Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

EENT and Upper Respiratory Disorders > EENT and Upper Respiratory Disorders > Flashcards

EENT and Upper Respiratory Disorders Flashcards

1
Q

In a normal eye, what is the cup to disk ratio?

A

Cup should not be more than 1/2 the size of the disc diameter

If larger - ? glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the normal A/V ratio?

A

Arteries are brighter red and more narrow than veins

2:3 or 4:5

AV nicking - ? HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where is the macula located?

A

Centered, 2-2.5 disc diameters temporal to optic disc and is avascular

Fovea Centralis - Looks slightly darker and lies in the center of the macular region

Macular Degeneration - deterioration of central portion of vision - Leading cause of blindness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

If you are having difficulty visualizing the macula on your opthalmic exam, what should you instruct the patient to do?

A

Look into the light of the opthalmoscope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Define hyperopia

A

farsightedness

Increased in Gero’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Define myopia

A

Nearsightedness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is presbyopia?

A

difficulty focusing up close… common after age 40 due to weakening of ciliary muscles and less flexible lens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the primary pathogen implicated in Hordeolum?

A

Staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Differentiate between hordeolum, chalazion, and blepharitis

A

Hordeolum: stye and is painful. refer if not better with warm compresses in 2 days.
Chalazion: beady painless nodule. May cause light sensitivity and increased tearing. Refer for I&D if no improvement with warm compresses.
Blepharitis: inflammation of eyelash base, red, scaly, greasy flakes requiring hot compresses and thorough lid scrubbing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If using topical products for hordeolum or blepharitis, what do you use?

A

bacitracin or erythromycin ointment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What symptoms would you expect to see in bacterial conjunctivitis and how would you treat it?

A

You would expect to see purulent drainage among the other expected symptoms of itching, burning, redness, tearing, swelling of eyelids, and sensation of foreign body in the eye.

Painless

It is self-limiting, but you could treat with a antibiotic drops… levofloxacin, ofloxacin, ciprofloxacin, tobramycin, gentamycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What would you expect to see if chlamydial or gonoccocal conjunctivitis?

A

Very copius, purulent drainage.
Treat Gonorrhea with Ceftriaxone 250mg IM
Treat chlamydia with erythromycin opthalmic ointment or oral tetracycline, erythromycin, clarithromycin, azithromycin, doxycyline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What would you expect to see in allergic conjunctivitis?

A

Stringy discharge with increased tearing

Treat with oral antihistamines.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What would you expect to see if viral conjunctivitis?

A

Watery discharge… symptomatic care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When is screening with tonometry recommended and what does it screen for?

A

It is recommended by age 40. Used to screen for glaucoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is Open-Angle Glaucoma?

How is it treated?

A

Open-angle: chronic, often asymptomatic, cupping of disc, constriction of visual fields - tunnel vision secondary to peripheral vision loss.

Managed with drops:
alpha2 adrenergic agonists - brimonidine, alphagan
beta-adrenergic - timolol
miotic agents - pilocarpine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

If a patient tells you they are seeing halos around light, what are your top 3 differential diagnoses?

A

Cataracts
Closed-angle glaucoma
Digoxin toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are some causes of cataracts?

A 
Aging
Heredity 
Trauma
Toxins such as drugs, smoking, and alcohol
Diabetes
AV sunlight exposure - tanning beds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are some signs/symptoms of cataracts?

A 
Painless
Clouded, blurred or dim vision
Halos around lights
Difficulty with night vision
Sensitivity to light/glare
Fading/yellowing of colors
Diplopia - double vision in a single eye
Need or brighter light
No red reflex
Opacity of the lens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If you diagnose cataracts, what are your next steps?

A

Have patient change glasses as cataract develops

Refer to opthalmology

Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is retinal detachment?

A

It is the separation of the light-sensitive membrane in the back of the eye from it’s supporting layers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are signs/symptoms of retinal detachment?

