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ENT Flashcards

1
Q

s/s of herpes keratitis

A

sever eye pain, photophobia, and blurred vision in one eye

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2
Q

herpes keratitis is diagnosed with

A

fernlike lines on corneal surface using flourescein dye

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3
Q

complication of herpes keratitis

A

corneal blindness

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4
Q

exam with acute angle-closure glaucoma reveals

A

mid-dilated pupil that’s oval shaped, cloudy cornea

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5
Q

treatment for acute angle-closure glaucoma

A

medical emergency

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6
Q

s/s of acute vision loss

A

sudden onset of floaters or black dots, scotoma (retinal detachment), blurred vision, eye pain

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7
Q

s/s of cholesteatoma

A

“cauliflower-like” growth with foul-smelling discharge to ear; hearing loss

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8
Q

those with cholesteatoma often have a hx of

A

chronic otitis media infections

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9
Q

complication of cholesteatoma

A

can damage CN VII (facial)

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10
Q

treatment for cholesteatoma

A

atbx and surgical debridement, refer to ENT

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11
Q

acute onset of bruise behind ear over the mastoid area after recent trauma

A

Battle’s sign

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12
Q

Battle’s sign indicates

A

fracture of basilar skull

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13
Q

s/s of basilar skull fracture

A

Battle’s sign, clear golden fluid discharge from ear or nose (CSF)

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14
Q

rare complication where a patient with a hx of sinus or facial infection will present with severe headache and high fever

A

cavernous sinus thrombosis

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15
Q

s/s of peritonsillar abscess

A

severe sore throat, difficulty swallowing, trismus, “hot- potato” voice, fever, one-sided swelling with uvula displaced

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16
Q

trx for peritonsillar abscess

A

refer to ED for I&D

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17
Q

sore throat, fever, swollen neck “bull neck”, hoarsness, dysphagia with gray-yellow colored pharynx

A

diphtheria

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18
Q

the macula is responsible for

A

central vision

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19
Q

the area of the eye that determines 20/20 vision

A

fovea

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20
Q

cobblestoning inner conjunctiva can be seen in patients with

A

atopy, allergic rhinitis, allergic conjunctivitis

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21
Q

age-related vision change that causes difficulty focusing and ability to read print at close range

A

presbyopia

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22
Q

thickened, white patches inside of mouth that may be cancerous

A

leukoplakia

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23
Q

management for avulsed tooth

A

store in cool milk see refer to dentist ASAP

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24
Q

this kind of nystagmus is always abnormal

A

vertical

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25
Q

optic disc swelling with blurred edges d/t increased ICP

A

papilledema

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26
Q

finding with hypertensive retinopathy

A

copper and silver wire arterioles

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27
Q

finding with diabetic retinopathy

A

microaneurysms caused by neovascularization

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28
Q

chronic steroid use can cause

A

cataracts

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29
Q

“grain of salt” papules in the buccal mucosa

A

Koplik spots, appear with measles

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30
Q

mucosal lining inside eyelids

A

palpebral conjunctiva

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31
Q

mucosal lining covering the eyes

A

bulbar conjunctiva

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32
Q

farsightedness

A

hyperopia

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33
Q

nearsightedness

A

myopia

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34
Q

abnormal Snellen chart result

A

two-line difference between each eye; less than 4 out of 6 letters correct

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35
Q

interpretation of 20/60

A

a person can see at 20 feet what the patient can see at 60 feet

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36
Q

legal blindness is characterized as

A

20/200

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37
Q

Weber test

A

placed on forehead, sound should not lateralize

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38
Q

Rinne test

A

placed on mastoid process, then front of ear. Normal is AC> BC

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39
Q

fluorescein dye with corneal abrasion

A

linear lines on cornea

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40
Q

s/s of corneal abrasian

A

severe eye pain with tearing; will keep affected eye shut.

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41
Q

treatment for corneal abrasion

A

check vision, flush with NS, if unable to remove, refer. Treat with erythromycin or polytrim x3-5 days.

