ENOT/Ophthalmology Flashcards
1
Q
Organism that causes acute sinusitis?
A
Strep pneumoniae
2
Q
1st txt for acute sinusitis?
A
Augmentin
3
Q
Dx of acute sinusitis?
A
CT scan
4
Q
Organism that causes chronic sinusitis?
A
staph aureus
5
Q
Acute vs. chronic sinusitis?
A
< 4 weeks
> 12 weeks
6
Q
What causes allergic rhinitis?
A
IgE mediated reactivity to airborne antigens
7
Q
Pt has boggy turbinates, allergic shiners and allergic salute
A
allergic rhinitis
8
Q
Overzealous use of decongestant drops or sprays can cause?
A
Rhinitis medicamentosa
9
Q
Overuse of what two drugs can cause Rhinitis medicamentosa?
A
Oxymetazoline
Penylephrine
10
Q
Txt for rhinitis?
A
intranasal decongestants
11
Q
Txt for pt with severe allergic rhinitis who fail to respond to dx thx and allergen avoidance
A
immunotherapy
12
Q
2mm round ulceration with a yellow gray center surrounded by a red halo on the left buccal mucosa?
A
apthous ulcers
13
Q
Tx for apthous ulcers?
A
symptomatic or “Magic swizzle”- liquid Bendryl and magnesium hydroxide
14
Q
Another name for apthous ulcer?
A
canker sores
15
Q
crusting, scaling, red rimming eyelid and eyelash flaking with hx of seborrhea and rosacea?
A
Blepharitis
16
Q
Txt for blepharitis?
A
baby shampoo and topical abx, warm compresses
17
Q
What organism causes blepharitis?
A
staph
18
Q
crusty eyelids in the am
A
Blepharitis
19
Q
Dx for blepharitis?
A
slit-lamp exam
20
Q
What gland is affected in Blepharitis?
A
meibomian gland
21
Q
What can be cause by chronic eustachian tube dysfunction?
A
Cholesteatoma
22
Q
painless otorrhea (brown/yellow discharge w/ strong odor), tinnitus, dizziness, otorrhea
A
Cholesteatoma
23
Q
Dx for cholesteatoma?
A
CT scan and audiogram
24
Q
Txt for cholesteatoma?
A
surgical excision and reconstruction of ossicles
25
MC cause of viral conjunctivitis?
adenovirus
26
copious watery discharge, scant mucoid discharge with cobblestoning of palpebral conjunctiva?
viral conjunctivitis
27
txt for viral conjunctivitis?
cool compress, artifical tears, antihistamines
28
eyes glued shut in the am
bacterial conjunctivits
29
MC cause of bacterial conjunctivitis in adults?
staph aureus
30
MC cause of bacterial conjunctivitis in children?
H influenzae
31
MC cause of bacterial conjunctivitis in neonates?
C. trachomatis
32
Cobblestone mucosa in the inner/upper eyelid?
allergic conjunctivitis
33
Txt for allergic conjunctivitis?
topical antihistamine H1 blockers- Azelastine (Optivar)
34
Txt for bacterial conjunctivitis in adults?
Gentamicin/tobramycin
35
Txt for bacterial conjunctivitis in newborns?
oral erythomycin
36
Txt for contact use pseudomonas infection?
Fluoroquinolone - Cipro
37
Eye infection caused by swimming pool?
viral conjunctivitis
38
The MC ophthalmologic visit to the ER ?
corneal abrasion
39
Dx of corneal abrasion?
fluorescein staining w/ slit lamp
40
Txt for corneal abrasion?
topical abx ointment
41
How does patching work for corneal abrasions?
no longer recommended bc it can delay healing
42
What should be done before examining or treating a corneal abrasion?
visual acuity
43
Dx of corneal ulcer?
fluorescein angiography
44
dendritic ulcer w/ fluorescein stain
herpes simplex keratitis
45
Risk factor for contact lens wearers?
corneal ulcer
46
Txt for corneal ulcer?
IMMEDIATE referral to ophtho
47
What is dacryoadenitis?
inflammation of nasolacrimal duct or gland
48
Inflammatory enlargemnt of lacrimal galnd
rapid onset
unilateral severe pain , redness, and pressure
supratemporal region
dacryoadenitis
49
infectious obstruction of nasolacrimal duct
rapid onset
epiphora
intramedial region
dacryocysitis
50
Txt of darcyoadenitis?
warm to cool compress & systemic abx
51
inward turning of lower eyelid?
entropion
52
outward turning of eyelid?
ectropion
53
definitive txt for entropion/ectropion?
artificial tears and surgery
54
MC area for anterior nose bleed?