A

Flashes of light (photopsia) especially in peripheral fields
Floaters
Blurred vision
Shadow or blindness in part of the visual field of one eye.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is otitis externa?

What is the primary pathogen indicated in otitis externa?

A

Inflammation and/or infection of the external auditory canal (and/or auricle & TM).

Tyes:
Acute localized (furunculosis)
Acute diffuse bacterial (swimmer’s ear)
Others… chronic, fungal, eczema

Staph aureus causes furuncles and pustules in the outer third of the ear canal that cause severe pain (otalgia) with area of cellulitis, itching, erythema, scaling, fissures, crusting, possible exudate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How is OE managed?

A

Cleansing and debridement of the ear
Topical otic drops (cortisporin otic)
Analgesics (NSAIDs, topical corticosteroids)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

In order of commonality, what bacteria are the most common in acute OM/serous OM?

A

1 Step pneumoniae (40-50%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are signs/symptoms of acute OM/serous OM?

A

Otalgia (slight-to-severe) spreading to temporal region
Otorrhea
Vertigo
Nystagmus
Tinnitus
Fever
Lethargy
N/V
Anorexia
Local inflammation - erythema with diminished light
reflex, fluid in middle ear
Exudative phase - middle ear serous exudate
Suppurative phase (serous) - Purulent exudate, retraction
and poor mobility of the TM, membrane becomes
bulging and convex, membrane may rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the treatment of acute OM/serous OM?

A

Viral - Most uncomplicated cases resolve spontaneously or with hydration, avoidance of irritants, use of topical or oral decongestants and cool mist humidifiers

Antibiotic for suspected bacterial infections only -
Amoxicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What causes cholesteatoma?

A

Chronic otitis media consisting of peeling layers of scaly or keratinized epithelium… if untreated, may erode the middle ear and lead to deafness and nerve damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are some signs/symptoms of cholesteatoma?

A

*Squamous epithelium lined sac, filled with desquamated
keratin
*Chronic infection
*Painless otorrhea, either unremitting or frequently
recurrent
*Hearing loss (ossicular damage)
*Canal filled with mucopus and granulation tissue
*TM perforation in 90% of cases

Surgery - Referral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the most common type of vertigo?

A

Benign paroxysmal positional vertigo (BPPV)

Sensation of motion either of the person or the environment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are common causes of BPPV?

A 
Brain tumors
Medications
OM or labrynthitis
Meniere's disease
Acoustic neuroma
Head trauma
Neck injury 
Migraines
Cerebellar hemorrhage
32
Q

Vertigo S/S

A 
Sensation or disorientation or motion
Positive Dix-Hallpike
N/V
Sweating
Nystagmus
Hearing loss
Tinnitus
Visual disturbance
Weakness/difficulty walking
Difficulty speaking
Decreased level of consciousness
33
Q

How many decibels do you need to have lost in order to have definitive hearing loss.

A

20 dB or more

34
Q

What is the Weber test? Interpret it.

A

It is a tuning fork test that lateralizes to affected ear in conductive hearing loss and unaffected ear in sensorineural hearing loss.

*Normal finding - it does not lateralize

35
Q

What is the Rinne test? Interpret it.

A

It is a tuning fork test that measures air and bone conduction. A normal finding is AC>BC.

In conductive hearing loss, BC>AC in the affected ear.

In sensorineural hearing loss, normal in the affected ear.

36
Q

In addition to a otoscopic exam if hearing loss is suspected, what other tests would you perform?

A

General neurological exam, cranial nerve testing
Audiometry testing
CT scan if neurologic condition is suspected
Serum blood tests as needed

37
Q

You diagnoses a patient with viral rhinitis (otherwise known as the common cold). How long do you tell him you expect it to last? And how do you advise him to manage it?

A

5-10 days.

Warm salt water gargles. Hydration. Tylenol/Motrin for sore throat or fever= supportive care.

38
Q

What is the FLEA criteria and what does it mean?

