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EENT Flashcards

1
Q

ectropion

A

eyelashes and lashes turned outwear- dryness, tearing irritaton

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2
Q

entropion

A

eyelid adn lashes turned inward- cornea abrasions from eyelashes. lubrication eye drops or surgery

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3
Q

dacrocystitis

A

mc. s. aureus

abx: clinda, vacnco plus ceftriaxone

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4
Q

blephritis

A

both eyelids
anterior: infectious or seborrheic
incfectious from staph aureus
posterior: mbemobian gland dysfucntion
red rimming, crusting, scaling of eyelid and eleash flaking
eyelid hygeine, regular massage/expression of meibomian gland

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5
Q

stye

A 
staph arues
near the lid margin
warm compress
i and d if not drained after 48 hours
erythro, bacitracin if active draining
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6
Q

chalazion

A

painless granuloma of the internal meibomian sebacious gland- nontender eyelid sweeling
eyelid hygeine, warm compresses

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7
Q

globe rupture

A

penetrating trauma, visual acuity decreased
enopthalmos- recession of globe in the robit
severe conjunctival hemorrhage
+seidel’s test: parting of flouresceine dye
teardrop or irreg shaped pupil, hyphema
rigid eye shield- dont remove impaled ojbect
hyphema: place at 45 degrees

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8
Q

blow out fractures

A

decreased visual acuity,
diplopia especially with upward gaszze- inferior rectus muscle entrapped
orbital emphysema
epistaxis
nasal decongestion, avoid blowing nose, abx- unasyn or clinda

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9
Q

macular degeneration

A

mc permanent legal blindness and visual loss- color vision and central vision gone
dry-drusen- small, round, yellow-white spots on the outer retina
NEOVASCULARIZATION- new abnormal vessels- WET
straight lines seem bent
amsler grid to monitor stability
bevacizumab- inhibits vascular endothelial growth - reduces neovasc
laser photocoag

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10
Q

Diabetic retinopathy

A

new, permanent loss- most common reason- 25-76
glycolyation of collage of blood veselss- capillary wall breakdown- microaneurysms
blot and dot hemorrhage, cotton wool spots, hardexudates!!- nonproliferative due to microaneurysms- not associated with vision loss- strict glucose control at this point

proliferative: neovasc- vitreus hemorrhage- use bvacizumab
maculopathy: central vision loss, macular edema or exudates- do laser

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11
Q

htn retinopathy

A

arterior narrowing- silver wiring is severing copper is moderative
av nicking
flame shaped hemorrhage, cotton wool spots
papilledema

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12
Q

retinal detach

A

retinal tear- detaches from the choroid plexus- myopia and cataracts at risk
flashing lights,floaters, curtain coming down in peripherary intially- loss of central visual field- no PAIN!
keep patient supine- don’t use miotic DROPS!

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13
Q

corneal abrasion or foreign body

A

contact lesne wearers- cipro
abx: topical erythro, polymixin/trimethoprim, cipro, sulfacetamide
rust ring- rotating burr
CHECK ACUITY FIRST

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14
Q

viral conjunctivitis

A

ADENOVIRUS!- same cause as acute bronchitis!
watery, punctate staining on slit lamp
supportive

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15
Q

allergic

A

cobble stone mucosa- chemosis (conjunctiva swelling)
olapatdine- topical h1 blockers!- antihistamine
pheniramine/naphazoline
topical corticosteroids

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16
Q

bacterial

A

most comon is S. arruesus, s. pneumo
erythro, fluroquinolines, sulfonamides, aminoglycosides
if chalmydia or gonorrea- admit for IV

2-5 day old- gonocooccal
day 5-7: chalmydai

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17
Q

chemical burns

A 
IMMEDIATE IRRIGATION!!!
alkali is worse than ACID
use lactated ringers or normal saline
ph and visual acuity after irrigation
irrigate until 7 to 7.3
ABX: moxi and CYCLOPLEGIC AGENTS- atropine drops
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18
Q

orbital cellulitis

A

usually SECONDARY to sinus infections- ETHMOID
proptosis, decreased vision, pain with ocular movement
high resoluation CT SCAN!!!- inection of the fat and ocular muscles
IV ABX : vanco, clinda, cotaxime, unasyn
amox if preseptal
preseptal: no changes in vision and no pain with ocular movemnt- eyelid and periocular tissue infected

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19
Q

strabismus

A

deviated inward - esotropia
exotropia- deviated outward

hirschberg corneal light reflex testing
cover and uncover test- to determin eangle of strabismus
patch therapy-
corrective surgery
treat before 2 years old- can’t be corrected after

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20
Q

ekratitis

A

MC- bacterial- psueodmonas!!
ciliary injection, corneal ulceration
hazy cornea- bacterial-
hsv - dendritic lesions- trifluradine, po acyclovir

