Brainscape's Knowledge GenomeTM

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


See full index

R9 - Emergency Medicine > ENOT/Ophthalmology > Flashcards

ENOT/Ophthalmology Flashcards

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards
1
Q

sinusitis (acute, subacute, chronic, recurrent) etiology, RF, and sxs

A
  • Acute sinusitis: mostly viral, MCC S. pneumo, H flu, M. cat
    • cofactor: air pollution, nasal polyps, pregnancy, rhinitis medicamentosa, oral antihypertensives, anti-osteoporosis agents or HRT sprays, mucociliary dysfunction
    • sxs: follows URI, up to 4 wk, 2 or more major signs and sxs, 1 major and 2+ minor, nasal purulence on exam, rapid onset
      • Major: facial pain, pressure, nasal obstruction, PND, purulence, hyposmia, anosmia, fever
      • Minor: HA, halitosis, fatigue, dental pain, cough, ear pain, pressure, fullness
    • signs: TTP over affected sinus
  • Subacute sxs: same as acute, but complications include orbital cellulitis, osteomyelitis, cavernous sinus thrombosis
  • chronic: MCC = S. aureus, sxs are same as acute but 12+ wks
  • Recurrent sxs: 4+ eps of acute dz per year, lasting 7+ d
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

sinusitus (acute, subacute, chronic, recurrent) dx and tx

A
  • dx: clinical dx - routine radiographs not recommended, nasal endoscopy for pts who dont respond to tx, CT >>> MRI
  • tx: supportive - NSAIDs, hydration, nasal saline sprays, steam, mucolytic (guaifenesin like mucinex, robitussin)
    • oral decongestant: sudafed, topical nasal casoconstrictors (phenylephrine or afrin), intranasal steroids
    • oral abx x 1-2wk: amox (1st line), augmentin, macrolide or bactrimif PCN allergy, FQ, 3rd gen ceph.
  • consider bact if sxs worsen after 5d, persist 10+d, or out of proportion to viral infxn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

labrynthitis

A
  • unkown etiology, likely viral, head injury, stress or allergy related
  • sxs: acute severe vertigo, lasting several days to a week, improves over a few weeks, but hearing loss may or may not resolve, imbalance, hearing loss, nausea or vomiting
  • signs: severe nystagmus
  • tx: abx for fever or signs of infxn, vestibular suppressants for acute sxs (diasepam, meclizine), sxs regress after 3-6wk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Tympanic membrane perforation (barotrauma/TM perforation)

A
  • MCC: infxn (AOM), trauma (barotrauma, direct impact, explosion)
  • sxs: most are asxatic, audible whistling sounds during blowing nose and sneezing, decreased hearing, increased tendency of ear infxn during colds and with water immersion
  • signs: copious sanguineous purulent d/c, painless if no overlying infxn or cholesteatoma
  • dx: clinical dx, tympanometry
  • tx: most self-resolve and asx not requiring tx, no tx for nonswimming pts w/ minimal hearing loss, systemic abx (bactrim, amox), trichloroacetic acid to cauterize edges of TMP, surg repair of TM
  • avoid water exposure, avoid eardrops containing gentamicin, neomicin sulfate, tobramycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

otitis externa - bacterial

A
  • “swimmers ear”; MCC = pseudomonas, proteus, fungi
  • RF: water, trauma, exfoliative skin conditions (psoriasis, eczema)
  • sxs: ear pain (especially w/ mvmt of auricle, tragus, or eating)
  • signs: redness, swelling of ear canal or purulent exudate, foul smelling, pre- or postauricular LAD
  • dx: tuning fork BC > AC
  • tx: abx drops - aminoglyc (neomycin, polymyxin), FQ (ofloxacin), +/- topical steroid
  • complications: in DM or immunocomp - malignant otitis ex may develop (needs hosp and IV abx), periauricular cellulitis, cranial nerve palsies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

otitis externa - fungal (mycotic otitis externa)

