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joy's deck for FNP > ENT > Flashcards

ENT Flashcards

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Family Nurse Practitioner (FNP) flashcards
1
Q

herpes keratitis

A

SEVERE eye pain, photophobia, blurred vision
fernlike lines in corneal surface (using black lamp)
EMERGENCY=blindness

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2
Q

acute angle closure glaucoma

A

elderly, severe eye pain, n/v, “halos”. exam: dilated oval shaped pupil, cloudy cornea, “cupping”. EMERGENCY

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3
Q

cholesteatoma

A

cauliflower like growth with foul smelling ear discharge
hearing loss
hx of otitis media, not concerous by may effect CN 7

refer

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4
Q

battle sign

A

bruise behind the ear (mastoid) area after recent trauma
indicates skull fracture
look for clear golden discharge
Emergency

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5
Q

clear fluid from nose or ear

A

sign of skull fracture
test fluid with urine dipstick=glucose (CSF)

emergency

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6
Q

cavernous sinus thrombosis

A

hx of sinus injection with SEVERE headache/fever,

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7
Q

peritonsillar absess

A

severe sore throat, odonophagia (painful swallowing), truisms (jaw tightening), “hot potato”, uvula displaced, fever.

Refer to ED fro incision and drainage

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8
Q

diptheria

A

swollen “bulls neck”

posterior pharynx coated with gray/yellow psudomembrane, very contagious. ED

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9
Q

normal eye findings

A

veins larger than arteries

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10
Q

leukoplakia

A

on the tongue, may be cancerous, high risk in tobacco users

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11
Q

apthous stomatitis ( canker sores)

A

painful shallow ulcers of soft tissue

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12
Q

geographic tongue

A

map like appearance on tongue
patches may move
soreness with acidic/spicy foods
benign

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13
Q

torus palatinus

A

benign

bony protuberance midline on the hard palate

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14
Q

fishtail or split uvula

A

benign

may be a sign of occult cleft lip

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15
Q

nystagmus

A

few beats on extreme lateral gaze that resolves when back to midline .

VERTICAL nystagmus is ALWAYS abnormal

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16
Q

papilledema

A

swollen optic disc

secondary to bleeding, brain tumor, abscess, pseudo tumor cerebri

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17
Q

hypertensive retinopathy

A

silver/copper wire arterioles

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18
Q

diabetic retinopathy

A

microaneurysms caused by neovascularization (new arteries in the retina fragile)

On funduscopic exam, cotton wool spots, flame hemorrhages (similar lesions are also caused by the alpha-toxin of Clostridium novyi), and dot-blot hemorrhages.

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19
Q

cataracts

A

opacity of the cornea

chronic steroid can cause

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20
Q

allergic rhinitis

A

blue tinged or pale/swollen boggy nasal turbinates

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21
Q

koplik spots

A

measles

small red papules with blue/white centers inside the cheeks by the lower molars

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22
Q

hairy leukoplakia

A

elongated papilla on the lateral tongue, HIV injection caused by EBV

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23
Q

leukoplakia of the tongue

A

bright white plaque caused by chewing tobacco or chronic infection ( rule out cancer)

24
Q

nystagmus

A

horizonal is normal, vertical his not

rule out strabismus

25
Q

abnormal vision test

A

2 line difference between each eye

26
Q

test for color blindess

A

ishihara chart

27
Q

vision test if illiterate

A

tumbling E chart

28
Q

legal blindess

A

20/200 or visual field

29
Q

normal rinne test

A

air conduction > bone conduction ( can hear longer in front of the ear than on mastoid bone)

30
Q

herpes keratitis

A

look for herpetic rash not eh side of the temple/tip of the nose (rule out shingles) of CN 5

The trigeminal nerve (the fifth cranial nerve, or simply CN V) is a nerve responsible for sensation in the face and certain motor functions such as biting and chewing. It is the largest of the cranial nerves.

31
Q

corneal abrasions

A

appear linear line on back lamp ( fernlike for herpes keratitis)

flush out with saline, if unable to remove refer
if corneal abrasion, use topical antibiotic (erythro, plytrim). do NOT patch eye. f/u in 24 hours

32
Q

hordeolum (stye)

A 
painful bacterial infection of a hair follicle of the eyelid
antibiotic drops (sulfa or erythromycin gtts), warm packs
33
Q

chalazion

A

chronic inflammation of the meibomian gland (sweat gland) of the eyelids
“PAINLESS” nodule to the upper eyelid, benign
tx: if nodule enlarges or does not resolve in a few weeks, biopsy to r/u squamous cell cancer.

34
Q

pinguecula

A

yellow triangular thickening of the bulbar conjunctiva caused by UV damage

A pinguecula (above) is a yellowish patch or bump on the conjunctiva, near the cornea. It most often appears on the side of the eye closest to the nose. It is a change in the normal tissue that results in a deposit of protein, fat and/or calcium. It is similar to a callus on the skin.

35
Q

pterygium

A

yellow triangular thickening of the conjunctiva that extends to the cornea on the nasal or temporal cornea du to UV.

A pterygium (also known as surfer’s eye or farmer’s eye) is a triangular-shaped growth of fleshy tissue on the white of the eye that eventually extends over the cornea. This growth may remain small or grow large enough to interfere with vision. A pterygium can often develop from a pinguecula.

36
Q

subconjuctival hermorrhage

A

blood trapped under conjunctiva and sclera, resolves within 1-3 wks.
watchful waiting

37
Q

primary open angle glaucoma

A

gradual >IOP, >22mm hg dt lbokcage of the drainage of aqueous humor. CN2 can be permanently damaged (glaucoma, 60-70%)

most common in elderly, AA
gradual change in peripheral first. if shoes “cupping”- refer

tx:
BB gtts Betimol (timolol)
side effects: fatigue/depression, bradycardia
contraind: heart block, heart failure, copy/astham/emphysema

38
Q

closed angel glaucoma

A

SUDDEN blockage, increase IOP causing ischemia and permanent CN 2 damage

ie: elder with sudden headache and eye pain, sees halos, n/v
objective: fixed, mid dilated cloudy pupil. oval shaped. REFER ED

39
Q

anterior uveitis (iritis)

A

inflammation of the iris

refer to opthamalogist
higher risk with autoimmune; RA, lupus, anklosing spodylitis, etc.

complains of red sore eyes, no discharge

40
Q

age related macular degeneration

A

higher risk in smokers
gradual damage to the macula
treatment: refer
pt is given AMSLER grid (focus on central dot and view grad 12” from eye). check daily or weekly

“areds” formula ocular vitamins (Antioxidents and zinc)

41
Q

sjorgrens syndrome

A

autoimmune. 3 months, gritty eyes (keratoconjuntivitis sicca). swollen salivatory glands

OTC tear substitute eye gtts, refer

42
Q

belpharitis

A

chronic condition, inflammation of base of eyelashes, redness, crusting

tx: baby shampoo until resolved. or erythromycin gtts

43
Q

allergic rhinitis

A

chronic nasal congestion, clear mucus post nasal drip, cough worse in supine.

objective: blue tinged or pale boggy nasal turbinates
mucus clear
tx: flonase, decongestants, zyrtec, avoid dust mite allergies

complications: acute sinusitis
acute otitis media

44
Q

rhinitis medicamentosa

A

prolonged use of topical nasal decongestants (>3 days) causes rebound.

45
Q

epistaxis

A

tilt head forward and apply pressure, use afrin prn, nasal packing, antibiotic prophylaxis for staph/strep prn.

posterior nose bleeds refer to ED

46
Q

strep throat

A

acute infection of the pharynx
B. streptocuccus gram + group A
classic example: acute onset of pain on swallowing, mild submandibular nodes, no rhinitis, pharynx pink/red, afebrile, tonsillar exudate, pettechiae on the palate

Tx: throat culture and sensitivity (C&S) or rapid strep test
first line: PCN QID x 10 days
salt water gargles, throat lozenges
repeat culture if high risk: hx of mitral valve or valve surgery

pcn allergy:
azithromyzin ( zpack) x 5 days
levo x 10 days ( contraindicated if

47
Q

acute otitis media

A

acute infection middle ear
organisms: S. pneumoniae, h. influenza, m. catarrhalis
classic ex: ear pain (otalgia), popping nose, hx of cold/allergies.

48
Q

bullous myringitis

A

AOM but causes more PAIN

blisters (or bulla) on tempanic membrane, hearing closs

49
Q

tx for AOM

A

amoxicillin gold standard for all age groups
or 2nd line augmenting, ceftin, cefzil
(use 2nd line if antibiotic use in past 3 mos, no response to amoxicillin, or severe AOM (high fever, severe pain).

if allergic to PCN:
azithro, bacterium, levo (>18 yo dt risk of tendinitis/achilles tendon rupture

complications:
meningitis ( positive brudzinski or kerning sign)

50
Q

otitis externa ( swimmers ear)

A

bacterial infection of the skin of the external ear canal

p. aeruginosa
s. aureus

external ear pain, swelling, green discharge
“ear pain with tragus”.

tx: cortisporin otic suspension qid x 7 days. keep water out of ear. if recurrent, prophylaxis is otic domeboro (boric) or alcohol and vinegar (vosol)

51
Q

mono

A 
EPV 
15-24yo
triad; fatigue, pharyngitis, lymphadenopathy
stomach pain ( dt splenomegaly)
objective: cbc (>50% lymphocytes)
Positive mono spot
tender cervical nodes, tonsils inflamed

Tx: abdomen US if splenomegaly
no contact sports 4-6 wks
avoid amoxicillin if patient has strep throat

** keep checking lymphocytes until normal**

52
Q

cheilosis

A

skin fissures corner of the mouth

apply topical antibiotic

53
Q

tx for otitis externa

A

corisporin otic drops

otitis externa = pseudomonas

54
Q

if pt has used antibiotics in the past 3 months

A

do nOT use amox

use augmenting of ceftin

55
Q

PCN allergy

A

use macrolides, sulfa (avoid cephalosporins if true PCN allergy)

56
Q

weber and rinne test which CN

A

8 (acoustic)

57
Q

most common cerumen tx

A

carbamide peroxide

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