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PANCE > EENT 9% > Flashcards

EENT 9% Flashcards

1
Q

Inflammation of both eyelids =

Common in pts w/ ____.

A

Blepharitis

Common in Down’s syndrome, Eczema

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2
Q

Painful, warm, swollen red lump on eyelid

Tx:

A

Hordeolum (Stye)

Tx: Warm compresses +/- topica abx (Erythromycin, Bacitracin)
I+D if no drainage after 48 hrs

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3
Q

PainLESS granuloma of internal meibomian sebaceous gland

Presentation:

A

Chalazion

Hard, non-tender eyelid swelling

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4
Q

Infection of lacrimal gland =

MC cause:

Tx:

A

Dacrocystitis

MC: S. aureus, GABHS, S. epidermis, H. flu, S. pneumo

Tx: Clindamycin + 3rd gen cephalosporin

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5
Q

Fleshy, triangular-shaped GROWING fibrovascular mass =

A

Pterygium

Associated w/ increased UV exposure in sunny climates

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6
Q

Yellow, elevated nodule on nasal side of eye (fat and protein) =

A

Pinguecula

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7
Q

Orbital floor “blowout” fracture causes diplopia especially with ___ d/t ____.

Tx:

A

upward gaze
inferior rectus muscle entrapment

Tx: Initial –> nasal decongestants, avoid blowing nose, prednisone
Abx (Unasyn, Clindamycin)

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8
Q

Positive Seidel’s test seen in ___.

A

Globe rupture

= parting of fluorescein dye by clear stream of aqueous humor from anterior chamber

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9
Q

Drusen =

Seen in ___.

A

small, round yellow-white spots on outer retina

Dry (atrophic) macular degeneration

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10
Q

Dx of wet macular degeneration =

A

Flurescein angiography

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11
Q

Scotomas =
Metamorphopsia =
Micropsia =

Seen in ____

A 
Scotomas = blind spots, shadows
Metamorphopsia = straight lines appear bent
Micropsia = object seen by affected eye looks smaller than in unaffected eye

Macular degeneration

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12
Q

Amsler Grid used for ___

A

management of DRY macular degeneration to monitor stability at home

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13
Q

Tx of WET macular degeneration

A

Anti-angiogenics (Bevacizumab)

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14
Q

What can be used to slow progression of DRY macular degeneration?

A

Vit A, C, E, zinc

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15
Q

Presentation of Hypertensive Retinopathy based on stage

A

I: Arterial narrow –> Copper wiring (moderate), Silver-wiring (severe)
II: AV nicking
III: Flame shaped hemorrhages, cotton wool spots
IV: Papilledema = malignant HTN

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16
Q

patient’s pupils constrict less (therefore appearing to dilate) when a bright light is swung from the unaffected eye to the affected eye =

Positive in ___ (2)

A

Marcus Gunn

Positive in Papillitis, Retrobulbar neuritis

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17
Q

Photopsia =
Progression:

Seen in ___.

A

Flashing lights
–> floaters* –> unilateral vision loss/shadow “curtain” in peripheral –> central visual fields*
Retinal detachment

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18
Q

Positive Schaffer’s sign =

Seen in ___.

T/F: Normal or decreased intraocular pressure.

A

clumping of pigment cells in anterior vitreous

Retinal detachment

True.

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19
Q

T/F: Acidic burns is worse than alkali burns.

Tx:

A

False. Alkali burns are worse –> liquefactive necrosis

Tx: Immediate irrigation (Lactated Ringers, NS)
Broad spectrum abx (Moxifloxacin)

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20
Q

Infection of eyelid and periocular tissue =

T/F: Associated w/ visual changes and pain w/ ocular movement.

A

PRESEPTAL cellulitis

False: Associated w/ POSTseptal cellultis

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21
Q

Tx of Postseptal cellultis

A

Tx: IV Vancomycin, Clindamycin, Cefotaxime

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22
Q

Halo around lights, “steamy cornea”, mid-dilated nonreactive pupil, eye hard to palpation seen in ___.