A
  • MCC: aspergillus niger (black), A. flavus (yellow), or A. fumigatus (gray), candida albicans (white)
  • sxs: pruritis, weeping, pain, hearing loss, aural fullness
  • signs: swollen, hyphae +/- spores, moist/wet
  • tx: hygiene, topical antifungal powder + antifungal otic drops (acetic acid, vosol)
  • prophylaxis: 1:1 ethanol/white vinegar in each ear after showering
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

acute otitis media

A
  • viral URI - eustachian tube dysfn or blockage, buildup of fluid/mucus, anatomic deformities or edema
    • in infants and children - S. pneumo, H flu, M. cat, S. pyogenes; adults - mostly viral
  • sxs: fever, otalgia, ear pressure/fullness, hearing loss
  • otoscopic exam: TM erythema, pneumotoscopy, bulging, pre or postauricular LAD
  • dx: tuning fork (BC > AC), tympanometry
  • tx: watch and wait for older kids, HD amox (1st line), ceftriaxone, resistant = cefaclor or augmentin, recurrent = tympanostomy, tympanocentesis, myringotomy
  • complications: mastoiditis, Bell’s palsy, central venous sinus thrombosis, hearing loss, speech delay, bact meningitis, intracranial abscess, TM perf
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

serous OM

A
  • effusion without infxn, retention of transudate fluid in middle ear
  • hx: recent viral URTI, sinus infxn, allergies, flying while congested, AOM, adenoid hypertrophy, nasopharyngeal mass
  • sxs: fullness, pressure, hearing loss, popping/gurgling after yawn or blowing nose, dizziness or swimming sensation
  • signs: retracted TM, amber-or coca cola colored fluid, displaced cone of light, air bubbles behind TM
  • dx: pneumatic otoscopy (dec mvmt TM), BC >AC
  • tx: resolves slowly, nasal steroid sprays, short course PO roids, consider tympanostomy after 3mo
  • **avoid decongestants, antihistamines, abx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

blepharitis

A
  • chronic conjunctival and lid margin inflamm
  • causes: seborrhea, staph or strep, dysfn of meibomian glands
  • post more common, inflamm of inner eyelid at level of meib gland
  • sxs: rims red, eyelashes adhere, dandruff like deposits, clear to red conjunctiva, thick, cloudy discharge, gritty or burning, excessive tearing, itchy eyelids, photophobia
  • signs: greasy appearance of lid margin w/ scaling around lashes
  • dx: slit lamp
  • tx: warm compress, lid massage, lid washing, topic abx if infxn (azithro), oral abx (azithro, doxy, tetra)
  • associated probs: rosacea, seb derm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Bacterial conjunctivitis

A
  • associated: steroid or OTC eye drops, contact lens, age, sexual activity, immunodef.
  • MCC: S. pneumo, S. aureus, H. aegyptius, M. cat
    • transmission: direct contact or fomites (autoinnoc)
  • rare: chlamydia or gonorrhea
    • direct contact, fomites, nonchlorinated swimming pool, sexual contact, SVD
  • sxs: injection, purulent dc, difficulty prying lid open upon awakening
  • signs: no preauric LAD, yellow-green dc, bilateral injection
  • tx: self-limiting but secondary keratitis may dev., topical sulfonamide (TMP-SMX), gentamicin, tobramicin, norfloxacin, or TMP-polymyxin B sulfate, good handwashing, avoid contaminated pillows/makeup, etc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

viral conjunctivitis

A
  • MC = adenovirus, midsummer to early fall
  • highly contagious
  • transmission: direct contact, swimming pools
  • sxs: recent URTI, no resolution w/ eye drops, unilateral or bilateral, ipsilateral preauricular lymphadenopathy, epiphora (watery dc)
  • signs: hyperemia, chemosis, follicular conjunctival injection, subconjunct. hemorrhage
  • tx: eye lavage w/ nl saline, vasoconstrictor anthistamine drops, opthalmic sulfonamide drops, supportive (cold, lubricants, hand hygiene)
  • prognosis: self-limiting 2-4wks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

corneal abrasion

A
  • MCC: contact lenses; other causes: fingernail, eyelash, small FB
  • sxs: pain, FB sensation, photophobia, tearing, injection, blepharospasm, blurred vision
  • signs: multiple vertical linear abrasions under upper eyelid suggests FB, record visual acuity before exam
  • dx: slit lamp or fluorescein stain
  • tx: topical anesthetic, saline irrigation, abx ointment (gent, sulfacetamide), tylenol for pain, patchin no longer than 24h, daily FU and referral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

