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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
Viral conjunctivitis MC caused by ___ pathogen
Adenovirus
26
Keratitis (A.k.a ____) Bacterial presents w/ ____. Tx: HSV presents w/ ____. Tx:
Corneal ulcer/inflammation Bacterial: Hazy cornea Tx: FQ (Moxifloxacin) HSV: Dendritic lesions Tx: Trifluridine, vidarabine, Acyclovir (ointment/PO)
27
MC etiology of Optic Neuritis PE: Tx:
Multiple Sclerosis = inflammation of optic nerve CN II PE: Marcus Gunn Pupil Tx: IV methylprednisolone --> PO steroids
28
Anterior or posterior Uveitis? | Unilateral, ocular pain, redness, photophobia
Anterior
29
Anterior or posterior Uveitis? Blurred/decreased vision Floaters NO pain
Posterior
30
Ciliary injection (limbic flush), consensual photophobia, inflammatory cells and flare seen in ____ Tx:
Uveitis Anterior: topical steroids Posterior: systemic corticosteroids
31
Pale retina w/ cherry-red macula (red spot) | Box car appearance of veins
Central Retinal ARTERY Occlusion
32
Blood and thunder appearance | Extensive retinal hemorrhages
Central retinal VEIN occlusion
33
____ artery commonly involved in Amaurosis Fugax
External carotid artery
34
Tx of Otitis Externa
- Ciprofloxacin/dexamethasone | - Neomcin/polytrim-B/hydrocortison (do NOT use if TM perforation if suspected)
35
MC cause of acute otitis media
S. pneumo
36
If bullae on TM, suspect ___ as cause of acute otitis media.
Mycoplasma
37
Tx of Otitis Media
Drug of choice: Amoxicillin x 10-14 days | If PCN allergy: Erythromycin-Sulfisoxazole
38
Tx of mastoiditis
``` IV Abx (Ampicillin, Cefuroxime) w/ myringotomy Refractory --> mastoidectomy ```
39
UNIlateral hearing loss is ____ until proven otherwise.
Acoustic (vestibular) CN 8 Neuroma
40
Epley Maneuver
Management of Benign Paroxysmal Positional Vertigo = canalith repositioning
41
Vestibular neuritis + hearing loss/tinnitus = Tx:
Labyrinthitis Tx: corticosteroids
42
(Vertical/horizontal) nystagmus seen in central vertigo.
Vertical
43
(Vertical/horizontal) nystagmus seen in pheripheral vertigo.
Horizontal
44
Weber lateralizes to (normal/affected) ear in sensorineural loss.
Normal SensoriNeural lateralizes to Normal ear + Normal Rhinne
45
Weber lateralizes to (normal/affected) ear in conductive loss.
Affected
46
Rinne test has AC ( > or < ) BC in normal hearing.
AC > BC
47
Rinne test has AC ( > or < ) BC in sensorineural loss.
NORMAL: AC > BC
48
Rinne test has AC ( > or < ) BC in conductive loss.
AC < BC
49
X ray view to dx acute sinusitis
Water's view CT scan = diagnostic test of choice
50
Tx of acute sinusitis
Amoxicillin x 10-14 days** Doxycyline Bactrim
51
Mucormycosis Tx:
Fungi that invades sinuses that may enter CNS Immunocompromised pts Affects orbits, sinuses, lungs, CNS Tx: Amphotericin B, Posaconazole
52
____ associated w/ nasal polyps worse in AM
ALLERGIC Rhinitis
53
MC type of Rhinitis MC infectious cause of rhinitis
MC type: Allergic = IgE mediated mast cell histamine release Rhinovirus
54
Intranasal decongestants used > 3-5 days may cause ____
Rhinitis medicamentosa = rebound congestion
55
Sialolithiasis: Salivary stones MC in ___.
Wharton's duct (submandibular) Stenson's duct = parotid glands
56
Oral lichen planus has increased incidence in pts/ with ___
HCV
57
Lacy leukoplakia lesions of oral mucosa
Oral lichen plancus
58
White patchy lesion that canNOT be rubbed off
Oral leukoplaia
59
T/F: 90% of oral leukoplakia are precancerous for dysplastic or evident of adenocarcinoma.
False. 90% of erythroplakia precancerous for SQUAMOUS CELL carcinoma 6% of oral keukoplakia are precancerous for squamous cell carcinoma
60
Oral hairy leukoplakia is caused by ____. MC in pts with ____. T/F: Can be scrapped off.
Epstein Barr Virus HIV/immunocompromised False. Can NOT be scrapped off
61
T/F: Oral candidiasis can be scraped off but leaves behind erythema/bleeds.
True
62
Tx of RECURRENT aphthous ulcers.
Cimetidine
63
Tx of peritonsillar abscess
Drainage + Abx (Unasyn or Clindamycin)
64
Tx of epiglottitis
IV Ceftriaxone +/- clindamycin Rifampin for prophylaxis
65
Primary manifestation of HSV-1 in children
Acute herpetic gingivostomatitis | 6 mo-5 y/o
66
Primary manifestation of HSV-1 in adults
Acute herpetic pharyngotonsillitis
67
Cellulitis of sublingual and sumaxillary spaces in the neck = Presentation: Tx:
Ludwig's angina Swelling and erythema of upper neck and chin w/ pus on floor of mouth. PCN + Metronidazole Clindamycin Ampicillin/Sulbactam (Unasyn)
68
Ramsay-Hunt Syndrome = Caused by: Tx:
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
Hutchinson's sign = Suggestive of ____
Involvement of tip of nose w/ herpes virus Involvemnt of cornea w/ herpes --> urgent ophtho referral
70
Tensilon test (A.K.A. ___) used to dx ___
edrophonium testing Myasthenia gravis (MG)
71
Permanent decrease in visual acuity in child caused by abnormal visual exposure during maturation process =
Amblyopia
72
Hutchinson's incisors (notching of incisors) can be caused by ____.
congenital syphilis
73
"Tree branch" pattern on fluorescein stain
Herpetic infection of cornea = Herpetic keratitis
74
Otosclerosis causes (conductive/sensorineural) hearing loss
Conductive Familial condition Bones of middle ear soften and then harden at joints
75
Presbycusis causes (conductive/sensorineural) hearing loss
Senorineural = age related hearing loss
76
T/F: Myringosclerosis causes conductive hearing loss.
False. Scarring of TM does NOT cause hearing loss
77
CN3 palsy is frequently associated with ____
unruptured cranial aneurysm Ptosis, dilated pupils, lateral deviation of eye, double vision
78
Painful gingivitis and stomatitis d/t spirochetal and fusiform bacterial infection
Vincent's angina
79
Enlargement skull compresses ____ in Paget's disease.
auditory nerve (CN8) --> neural deafness
80
Medications that may worsen psoriasis
BB Anti-malarials Lithium
81
Condyloma lata is caused by
Treponema pallidum =fused, weeping papules in perineum

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