A 
Centor Criteria - suggestive of Group A strep
F= Fever
L= Lack of cough
E= Exudate 
A= Anterior cervical adenopathy

If 1 or more of these are present, it is a good indicator the patient has strep throat and a strep test should be performed.

39
Q

If your patient has a positive strep test, which antibiotic do you prescribe. What if allergies?

A

PCN V. If allergic, erythromycin.

40
Q

What is the primary pathogen implicated in strep throat?

A

group A beta hemolytic streptococcus

41
Q

What is an example of a neuraminidase inhibitor?

How does it work?

A

Oseltamivir (Tamiflu). Shortens flu-symptoms by 2 days.

42
Q

What is the incubation period for mono?

A

1-2 months

43
Q

What are two symptoms that distinguish mono from strep?

A

Splenomegaly and posterior cervical adenopathy… AND they cannot play contact sports for 3 weeks to several months.

44
Q

What pathogens are implicated in sinusitis if bacterial? What makes you think it may be bacterial vs viral?
How would you treat?

A

Most likely bacterial if fever and purulent nasal drainage present

Strep pneumoniae
H. influenzae

Treat with Amox/Clav or Clarithromycin

45
Q

Ophthalmoscope

A

My R hand, my R eye, patient’s R eye

Start wheel at 0

Start 12” from pt with both eyes open

After obtaining red reflex, exam should proceed from optic disk and end with fovea

46
Q

Optic Disc

A

Doughnut-shaped with orange/pink neuroretinal rim with a central white depression (cup)

47
Q

Snellen 20/20

A

Patient can see what a normal person can see at 20’

The larger the denominator, the poorer the patient’s vision

20/30 - pt can see at 20’ what a normal person can see at 30’ - Needs referral

48
Q

Arcus Senilis

A

Cloudy appearance of the cornea with a gray/white/bluish arc or circle around the limbus due to deposition of lipid material - hyperlipidemia

Has no effect on vision

Permanent and Benign

49
Q

What is pterygium?

A

Raised, wedge-shaped growth of thin, noncancerous tissue over the conjuntiva

Conjuncitva is clear

50
Q

What is a hordeolum?

A

Stye
It HURTS
Staph

Acute inflammatory, most commonly infectious process affecting the eyelid, usually caused by staph aureus

51
Q

S/S of hordeolum

A

Abrupt onset
Pain
Erythema of eyelid
Localized, tender mass

52
Q

Hordeolum treatment

A

Warm compresses, try to bring to a head

Topical bacitracin or erythromycin ointment

Refer if not resolved in 2 days

53
Q

What is a chelazion?

A

Nodule on eyelid
Infection or retention cyst of meibomian gland, usually on the upper eyelid

Painless apart from tenderness secondary to localized swelling.

54
Q

S/S of chelazion

A 
**Painless**
Nodule on eyelid
Swelling
Tenderness
Sensitivity to light
Increased tearing
May cause astigmatism if very large
55
Q

Chelazion Treatment/Management

A

Warm compresses

Referral for surgical removal

56
Q

What is blepharitis?

A

Staphylococcus infection or Seborrheic dermatitis of eyelid

57
Q

S/S of blepharitis

A

Red, scaly, greasy flakes, thickened, crusted lid
Burning
Itching
Tearing

58
Q

Blepharitis treatment/management

A

Hot compresses, topical antibiotics
bacitracin or erythromycin

Vigorously scrub lashes and lid margins with eyes closed followed with thorough rinsing - use old toothbrush

59
Q

What is the most common eye disorder?

A

Conjunctivitis

60
Q

What is pathophys of glaucoma

A

Increased IOP

61
Q

What is Closed-Angle Glaucoma?

How is it treated?

A

Closed-angle: acute, extremely painful, blurred vision, halos around lights, with fixed or dilated pupil.

