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Emergency Medicine > EENT + Toxic Ingestion > Flashcards

EENT + Toxic Ingestion Flashcards

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1
Q

how to record visual acuity?

A

lowest line patient can read with 2 or less mistakes
test both eyes with glasses/contacts

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2
Q

how does red light reflex reveal opacities?

A

appear as black silhouettes

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3
Q

during a fluorescein staining, what are we looking for?

A

green uptake

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4
Q

if there is pain/redness in eye, what test should we do?

A

intra-ocular pressure test

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5
Q

shining light from side and should be able to see the entire iris; if shaded, light is not able to move across the iris

A

anterior chamber depth assessment

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6
Q

what is the most common etiology of conjunctivitis?

A

viral

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7
Q

a patient presents with a feeling of irritation of the eye. Dx? treatment? (3)

A

conjunctivitis

anti-histamine
lubricants
antibiotics

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8
Q

patient presents with eye pain and foreign body sensation. fluorescein shows corneal dendrite; Hutchinson sign. Dx? treatment? (2)

A

herpes simplex keratitis

antiviral
consult ophthalmologist

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9
Q

a patient presents with eye pain, FB sensation; you see a opaque ulcer with fluorescein showing ulcer. Dx? treatment? (2)

A

corneal ulcer

compounded drops q hour
ophtho consult

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10
Q

what is the most common cause of corneal ulcer?

A

contact lens use

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11
Q

a patient presents with a deep, boring eye pain, headache, N/V, photophobia, halos around bright lights. Patient states lots of pain when exposed to light. Dx? treatment options (2)?

A

acute angle closure glaucoma

ophtho consult
DROPS: timolol / pilocarpine
ORAL: acetazolamide / osmotic diuretics

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12
Q

patient presents with pain in left eye when the right eye is exposed to light. Dx? management?

A

iritis / uveitis
ophtho consult

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13
Q

a patient presents with a sector/portion of the eye that feels painful and has FB sensation. Dx? treatment? (3)

A

episcleritis

lubricating drops
optho consult
ocular NSAIDS

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14
Q

a patient presents with eye pain, normal vision, but the eye is very tender with pain during EOM use. Dx? treatment?

A

scleritis

oral NSAIDS
ophtho f/u

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15
Q

a patient presents with sudden monocular vision loss and fundoscopic exam reveals cherry red spot. Dx? treatment options (3)?

A

central retinal artery occlusion

CO2 for arterial dilation
eyeball massage
timolol / acetazolamide
consult ophtho

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16
Q

a patient presents with rapidly progressive vision loss and fundoscopic exam reveals blood and thunder fundus. Dx? management?

A

central retinal vein occlusion

consult ophtho

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17
Q

a patient presents with decreased visual fields (curtain drop in certain area) with visual floaters. Exam reveals hazy gray billowing retina. Dx? management?

A

retinal detachment

ophtho consult

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18
Q

a patient presents with periorbital edema, without vision changes or pain with EOM use. Dx? treatment?

A

periorbital cellulitis

PO antibiotics

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19
Q

what is the most common cause of periorbital cellulitis? what can it lead to?

A

sinusitis

meningitis

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20
Q

a patient presents with edematous lid, proptosis (bulging eyes), painful EOM use, diplopia, and vision loss. Dx? treatment?

A

orbital cellulitis

IV antibiotics

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21
Q

what are 4 diagnostics for orbital cellulitis?

A

CT orbits / sinuses
CBC
culture
+/- LP

22
Q

a patient presents with pain and FB sensation. Fluorescein uptake shows abrasion. Dx? treatment?

A

corneal abrasion

antibiotic drops

23
Q

a patient presents with pain, FB sensation, very decreased vision. Fluorescein shows seidel sign - leaking aqueous humor. Dx? treatment?

A

penetration of globe

protect globe by covering both eyes
consult ophtho

24
Q

a patient presents with inability to move eyes upwards. Dx? management?

