EENT JB Flashcards
Acoustic neuroma dx
MRI, CT, audiology
Unilateral sensorineural hearing loss is acoustic neuroma until proven otherwise
Acute narrow angle closure glaucoma tx
Acetazolamide 1st line
timolol
pilocarpine/carbachol
Acute OM 4 MC organisms
S. pneumo MC
H. flu
M. Cat
Strep pyogenies (GABHS)
OM Tx
amoxicillin TOC
Cefixime in children
Augmentin/ cefaclor 2nd line
erythromycin-sulfisoxazole, azithromycin, bactrim if penicillin allergy
Acute sinusitis tests
Mainly clinical
CT w/o contrast TOC
sinus radiographs: order waters view
Acute sinusitis tx
symptomatic therapy
Abx (if sx 10-14d or complications): amoxicillin DOC, doxycycline or bactrim 2nd line, FQ or augmenting if recent abx use/refractory
Allergic rhinitis sx
worse in mornings, clear rhinorrhea, boggy turbinates, nasal polyps with cobblestoning of the mucosa
Amaurosis fugax sx
Mini TIA
temporary unilateral vision loss (lasts minutes) with complete recovery
“curtain” that resolves (lifts up) within 1h
Blepharitis anterior vs posterior
Anterior: involves skin and base of eyelashes
posterior: meibomian gland dysfunction
CRAO PE
monocular vision loss
Cherry red macula (red spot)
box car appearance of retinal vessels
hx of atherosclerosis
Ophthalmic chemical burn tx
irrigation ASAP
moxifloxacin or atropine drops
Optho f/u
Cholesteatoma PE
Painless otorrhea w/ strong odor
peripheral vertigo
Corneal abrasion fluorescein stain
“ice rink” linear abrasions
Dacrocystitis location
Medial canthus
Diptheria sx
tonsillopharyngitis or laryngitis classes presentation
pseudomembranes friable gray/white on pharynx that bleeds if scraped
bull neck, myocarditis, arrhythmias, HF
Diptheria tx
Antitoxin most important + erythromycin/penicillin
clindamycin and rifampin (alternatives)
PCN + amino glycoside for endocarditis
Diptheria prophylaxis
erythromycin or penicillin benzathine G
Diptheritic pharyngitis etiology
corynebacterium diphtheriae (gram + rod)
Anterior epistaxis MC location
kiesselbach’s plexus
Posterior epistaxis MC location
palatine artery
Types of macular degeneration
Dry (atrophic): drusen spots
Wet (neovascular or exudative): new abnormal vessels
Nasal polyps tx
intranasal CS TOC
Surgery
optic neuritis sx
loss of color vision, visual field defects (central scotoma), over a few days, unilateral.
ocular pain worse with eye movement
Marcus gunn pupil
Optic neuritis dx
usually clinical
swinging light test, fundoscopy
MRI
Oral candidiasis (thrush) tx
nystatin liquid TOC
clotrimazole
oral fluconazole
Oral hairy leukoplakia caused by:
EBV (HHV4)
Oral hairy leukoplakia sx
painless white plaque
hairy or feathery with prominent folds
cannot be scraped off
Oral lichen Planus tx
local or systemic CS
orbital cellulitis sx
decreased vision
pain with EOM
proptosis, eyelid erythema
edema around orbit
Orbital cellulitis dx
high resolution CT w/ IV contrast
Otitis externa tx
ciprofloxacin/dexamethasone
amino glycoside combo (neomycin/polytrim-B/hydrocortisone otic)
fungal: amphotericin B
parotitis prevention
MMR vaccine @ 12-15, and 4-6yo
Peritonsilar abscess sx
hot potato voice
uvula deviation contralateral side
anterior cervical lymphadenopathy
peritonsilar abscess dx
CT 1st line
Peritonsilar abscess MCC
Strep pyogenes (GABHS)
Retinal detachment sx
photopsia –> floaters –> progressive unilateral vision loss
curtain coming down in periphery –> central vision loss
no pain or redness
Retinal detachment test
fundoscopy + shafers sign
retinoblastoma PE
absent red reflex
white pupil
Sialadenitis MCC
S. aureus
Sialolithiasis MC location
Wharton’s duct
Stensons duct
Sialolithiasis tx
sialogouges
Abx: dicloxacillin/nafcillin + metronidazole/clindamycin
avoid anticholinergics
streptococcal pharyngitis tx
penicillin g or VK 1st line
amoxicillin, augmentin
macrolide if PCN allergic
clindamycin, cephalosporins
Uveitis PE
associated w/ HLAB27, sarcoidosis, toxoplasmosis, TB
ciliary injection (limbic flush)
photophobia
inflammatory cells and flare within aqueous humor
Uveitis tx
Anterior: topical CS
posterior: systemic CS
Anterior vs Posterior uveitis
anterior: unilateral ocular pain/red/photophobia. excessive tearing. usually after blunt trauma
posterior: blurred/decreased vision, floaters, no anterior involvement, no pain
Viral conjunctivitis MCC
Adenovirus
Vitreous hemorrhage sx
blurry vision, floaters, cobweb like apparitions floating through field of vision
reddish tint to vision
photopsia