A

Acute narrow-angle closure glaucoma

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23
Q

Dx of Acute narrow-angle closure glaucoma

Tx:

A

Increase IOP by Tonometry (>21 mmHg)
“Cupping” of optic nerve

Tx:
1st line: Acetazolamide IV
Topical beta blocker: does NOT affect visual acuity
Miotic/cholinergics: Pilocarpine, Carbachol

Definitive tx: Peripheral iridotomy

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24
Q

Slow progressive Bilateral peripheral vision loss =

Tx:

A

Chronic open angle glaucoma
“Tunnel vision”

1st line: Prostaglandin analogs (Latanoprost)
Timolol

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25
Q

Viral conjunctivitis MC caused by ___ pathogen

A

Adenovirus

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26
Q

Keratitis (A.k.a ____)
Bacterial presents w/ ____. Tx:
HSV presents w/ ____. Tx:

A

Corneal ulcer/inflammation

Bacterial: Hazy cornea
Tx: FQ (Moxifloxacin)

HSV: Dendritic lesions
Tx: Trifluridine, vidarabine, Acyclovir (ointment/PO)

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27
Q

MC etiology of Optic Neuritis

PE:

Tx:

A

Multiple Sclerosis

= inflammation of optic nerve CN II

PE: Marcus Gunn Pupil

Tx: IV methylprednisolone –> PO steroids

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28
Q

Anterior or posterior Uveitis?

Unilateral, ocular pain, redness, photophobia

A

Anterior

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29
Q

Anterior or posterior Uveitis?
Blurred/decreased vision
Floaters
NO pain

A

Posterior

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30
Q

Ciliary injection (limbic flush), consensual photophobia, inflammatory cells and flare seen in ____

Tx:

A

Uveitis

Anterior: topical steroids
Posterior: systemic corticosteroids

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31
Q

Pale retina w/ cherry-red macula (red spot)

Box car appearance of veins

A

Central Retinal ARTERY Occlusion

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32
Q

Blood and thunder appearance

Extensive retinal hemorrhages

A

Central retinal VEIN occlusion

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33
Q

____ artery commonly involved in Amaurosis Fugax

A

External carotid artery

34
Q

Tx of Otitis Externa

A
  • Ciprofloxacin/dexamethasone

- Neomcin/polytrim-B/hydrocortison (do NOT use if TM perforation if suspected)

35
Q

MC cause of acute otitis media

A

S. pneumo

36
Q

If bullae on TM, suspect ___ as cause of acute otitis media.

A

Mycoplasma

37
Q

Tx of Otitis Media

A

Drug of choice: Amoxicillin x 10-14 days

If PCN allergy: Erythromycin-Sulfisoxazole

38
Q

Tx of mastoiditis

A 
IV Abx (Ampicillin, Cefuroxime) w/ myringotomy
Refractory --> mastoidectomy
39
Q

UNIlateral hearing loss is ____ until proven otherwise.

A

Acoustic (vestibular) CN 8 Neuroma

40
Q

Epley Maneuver

A

Management of Benign Paroxysmal Positional Vertigo

= canalith repositioning

41
Q

Vestibular neuritis + hearing loss/tinnitus =

Tx:

A

Labyrinthitis

Tx: corticosteroids

42
Q

(Vertical/horizontal) nystagmus seen in central vertigo.

A

Vertical

43
Q

(Vertical/horizontal) nystagmus seen in pheripheral vertigo.

A

Horizontal

44
Q

Weber lateralizes to (normal/affected) ear in sensorineural loss.

A

Normal

SensoriNeural lateralizes to Normal ear + Normal Rhinne

45
Q

Weber lateralizes to (normal/affected) ear in conductive loss.

A

Affected

46
Q

Rinne test has AC ( > or < ) BC in normal hearing.

A

AC > BC

47
Q

Rinne test has AC ( > or < ) BC in sensorineural loss.

A

NORMAL: AC > BC

48
Q

Rinne test has AC ( > or < ) BC in conductive loss.

A

AC < BC

49
Q

X ray view to dx acute sinusitis

A

Water’s view

CT scan = diagnostic test of choice

50
Q

Tx of acute sinusitis

A

Amoxicillin x 10-14 days**
Doxycyline
Bactrim

51
Q

Mucormycosis

Tx:

A

Fungi that invades sinuses that may enter CNS
Immunocompromised pts
Affects orbits, sinuses, lungs, CNS

Tx: Amphotericin B, Posaconazole

52
Q

____ associated w/ nasal polyps worse in AM

A

ALLERGIC Rhinitis

53
Q

MC type of Rhinitis

MC infectious cause of rhinitis

A

MC type: Allergic = IgE mediated mast cell histamine release

Rhinovirus

54
Q

Intranasal decongestants used > 3-5 days may cause ____

A

Rhinitis medicamentosa = rebound congestion

55
Q

Sialolithiasis: Salivary stones MC in ___.

