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ER EOR > ENT > Flashcards

ENT Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

MCC AOM

A

strep pneumo
H flu
m catarrhalis

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2
Q

tx AOM

A

amoxicillin/augmentin
azithromycin if allergy

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3
Q

MCC bacterial pharyngitis

A

viral MC overall
strep pyogenes (GAS) mc bacterial

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4
Q

tx bacterial pharyngitis

A

PCN (IM or oral)

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5
Q

MCC sinusitis

A

s pneumo, h flu

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6
Q

tx sinusitis

A

amoxicillin/augmentin
(same as AOM bc same organisms)

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7
Q

tx allergic rhinitis

A

intranasal steroids (Flonase)

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8
Q

sx blepharitis

A

inflammation of eyelids WITHOUT significant pain

crusting, scaling, red-rimming of the eyelid

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9
Q

tx blepharitis

A

eyelid hygiene!!!!

if refractory - azithromycin solution or ointment

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10
Q

MCC viral conjuncitivits

A

adenovirus –> pre auricular lymph node

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11
Q

MCC bacterial conjunctivitis

A

staph aureus –> eye glued shut

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12
Q

tx for corneal abrasion

A

non contact lens wearer - erythromycin ointment
contact lens wearer - topical ciprofloxacin or ofloxacin

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13
Q

sx with orbital floor blowout fracture

A

decreased visual acuity
diplopia (double vision) especially with upward gaze due to inferior rectus muscle entrapment

eyelid swelling (orbital emphysema) due to air from maxillary sinus

numbness to the anteromedial cheek from stretching of the infraorbital nerve

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14
Q

dx orbital floor blowout fx

A

CT scan - tear drop sign - inferior herniation of the orbital fat inferiorly

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15
Q

tx epiglottitis

A

second or third generation cephalosporin + vancomycin

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16
Q

what is acute narrow angle-closure glaucoma

A

increased intraocular pressure leading to damage of the optic nerve

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17
Q

sx acute narrow angle-closure glaucoma

A

sudden onset of severe, unilateral ocular pain

vision changes - halos around lights and peripheral vision loss (tunnel vision)

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18
Q

PE acute narrow angle-closure glaucoma

A

conjunctival erythema
cloudy, steamy cornea
mid-dilated fixed pupil (reacts poorly to light)

funduscopy - optic disc blurring or cupping of the optic nerve

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19
Q

tx acute narrow angle-closure glaucoma

A

topical agent to reduce intraocular pressure (timolol, apraclonidine)

agent to induce miosis (pilocarpine)

systemic agent to lower intraocular pressure (PO or IV acetazolamide or mannitol)

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20
Q

dx acute narrow angle-closure glaucoma

A

tonometry - increased intraocular pressure > 21

gonioscopy - criterion standard - allows one to observe a narrow chamber angle

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21
Q

sx chronic open angle glaucoma

A

asx
slow, progressive painless bilateral peripheral vision loss (tunnel vision)

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22
Q

PE chronic open angle glaucoma

A

cupping of optic discs

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23
Q

tx chronic open angle glaucoma

A

prostaglandin analogs are first line (latanoprost)

laser therapy if medical tx fails

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24
Q

what meds should you avoid if hyphema

A

NSAIDs

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25
Q

tx hyphema

A

shield, elevate head, topical steroid if trauma

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26
Q

what is labyrinthitis

A

inflammation of the vestibular and cochlear portion of CN8

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27
Q

what usually causes labyrinthitis

A

associated with viral or post viral inflammation

28
Q

sx labyrinthitis

A

continuous peripheral vertigo
nystagmus is horizontal or rotary
hearing loss

29
Q

dx labyrinthitis

A

usually clinical
MRI to rule out alternative causes

30
Q

tx labyrinthitis

A

steroids first line
symptomatic relief (Meclizine)

31
Q

sx menieres

A

episodic peripheral vertigo (minutes –> hours)
unilateral fluctuating sensorineural hearing loss
tinnitus
ear fullness

horizontal nystagmus

32
Q

dx menieres

A

dx of exclusion
rule out syphilis

33
Q

tx meneires

A

sodium, caffeine, nicotine, chocolate, alcohol restriction

meclizine and HCTZ

34
Q

MCC of permanent legal blindness and vision loss in older adults in the US

A

macular degeneration

35
Q

sx macular degeneration

A

bilateral, progression central vision loss (including detailed and colored vision)

metamorphosis - straight lines appear bent

36
Q

PE macular degeneration (wet)

A

new abnormal choroidal vessels

37
Q

dx macular degeneration

A

fundoscopy
fluorescein angiography
ambler grid shows metamorphopsia (line distortion)

38
Q

tx wet macular degeneration

A

VEGF inhibitors (Bevacizumab, Ranibizumab, Aflibercept)

39
Q

mastoiditis is usually a complication of

A

AOM!!!

40
Q

sx mastoiditis

A

deep ear pain (usually worse at night)

41
Q

PE mastoiditis

A

otalgia
fever
mastoid tenderness, edema, erythema
protrusion of the auricle

42
Q

dx mastoiditis

A

CT with contrast
MRI

43
Q

tx mastoiditis

A

IV abx + middle ear drainage (myringotomy) with or without tube placement

abx - Vancomycin + cef or piperacillin-tazobactam

if refractory - mastoidectomy

44
Q

what is optic neuritis

A

acute inflammatory demyelination of the optic nerve

45
Q

2 important causes of optic neuritis

A

MS
ethambutol

46
Q

sx optic neuritis

A

painful MONOCULAR vision loss
decrease in color vision
visual field defects - central scotoma (blind spot)

47
Q

PE optic neuritis

A

ocular pain w eye movement
Marcus-Gunn pupil - from unaffected eye to affected eye, the pupils dilate

48
Q

dx optic neuritis

A

MRI of brain and orbits

49
Q

tx optic neuritis

A

IV methylprednisolone

50
Q

orbital cellulitis is MC due to

A

sinus infection

51
Q

dx orbital cellulitis

A

CT

52
Q

tx orbital cellulitis

A

admit
IV vancomycin + cef or ampicillin-sulbactam

53
Q

MCC otitis externa

A

pseudomonas

54
Q

tx otitis externa

A

topical abx + topical steroid

ciprofloxacin-dexamethasone

55
Q

what is papilledema

A

optic nerve (disc) swelling secondary to increased ICP (usually bilateral)

56
Q

sx papilledema

A

HA
N/V
transient visual changes following abrupt shifts in posture or may happen spontaneously

57
Q

dx papilledema

A

funduscopy - swollen optic disc with blurred margins

58
Q

tx papilledema

A

acetazolamide

59
Q

sx retinal detachment

A

photopsia (flashing lights) followed by floaters followed by progressive unilateral peripheral vision loss

NO PAIN

60
Q

dx retinal detachment

A

funduscopy - detached tissue flapping in vitreous humor

61
Q

tx retinal detachment

A

EMERGENCY - keep patient supine while awaiting eye doc – turn head TOWARD side of detachment

62
Q

sx retinal vein occlusion

A

sudden painless unilateral vision loss due to thrombosis

63
Q

dx retinal vein occlusion

A

retinal hemorrhages on funduscopy

64
Q

tx retinal vein occlusion

A

VEGF inhibitors

65
Q
A

ER EOR (28 decks)

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