ENT

Question 1

Cause of dacryoadenitis

Answer 1

clogged lacrimal duct

Question 2

What are the 2 most common etiologies of dacryoadenitis?

Answer 2

Staph

GABHS

Question 3

What is the MCC of viral conjunctivitis?

Answer 3

adenovirus 3, 8, 19

Question 4

MCC of bacterial conjunctivitis in non-neonates

Answer 4

staph aureus

strep pneumo

Question 5

MCC of bacterial conjunctivitis in neonates?

Answer 5

gonococcal, chlamydia, HSV

Question 6

What symptom will tell you that a neonate has bacterial conjunctivitis caused by chlamydia?

Answer 6

nontender preauricular lymphadenopathy

Question 7

What is the MC etiology of Otitis externa?

Answer 7

pseudomonas aeruginosa

Question 8

CPx of Otitis Externa

Answer 8

• pruritis
• purulent discharge
• pain with pinna and auricle movement

Question 9

Tx of OE

Answer 9

ciprofloxacin/hydrocortisone

Question 10

What is the CPx of Sialolithiasis/Sialoadenitis?

Answer 10

• increased saliva production
• mouth swelling
• pain worse with meals

Question 11

Tx of Sialodenitis/Sialolithiasis

Answer 11

sialogogues like lemon drops that increase salivation

Question 12

MCC of dental caries

Answer 12

Strep Mutans-refer to dentist

**supplement fluoride to protect against dental caries**

Question 13

MCC of peritonsillar abscess

Answer 13

strep pyogenes

Question 14

Cpx of peritonsillar abscess

Answer 14

• hx of pharyngitis
• sore throat + odynophagia
• hot potato voice

- uvula displaced away from PTA

-

Question 15

Tx of Peritonsillar Abscess

Answer 15

I & D + Penicillin

Medical emergency!!

Question 16

CPx of Benign Paroxysmal Positional Vertigo

Answer 16

sudden onset sensation of room spinning w/positional changes of the head, lasting seconds-minutes

Question 17

How is dx of BPPV made?

Answer 17

Dix- Hallpike manuever:

with pt sitting up, turn head 45 degrees to one side, lie pt down with head overhanging the edge of the bed & look for nystagmus, repeat on contralateral side

Question 18

Tx of BPPV

Answer 18

epley maneuver

Question 19

“blood and thunder”

Answer 19

Central retinal vein occlusion

Question 20

Sxs of retinal vein occlusion

Answer 20

sudden, painless loss of vision

Question 21

What will you see on PE (fundoscopic exam) of retinal vein occlusion?

Answer 21

dilated & tortuous retinal veins– MC presentation

cotton wool spots

diffuse intraretinal hemorrhages

swollen optic disk

retinal edema

Question 22

Pt with retinal vein occlusion will usually have a hx of what two diseases?

Answer 22

HTN

T2DM

Question 23

Tx for perforated tympanic membrane

Answer 23

ofloxacin

Question 24

What ear drops should you avoid for a perforated typmanic membrane?

Answer 24

aminoglycosides (ototoxic)

Question 25

Signs/sxs of HSV 1 infection

Answer 25

**Oral\*\*\*** prodrome of pain/burning/tingling eruption of painful, **grouped vesicles on erythematous base**

Question 26

Tx of HSV 1 infection

Answer 26

anti-virals (virs)

Question 27

What do you see on Tzanck smear of HSV1 vesicles?

Answer 27

multinucleated giant cells

Question 28

CPx of Infectious Mononucleosis

Answer 28

fever, sore throat posterior cervical LAD splenomegaly

Question 29

Dx of infectious mono

Answer 29

monospot Ab test

Question 30

Cpx of orbital cellulitis

Answer 30

proptosis, pain, fever, increased IOP restricted/painful eye movement _**\*\*usually 2ry to sinus infections\*\***_

Question 31

Workup for orbital cellulitis

Answer 31

orbital + sinus CT scan

Question 32

MCC of acute conjunctivitis

Answer 32

viral infection: serous/clear discharge

Question 33

What is a cholesteatoma?

Answer 33

Keratinized, desquamated collection of epithelial cells located in the middle ear

Question 34

What kind of hearing loss is associated with a cholesteatoma?

Answer 34

conductive hearing loss

Question 35

Sxs of acquired cholesteatoma

Answer 35

hx of chronic ear infections or tympanostomy tubes c/o painless otorrhea

Question 36

What will cholesteatoma look like on PE?

Answer 36

yellow/white mass behind tympanic membrane

Question 37

CPx of macular degeneration

Answer 37

older pt ## Footnote **c/o b/l gradual, central field vision loss**

Question 38

What will PE show in macular degeneration?

Answer 38

Drusen spots (atrophic changes and yellow retinal deposits)

Question 39

How is Dx of Macular degeneration made?

Answer 39

Amsler grid

Question 40

Cpx of pt with Pterygium?

Answer 40

Pt has hx of excessive sunlight exposure c/o "something in the eye"

Question 41

What is 1st line tx of Group A strep?

Answer 41

Penicillin

Question 42

CPx of dacryo stenosis

Answer 42

newborn, c/o eye discharge

Question 43

What will Dacryostenosis PE show?

Answer 43

Large tear lake overflow of years onto the cheek presence of mucoid material in the canthi

Question 44

Tx for dacryostenosis

Answer 44

nasolacrimal massage 2-3 times daily & cleansing with warm water

Question 45

What will the hx of a pt with corneal ulcer be?

Answer 45

hx of trauma, incomplete closure or extended contact lens use

Question 46

PE of corneal ulcer

Answer 46

oval ulcer with ragged edges, severe conjunctival inflammation

Question 47

sudden hearling loss can occur during what procedure?

Answer 47

cerumen impaction removal

Question 48

Best initial mgmt of **acute mastoiditis**

Answer 48

**CT scan** + Empiric IV abx **(vancomycin)**

Question 49

CPx of acute mastoiditis

Answer 49

pain + swelling of post-auricular area PE: tenderness w/palpation, warmth, erythema, swelling behind ear forward displacement of external ear fever

Question 50

typical cause of mastoiditis

Answer 50

untreated acute otitis media

Question 51

What causes acute painful loss of vision?

Answer 51

optic neuritis

Question 52

Optic Neuritis Cpx

Answer 52

sudden loss of **monocular vision** pain w/movement of affected eye **loss of color (red) vision** **Uhthoff phenomenon** (transient worsening of vision w/increased body temperature)

Question 53

Optic Neuritis tx

Answer 53

IV corticosteroids