A

Wharton’s duct (submandibular)

Stenson’s duct = parotid glands

56
Q

Oral lichen planus has increased incidence in pts/ with ___

A

HCV

57
Q

Lacy leukoplakia lesions of oral mucosa

A

Oral lichen plancus

58
Q

White patchy lesion that canNOT be rubbed off

A

Oral leukoplaia

59
Q

T/F: 90% of oral leukoplakia are precancerous for dysplastic or evident of adenocarcinoma.

A

False. 90% of erythroplakia precancerous for SQUAMOUS CELL carcinoma

6% of oral keukoplakia are precancerous for squamous cell carcinoma

60
Q

Oral hairy leukoplakia is caused by ____.
MC in pts with ____.
T/F: Can be scrapped off.

A

Epstein Barr Virus
HIV/immunocompromised
False. Can NOT be scrapped off

61
Q

T/F: Oral candidiasis can be scraped off but leaves behind erythema/bleeds.

A

True

62
Q

Tx of RECURRENT aphthous ulcers.

A

Cimetidine

63
Q

Tx of peritonsillar abscess

A

Drainage + Abx (Unasyn or Clindamycin)

64
Q

Tx of epiglottitis

A

IV Ceftriaxone +/- clindamycin

Rifampin for prophylaxis

65
Q

Primary manifestation of HSV-1 in children

A

Acute herpetic gingivostomatitis

6 mo-5 y/o

66
Q

Primary manifestation of HSV-1 in adults

A

Acute herpetic pharyngotonsillitis

67
Q

Cellulitis of sublingual and sumaxillary spaces in the neck =

Presentation:

Tx:

A

Ludwig’s angina

Swelling and erythema of upper neck and chin w/ pus on floor of mouth.

PCN + Metronidazole
Clindamycin
Ampicillin/Sulbactam (Unasyn)

68
Q

Ramsay-Hunt Syndrome =

Caused by:

Tx:

A

Herpes zoster oticus = acute facial palsy + otalgia and varicella or vesicular-type lesions.
Lesions on pinna**
Facial paralysis

Herpes varicella virus

Oral steroids, antiviral, pain medication

69
Q

Hutchinson’s sign =

Suggestive of ____

A

Involvement of tip of nose w/ herpes virus

Involvemnt of cornea w/ herpes –> urgent ophtho referral

70
Q

Tensilon test (A.K.A. ___) used to dx ___

A

edrophonium testing

Myasthenia gravis (MG)

71
Q

Permanent decrease in visual acuity in child caused by abnormal visual exposure during maturation process =

A

Amblyopia

72
Q

Hutchinson’s incisors (notching of incisors) can be caused by ____.

A

congenital syphilis

73
Q

“Tree branch” pattern on fluorescein stain

A

Herpetic infection of cornea = Herpetic keratitis

74
Q

Otosclerosis causes (conductive/sensorineural) hearing loss

A

Conductive

Familial condition
Bones of middle ear soften and then harden at joints

75
Q

Presbycusis causes (conductive/sensorineural) hearing loss

A

Senorineural

= age related hearing loss

76
Q

T/F: Myringosclerosis causes conductive hearing loss.

A

False. Scarring of TM does NOT cause hearing loss

77
Q

CN3 palsy is frequently associated with ____

A

unruptured cranial aneurysm

Ptosis, dilated pupils, lateral deviation of eye, double vision

78
Q

Painful gingivitis and stomatitis d/t spirochetal and fusiform bacterial infection

A

Vincent’s angina

79
Q

Enlargement skull compresses ____ in Paget’s disease.

A

auditory nerve (CN8) –> neural deafness

80
Q

Medications that may worsen psoriasis

A

BB
Anti-malarials
Lithium

81
Q

Condyloma lata is caused by

A

Treponema pallidum

=fused, weeping papules in perineum

PANCE (20 decks)

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