EENT Flashcards
1
Q
ability to fixate starts when
A
6 weeks
2
Q
color perception develops when
A
2 months
3
Q
binocular vision with convergence ability starts when
A
3 months
4
Q
preference for patterns/faces starts when
A
4 months
5
Q
visual acuity of newborn
A
20/200
6
Q
optokinetic nystagmus
A
ability to see a moving target, follow it, and return to original gaze. develops in first few months of life
7
Q
pendular nystagmus is a sign of
A
multiple sclerosis or spinocerebellar disease
8
Q
spasmus nutans
A
benign transient disorder with pendular nystagmus, intermittent head tilt and nodding/head bobbing
9
Q
loss of visual acuity due to active cortical suppression of the vision of one eye
A
ambylopia
10
Q
inward turning of eye
A
esotropia (form of strabismus)
11
Q
outward turning of eye
A
exotropia (form of strabismus)
12
Q
hyperopia
A
mild far sightedness (normal in 3 yr old)
13
Q
Hirschberg test
A
corneal light reflex
14
Q
deviation of alignment of one eye in relation to the other that worsens when focusing
A
strabismus
15
Q
untreated strabismus results in ___ by age ___
A
ambylopia by 6 years
16
Q
cover test
A
eye with strabismus deviates instead of fixating on object
17
Q
accommodative esotropia on cover test
A
uncovered eye moves outwards
18
Q
accusative exotropia on cover test
A
uncovered eye moves inward
19
Q
storage weber at increased risk for
A
glaucoma
20
Q
presentation of congenital glaucoma
A
tearing, photophobia, blepharospasm, corneal clouding, edema, progressive enlargement of the eye
21
Q
important associations with cataracts
A
CMV, rubella and galactosemia
22
Q
external hordeolum aka
A
stye
23
Q
external hordeolum treatment
A
warm compresses and topical antibiotics, possible I&D but never oral abx
24
Q
lipogranuloma within the eyelid
A
chalazion
25
cause of chalazion
chronic inflammation due to retention of secretions, usually painless, not an infection
26
chalazion vs stye
chalazion is painless and not an infection, requires surgical excision
27
nasolacrimal duct obstruction treatment
massage BID/TID. topical antibiotic if infected. ophthalmology if still there at 1 year
28
chlamydial conjunctivitis must have
bilateral eye discharge
29
most common cause of orbital cellulitis
staph aureus
30
buzzwords for orbital cellulitis rather than preseptal
compromised vision, proptosis, decreased extra ocular movements, pain exacerbated by eye movement
31
orbital cellulitis treatment
CT scan to determine extent and c/s ophthalmology, admit for IV abx
32
treatment for corneal abrasion
fluorescein stain the eye first, then topical antibiotic
33
photophobia, tearing, intermittent sharp pain, irregular red reflex, dulled corneal light reflex
corneal abrasion
34
retinitis pigments fundoycopic view
optic disc w/ central pallor, narrow arterioles coming off of the optic disc, retinal pigment deposition on the periphery
35
flame shaped hemorrhages
retinal hemorrhage (NAT)
36
who gets screened for ROP
weight <1500 grams, GA <32 weeks or weight <2000 grams w/ unstable clinical course
37
when to screen for ROP
31-34 weeks post conceptions or 4 to 6 weeks after birth (whichever is later)
38
greatest risk factor for ROP
prematurity due to incomplete retinal vascularization
39
ophthalmia neonatorum
conjunctivitis in the first 4 weeks after birth
40
watery discharge 5 to 14 days after birth that becomes mucopurulent
chlamydia conjunctivitis
41
chlamydia conjunctivitis treatment
oral erythromycin x14 days (likely has co-infection so needs systemic treatment)
42
hyper acute hyper purulent conjunctivitis 24 to 48 hours after birth
N. gonorrheae neonatal conjunctivitis
43
N. gonorrhea conjunctivitis treatment
IV ceftriaxone and frequent saline lavage
44
diffuse uptake of fluorescein stain
G- infection or ulceration of corneal epithelium 2/2 contacts
45
most common cause of viral conjunctivitis
adenovirus
46
viral conjunctivitis treatment
artificial tears and cool compresses
47
non-purulent bilateral conjunctivitis with perilimbal sparing
kawasaki disease
48
collection of blood between cornea and iris (anterior chamber)
hyphema
49
hyphema treatment
bed rest and elevate head 30 degrees to decrease intraocular pressure with eye shield in place
50
blowout fracture
fracture to orbital wall or floor
51
double vision when looking to one side of dysconjugate gaze to one side
blowout fracture
52
curtain like visual deficit
detached retina
53
most common cause of conductive hearing loss
effusion/otitis media
54
keratinization of the epithelial cells in the middle ear resulting in conductive hearing loss
cholesteatoma
55
foul smelling discharge despite treatment of perforated TM
cholesteatoma
56
malfunction of the cochlea and/or auditory nerve
sensorineural hearing loss
57
sudden onset of bilateral sensorineural deafness
viral labyrinthitis
58
temporary hearing loss can be caused by what meds
furosemide (lasix) and ethacrynic acid - loop diuretics
59
reversible ototoxicity with high pitched tinnitus
salicylates
60
most common cause of congenital sensorineural hearing loss
congenital CMV
61
infectious causes of sensorineural hearing loss
CMV, measles, mumps, rubella, varicella, syphilis
62
antibiotics that cause sensorineural hearing loss
aminoglycosides (gentamicin, tobramycin)
63
most common acquired cause of sensorineural hearing loss
bacterial meningitis (usually occurs within the first 24 hours)
64
bilateral sensorineural hearing loss and hematuria in a boy