corneal ulcer

A
  • MCC: pseudomonas, staph, strep, HSV, acanthamoeba
  • etiology: contact lenses, trauma, poor lid apposition
  • sxs: pain, photophobia, dc, tearing, decreased vision, FB sensation
  • signs: circumcorneal injection, watery to purulent dc
  • dx: stains and cultures ASAP, slit lamp, dendritic lesion = herpes keratitis
  • tx: immediate ophthalmology consult, intensive topical abx (FQ, ceph or vanco +/- aminoglyc), STEROIDS AND PATCHING CONTRAINDICATED (dc contact lenses, discard opened lens and solutions, sterilize lens equipment)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

glaucoma

A
  • increased IOP with optic nerve damage
  • dx: visual field testing, opthalmoscopy, gonioscopy (determines cause), tonometry to measure IOP
  • Normal IOP: 10-21 mmHg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

acute angle closure glaucoma

A
  • peripheral iris blocks outflow of aqueous humor from anterior chamber, associated with papillary dilation
  • RF: old, asian, hyperopes
  • sxs: sudden dull or severe eye pain (bilateral), worse in dark rooms, blurry vision, frontal HA, tearing, N/V, sweating
  • PE: conjunctival hyperemia, ciliary flush, cloudy or hazy cornea, midposition or middilated and nonreactive pupil
  • dx: penlight test - project from lateral to nasal, will project shadow on nasal side; tonometry (markedly increased IOP), cornea edematous
  • tx: immediate referral, first line topical agents = BB, alpha antag (brimonidine, apraclonidine0, prostaglandin analogues (latanoprost)
    • topical miotic: pilocarpine
    • adjunct cycloplegic agents: IV acetazolamide, IV mannitol
    • laser iridotomy (definitive)
    • DO NOT administer mydriatics to these pts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

hyphema

A
  • blood in the anterior chamber resulting from a rupture of one or more iris stromal vessels, MC in children (70%)
  • RF: sickle cell dz or trait, AA, ASA use
  • tx: rest, elevation of head, topical steroids, avoid ASA and NSAIDs
  • Complications: 4 S’s - Staining of cornea, Synechiae (iris adheres to cornea or lens), Secondary rebleed on days 2-5, Significantly increased IOP
  • Prognosis: poor prognostic factors = hyphema in greater 1/3 of anterior chamber, tx after 24h, high IOP, prior low visual acuity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

papilledema

A
  • bilateral edema of head of optic nerve dt increased ICP → disc margins blurred, cup diminished or gone, nerve head elevated w/ vasc congestion, flame-shaped hemorrhages seen on or adjacent to nerve head
  • causes: malignant HTN, hemorrhagic stoke, acute subdural hematoma, pseudotumor cerebri
  • sxs: asx or transient visual alterations (seconds), bilateral, develops over hours to weeks
  • dx: disc appears swollen, ICP increased
  • tx: tx underlying cause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

retinal detachment

A
  • separation of retina from pigmented ep layer, can occur spontaneously or 2ary to trauma or extreme myopia
  • sxs: curtain of darkness with periph flashes, preceding post vitreous detachment (flashes of light, floaters, feeling of heaviness in eye, acute onset, painless vision loss (peripheral to central loss), blurred or blackened vision over several hours, partial or complete monocular blindness
  • dx: detached retinal flapping in vitreous humor
  • tx: emergent ophthal consult, remain supine w/ head turned to side of detachment, laser surg or cryosurg
  • Prognosis: 80% recover w/ no recurrenc, 15% require retreatment, 5% will never reattach
19
Q

central retinal vein occlusion

A
  • blood and thunder fundus
  • 50+, MC associated with HTN, POAG, occurs secondary to thrombotic event
  • sxs: sudden, painless unilateral vision loss, blurred or complete loss
  • PE: retinal hemorrhages in all quadrants
  • dx: fundoscopy - dilated veins, macular edema, cotton wool spot, massive superficial/deep hemorrhage with vitreous involvement
  • tx: spontaneously resolves over time, workup for thrombosis
20
Q

macular degeneration

A
  • RF: long hx of smoking, metabolic syndrome, FHx, F, white, >50yo, drugs (chloroquine, phenothiazine), leading cause of irreversible central vision loss
  • sxs: insidious onset, gradual loss of central vision clarity (metamorphopsia - wavy or distorted vision, measure with Amsler grid)
  • dx: drusen formation, mottling, serous leaks, hemorrhages on retina
  • tx: no effective tx, laser tx, anti VEGF intravitreal injecitons of monoclonal antibody drugs: slows progression, vitamins and antioxidants slow progression
21
Q