Refer to surgery

Managed with:
Carbonic anhydrase inhibitor - acetazolamide (Diamox)
Osmotic diuretics - mannitol

62
Q

What are cataracts?

A

Clouding and opacification of the normally clear lens of the eye

Highest cause of treatable blindness

Most common surgical procedure in patients >65d
-senile cataracts-

63
Q

What is Acute OM/Serous OM?

A

Presence of fluid in the middle ear accompanied by S/S of infection.

Most common: URI (viral)

64
Q

Vertigo Labs/Diagnostics

A 
CT scan
VDRL/RPR
Serum medication levels
Hearing exam
Blood glucose and EKG may be helpful
65
Q

Vertigo Management

A 
Diazepam (Valium) - Benzo's
Meclizine (Antivert) - antihistamine
Diphenhydramine (Benadryl) - antihistamine
Scopolamine patch
Antiemetics
66
Q

What are some causes of conductive hearing loss?

A

Foreign body in ear canal/cerumen build up - Most
common cause of hearing loss, most treatable
Hematoma
Perforated TM
OM
OE
Otosclerosis

67
Q

What are some causes of sensorineural hearing loss?

A

Damage to hair cells and/or nerves that sense sound
waves
Acoustic trauma
Barotrauma (usually in divers)
Head trauma
Ototoxic drugs - aminoglycosides, diuretics, salicylates,
NSAIDs, antineoplastics
Meniere’s disease
Acoustic neuroma
Infections - mumps, measles, herpes zoster, syphilis,
meningitis, etc.

68
Q

Ototoxic drugs

A 
Aminoglycosides
Diuretics
Salicylates
NSAIDs
Antineoplastics
69
Q

What is Pharyngitis/Tonsillitis?

Causes?

A

Inflammation of the pharynx or tonsils.

Viral (influenza A&B, Epstein-Barr, etc.)
Bacterial

70
Q

Strep Throat S/S

A 
Erythematous pharynx
Rhinorrhea 
Fever
Anterior cervical adenopathy 
Painful throat
Maculopapular rash
Lack of cough
71
Q

What is influenza?
What are S/S?
Management?

A

Acute febrile illness caused by infection with influenza type A and B viruses

S/S: Abrupt onset of - fever, HA, myalgias, coryza, anoexia, malaise, cough

Management: 
Supportive care
Neuraminidase inhibitor 
  zanamivir (Relenza) - inhaler
  oseltamivir (Tamiflu) - oral
72
Q

What is mononucleosis?
S/S?
Labs?
Management?

A

Symptomatic infection caused by Epstein-Barr virus, common in young adults 15-24 yo

Kissing Disease

S/S: Fever, chills, malaise/fatigue, anorexia, pharyngitis (most severe symptom), white tonsillar exudate, POSTERIOR cervical lymphadenopathy, splenomegaly

Labs: Monospot, increased WBC with relative lymphocytosis and neutropenia

Management: Supportive care, prednisone taper if severely enlarged tonsils, NO contact sports for weeks to months

73
Q

What is sinusitis?

Causes?

A

Inflammation of the mucous membranes lining one or more of the paranasal sinuses, almost always accompanied by inflammation of the nasal mucosa

Causes:
Streptococcus pneumonaie
Haemophilus influenzae

74
Q

Sinusitis S/S and Treatment/Management

A

S/S:
Often hx of recent URI with some improvement then
relapse
Red nasal mucosa
Pain/pressure over face, nose, cheeks, teeth/molars
Purulent nasal drainage (Bacterial)
Fever (Bacterial)
Tenderness over sinuses
HE in supine or bending position - dull/throbbing
Foul smelling nasal or post-nasal drainage

Tx: Supportive, Abx only if bacterial…
Amox/clav (Augmentin)
clarithromycin (Biaxin)

Consider 2nd line agent if no improvement after 72 hrs

75
Q

What is most common site of nose bleeds?

A

Anterior Septum

Kiesselbach plexus

EENT and Upper Respiratory Disorders (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions