ENT Flashcards
Acute onset severe eye pain, photophobia, tearing and blurred vision in one eye. Flouriscine dye shows fern like lines on cornea.
Herpes Keratitis
Elderly patient with acute onset severe eye pain with headache, nausea, haloes around lights, and decreased vision. Pupils have decreased reactivity and cornea appears cloudy.
Acute Angle closure glaucoma
Swollen eye lid with proptosis, eye pain with movement.
Orbital cellulitis
Sudden onset floaters with curtain sign and photopsia
Retinal detachment
Cauliflower like gross with foul smelling ear discharge
Cholsteatoma- refer to otolaryngologist
Presbyopia is caused by what?
Affects what vision type first?
- stiffening of the lenses- inability to accomodate
- near vision is affected
What sinuses are present at birth
Ethmoid and maxillary
When do frontal sinuses develop?
When are all sinuses developed?
Frontal- 5yrs
Sphenoid - last = by 12 yrs
White to light gray patch on tongue or floor of the mouth or inside cheek
Leukoplakia- rule out oral cancer
Painful shallow ulcers on soft tissue of mouth
Apthous ulcer/ stomatitis aka canker sores
- resolve 7-10 days
- treat symptoms- cause unknown
Vermilion border-
Oral comissure-
Edge of lips
Corner of lips
Salivary glands
Parotid, submandibular, sublingual
Painless boney protuberance midline on the hard palate
Torus Palatinus = benign
Tongue surface has a map like appearance with patches that move day to day
Geographic tongue = benign
Cluster of small sized read papules with white centres inside the cheeks by the lower molars
Kopliks spots
= measles
Hairy leukoplakia associated with what?
HIV
-caused by EBV infx of tongue
Hyperopia
Far sightedness
Myopia
Near sightedness
Parts of the ear affected by conductive hearing loss?
Outer & middle
Parts of the ear affected in sensorineural hearing loss?
Inner ear or CN 8
Example of sensorineural hearing loss
Ménière’s disease, presbycusis
Antibiotic eardrops with ruptured Tympanic membrane
Ofloxacin
Classes of Ototoxic medications- x 7
Abx = tetracyclines + macrolides + aminoglycosides
Anti- malarials + anti- neoplastics + anti-inflammatory
Loop diuretics
Rinne test results in Conductive & Sensorineural Hearing Loss
Conductive - BC> AC
SN- AC > BC
Bleeding in Kiesselbachs plexus =
Anterior nose bleeds - tx with pressure 1st
What nose bleed type can lead to hemorrhage
Posterior
Rhinitis medicamentosa is caused by what?
Overuse of topical nasal decongestant >3d
What antihistamine class are less sedating? 2 examples?
2nd generation ie. cetirizine / loratadine
Group A Strep throat treatment
Penicillin V x 10d
Most common organism in acute otitis media?
S. Pneumoniae
Then H.flu
Middle ear effusions can persist for long post treatment of otitis media?
8 weeks or more
1st line tx for AOM (if no abx within 1 month)
Amoxicillin x 5-7d
Pt with AOE has been treated with amoxicillin for 48h and symptoms have no improvement- what do you do?
Change to amoxiclav x 5d
Rhinosinusitis is most commonly caused by ———-.
How long do you watch and wait before adding antibiotics?
What abx?
Viral
10 days
Amoxicillin or amoxiclav
Treatment of rhinosinusitis with penicillin allergy
Doxycycline
Otitis externa common pathogens and treatment
S. aureus & pseudomonas
Polymyxin B + hydrocortisone gtts x 7d
Or
Ofloxacin/ ciprofloxacin gtts x 7d
First line treatment for allergic rhinitis
Nasal steroids i.e. fluticasone
Benadryl / diphenhydramine is what generation of antihistamine
1st = more sedating
Pen allergic pts use what 2 classes instead?
Macrolides
Gram + coverage- quinolones
What class of medication’s has cross-reactivity with penicillin allergy
Cephalosporins
Weber test lateralized to the bad year and what kind of hearing loss
Conductive
20/ 40 vision means?
Pt sees at 20ft what normal vision can see at 40ft
Common ceruminosis tx
Carbamide peroxide
To assess for corneal abrasions and keratitis use ———
Fluorescein strips
Raised yellow to white small round grows on the bulbar conjunctiva next to the cornea.
Pinguecula
Yellow triangular thickening of conjunctiva that extends across the cornea
Pterygium
External Hordeolum involves inflammation of what-
Internal hordeolum -
Ext- Hair follicle & sebaceous gland
Int- Meibomian gland
-painful, infected, usually self resolve- warm compresses
Inflammation of the meibomian gland of the eyelids- non-painful, hard.
Chalazion
Usually resolve in 2-8 weeks
Sometimes need cutting out
Normal optic disc appearance and cup to disc ratio
Sharp outline
< 0.5
Normal intraocular pressure
8-21 mmhg
Scotoma
Central vision blind spot- macular degenerations
Describe intraoccular veins and arteries
Veins are larger, darker, and pulse
When an artery crosses of them in the eye this is called
Arteriovenous nicking- 2nd to HTN
What are the components of the Centor score
Cough absent
Exudative/ swollen tonsils
Nodes swollen- anterior cervical
Temp- fever
Ages 3-14 + 1
> 45y -1
What centor score indicates need to test
> 2
Treatment for Group A strep
Penicillin V x 10d
Common diagnostic findings in mononucleosis
Lymphocytosis, atypical lymphocytes, elevated liver enzymes, splenomegaly
Otitis media tx
Amoxicillin
Bacterial rhinosinusitis tx
Amoxi-clav
Otitis media with effusion tx
Oral decongestants
Nasal steroid