Kiesselback plexus
55
MC difficult area to control posterior bleeds?
internal maxillary artery
56
MC area for posterior nose bleeds?
Woodruff plexus
57
artery responsible for severe posterior nosebleeds?
sphenopalatine artery
58
What should pts w/ nose bleeds be asked?
aspirin or ibuprofen use
59
Txt for anterior nosebleed?
direct pressure
Afrin
Abx
60
Txt for posterior nosebleed?
posterior ballon packing
61
sudden ocular pain, halos, cloudy cornea, fixed dilated pupil
aute closure glaucoma
62
What causes open angle glaucoma?
impaired aqueous outflow through diseased trabecular meshwork
63
MC glauocoma?
open angle
64
Peripheral to central vision loss?
glaucoma
65
central to peripheral vision loss?
macular degeneration
66
Txt for open angle glaucoma (chronic)
Carbonic anhydrase inhibitor (-Amide)
Timolol
miotic drops (Pilocarpine)
67
Screening for glaucoma?
< 40 AA q 3-5
| > 40 q 2yrs
68
Mechanism of carbonic anhydrase inhibitors?
reduces production of fluid in eye
69
Dx of glaucoma?
tonometry
70
Txt for acute narrow angle glaucoma?
EMERGENCY!
IV acetazolamde
timolol
miotics
71
Definitive txt for acute narrow angle glaucoma?
peripheral iridotomy
72
Txt for chronic glaucoma?
Prostaglandin analogs- Latanoprost
timolol
trabeculoplasty
73
What SHOULDN'T be admin to acute angle glaucoma pts?
Mydriatics (anticholinergics)
74
PAINFUL HOT swelling of upper or lower eyelid in an eyelash follicle
Hordeloum (stye)
75
MC cause of hordeolum?
staph aureus
76
Txt for hordeolum?
warm compress and topical abx
77
What is a hyphema?
bleeding in the anterior chamber caused by blunt trauma
78
Dx of hyphema?
Orbital CT
79
Txt for hyphema?
blood is reabsorbed, txt includes rest with bed tilt @ 30d
80
What meds are C/I in hyphema?
NSAIDS
81
dizziness, flu, and I can't hear out of this ear?
Labyrinthitis
82
hearing loss, tinnitus, vertigo, n/v, and horizontal nystagmus?
Labyrinthitis
83
acute onset, vertigo, hearing loss, tinnitus after a URI
Labyrinthitis
84
What is the difference between labyrinthitis and Meniere's syndrome?
Menieres is episodic and NOT associated w/ viral infection.
85
What is consequence of labyrinthtis?
hearing loss
86
Txt for labyrinthitis?
Vestibular suppressants - Meclizine
87
acute hoarseness 2 days ago?
laryngitis
88
hoarseness> 2weeks
consider squamous cell carcinoma w/ hx of ETOH and smoking
89
MC cause laryngitis?
virus
90
Txt of laryngitis?
symptomatic
abx - if bacterial
Oral or IM corticosteriods- hasten recovery
91
Singing or shouting with laryngitis increases risk for?
vocal fold hemorrhage
poly
cyst
92
PAINLESS central vision loss with drusen deposits
macular degeneration
93
neovasularization is seen in?
wet macular degeneration
94
drusen spots is seen in?
dry macular degeneration
95
Dx for macular degeneration?
dilated funduscopic
96
Txt for macular degeneration?
zinc and antioxidant vitamins
97
What two drugs can cause macular degeneration?
chloroquine or phenothiazine
98
Leading cause of irreversible central visual loss in older population?
macular degeneration
99
episodic vertigo, unilateral low frequency sensorineural hearing loss, and tinnitus
Meniere syndrome
100
Dx of Meniere?
audiogram and MRI
101
Tx of Meniere?
low salt diet, diuretics to reduce aural pressure
102
ear fullness or pain, unilateral hearing loss, tinnitus
Meniere
103
teardrop shaped growths partially obstructing the nasal passages
nasal polyps
104
What predispose a pt to nasal polyps?
allergic rhinitis
acute and chronic infections
cystic fibrosis
105
Whats a red flag of nasal polyps?
cystic fibrosis
106
Samter's triad?
asthma
aspirin sensitivity
nasal polyps
107
Txt for nasal polyps?
topical nasal corticosteroid
108
Medication C/I in a pt with nasal polyps/
aspirin
109
The MC organism of otitis media?
strep pneumoniae
110
acute otitis media?
