ENOT/Opthalmology Flashcards
what is the MC location for acute bacterial sinusitis
maxillary sinus
what is the MC pathogens for bacterial sinusitis
- strep pnuemo (MC)
- H flu
what are s/s of acute bacterial sinusitis
- nasal congestion
- tooth pain
- purulent nasal discharge
- fever
preceeded by a URI (better and then worse again or 10 days straight)
what is the treatment for acute bacterial sinusitis
- augmentin
- doxy, levo or z pack for PCN allergy
can use clinda
what is considered chronic bacterial sinusitis
symptoms for >12 weeks
how do you diagnose chronic bacterial sinusitis
CT face/sinuses
what is the treatment for chronic bacterial sinusitis
- treat emperically w augmentin or clinda
- nasal secretion culture
- abx based on culture
what is the treatment of allergic rhinitis
- daily intranasal glucocorticoids
- Antihistamines
- decongestants
- montelukast
what is the MC location for epistaxis
Anterior: Kiesselbach’s plexus
how do you manage anterior epistaxis
- pressure for 15 min
- sit, lean forward
- phenylephrine
- if still bleeding topical lidocaine or cocaine
- then if still, silver nitrate
- then if still nasal packing
how do you manage posterior epistaxis
- ENT consult
- packing
what is the abx management for nasal packing
augmentin, clinda, or keflex
what are the common underlying cuases of nasal polyps
- allergic rhinitis
- cystic fibrosis
what is the treatment for nasal polyps
- topical nasal steroids for 1-3 months
- if still, short course of oral steroids
- surgical removal if remain
what is the major predisposing factor for aphthous ulcers
stress
some association with herpes 6
what is the presentation of an aphthous ulcer
- small round ulceration with yellow gray center surrounded by red halos
- painful
- lasts 1-3 weeks
what is the treatment for aphthous ulcers
symptomatic:
- viscous lidocaine
- topical steroid
- magic mouthwash (lidocaine, nystatin, diphenhydramine)
what is the treatment for herpes gingivostomatitis
antivirals within 24-48 hours
viscous lidocaine
presentation of mono (EBV)
- pharyngitis w/wo exudate
- fever
- posterior cerv LAD
- splenomegaly
- rash w amoxicillin
diagnosis for mono
monospot
treatment for mono
- no contact sports 4 weeks
supportive
Presentation of strep throat
fever
sore throat
N/V
anterior cerv LAD
palatal petechiae
NO COUGH
testing for strep
- swab
- culutre
treatment for strep throat
- penicillin
- amox
- azithro for allergy
change toothbrush
What lab value will be elevated after recent strep infections
ASO titer
Complications of strep throat
- otitis media
- rheumatic fever/valvular heart disease
- poststreptococcal glomerulonephritis
presentation of a peritonsillar abscess
- severe sore throat (unilateral)
- fever
- muffled voice
- neck swelling/pain
- deviation of uvula to opposite side
how do you confirm a peritonsillar abscess
cut into that thing and aspirate pus
treatment for peritonsillar abscess
- I&D
- IV Unasyn or clinda
- followed by oral augmentin or clinda
what is a retropharyngeal abscess
abscess of the deep neck structures
presentation of retropharyngeal abscess
- neck swelling/LAD
- fever
- odynophagia
- dysphagia
how do you confirm retropharyngeal abscess
CT neck with contrast
what is the management of a retropharyngeal abscess
- IV Abx: unasyn, rocephin + metro, or clinda + levo
- surgical drainage
presnetation of acute laryngitis
- hoarseness
- preceeded by URI
- if bacterial: exudative tonsills, fever and ant cerv LAD
what is the treatment for acute laryngitis
consider viral, bacterial, and vocal strain
- viral - supportive
- bacterial - PCN, erythromycin
strain - steroids and/or surgical
Presentation of croup
- seal like cough
- inspiratory stridor
- fever
parainfluenza is the cause
what would you see on Xray of croup
steeple sign
Treatment of croup
- dexamethasone or prednisone + neb epi
presentation of epiglottitis
- tripod position
- dysphagia, drooling and distress
- high fever
- toxic appearance
treatment of epiglottitis
- airway maintenance
- Rocephin + Vanc
Presentation of bacterial conjunctivitis
- purulent discharge
- discomfort
MC organism for bacterial conjunctivitis
- Staph Aureus
- strep pneumo
psuedomonas for contact wearers
treatment for bacterial conjunctivitis
- topical erythromycin
- trimethoprim-polymyxin B
- severe or pseudomonas = topical FQ
- gonococcal - rocephin
- chlamydial - azithromycin
presentation of viral conjunctivitis
- watery discharge
- associated pharyngitis, fever, malaise, and preauricular adenopathhy
treatment of viral conjunctivitis
supportive
presentation of allergic conjunctivitis
- itching, redness, tearing
- stringy discharge
- cobblestone papillae on exam
treatment of allergic conjunctivitis
- topical antihistamines (alaway, patanol, olopatadine)
- topical NSAIDs