A

blowout fracture (entrap inferior rectus + orbital fat)

CT orbits
ophtho consult

25
Q

when do most eye complaints require a follow up?

A

in 24 hours

26
Q

otitis externa that extend into underlying tissues and possible skull

A

malignant otitis externa

27
Q

what is the criteria for malignant otitis externa?

A

persistent despite 2-3 weeks of topical antimicrobial

28
Q

how is malignant otitis externa confirmed? treatment?

A

CT / MRI
IV antibiotics

29
Q

a patient presents with postauricular erythema, swelling, and tenderness, with protrusion of the auricle and obliteration of the postauricular crease. Dx? treatment?

A

acute mastoiditis

IV antibiotics / myringotomy / tympanocentesis

30
Q

how is acute mastoiditis confirmed?

A

CT / MRI

31
Q

caused by trauma to the ear sheering blood vessels from cartilage to skin

A

auricular hematoma

32
Q

treatment for auricular hematoma?(2)

A

remove fluid collection
maintain pressure x several days

33
Q

what to do when insect is identified in external auditory canal? (3)

A

pour lidocaine into ear canal
remove with forceps
antibiotic drops

34
Q

4 treatment options for anterior epistaxis?

A

afrin (oxymetazoline)
lidocaine + epi packing
silver nitrate (chemical cautery)
Rhino Rocket

35
Q

patient presents with blood coming out of both nostrils and mouth. Dx? 2 treatment options?

A

posterior epistaxis

Rhino Rockets until ENT f/u
foley catheter

36
Q

management for closed nasal fracture?

A

refer to ENT w/in 6-10 days
PO antibiotics

37
Q

management for grossly open nasal fracture?

A

emergent ENT consult

38
Q

management for nasal septal hematoma? (3)

A

incise and drain to avoid ischemic necrosis
antibiotics
ENT follow up

39
Q

a patient presents with dental pain followed by local swelling that spreads within the facial plane. Dx? treatment? (3)

A

dental abscess

incision
penicillin VK / amoxicillin
dental f/u

40
Q

a patient presents with swollen, erythematous, and indurated submandibular space. Dx? treatment? (3)

A

ludwig angina

IV antibiotics
emergency surgical consult
prep intubation

41
Q

a patient presents with sensitivity to hot/cold stimuli and air passing over exposed surface during breathing. Dx? treatment? (3)

A

enamel-dentin fracture

dental sealant
antibiotics
dental f/u

42
Q

treatment for crown-root fracture? (3)

A

splint x 4 weeks
dental f/u within 24-48 hours
antibiotics

43
Q

treatment for luxation dental fracture?

A

splint
dental f/u

44
Q

treatment for avulsion dental fracture? (3)

A

rinse tooth x 10 secs with water
replace tooth with splint
antibiotics

45
Q

a patient presents with severe sore throat, displacement of tonsils, deflection of swollen uvula, and tender cervical lymphadenopathy. They also have trismus and muffled voice. Dx? Treatment? (3)

A

peritonsillar abscess

drainage
1 dose IV steroids
antibiotics x 10 days

46
Q

a patient presents with drooling, dysphagia, and distress. They are sitting up, leaning forward, with their mouth open, and panting. Dx? treatment? (4)

A

epiglottitis

humidified O2
IV hydration
IV antibiotics
IV steroids

47
Q

what is seen on radiographs of epiglottitis?

A

thumb sign

48
Q

treatment for post-tonsillectomy bleeding? (2)

A

immediate ENT consult
direct pressure with gauze w/ lidocaine or epi

49
Q

what 3 diagnostics should be done for ingestion-related esophagitis?

A

chest xray
acute abdominal series xrays
upper endoscopy

50
Q

what diagnostic is used for possible battery ingestion?

A

abdominal xray

51
Q

treatment for ingestion-related esophagitis from battery? (2)

A

stabilize airway
remove via endoscopy

52
Q

what should NEVER be done to treat ingestion-related esophagitis? (2)

A

induce vomiting
use neutralizing agents

Emergency Medicine (12 decks)

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