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21
Q

uveitis

A

anterior: iris and ciliar body
posterior: choroid inflammation
HLA b027!!
infectious: cmv, toxoplasmosis, syphillis, TB
unilateral ocular pain , redeness, photophobia
consensual photophobia- ciliary infection, inflammatory cells and flare within the aqueous humor
anterior- topical corticosteroids- cycloplegics!
posterior- systeic cortciosteroids

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22
Q

cataract

A

lens opacification- agining- cigg smoking

blurred vision over month/years
TORCH- toxo, rubella, CMV, HSV, syphillis

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23
Q

retinoblastoma

A

absent red reflex- white pupil

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24
Q

papilledema

A

optic nerve disc swelling- increased intracranial pressure
HTN- pseudotumor cerebri, or lesion, severe HTN, cerebral edema
tx: DIURETICS AND ACETAZOLAMIDE- decreases production of queous humor and CSF

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25
optic neuritis
MC- MULTIPLE SCLEROSIS, ethmabutol!! demyelination of optic nerve loss of color vision, loss of vision in one side- central scotoma, visual fields defects, worse with eye momvement pain MARCUS GUNN PUPIL- affected eye seems to dilate in the flashlight swinging test- AFFERENT pupillary defect IV methylprednisolone with corticosteroids
26
argyll-robertson pupil
pupil constricts on accomodation but does not react to bright light!! neurosyphillis
27
optic nerve defect
total blindeness of same eye
28
optic chiasm defect
bitemporal heteronymous hemianopsia- sides can't see peripheral on both eyes
29
optic tract defect
other side homonymous hemianopsia | so if left optic tract gone---> right of both eye can't see
30
angle closure glaumcoma
optic nerve damage- increased iop decreased draining of aqueous humor via trabecular meshwork and canal of schelmm anticholienergics, or sympathomimetics make it worse uniltaeral ocular pain, nausea, vomiting, headache, peripheral vision loss steamy cornea mid dilated fixed nonreactive pupil- eye feels hard to palpation cupping of optic nerve ACETAZOLAMIDE- 1st line topical beta blockers- timolol reduces iop pressure miotics/cholinergics: pilocarpiene, carbachol - peripheral iridotomy def treatment
31
acute angle closure glaucoma
AVOID sympathomimetics and anticholinergics
32
chronic open angle glaucoma
bilateral peripheral vission loss- slow- cupping of optic discks LATANOPROST, timolol, acetazolamide (carbonic anhydrase inbhitiors) laser therapy - surgery
33
central retinal artery oclusion
ATHEROsclerotic disease- retial artery thrombus or embolus amaurosis fugax pale retina with cherry red macula , BOX CAR ACETAZOLAMIDEE!!- decreased pressure!!, revasc
34
central retinal vein occlusion
acute , sudden, monocular vision loss, EXTENSIVE retinal hemorrhage, blood and thunder appearnace no known effetive TX
35
otitis externa
swimmer's ear- pseudomonas mc auricular discharge, pressure, fullness, ear pain, pain on traction of ear canal/tragus cipro/dexamethasone- ofloxacin is safe for TM perforation!! keep ear dry aminoglycosdes- NOT USED IF TM perforation
36
malig otitis externa
osteomyleitis at skull base- 2ndry to pseudomonas- DM and immunocompromised IVantispeduo- piperacillin, fouroquinolones, aminoglyco
37
mastroiditsi
inadequate treated OTITIS MEDIA!! deep ear pain, mastoid tenderness IV ABX:- myringotomy CT SCAN
38
AOM
mc viral URI first comes s. pneumoa, h.influeza, moraxella cat, strep pyogenes- same as acute sinusitis- same as pneumonia ET dysfunction, young (et is narrower , shorter and more horizontal) otalgia, ear tugging in infants, fever, if tm perfor: rapid relief of pain WITH OTORRHEA!! bulging, erythematous tympanic emembrane with EFFUSION!! decreased tympanic membrane motility aBX: amoxcillin, cefixime in children if pcn allergic: erythro,
39
aom recurrent
myringotomy- surgical drainage
40
otitis media with effusion
OBSERVATION IN MOST CASES
41
chronic otitis media
pseudomonas, most likely reason, PERFORATED TM AND PERSISTENT OR RECURRENT PURULENT OTTORHEA CONDUCTIVE HEARING LOSS CHOLESTEATOMA CAN FORM topical ABX: OFLOXACIN , avoid moisture/water or aminoglycosides in the EAR WHENEVER THERE IS TM rupture
42
eustacian tube dysfunction
Eustacian tube swelling inhibits ET's autoinsufflation ability often follows VIRAL URI or allergic rhinitis ear fullness, poppin of ears, underwater feeling, fluctuating conductive hearing loss, tinnitus may see fluid behind TM if acute serous otitis media decongestants like pseudoephedrine , phenylephrine nasal spray, autoinsfflation- yawn, swallow, or corticosteroids ACute serous otitiscan become infected
43
barotraum
rapid pressure change- inability of Et to equalize pressure flight on airplane, scuba drivers 1. autoinsfflation, decongestants or antihistamines
44
TM perforation
can lead to cholesteatoma development
45
cholesteatoma
abnormal keratinized collection of squamous epithelium erodes ossicles over time- leads to conductive hearing loss PAINLESS OTORRHEA!!, conductive hearing loss!! weber lateralizes to the affected ear, bone conduction better than air in the affected ear
46
otosclerosis
bony overgrowht of the stapes bone- conductive hearing loss!!! stapedectomy with prothesis is the tx
47
foreign body in the ear
ear pain, drainage, conductive hearing loss
48
BPV
episodic vertigo, no hearing loss- changes with position displaced otoliths- mc cause of vertigo- changes with head position epley maneuver
49
menier's
episodic vertico and hearing loss idiopathic distention of the endlymphatic compartment of the inner ear by excess fluid diuretics as preventative AVOID salt, caffeine, chocolate, ETOH
50
vestibular neuritis:
inflammation of the vestibular portion of CN 8- after viral infection!! continuous vertigo , no hearing loss
51
labyrinthisi
cochlea is involved which allowes for hearing- continuous vertigo with hearing loss CORTICOSTEROIDS - TX!!- cuz it is due to inflmaation
52
peripheral vertigo
horizontal nystagmus- fatigable
53
central vertigo
brainstem or cerebellar- vertical nystagmus, nonfatiguable
54
vertigo tx
antihistamines- meclizine- anticholinergic properties dopamine blockers: metocopramide, prochlorperazine, iv promethazine- used to treate severe nasueavomiting anticholinergics: scopolamine- benzo
55
acoustic neruoma
benign tumor of the schwann cells which produce myelin sheath- cranial nerve 8!! unilateral senosrineural hearing loss iS AN acoustic neuroma until proven otherwise!! tinitus, headache, facial numbness!! MRI!
56
acute sinusitis
ACUTE otitis media caues- s.pneumo, h flu, gabhs, m.cat maxillary MC- worse with bending down and leaning forward, headache, purplent sputum or nasal discharge opacification with transillumination CT SCAN DOC amoxicillin doxy, bactrim- second line
57
chronic sinusitis
s. auresus MC!!!- wegener;s- more than 12 weeks of sinus symptoms
58
rhinitis
rhinovirus mc nasal pollyps allergic: pale/violaceous, boggy turbinates, nasal polyps viral: erythematous turbinates INTRANASAL CORTICOSTEROIDS IF ALLERGIC decongestant- can cause rhinits medicametosa- rebound congestion- such as oxymetazoline oral antihistamines- cetrizine, loratidine intranasal steroids- Most effective for allergic rhinitis
59
nasal polyps
intransal corticosteroids toc
60
epistaxis
kiesselbach's plexus mc- anterior posteriro- palatine artery!!bleeding in both narse and posterior pharynx direct pressure- 1st line- lean forward topical decongestants- phenylephrine, oxymetazoline cauterization- silver nitrate nasal pack
61
strep pharyngitis
tender anterior cervical lymphadenopathy, absense of cough, fever, exudates pen G or VK macrolides if pcn allergic make sure it doesn't become rhumeatic fever
62
peritonsilar absess
most common strep pyogenes, staph arues, polymicrobial (anaerobes) muffled hot patato voice- can't handle oral secretions- trismus, uvula devation to other side CT SCAN FIRST! ABX- aspiration or ID unasyn, clinda
63
oral hairy leukoplakia
lateral tongue borders or bucal murocas- painless whie plaque- epstein barr virus- hhp4- HIV, immunocomp patients
64
sialolithiasis
stones in mc in wharton's duct- subamndibular gland duct stensen's duct- partoid glad duct sialogogues is treatment
65
suppurative sialedinitis
s. aureus MC | tx: dicloxacillin or naficillin plus metro or clinda if severe
66
oral lichen plansu
lacy leukoplakia of the oral mucosa common (wickham striae)- increased in patients iwth HCV infectsion
67
acute herpetic gingivostomatisi
primary manifestation of hsv 1 in children- gingitivits, gum swell, friable/bleed bums acyclovir if severe
68
ludwig's angina
swellingand erythema of the upper neck chin with pus on the floor of the mouth CT SCAN unasyn, pen plus metro or clinda
69
osteomyletisi of the otitis externa
DM patients- tx is cipro- but needs to be IV- so admit
70
topical cyclosporin
D. Topical cyclosporine Cyclosporine (Restasis) is used to increase tear production in patients with chronic dry eyes. Ophthalmic antihistamines or antibiotics are not usually indicated in the treatment of dry eye.
71
dry eyes
Causes of dry eye is classified into two classes: 1) decreased tear production and increased evaporative loss. Both primary and secondary Sjogren’s result in decreased tear production. MGD is the most common cause of increased evaporative loss, where accessory lacrimal glands responsible for the lipid component of the tear film are dysfunctional.
72
hand foot disease mouth
coxsackie virus

PANRE (18 decks)

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