Alport syndrome
65
low amplitude/flat tympanogram
stiff membrane, middle ear fluid present or obstructed PE tube
66
area under the tympanogram curve reflects
area in the external ear canal
67
Type B tympanogram
high volume = perforated TM = continuity between middle and outer ear
68
most common causes of AOM
strep pneumo, non typeable H. flu, moraxella catarrhalis, grp A strep
69
conjunctivitis otitis syndrome
H. flu, treat w/ augmentin
70
most common cause of chronic suppurative otitis media
pseudomonas
71
chronic suppurative otitis media treatment
topical/otic ofloxacin with daily canal suctioning
72
AOM treatment w/ penicillin allergy
azithromycin or clarithromcyin
73
things associated with recurrent AOM
age <2 years, bottle propping, daycare
74
bloody discharge and erythematous mass after PE tube placement
tympanovstomy tube granuloma
75
otitis externa most common cause
pseudomonas
76
otitis externa treatment
antibiotic/steroid drops
77
otitis externa prevention
boric acid or acetic acid solution before and after swimming
78
outwardly displaced pinna
mastoiditis
79
mastoiditis diagnosis
CT and tympanocentesis with culture
80
mastoiditis treatment
IV antibiotics and surgery
81
acute onset of self-limited vertigo without vomiting or LOC, with nystagmus and pallor
benign paroxysmal vertigo
82
acute onset of vertigo with hearing loss
labyrinthitis
83
cyanosis with feeds that resolves with crying
choanal atresia
84
nasal polyps are associated with
CF ( order sweat test if present)
85
maxillary sinus develops when
at birth
86
ethmoid sinus develops when
at birth
87
sphenoid sinus develops when
5 to 6 years
88
frontal sinus develops when
5 to 6 years
89
ethmoid sinusitis can result in
orbital cellulitis
90
frontal sinusitis can result in
brain abscess
91
next step with epistaxis that is worsening in frequency and severity
CT scan to look for posterior nasopharyngeal mass such as nasopharyngeal angiofibroma
92
incubation period for mono
2 to 7 weeks
93
testing for mono if <4 years
viral specific IgM (mono spot is not sensitive if <4 yrs)
94
teen with sore throat and erythematous patches on exam
gonococcal pharyngitis
95
dysphagia, difficulty opening mouth, unilateral swelling of tonsil and deviation of uvula
peritonsillar abscess
96
peritonsillar abscess treatment
unasyn, clindamycin or augmentin plus I&D
97
diagnosis of peritonsillar abscess
CT
98
hyperextended neck, high fever, difficulty swallowing, drooling
retropharyngeal abscess
99
lateral neck film w/ widening of paravertebral soft tissues
retropharyngeal abscess
100
epiglottis vs RPA
```
epiglottitis = lean forward for comfort
RPA = hyperextend for comfort
```
101
RPA treatment
clindamycin or unasyn
102
RPA vs peritonsillar age
RPA more common in <4 yrs
103
grayish/white coagulum surrounded by a thin rim of bright erythema
aphthous ulcers
104
infant with tender red deep-seated plaques/nodules on cheek but afebrile
cold induced panniculitis
105
what is normal for delayed tooth eruption
up to 16 months
106
common causes of delayed tooth eruption
```
Hypothyroid
Hypopituitary
Hypoplasia (ectodermal)
Hypohidrosis
Rickets
```
107
how to transport avulsed tooth
saliva or chilled milk
108
treatment for dental abscess
penicillin (clindamycin or erythromycin if allergic)
109
clefts are most common in what population
Native Americans and asians
110
cleft lip is more common in what gender
males
111
when to repair cleft lip
10 weeks
112
cleft palate is more common in what gender
females
113
when to repair cleft palate
9 to 12 months
114
syndromes associated with clefts
Pierre robin, crouton, apart, treacher collins
115
gold standard for diagnosing OSA
polysomnography
116
EKG in sever OSA
RVH
117
postop complication of T&A after severe OSA
pulmonary edema
118
inspiratory vs expiratory stridor
inspiratory is extrathoracic
119
most common cause of congenital stridor
laryngomalacia
120
stridor that worsens when supine and agitated but improves with expiration
laryngomalacia
121
blunted inspiratory loop on spirometry
vocal cord paralysis
122
injury to recurrent laryngeal nerve
vocal cord paralysis
123
high pitched inspiratory stridor
vocal cord paralysis
124
wet, variably pitched inspiratory stridor
laryngomalacia
125
progressive hoarseness that is less severe in the morning
vocal cord nodules
126
feeding difficulties and expiratory stridor
vascular ring
127
thumb sign on lateral neck film
epiglottitis
128
rapid deterioration in a patient diagnosed with croup
bacterial tracheitis
129
neck film with ragged air column or subglottic narrowing
bacterial tracheitis
130
preauricular adenopathy and conjunctivitis
adenovirus
131
viral vs bacterial cervical LAD
```
unilateral = bacterial (staph, grp A strep_
viral = bilateral
```
132
atypical mycobacterium LAD treatment
leave it alone
133
nontender, firm, fixed mass
neoplasm
134
midline lesion on anterior neck
thyroglossal duct cyst (moves vertically with swallowing or sticking tongue out)
135
mass of dilated lymph vessels
cystic hygroma
136
most common cause of bacterial parotitis
staph aureus
137
recurrent swelling of both parotid glands
salivary gland stone
138
must think of what with parotitis
HIV
139
are low birthweight newborn far or near sighted
near sighted
140
most common cause of visual loss in children
ambylopia
141
what structure is the origin of bleeding in most cases of epistaxis
kiesselbach plexus
142
first line antibiotic for acute sinusitis
amoxicillin