allergic rhinitis

A
  • IgE-mediated reactivity to airborne Ags (pollen, molds, danders, dust)
  • RF: FHx, atopic triad (asthma, eczema, allergic rhinitis)
  • sxs: similar to common cold, allergic shiners, rhinorrhea, itchy watery eyes, sneezing, nasal congestion, dry cough
  • signs: pale, boggy, bluish mucosa, clear, watey dc
  • dx: clinical dx
  • tx: avoid known allergens and use antihistamines, cromolyn sodium, nasal or systemic corticosteroids, nasal saline drops or washes, immunotx
22
Q

anterior epistaxis

A
  • kiesselbach plexus
  • RF: nose picking, dry nasal mucosa, HTN, cocaine, ETOH, more than 90% of bleeds
  • sxs: typically unilateral and easily visualized
  • dx: clinical dx
  • tx: direct pressure at site of bleed (sit, leaning forward, compress nares 15min)
    • topical cocaine used as anesthetic and vasoconstrictor, or other topical decongestatnts (oxymetazoline) and anesthetics (lidocaine)
23
Q

posterior epistaxis

A
  • posterior is less common occuring in Woodruff plexus
  • RF: HTN, atherosclerosis
  • sxs: typically bilateral or from posterior pharynx, if placement of ant pack doesnt stop bleeding and bleeding noted in post pharynx
  • dx: clinical dx
  • tx: posterior packing is difficult and high risk of complications, consult with inpt monitoring (balloon packing)
  • prognosis: greater risk of airway compromise, aspiration of blood, and more difficult to control bleeding
24
Q

peritonsillar abscess

A
  • penetration of infxn through tonsillar capsule
  • sxs: sore throat, pain with swallowing (odynophagia), trismus, deviation of soft palate or uvula, muffled “hot potato” voice
  • signs: deviation of soft palate, asymmetric risk of uvula, erythematous and edematous tonsil
  • dx: neck CT
    tx: needle aspiration, incision and drainage +/- abx (IV amox, unasyn, and clinda), tonsillectomy
25
Q

laryngitis

A
  • viral >>> bacterial (M. cat, H. flu)
  • follows URI: hoarseness, cough, absence of pain or sore throat
  • tx: supportive care (vocal rest, avoidance of singing, shouting), if bacterial → erythromycin, cefuroxime or agumentin, oral or IM steroids for faster recovery but requires vocal fold eval
  • complications: vocal fold hemorrhage, polyp or cyst formation
26
Q

tonsilitis and pharyngitis

A
  • viral >>> bacterial
  • Group A B-hemolytic Strep = MCC bacterial cause - treat to prevent complications
  • sxs: rapid onset high fever, sore throat, lack of cough (not suggestive of strep = coryza, hoarseness, cough)
  • signs: beefy-red uvula, tender anterior cervical adenopathy,palatal petechiae, gray furry tongue, pharyngotonsillar exudate
    • CENTOR CRITERIA: presents of 1-4 suggests GABHS
  • dx: if 3/4 criteria met → rapid strep test, if neg → throat cx (confirms, GOLD STANDARD)
  • tx: IM PCN, oral PCN, if PCN allergy give macrolide (erythromycin)
  • complications: scarlet fever, glomerulonephritis, abscess formation
27
Q

mastoiditis

A
  • evolve following several weeks of inadequately treated AOM
  • postauricular pain and erythema, spiking fever
  • CT scan = coalescence of mastoid air cells dt destruction of bony septa
  • initiatl tx = IV abx (cefazolin) and myringotomy for cx and drainage
    • failure of med tx indicates need for surg drainage (mastoidectomy)
28
Q

acute epiglottitis: etiology, sxs

A
  • 3Ds: dysphagia, drooling, distress
  • pathogen: H. flu type B (MCC, now rare dt vax), S. pneumo, GAS, MRSA
  • infectious causes: psudomonas, candida
  • noninfectious causes: thermal injury, FB, caustic ingestion
  • RF: lack of IMZ for Hib, inflamm of epiglottis and adjacent supraglottis stuctures, results form bacteriemia or direct invasion of epithelial layer
  • sxs: rapid, abrupt onset in kids
    • difficulty breathing, muffled speech (hot potato voice), sudden onset high fever, severe sore throat, dysphagia, absent cough or hoarseness, anxiety, restless, irritable
  • signs: resp distress (stridor), drooling, difficulty swallowing, pharyngitis, tripod position, neck hyperextended, chin thrust forward, insp retractions, appear toxic
29
Q

