ENOT/Opthalmology Flashcards
What is the etiology of AOM
Viral URI that leads to bacteria
what are the MC organisms for AOM
- strep Pneumo
- M. Cat
- H. Flu
How do eustachian tubes of children differ from eustachian tubes of adults
children’s eustachian tubes are shorter and more horizontal
what are the s/s of AOM
- preceding URI
- fever, otalgia, otorrhea, irritability, tugging at ears
- inflammation of TM
- bulging TM
How do you treat AOM?
- amoxicillin
- PCN allergy = erythromycin-sulfisoxazole
I saw this PCN allergy thing on kaplan, must be an updated thing. Idk, take it as you will lol.
what is the etiology of strep pharyngitis
GAS
what are S/S of strep pharyngitis
- sore throat
- absence of cough
- anterior cervical LAD
- palatal petechiae
- tonsillar exudates
How do you treat strep pharyngitis
- PCN or amoxicillin
- PCN allergy = keflex or cefdinir or azithromycin or clinda
change toothbrush after 24 hours!
history of patient with allergic rhinitis
- family and personal history of allergy symptoms
- dermatitis and eczema and asthma
what are s/s of allergic rhinitis
-rhinorrhea
-sneezing
-nasal obstruction
-itching
-cough
-shiners
-salute sign
-pale, boggy mucosa
-cobblestoning
Management of allergic rhinitis
- intranasal steroids
- antihistamines
what are the s/s of bacterial conjunctivitis
- purulent discharge
- conjunctival injection
what is the MCC of bacterial conjunctivitis in children
strep pneumo
what is the treatment for bacterial conjunctivitis
- polytrim eye drops (polymyxin B/ trimethoprim)
- could also use erythromycin drops
what is the treatment for gonococcal conjunctivitis
rocephin
what is the treatment for chlamydial conjunctivitis
azithromycin (1G oral one dose)
or doxycycline
what is the MC infectious cause of blindness
chlamydial conjunctivitis
what are the s/s of viral conjunctivitis
- watery drainage
- BILATERAL red or pink eye
- foreign body sensation
- preauricular LAD
what is the MCC of viral conjunctivitis
adenovirus
what is the treatment of viral conjunctivitis
- cool compress
- artificial tears
- antihistamines for itching/redness
what are s/s of allergic conjunctivitis
- BILATERAL red eyes
- itching
- clear watery discharge
- cobblestoning on inner and upper eyelid
what is the treatment of allergic conjunctivitis
- topical antihistamines (olopatadine)
what is the etiology of epiglottitis
H influenza (Hib)
what are the clinical findings of epiglottitis
- rapid onset of fever and dysphagia
- drooling, tripod stance and inspiratory stridor
- toxic appearance
how do you diagnose epiglottitis
- xray of lateral soft tissue of the neck showing thumbprint sign
- also clinically with visualization of cherry red epiglottis
what is the treatment for epiglottitis
- maintain the airway
- IV vanc and rocephin
what is the MC type of epistaxis
anterior bleed from kiesselbachs plexus
how do you manage anterior epistaxis
- pressure on site with sitting leaning forward
- if bleeding continues: vasoconstriction (via cocaine, lidocaine, epi) or silver nitrate
- if continues: nasal packing (gross)
rosh said oxymetolazine 1st line for vasoconstriction then phenylephrine
what is the management of posterior epistaxis
packing via foley, gauze or intranasal balloon device
What must be given to all patients when they recieve nasal packing
prophylactic antibiotics for TSS
(augmentin, keflex or bactrim is what is recommended via my personal research)
what is the MC congenital abnormality in newborns
hearing loss
how are hearing screenings performed
- birth to 3: behavioral and language responses
- 4+: audiometry
what is the etiology of mastoiditis
untreated OM
what is the presentation of mastoiditis
- fever
- otalgia and proptosis
- erythema to the posterior ear (mastoid process)
how do you diagnose mastoiditis
CT scan
what is the treatment of mastoiditis
IV rocephin followed by oral augmentin
what are risk factors for oral candidiasis
- young infants
- DM
- immunocompromised
what is the presentation of oral candidiasis
- burning of the tongue
- creamy curd on the tongue and mucosa
- CAN be scraped off
how do you diagnose oral candidiasis
- mostly clinical
- wet prep with KOH
what is the treatment of oral candidiasis
oral nystatin
what is the etiology of orbital cellulitis
acute sinusitis
what is the presentation of orbital cellulitis
- fever
- pain and erythema with ptosis and chemosis
- limited EOM!!!
How do you diagnose orbital cellulitis
orbital CT
what is the treatment of orbital cellulitis
- IV vanc + rocephin
- then switch to PO bactrim for 2-5 weeks
what is the MCC of otitis externa
psuedomonas
what are the s/s of acute otitis externa
- itching
- pain with palpation of tragus or traction of auricle
- purulent discharge
what is the treatment of otitis externa
- topical antibiotics (cipro or ofloxacin)
- ear wick
what is the treatment of diffuse otitis externa
oral cipro
who is diffuse otitis externa MC seen in?
immunocompromised patients
what is furunculosis
infection of hair follicle in the ear
what is the MCC of acute otitis externa 2/2 furnuculosis
staph aureus
how do you treat furunculosis otitis externa
- oral dicloxacillin or keflex
- I&D if needed
what is the etiology of otomycosis
aspergillosis and/or candidiasis
what is the presentation of otomycosis
- deep seated itching
- foreign body sensation in ear
- soft white sebaceous-like material that fills ear canal
what is the treatment of otomycosis
clotrimazole 1% solution BID
what is the etiology of non-infective otitis externa
- seborrheic dermatitis
- psoriasis
- contact dermatitis
what is the treatment of non-infective otitis externa
topical steroids
what is the etiology of malignant otitis externa
pseudomonas
what is the presentation of malignant/necrotizing otitis externa
- severe deep seated otalgia out of proportion to exam findings
- granulation tissue at the bony cartilaginous junction of the ear canal floor
how do you diagnose chronic otitis externa
- CT
- biopsy of granulation tissue
what is the treatment of chronic otitis externa
IV and oral cipro
what is the etiology of peritonsillar abscess
- strep pyogenes
- staph aureus
what is the presentation of peritonsillar abscesses
- unilateral swelling with a deviated uvula
- drooling, odynophagia, muffled voice
- severe sore throat
How do you diagnose peritonsillar abscess
CT w contrast
what is the management for peritonsillar abscess
- airway management
- unasyn or clinda IV then switch to augmentin or clinda PO
what is strabismus
crossed eyes
what are the types of strabismus
- esotropia (inward)
- exotropia (outward)
- hypertropia (upward)
- hypotropia (downward)
what is a corneal light reflex
shine a light toward a child’s eye. the light should be reflected in the same spot in the two corneas.
what is the cover test
- child fixated on target in distance
- briefly cover one eye
- watch for eye to refixate when covering the other eye
what is the cover/uncover test
- child visually fixates on item in distance
- watch for eye to deviate when covering and uncovering
what is the bruckner red reflex
shine light on eyes to make sure both red reflexes are the same
what is the treatment of strabismus
- corrective lenses
- patching
- surgery
what is the treatment of a ruptured TM
- audiogram
- oral amoxicillin
- earplugs when swimming and bathing
- resolves spontaneously