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42
Q

Do not do this for corneal abrasion

A

do NOT patch eye

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43
Q

F/U for corneal abrasion in

A

24 hours, if not improved, refer

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44
Q

painful acute bacterial infection of hair follicle on eyelid

A

hordeolum (stye)

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45
Q

trx of stye

A

sulfa or erythromycin drops, warm compress bid-tid

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46
Q

chronic inflammation of the meibomian gland

A

chalazion

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47
Q

different between hordoleum (stye) and chalazion

A

hordoleum is painful and itchy; chalazion is not painful

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48
Q

yellow triangular thickening of bulbar conjunctiva caused by UV damage

A

pinguecula and pterygium

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49
Q

difference between pinguecula and pterygium

A

pinguecula will not cover the cornea; pterygium can cover cornea and affect vision

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50
Q

treatment for pinguecula and pterygium

A

weak steroid eye drops, sunglasses, surgery if pterygium starts affecting vision

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51
Q

subconjunctival hemorrhage can be caused by

A

coughing, sneezing, heavy lifting, vomiting, on ASA or anticoagulants

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52
Q

subconjunctival hemorrhage usually resolve within

A

1-3 weeks

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53
Q

normal intraocular pressure

A

8-21 mmHg

54
Q

risk factors for primary open-angle glaucoma

A

elderly, African Americans, diabetes

55
Q

In primary open-angle glaucoma, gradual changes occur in ____ first, then ____

A

peripheral vision; central

56
Q

caused by gradual onset on increased intraocular pressure

A

open angle glaucoma

57
Q

treatment for open angle glaucoma

A

Betimol beta blocker eye drops

58
Q

contraindications for betimol beta-blocker eye drops for open angle glaucoma

A

asthma, COPD, heart block, heart failure

59
Q

sudden blockage of aqueous humor causing increased intraocular pressure

A

primary angle closure glaucoma

60
Q

s/s of primary angle closure glaucoma

A

acute onset of severe frontal headache with eye pain, decreased vision, halos around lights N/V

61
Q

high risk of anterior uveitis in those with

A

autoimmune disease

62
Q

s/s of anterior uveitis

A

red sore eyes with increased tearing

63
Q

which form of macular degeneration is most common and less severe?

A

atrophic (dry form)

64
Q

The exudative (wet form) of macular degeneration is responsible for

A

vision loss

65
Q

s/s of macular degeneration

A

painless central vision loss; peripheral vision not affected

66
Q

Treatment for macular degeneration

A

refer to opthalmologist, Amsler grid (focus eye on center dot daily).

67
Q

chronic autoimmune disorder where there is decreased function of the lacrimal and salivary glands

A

Sjogren’s syndrome

68
Q

s/s of Sjogren’s syndrome

A

dry eyes and dry mouth for > 3 months

69
Q

trx for Sjogren’s syndrome

A

artificial tear gtts, check ESR/CRP, refer to ophthalmologist and rheumatologist.

70
Q

chronic red inflammation to eyelids that causes itching

A

blepharitis

71
Q

trx for blepharitis

A

johnson’s baby shampoo with warm water scrub eyelids;

72
Q

Treatment for allergic rhinitis

A

nasal steroid sprays, decongestants, antihistamine

73
Q

prolonged use of nasal decongestants for more than 3 days causing rebound nasal congestion

A

rhinitis medicamentosa

74
Q

First line trx for strep throat

A

penicillin; Zpack if allergic to PCn

75
Q

An acute type of AOM that causes more pain; presence of blisters on red/bulging TM.

A

bullous myringitis

76
Q

AOM will lead to this kind of hearing loss

A

conductive

77
Q

If AOM does not start resolving in 48-72 hours then,

A

switch to either Augmentin or (cefuroxime) Ceftin

78
Q

first line trx for AOM

A

amoxicillin 875 mg x 10-14 days

79
Q

first line trx for AOM if allergic to PCN

A

Zpack x 5 days, Bactrim DS

80
Q

s/s of otitis media with effusion

A

bulging TM with fluid level

81
Q

trx for otitis media with effusion

A

oral decongestants, steroid nasal spray

82
Q

organisms that cause otitis externa

A

Pseudomonas aeruginosa (-), Staph aureus (+)