acute epiglottitis dx and tx

A
  • dx: direct or fiberoptic laryngoscopy (GOLD STANDARD) - erythematous, edematous epiglottis; lateral x-ray (thumb sign, loss of vallecular air space, thickened folds, distende hypopharynx), labs not routinely performed, CBC, blood cx, throat/epiglottis cx
  • tx: MEDICAL EMERGENCY, stabilize airway (mainstay), BVM, supplemental O2, endotrach tube, emergent tracheostomy
    • abx x7-10d (3rd gen ceph)
    • AND antistaph agent(vanco or clinda)
  • prevention: Hib vaccine, pneumococcal vaccine
  • complications: airway obstruction, epiglottic abscess, secondary infection, necrotizing epiglottitis, death
30
Q

orbital cellulitis

A
  • more common in children, median age = 7-12yo
  • causes: dental infxn, facial infxn, infxn of globe or eyelids or lacrimal system, trauma
  • MC bugs: S. pneumo, S. aureus, H. flu, G- bact, MRSA
  • sxs: ptosis, eyelid edema, exophthalmos, purulent dc, conjunctivitis, fever, restricted ROM of eyes, sluggish pupillary response, edema and erythema of lids
  • dx: CBC, blood cx, cx of any drainage - high WBC, CT scan (broad infiltration of orbital soft tissue)
  • tx: medical emergency requiring hospitalization (IV abx - broad spectrum, nafcillin, flagyl, clinda, 2nd or 3rd gen cephalosporin, and FQs), surgical I and D
31
Q

barotrauma

A
  • inability to equalize barometric hcanges on middle ear when encountering quick change sin pressure, such as flying, diving, or altitude change
  • etiology: congenital narrowing or acquired mucosal edema
  • sxs: ear pain, hearing loss
  • dx: clinical dx
  • tx: swallow or yawn to autoinflate the eustachian tube, systemic or pO decongestants, myringotomy
  • health maintenance: if left unequalized, can cause TMP or AOM
32
Q

trauma/hematoma (external ear)

A
  • develops between cartilage and perichondrium
  • sxs: purplish swelling of upper part of ear, obscured cartilage folds
  • dx: clinical dx
  • tx: referral to ENT, aspiration of area with applied pressure dressing, recurrent requires I&D
33
Q

vision loss ddx

A
  • Transient loss differential: TIA, emboli (amaurosis fugax), or giant cell (temporal) arteritis
  • sudden loss differential: central retinal vein or branch vein occlusion, optic neuropathy, papillitis, or retrobulbar neuritis
  • gradual loss differential: macular degen, tumors, cataracts, glaucoma
34
Q

Cataract

A
  • Any opacity in the lens that causes lens to lose transparency
  • 50% of ppl ≥ 80yo
  • Three varieties: nuclear sclerosis, posterior subcapsular, cortical spoking
  • RF: inc hours of sunlight exposure, smoking, heavy alc consumption, low educational level, diabetics, AA females
  • Dx: slit lamp
  • Tx: surgical – 20/50 visual acuity or worse with glare testing is considered surgical level of dysfunction
  • Lens opacification (thickening); usually bilateral
  • Risk factors = aging (>60y), cigarette smoking, corticosteroids
  • Clinical manifestations
    • Blurred/loss of vision over months-years
    • Absent red reflex, opaque lens
  • Management
    • Surgical
35
Q

amaurosis fugax

A
  • etiology: atherosclerosis (emboli to the ophthalmic artery), carotid stenosis
  • sxs: “fleeting blindness” or “curtain coming down” vertically into the field of vision - painless, transient, unilateral vision loss, seconds of a graying out of vision in one eye
  • dx: retinoscopy (refractile arterial lesions (hollenhorst plaques, cholesterol crystals)
  • tx: annual risk of stroke is 1-2%
36
Q

blowout fx

A
  • fx of the floor of the orbit resulting in inc IOP, blunt force trauma against eye
  • sxs: intraocular mm and fat pads caught in fx
  • signs: enophthalmos, upward gaze diplopia (inf rectus entrapment), infraorbital rim, upper lip, cheek anesthesia, step off of infraorbital rim
  • complications: retinal detachment, lens dislocation, ruptured globe, hyphema
  • dx: orbital CT
  • tx: tetanus vax, pain control, prophylactic abx, avoid blowing nose and valsalva, consult ophthalmology and maxillofacial surgeon
37
Q

