ENT 3

Question 1

Blow out fracture general characteristics

Answer 1

Blunt trauma, such as that from a fist or a ball, causes the floor to fracture, trapping the orbital structures inferiorly.

Question 2

blowout fracture clinical features

Answer 2

(1) Patients present with swelling and misalignment.

Movement of the globe is restricted, specifically an inability to look up

(2) Double vision is common.
(3) Subcutaneous emphysema and exophthalmos are commonly present.

Question 3

blowout fracture treatment

Answer 3

(1) Prompt referral to an ophthalmologist is important
(2) Patients should be kept calm and avoid sneezing or anything that would increase pressure.
(3) Nasal decongestants, ice packs or cold compresses, and antibiotics are started during transport.

Question 4

corneal abrasion clinical features

Answer 4

(1) Pain and sensation of a foreign body can be accompanied by photophobia, tearing, injection, and blepharospasm.
(2) Patients may complain of blurred vision.
(3) A slit-lamp examination or fluorescein staining will reveal an epithelial defect but a clear cornea.

Question 5

corneal abrasion treatment

Answer 5

(1) Topical anesthetic will provide immediate relief; however, it should be used only to assist in confirming the diagnosis
(2) Saline irrigation will loosen debris. Antibiotic ointment, such as gentamicin or sulfacetamide, should be applied.
(3) Patching for no longer than 24 hours is recommended only for large abrasions
(4) Daily follow-up of all abrasions is essential. Failure to heal should prompt referral to an ophthalmologist.

Question 6

retinal detachment general characteristics

Answer 6

a separation of the retina from the pigmented epithelial layer, causing the detached tissue to appear as flapping in the vitreous humor.

(b) The tear most commonly begins at the superior temporal retinal area.
(c) The tear can happen spontaneously or be secondary to trauma;

Question 7

retinal detachment clinical features

Answer 7

(a) The patient may report acute onset of painless blurred or blackened vision
(b) It is classically described as a curtain being drawn over the eye from top to bottom.
(c) The patient may sense floaters or flashing lights at the initiation of symptoms. Intraocular pressure is normal or reduced.
(d) There will be a relative afferent pupillary defect.

Question 8

retinal detachment treatment

Answer 8

(a) An emergency consult with an ophthalmologist regarding possible laser surgery or cryosurgery is needed.
(b) Patients with retinal detachment should remain supine, with the head turned to the side of the retinal detachment.

Question 9

central retinal artery occlusion general characteristics

Answer 9

This disorder is considered to be an ophthalmic emergency; prognosis is poor, even with immediate treatment.

(b) Common causes are emboli, thrombotic phenomenon, and vasculitides.

Question 10

central retinal artery occlusion clinical features

Answer 10

It is characterized by sudden, painless, and marked unilateral loss of vision.

(b) Funduscopy reveals pallor of the retina, arteriolar narrowing, separation of arterial flow ( box-carring), retinal edema, and perifoveal atrophy (cherry red spot).

Question 11

central retinal vein occlusion general characteristics

Answer 11

usually occurs due to thrombus

sudden, painless, blurred vision or loss

afferent pupid defect, blood and thunder retina

vision usually resolves in time

Question 12

two types of retinopathy

treatment

Answer 12

hypertensive and diabetic

glucose control, HTN control, laser coag, vitrectomy

Question 13

signs of hypertensive retinopathy

Answer 13

diffuse arteriolar narrowing, copper or silver wiring, and arteriovenous nicking

Question 14

what is the leading cause of blindness in US adults

Answer 14

diabetic retinopathy

Question 15

signs of proliferative and nonproliferative diabetic retinopathy

Answer 15

(b) Nonproliferative: venous dilation, microaneurysms, retinal hemorrhages, retinal edema, hard exudates
(c) Proliferative: neovascularization, vitreous hemorrhage

.

Question 16

orbital cellulitis general characteristics

Answer 16

(1) Orbital cellulitis is more common in children than in adults.
(2) Orbital cellulitis is primarily associated with sinusitis.
(3) Causative agents include Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, and Gram-negative bacteria.

Question 17

orbital cellulits clinical features

Answer 17

ptosis, eyelid edema, exophthalmos, purulent discharge, and conjunctivitis.

(2) fever, restricted EOM ROM, edema and erythema of the lids and surrounding skin, and a sluggish pupillary response.

Question 18

amblyopia defined

causes

Answer 18

a. Amblyopia is reduced visual acuity not correctable by refractive means.
b. It may be caused by strabismus (most commonly); uremia; or toxins, such as alcohol, tobacco, lead, and other toxic substances.

Question 19

blepharitis definition and typical causes

Answer 19

inflammation of the lid margins

seborrhea, staphylococcal or streptococcal infection, and dysfunction of the meibomian glands.

Question 20

blepharitis treatment

Answer 20

Lid scrubs using diluted baby shampoo on cotton-tipped swabs are helpful.

Massage to express meibomian glands.

(b) Topical antibiotics can be used if infection is suspected.

Question 21

viral conjunctivitis general characteristics

Answer 21

usually is caused by adenovirus type 3, 8, or 19.

Viral conjunctivitis is highly contagious. Transmission is by direct contact,

Question 22

clinical features of viral conjunctivits

Answer 22

acute onset of unilateral or bilateral erythema of the conjunctiva

copious watery discharge

ipsilateral tender preauricular lymphadenopathy.

Question 23

treatment of viral conjunctivitis

Answer 23

(1) eye lavage with normal saline twice a day for 7 to 14 days
(2) Warm to cool compresses reduce discomfort.

Question 24

pterygium

Answer 24

(1) Slowly growing thickening of the bulbar conjunctiva
(2) It can be unilateral or bilateral.