ENT Flashcards
What nerve is affected In a blowout fracture?
Infra orbital nerve
Double vision from a blowout fracture involves what muscle?
Inferior rectus
This is a granulomatous inflammation of the meibomian gland. Painless hard swelling of eyelid.
Chalazion treat with warm compress, topical abx, I and d.
What Meds do you avoid in bacterial conjunctivitis?
Neomycin and steroids.
What is hutchinsons sign?
Shingles in tip of nose. Refer to ophthalmologist.
What can be seen on fluorescien stain in herpes simplex of the eye?
Dendritic ulcers
What med do you give for a corneal abrasion in a contact wearer?
To rambling or fluroQuinolones to cover pseudomonas. Follow up in 24 hrs and no contact foR 1 week.
What his dacryocystitis?
Infection of the lacrimal sac. Treat with ABX and lid hygiene.
First test if you suspect a foreign body in the eye?
Visual acuity.
What is an ophthalmic topical anesthetic?
Proparacaine 0.5%
When should you remove the rust ring in an eye?
24 hrs
What is normal IOP?
8-21 mmHg
This presents with extreme pain, blurry vision, halos, n/v, ha, red eye with steamy cornea, no reactive pupils and a hard eye.
Acute glaucoma. Give IV diamox, pilocarpine, and refer.
This is due to abnormal drainage of aqueous through the trabecular mesh work. Asymptomatic.
Primary open angle glaucoma.
Treatment for primary open angle glaucoma?
Beta blockers, prostaglandin analogs. Referral.
What is a hordeolum?
Staph infection of the meibomian gland. Stye. Treat with warm compress and topical abx.
What is a hyphema and how do you treat it?
Hemorrhage into the anterior chamber. Place patient. At 45degree angle to keep RBC from staining cornea. No ASA or NSAIDs.
This is a unilateral painful red eye, blurry vision, photophobia WITHOUT discharge.
Acute iritis. Refer.
Leading cause of vision loss in the elderly.
Macular degeneration.
Rapid form of macular degeneration with greater severity, hemorrhages and neovascularization.
Exudate be or wet.
Slow version of macular degeneration with druses.
Atrophic or dry.
Test for macular degeneration?
Amsler grid chart.
This is an infection of the eyelids and peri ocular tissues, associated with a uri, sx are tearing, fever, erythema, tenderness. Visual acuity, pupil reaction and EOM are normal.
Periorbital cellulitis.
this is an infection of the orbital soft tissues, posterior to the orbital septum, pain. With eye movement, decreased visual acuity, proptosis.
Orbital cellulitis.
Treatment for peri orbital cellulitis?
Augmentin.
Treatment for orbital cellulitis?
Hospital IV abx.
Patient presents with sudden loss of vision, pain oath eye movement. Funduscopic exam shows inflammation of the optic nerve. What is dx and what is it associated with?
Optic neuritis. Associated with MS. Tx with steroids.
Fleshy lesion on cornea?
Pterygium. Pterodactyl
Yellow lesion on conjunctiva.
Pinguecula.
Painless curtain over vision, flashers and floaters, does not resolve.
Retinal detachment. Refer.. Keep in supine position.
Curtain on vision, comes and goes?
Amarosus fugex. Check carotids for plaques. Like TIA.
Sudden painless profound visual loss. Swelling of retina, box car arteries and pale retina with cherry red spot. What is this?
Retinal artery occlusion. Immediate referral
Vision loss with retinal hemorrhages.
Retinal vein occlusion.
Vision loss with retinal hemorrhages, neovascularization, cotton wool spots?
Diabetic retinopathy. Yearly eye exams and control diabetes.
Vision changes with av nicking, flame shaped hemorrhages on retina.
Hypertensive retinopathy.
Absent red reflex, white pupil.
Retinoblastoma. Refer.
Pathogens for acute otitis media?
S. Pneumo
H. Flu
M. CST
Tm bullae think….
Mycoplasm pneumonaie.
First line tx for AOM?
Amoxicillin. If PCN allergic use azithromycin
Treatment for chronic otitis media?
Cipro. Drops.
Patient presents with postsuricular pain and erythema, fever, bulging TM. Dx, treatment and test of choice?
Mastoiditis. CT is test of choice. Treat with IV ampicillin, surgical drainage.
Pathogens for otitis external?
Pseudomonas, staph, proteus, fungi aspergillus.
Treatment for otitis externa?
Otic aminogylcosides (neomycin, polymyxin b) Fungal Amphotericin b
Episodic vertigo lasting 1-8 hrs, low frequency hearing loss and tinnitus?
Ménière’s disease. Test with caloric testing. Treat with low salt diet, anti vertigo Meds, possible surgical decompression. Due to distention of the endolymphatic compartment of the inner ear.
Episodic vertigo, unilateral hearing loss, tinnitus?
Acoustic neuroma. Benign tumor of the myelin forming cells of the vestibulocochlear nerve. CN VIII
Acute onset of CONTINUOUS vertigo,neither hearing loss and tinnitus. Follows a URI frequently.
Labyrinthitis. Self limiting.
Patient over 50 with dizziness, vertigo, imbalance, nausea. Head movement makes it worse. Last s less than 1 min. Dx, tx.
BPPV. Dix Hallpike test positive. Treat with Eply maneuver or watch and wait.
Conductive hearing loss weber/rinne?
Weber: sound heard in ear with loss.
Rinne: BC>AC
Sensorineural loss Renne.
AC>BC
Meds that cause hearing loss.
Aminoglycosides (tobramycin, gentamicin)
Lasix
Cisplatin
ASA causes tinnitus.
Acute sinusitis time for sx, most common site, and common pathogens?
Greater than 10 days, maxillary, s. Pneumonaie, h. Flu, m. Cat
Test of choice for acute sinusitis?
CT
Treatment for acute sinusitis?
Augmentin for kids and adults. Second line levo. Treat for 10-14 Days.
Treatment length for chronic sinusitis?
2-3 weeks.
Eosinophils in nasal smear?
Allergic rhinitis.
Treatment for epistaxis?
Anterior: petroleum packing
Posterior: sponge pack, balloon Tamponade
Keflex, augmentin
Why do you avoid ampicillin in EBV?
- It is a virus.
2. Causes a rash.
Painless white patches overlying Erythematous mucosa in mouth. Easily ribbed off, no bleeding. Dx?
Oral candidiasis, thrush. Tx with nystatin, flucsonazole. Recurrent could mean HIV.
Lab txt for herpes simplex?
Tzanck smear.
White mouth lesion not able to scrape off and bleeds?
Oral leukoplakia.
Risk factors for oral leukoplakia?
Tobacco, alcohol, oral infections. Get bx to rule out malignancy.
Treatment for leukoplakia?
Hairy: acyclovir
Normal : isotretinoin
Remember to check HIV status and rule out malignancy
Where does an peritonsillar abscess form?
Between anterior and posterior tonsil pillars and the superior pharyngeal constrictor muscle.
Patient complains of acute swelling and pain with meals and tenderness at salivary gland duct opening. Dx?
Sialadenitis. Massage, lemon drops and bx if needed.