ENOT/Opthalmology Flashcards
how is chronic rhinosinusitis categorized
lasting 12 weeks or longer - despite attempts at medical management
what is the common treatment for chronic rhinosinusitis
amox-clavulantate 875mg BID for at least 3 weeks and up to 10 weeks
what are aphthous ulcers
single or multiple small, shallow ulcers with a yellow-grey fibroid center with red halos
how are aphthous ulcers diagnosed
clinical presentation and history
consider biopsy if lasting for more than 3 weeks
what is the treatment for apthous ulcers
viscous lidocaine 2-5%
define blepharitis
chronic inflammation of lid margins - caused by seborrhea, staph or strep
how is blepharitis diagnosed
slit-lamp examination
what is the treatment for blepheritis
warm compresses, daily lid wash with diluted baby shampoo, lid massages and topical abx if infection is suspected
what presents with painless otorrhea, brown/yellow dicharge with a strong odor
cholesteatoma
what causes cholesteatomas
chronic eustachian tube dysfunction resulting in chronic negative pressure causing granulation tissue
how is cholesteotoma diagnosed
otoscopic visualization of granulation tissue
confirm with CT and audiogram for hearing loss assessment
how are cholesteotomas treated
surgical removal
what are the different types of conjunctivitis
- viral
- bacterial
- allergic
what type of conjunctivitis presents with copious watery discharge, scant mucoid discharge
what is the common etiology
viral
adenovirus
what type of conjunctivitis presents with purulent discharge, crusting, usually worse in the morning
common etiologies
bacterial
S. pneumonia, S aurus for acute
M. catarrhalis and gonococcal/chlmydia
what is Giemsa stain includsion bodies indicative
chlamydia conjunctivitis
what type of conjunctivitis presents with red eyes, itching and tearing - typcially bilaterall
allergic
what is the treatment of bacterial conjunctivits
gentamicin/tobramycin
erythromycin ointment
trimethoprim and plymyxin B
if a patient has contacts what medications should be added to medication regimen
Fluoroquinolones - Ciprofloxacin/ciloxan drops
what presents with sudden onset of eye pain, photophibia, tearing, FB sensation, blurring of the vision and/or conjunctival injection
corneal abrasion
how are cornial abraisons diagnosed
fluoescen staining
what is the treatment for corneal abraisons
abx ointment - NO PATCHING
who commonly is affected by corneal ulcers
contact wearers
what is a corneal ulcer
deep infection of cornia by bacteria, virus or fungi
what is the presentation of corneal abrasion
white spot on the surface of the cornea that stains wtih fluorscein
what is the treatment of corneal ulcer
immediate referral - if not possible start topcial opthalmic antibiotics
define keratitis
inflammation of the cornia
what is inflammation of the lacrimal gland called
dacryoadenititis
what is the cause of dacryoadenitis
bacteria or virus
what is an infectious obstruction of the nasolacrimal duct called
dacryocystitis
what is the eversion of the eyelid called
ectropion
what is inversion of the eyelid called
entropion
what is the treatment for ectropion and entropion
tear supplements and ocular lubricants at night
- definitive = surgery
what is the common site for anterior nose bleeds
kiesselbachs plexus
what is the common site for posterior nose bleeds
Woodruffs plexus - phenopalatine artery
what needs to be given if anterior nasal packing is required
cephalosporin to prevent toxic shock syndrom
what is the classic triad associated with acute narrow angle closure glaucoma
injected conjunctiva, steamy cornea and a fixed dilated pupil
(opthalmic emergency)
how are glaucomas diagnosed
tonometry showing increased IOP
what is the treatment for acute narrow angle-closure glaucoma
acetazolaminde IV = first line agent
topical BB (timolol)
Miotics/cholinergics (pilocarpine)
what is the definitive treatment for acutre narrow-angle glaucoma
peripheral iridotomy
what is the treatment for chronic open-angle glocoma
prostaglanding analogs - first line (latanoprost)
topical BB (timolol)
what is a painful, warm, swollen red lump on the eyelid called
hordeolum
what is the treatment for hordeolum
warm compress and topical abx
what is a hyphema
trauma causing bleeding in the anterior chamber of the eye (between cornea and iris)
what is the tx for hyphemas
usually the blood is reabsorbed over days/weeks
- elevate head at night to 30 degrees
how does labrynthitis present
acute onset, continuous vertigo + hearing loss, tinnitus lasting several days to week.
what is the treatment of labrynthitis
vestibular suppressants (meclizine) and antiemetics (zofran/promethazine) to limit symptoms
10 day course of prednisone taper
what is the treatment of laryngitis
vocal rest and supportive therapy
what is gradual painless of central vision called
macular degeneration
what is seen with dry macular degeneration
DRUSEN - yellow retinal deposits
what is seen with wet macular degeneration
hemorrhage, neovascularization
what is the treatment for wet macular degeneration
VEGF inhibiors
photodynamic therapy
Zinc and antioxidant vitamins
what is the treatment of dry macular degeneration
zinc and antioxidant vitamin
what disease is characterized by excessive endolymph fluid in the cochlea that causes overstimulation of the hairs - causing vertigo and sudden hearing loss
meniere disease
what is the treatment of meiere disease
low salt diet and diuretics to reduce the aural pressure
What is Samter’s Triad
asthma
ASA sensitivity
nasal polyps
often seen in conjunction with allergic rhinitis
what pathogen is the common cause of bacterial otitis externa
Pseudomonas aeruginosa (swimmers ear)
or
S. aureus (digital trauma)
what is the treatment for bacterial otitis exeterna wtih chance of or perforated TM
Cipro and dexamethasone drops
what are diagnostic criteria for otitis media
- bulging of TM
- other signs of acute inflammation (erythema, fever, pain)
- middle ear effusion
what is the treatment options for otitis media
first line = amoxicillin
second line = augmentin
(macrolides if PCN allergic)
what is pailledema
optic disc swelling that is caused by increased ICP
what causes papilledema
malignant HTN
brain tumor/abscess
meningitis
cerebral hemorrhage
encephalitis
what is the presentation of a patient with parotitis
fever/chills
periauricular, mandibular pain and swelling
dysphagia
what is the treatment of parotitis
self limiting - treat with hydration and rest
vaccination is effective for prevention
what is the treatment of peritonsillar abscess
aspiration, incision and drainage and/or ABX
what is the most common etiology of pharyngitis
viral - adenovirus
or mononucleosis
what is the Centor Score
for streph pharyngitis
1. absence of a cough
2. exudates
3. fever (>100.4)
4. cervical lymphadenopathy
(3 or 4 (+) means strep test)
what is the treatment for GAS pharyngitis
PCN = first line
azithro if PCN allergic
what is the treament of gonorrhea pharyngitis
ceftriaxone 500mg IM as a single dose
what is a Pterygium
elevated, superficial, fleshy, tiragular-shaped “growing” fibrovascular mass - m/c in inner corner/nasal side of the eye
what is the treatment of pterygium
only surgically removal when vision is affected
what is the presentation of retinal detachment
curtain coming down across vision may sense floaters or flashes at onset
what is myopia
nearsightedness
what is the treatment of retinal detachment
opthalmologic emergency
what is the presentation of retinal vascular occlusion
sudden, painless, unilateral and usually sever vision loss
what is sialadenitis
bacterial infection of salivary gland
how is sailadenitis diagnosed
CT, US or MRI can confirm
if pus - gram stain and culture
how is sialolithiasis
clinical dx is usually adequate
what are the only type of antibioitcs that are non-ototoxic
floxin drops