< 3 weeks
111
chronic otitis media?
> 3mo
112
bulging, loss of landmarks, redness, and injection of TM, pus, limited mobility of TM
Otitis media
113
1st line Tx for acute otitis media?
Amoxicillin
114
2nd line txt for acute otitis media?
Augmentin
115
Txt for chronic otitis media?
myringotomy w/ ventilation tube
116
Consequences of NOT txt otitis media can lead to?
mastoiditis
abscess
meningitis
117
Txt of malignant otitis media?
IV ciprof
118
Chronic otitis media complication?
cholesteatoma
119
a ruptured tympanic membrane is usually due to
chronic otitis media
120
In otitis externa weber test is expected to lateralize to what side?
side of the blocked canal
121
painful, edema w/ cheesy white discharge
otitis media
122
What is the MC of otitis media?
Pseudomonas
123
Whom is malignant otitis externa MC seen in ?
diabetics
124
Fungal otitis externa is caused by?
aspergillus
125
Dx of otitis externa?
otoscopy
126
Txt of otitis media?
cipro + dexamethasone
127
Txt of fungal otitis externa?
topical therapy for yeast: clotrimazole
128
Intermittent headaches and blurred vision?
papilledema
129
Dx papilledema
MRI or CT
130
Txt of papilledema?
txt underlying disorder
131
Swelling of his face, and testes (orchitis)?
Parotits (mumps)
132
What causes mumps?
paramyxovirus
133
T/F mumps must be reported to the public health authorities?
True
134
What is complication of mumps?
nerve deafness
135
MC cause of bacterial parotitis?
Staph aureus
136
Parotitis is a complication of?
Sjogren's syndrome
137
muffled "hot potato" voice, extreme difficulty opening mouth (trismus), uvular deviation
peritonsillar abscess
138
DOC for peritonsillar abscess?
PCN
139
Organism that causes peritonsillar abscess?
Group A hemolytic strep
140
Dx of peritonsillar abscess
needle aspiration
| CT or ultrasonography of neck
141
Quincy abscess?
Peritonsillar abscess
142
Txt of peritonsillar abscess?
I&D
143
What organism causes pharyngitis
Group A strep
144
1st line txt for strep throat?
Penicillin or IM benzathine pcn
145
Gold sntd dx of strep?
throat swab culture
146
What should be consider in pts with recent sexual encounters or with non resolving pharyngitis?
gonorrhea pharyngitis
147
Common in pts using inhaled steroids?
fungal pharyngitis
148
Txt for fungal pharyngitis?
Clotrimazole troches
| Nystatin swish and swallow
149
Complications of strep throat?
scarlet fever
glomerulonephritis
acute rheumatic fever
abscess formation
150
Txt for gonorrhea pharyngitis?
IM ceftriaxone
151
Small grayish vesicles and punched out ulcers in the posterior pharynx
Coxsackievirus
152
Txt for Sialadenitis?
IV vancomycin or nafcillin
153
MC cause of Sialadenitis?
Staph aureus
154
Txt for sialadenitis?
LEMON DROPS! sialagogues, warm compresses
155
Whom is more likely to get sialadenitis?
Sjogren syndrome
156
Complication of sialadenitis NON-treatment?
abscess
157
Txt for tympanic membrane perforation?
Floxin drops ONLY
| TM will resolve itself
158
Tinnitus is associated with?
Sensorineural hearing loss
159
Txt for tinnitus?
identify the cause
160
elevated, superficial, fleshy, triangular shaped growing fibrovascular mass
pterygium
161
Txt for pterygium?
observation
| only surgery when vision is affected
162
Yellow elevated nodule on nasal side of eye, does not grow
pinguecula
163
MC common causes of retinal detachment?
Proliferative diabetic retinopathy
sickle cell disease
retinal vein occlusion
164
Curtain falling, Flashing light, floaters, vision loss
Retinal detachment
165
Txt of retinal detachment?
EMERGENCY!
| stay supine, laying towards the side of detachment
166
characteristic lesions of nonproliferative retinopathy?
microaneurysm, hard exudates, cotton wool spots, blot and dot hemorrhages
167
Txt of retinopathy?
blood glucose and bP control
168
Sudden vision loss in right eye, curtain came down over eye
Retina occlusion
169
Txt for central retinal artery occlusion?
EMERGENCY!
170
Txt for central vein occlusion?
intravitreal injection of VEGF inhibiotrs
171
Blood and thunder retina
Central retinal vein occlusion