83
Q

s/s of otitis externa

A

ear pain, swelling, green purulent discharge

84
Q

trx for otitis externa

A

cortisporin otic QID x 7 days; or ciprofloxacin + hydrocortisone bid x 7 days

85
Q

triad of mononucleosis

A

fatigue, pharyngitis, posterior cervical lymphadenopathy

86
Q

avoid this drug if allergic to PCN

A

cephalosporins

87
Q

difference b/t stye and chalazion

A

stye is painful, chalazion is not painful

88
Q

medication for angular cheilitis

A

topical nystatin

89
Q

common cause of angular cheilitis

A

C. albicans

90
Q

first line trx for acute bacterial rhinosinusitis (ABRS)

A

augmentin

91
Q

a characteristic of H. influenza is

A

may have some antimicrobial resistance to beta-lactamase

92
Q

when sound gets better in a noisy enviornment

A

conductive hearing loss

93
Q

Rinne test in conductive hearing loss

A

BC>AC

94
Q

Weber test in conductive hearing loss

A

lateralizes to impaired ear

95
Q

when hearing worsens in noisy enviornment

A

sensorineural hearing loss

96
Q

Rinne test in sensorineural hearing loss

A

AC> BC

97
Q

Weber test in sensorineural hearing loss

A

sound lateralizes to good ear

98
Q

diphenhydramine is cautiously given in those with

A

BPH, COPD, glaucoma

99
Q

most common cause of epiglottiitis

A

H influenza type b

100
Q

s/s of epiglottitis

A

sore throat, stridor, sniffing posture, drooling, fever

101
Q

Do not attempt to visualize pharynx if this is suspected

A

epiglottitis

102
Q

rotavirus is given at

A

2 and 4 months

103
Q

PCV13 is given at

A

2, 4, 6, 12-15 months

104
Q

MMR is given at

A

12-15 months, 4-6 years

105
Q

Hib is given at

A

2, 4, 12-15 months

106
Q

DTap is given at

A

2, 4, 5, 15-18 months, 4-6 years

107
Q

TdaP is given at

A

11-12 years, college freshmen, booster ever 10 years

108
Q

varicella vaccine is given at

A

12-15 months, 4-6 years

109
Q

s/s of acute rhinosinusitis

A

purulent nasal discharge, nasal congestion, tooth discomfort, facial pressure (esp when bending forward)

110
Q

s/s suggestive of bacterial sinusitis

A

fever, purulent drainage; symptoms for more than 10 days

111
Q

trx for rhinosinusitis

A

promote drainage

112
Q

trx for bacterial sinusitis if allergic to PCN

A

doxycycline or quinolone

113
Q

how long to trx for bacterial sinusitis

A

5-7 days

114
Q

when should noticeable improvement occur after atbx for ABRS

A

3-5 days

115
Q

complication of ABRS

A

periorbital cellulitis

116
Q

diagnostic for periorbital cellulitis

A

CT with contrast

117
Q

complications of GABHS

A

peritonsillar abscess, rheumatic fever, glomerulonephritis

118
Q

Centor criteria for GABHS

A

absence of cough, fever greater than 100.4F, anterior lymphadenopathy, tonsillar exudate and swelling, age 3-14
RADT if greater than 2 points

119
Q

If GABHS is not treated within 24-48 hours, then

A

symptoms will spontaneously resolve in 2-5 days. Can sequelae into rheumatic fever, glomerulonephritis.

120
Q

Mononucleosis is caused by

A

Epstein-barr virus

121
Q

s/s of mono

A

fever, pharyngitis, fatigue, posterior adenopathy, splenomegaly

122
Q

diagnostic for mono

A

monospot (likely to be positive on 2-3rd week); EBV titers, CBC shows atypical lymphocytes

123
Q

how long those with mono need to avoid direct contact sports

A

3-4 weeks

124
Q

treatment for rhinitis medicamentosa

A

nasal steroid

125
Q

first choice trx for allergic rhinitis

A

nasal steroid: diminishes allergic response overtime

126
Q

4 step assessment of all eye complaints

A
  1. assess visual acuity
  2. examine with lamp or penlight
  3. fluourescein staining
  4. lid eversion
127
Q

if patient only c/o scratchy and gritty sensation in eyes without visual changes, then suspect

A

viral conjunctivitis

128
Q

best predicting s/s of AOM

A

cloudy, bulging TM with impaired mobility

129
Q

causes of AOM in children

A

viral, streptococcus pneumonia

130
Q

AOM in those less than 6 months old

A

always treat with atbx

131
Q

f/u with AOM

A

in 48-72 hours

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