ENT Flashcards
irritation, burning and itching of eye lids. red rimmed eyes/scaly/frothy tears
blepharitis
tx blepharitis
hot wash cloth and baby shampboo, bacitracin to apply to lid margins. if posterior, try tetracyline po bid
tx bacterial conjunctivitis
topical sulfonamide TID
topical tx for allergic conjunctivitis
H1 antagonist levocabastine hydrochloride .05% or mast cell stabilizer cromolyn sodium 4%
you suspect corneal abrasion. dx and tx?
dx with slit lamp or fluorescein staining and check acuity. then topical anesthetic, antibiotic ointment bacitracin/polymyxin and acetaminophen for pain relief. patch and follow up in 1-2 days
dacryoadenitis
inflammatory conditions affecting lacrimal system of eye…cystitis is an infection within lacrimal drainage system.
tx dacryoadenitis
systemic antibiotic therapy, can prob duct if chronic
tx dacryocystitis
warm compress and massage, look for orbital cellulitis then need to admit for IV antibiotics
sxs dacryocystitis
sudden pain, erythema, edema overlying lacrimal sac, tearing, mattering, may have cellulitis
fever, proptosis, restriction of extraocular movements, swelling and redness of lids
orbital cellulitis
orbital cellulitis tx
hospitalize for IV nafcillin with metronidazole or clindamycin to cover anaerobes. if trauma, use cephalosporin to cover staph/strep. vanco or clinda if MRSA
cherry red spot, persistent painless loss of monocular vision
retinal artery occlusion
sudden blurring or vision loss in all or part of eye….common from HTN, diabetes, glaucoma, atherosclerosis
RVO. refer right away
painful focal abscess on eyelid
hordeolum
painless cyst of eyelid
chalazion
tx hordeolum
warm compresses, lid hygiene, massage, systemic cefalexin
blood in anterior chamber. next step?
CT of orbit to r/o orbital fracture or foreign body. screen for sickle cell and do a Hgb electrophoresis and refer to opthalmologist
curtain over eye…painless sudden appearance of floaters or flashes of light
retinal detachment
tx retinal detachment
refer emergently
blurry vision, halos, cloudy/steamy cornea, nausea and vomiting
acute angle closure glaucoma
tx AACG
reduce IOP with acetazolamide. can do osmotic diuretics such as oral glycerin and IV mannitol. refer
progressive bilateral loss of peripheral vision..tunnel vision..preserved visual acuity…cupping of optic disc
chronic / open-angle glaucoma
tx chronic glaucoma
prostaglandin analogs (latanoprost/bimatoprost), topical b adrenergic blockers such as timolol (CI in pts with reactive airway disease and heart failure)…definitive treatment is laser therapy and surgery
painless loss of central vision
macular degeneration
drusen
mac degen
tx mac degen
antioxidants, VEGF
microaneurysms, retinal hemorrhages, exudates/ischemia, neovascularization and vitreous hemorrhage
diabetic retinopathy
tx diabetic retinopathy
VEGF, tx diabetes. vitrectomy.
AV nicking, flame hemorrhages and cotton wool spots…stellate macula
HTN retinopathy
AV nicking, flame hemorrhages and cotton wool spots…stellate macula
HTN retinopathy
optic disc swelling secondary to increased ICP
papilledema
blurring, diplopia, visual disortions, may be asymptomatic…symptoms 2ndary to increased ICP such as HA and N&V
papilledema
tx papilledema
acetazolamide, prednisone, refer immediately
bone conduction over air conduction and louder in affected ear
conductive hearing loss
air conduction over bone, louder in unaffected ear
sensorineural hearing loss
