeolum
| MC S. aureus
52
hordeolum tx
Lid hygiene & warm compress
don't really need but sometimes give topical abx if actively draining
might need I and D if no drainage after 48 h
53
nontender eyelid swelling on conjunctival surface (rubbery nodule)
chalazion
54
chlamydial conjunctivitis
admit for IV azithromycin
no steroids
bad bad bad
55
bacterial conjunctivitis causes
S aureus, S pneumo
56
bacterial conjunctivitis tx
topical erythromycin
| if contact lens wearer, cover pseudomonas (fluoroquinolone, amino glycoside)
57
pain with ocular movement
proptosis
decreased vision
orbital cellulitis
58
orbital preseptal cellulitis tx
Amoxicillin
59
orbital postseptal cellulitis tx
IV abx to cover staph and strep (Vanco plus Ceftriaxone))
60
pain, photophobia, reduced vision, tearing, conjunctival erythema/injection, corneal ulceration/defect
keratitis
61
HSV keratitis tx
Topical Trifluridine drops (antiviral). Refer.
62
uveitis/iritis causes
systemic inflammatory diseases
infection (CMV, toxoplasmosis, syphilis, TB)
trauma
63
absent red reflex ddx
cataracts
| retinoblastoma
64
uveitis/iritis tx
anterior: topical corticosteroids
posterior: systemic corticosteroids
65
unilateral ocular pain, redness, photophobia after blunt trauma
anterior uveitis
66
choroid inflammation sx
= posterior uveitis
| blurred vision, floaters, no pain or sx of anterior uveitis
67
painless white plaque in mouth that cannot be scraped off
leukoplakia
68
Relative Afferent Pupillary Defect
Marcus Gunn pupil
| shine the light in the affected eye and it dilates = optic neuritis
69
Accommodation Reflex Present
| Pupillary Reflex Absent
Argyll-Robertson Pupil
70
Argyll-Robertson Pupil causes
neurosyphilis (MC)
midbrain lesions
diabetic neuropathy
71
round or oval painful ulcers (yellow, white or grey centers) with erythematous halo
apthous ulcers
72
MC site of sialolithiasis
Wharton's duct (submandibular gland duct)
73
postprandial salivary gland pain & swelling
sialolithiasis
74
sialolithiasis conservative tx
sialogogues: tart hard candies, lemon drops, xylitol containing gum
increase fluid intake
gland massage
avoid anticholinergics
75
sialadenitis cause
MC s. aureus infection
76
sialadenitis tx
CT scan to assess for abscess
antistaph abs (Dicloxacillin or Nafcillin) + Metronidazole or Clindamycin
Sialogogues
77
oral sores associated with HCV
oral lichen planus
78
lacy leukoplakia (Wickham striae) dx and tx
oral lichen planus
| local or systemic corticosteroids (autoimmune etiology)
79
swelling & erythema of the upper neck & chin
| + pus on the floor of the mouth
cellulitis of sublingual & submaxillary spaces in neck (Ludwig's Angina)
80
Ludwig's Angina tx
ampicillin/sulbactam
or
penicillin + metronidazole or clindamycin
81
fleshy, triangular-shaped "growing" fibrovascular mass usually on nasal side of eye extending laterally
pterygium
82
pterygium epidemiology
sunny climates
| sand, wind, dust exposure
83
elevated yellow nodule on the nasal side of sclera, does not "grow"
pinguecula
84
mgmt of pterygium & pinguecula
observation
pterygium - may remove if affecting vision
pinguecula - may remove for cosmetic reasons
85
drusen bodies are a sign of ___
ARMD
86
hard exudate is a sign of ____
diabetic retinopathy
87
soft exudate is a sign of ____
hypertensive retinopathy
88
cupping of the optic disc is a sign of ____
open angle glaucoma
89
bilateral peripheral vision loss is caused by
open angle glaucoma
90
signs of ARMD
blurred or loss of central vision
loss of detail and color vision
scotomas
metamorphopsia
91
myopic shift ("sudden sight") is a sign of ____
cataracts
92
risk factors for ARMD
age >50
caucasian
female
smoker
93
intravitreal anti-angiogenic (inhibits FEGF to reduce neovascularization)
management of wet ARMD and nonproliferative diabetic retinopathy
94
central vision loss DDX
ARMD
| maculopathy ass. w/ diabetic retinopathy
95
arterial narrowing, AV nicking are signs of ___
hypertensive retinopathy
96
signs of retinal detachment
photopsia (flashing lights)
floaters
progressive UNILATERAL vision loss (curtain coming down)
no pain/redness
97
risk factors for retinal detachment
```
myopia & cataracts
proliferative DM retinopathy
sickle cell
trauma
HTN/papilledema
```
98
convergent strabismus deviated inward (cross eyed)
esotropia
99
divergent strabismus - deviated outward
exotropia
100
symptoms of strabismus
diplopia, scotomas, amblyopia
101
strabismus tx
patch the normal eye
| corrective surgery
102
amblyopia
decreased visual acuity not correctable by refractory means, occurs if strabismus not treated by age 2
103
zoster keratitis tx
PO acyclovir
104
cataracts tx
sunglasses
no driving at night
surgery
105
open angle glaucoma tx
monitor IOP & visual fields
Latanoprost gtt (increase outflow)
Timolol gtt (decrease secretion)
trabeculoplasty/surgery
106
TED or Graves opthalmopathy tx
CON --> IV steroids +/- surgery (emergent)
| stable --> rituximab, selenium, treat thyroid
107
hypertensive retinopathy tx
treat HTN
laser therapy
intravitreal corticosteroid
intravitreal antiVEGF
108
diabetic retinopathy tx
treat DM
nonproliferative: intravitreal antiVEGF, corticosteroid implant
proliferative: pan retinal laser photocoagulation
109
seborrheic blepharitis tx
daily lid hygiene routine + artificial tears
110
bacterial blepharitis tx
topical erythromycin
111
demodex blepharitis tx
tea tree oil solution
| Ivermectin PO
112
dacrocystitis tx
nontender, no discharge: massage or irrigate
mild tenderness and discharge: warm compress and Augmentin PO
distension and erythema: I and D
113
dacroadenitis tx
first assume it is viral
warm compress and NSAIDs
If that fails, treat for bacterial w/ Keflex (Cephalosorin)
If that fails, refer for dx and treatment of fungal, protozoa, or inflammatory cause
114
chalazion tx
cosmetic - steroid injection (refer)
115
entropion and ectropion tx
surgical repair
116
chronic otitis media tx
cipro 10 drops then keep head tilted 20 minutes
| refer for surgical eval (cholesteatoma, perf repair) or PO amoxicillin
117
mastoiditis tx
IV ceftriaxone
118
mild otitis externa tx
acetic acid and hydrocortisone solution gtt
119
moderate to severe otitis externa tx
finafloxin gtt
120
fungal otitis externa
fluconazole PO
| consider immunodeficiency
121
malignant otitis externa tx
IV fluroquinolone
122
drug-induced hearing loss causes
```
aspirin
NSAIDs
aminoglycosides
loop diuretics
chemotherapeutic agents (cisplatin)
```