dental abscess

A
  • periodontal: chonic gingival dz
    • sxs: swelling of cheek, mouth, or neck, adjacent tooth tender too percussion, more localized
    • dx: clinical dx
    • tx: rinse area with warm salt water x10min q2h, apply ice, NSAIDs, opioids, I&D, abx (PCN, erythro, clinda)
  • periapical: dental caries
    • sxs: inc pain when supine, bad taste in mouth or tooth feels longer than other teeth, gumboil (abscess under gum)
    • dx: clinical dx
    • tx: complications = facial cellulitis
38
Q

dacryoadenitis

A
  • acute inflamm of the lacrimal gland seen in sterile inflamm dz, mostly dt gram + bacteria
  • MC virus: EBV
  • sxs: abrupt onset of swelling of upper eyelids, laterally
  • dx: bilateral dacryoadenitis seen in mumps
39
Q

optic neuritis

A
  • optic nerve swelling causes destruction of myelin sheath
  • MCC: multiple sclerosis
  • sxs: pain with mvmt of affected eye (precedes visual loss), sudden unilat central vision loss (blurry or “foggy” vision), central scotoma and change in color perception
  • signs: no chemosis or conjunctival injeciton, APD present, fundoscopic exam (swollen, edematous optic disc (papillitis))
  • dx: ICP normal, red desat test (have pt look with one eye at dark red object and then test other eye to see if object looks same color - affected eye will see red object as pink or light red)
  • tx: IV or PO steroids, consult neuro and ophthalmology
40
Q

allergic rhinitis

A
  • IgE-mediated reactivity to airborne Ags (pollen, molds, danders, dust)
  • RF: FHx, atopic triad (asthma, eczema, allergic rhinitis)
  • sxs: similar to common cold, allergic shiners, rhinorrhea, itchy watery eyes, sneezing, nasal congestion, dry cough
  • signs: pale, boggy, bluish mucosa, clear, watey dc
  • dx: clinical dx
  • tx: avoid known allergens and use antihistamines, cromolyn sodium, nasal or systemic corticosteroids, nasal saline drops or washes, immunotx
41
Q

aphthous ulcers

A
  • canker sores, ulcerative stomatitis
  • unclear etiology, may be associated with HHV-6
  • sxs: single or multiple painful, round ulcers with yellow-gray centers and red halos, occur on nonkeratinized mucosa, usually recurrent
  • tx: OTC topical anesthetics, nonspecific topical tx (steroids) provide sx relief, 1 wk oral prednisone taper, cimetidine (maintenance) in recurrent cases
42
Q

foreign body - ear

A
  • children, FB of metallic origin, plant, or organic matter
  • sxs: conductive hearing loss, otalgia or dc if secondarily infxn, bleeding if object is sharp
  • dx: none
  • tx: solids (loop, hook, alligator forceps, irrigate if rounded object), do not put water in ear if FB is organic (can swell), if insect - lidocaine or mineral oil can be used to immobilize before removal, irrigation (sterile room temp water or NS) if TM intact, after removal, otic topical abx with steroid
43
Q

FB - eye (corneal)

A
  • trauma to cornea by FB on surface, sets off inflamm rxn - if not removed can become infected, necrosis, or both
  • sxs: pain, erythema, photophobia, excessive tearing, FB sensation, blurred vision, hx recent trauma
  • signs: eyelid closed, ring infiltrate surrouding site of FB if embedded >24h
  • dx: check visual fields and acuity, slit lamp exam, fluorescein staining
  • tx: tetanus IMZ, topic anesthetic, moistened cotton0tipped applicator, sterile 22G needle or alger brush to remove, abx ophtalmic drops (polytrim, sulfacetamide sodium, tobramycin), apply eye patch with firm pressure, reassess in 24h, refer to ophtho
44
Q

FB - nose

A
  • bead or seed
  • sxs: foul smelling dc from affected nostril, rhinorrhea, bleeding, halitosis, nasal obstruction
  • tx: older child can attmpt to blow nose to dislodge, remove FB with topical anesthetic, nasal decongestion, restraints, good lighting, if wedged in refer to ENT, if battery operate must be removed within 4h!

R9 - Emergency Medicine (12 decks)

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