ENT and Opthalmology

Question 1

periorbital and orbital cellulitis
mx

which is more severe?

Answer 1

periorbital - skin, sub skin, eyelids
less severe

2ndary care
oral abx - co-amoxiclav

complication?
can turn into orbital

Question 2

periorbital signs
Ix
ddx

Answer 2

erythema / oedema of eyelids +surrounding tissues

ptosis of eye due to swelling

ddx- orbital and allergic reaction

Ix
bloods - esr/ crp
swab
contrast ct

Question 3

orbital cellulitis
how to diagnose

what signs are there
how does it differ to ddx of periorbital

Answer 3

if any orbital signs
RAPD, visual disturbances
inability to to do normal eye movements sos H test

severe ocular pain
opthalmoplegia
eyelid oedema and ptosis
drowsiness and nausea/vom if meningheal involvement

iv x
wbc elevated raised ESR/ CRP 
decreased vision 
afferent pupillary defect 
erythema 
CT with contrast- sinusitis deep inflammation 

swab

Question 4

most common bacterial causes of orbital ceullitis?

Answer 4

streptococcus
staphy aureus
haemophilus influenzae b

Question 5

peri orbital most common causative agents?

Answer 5

staph aureus
staph epidermis
streptococci
anaerobic bacteria

Question 6

is periorbital and orbital cellulitis a unilateral or bilateral presentation?

Answer 6

unilateral

bilateral suggests nephrotic syndrome

Question 7

if presenting with a red eye

what 3 questions?

Answer 7

acuity affected?
eye painful?
pupil reflexes?

Question 8

anterior uveitis patients present with systemic illness and an associated rheumatological condition

T/F?

Answer 8

false

rheumatoid arthritis / polyangitis is associated with scelrirtis not uveitis

Question 9

uveitis is associated with what conditions?

Answer 9

UC, Crohns

Ankylosing spondylitis
Reactive arthritis

sarcoidosis

Question 10

in what cause of a red eye are visual acuity and pupillary reflexes intact?

Answer 10

conjunctivitis

Question 11

centor criteria

Answer 11

hx fever
tonsilar exudates
no cough
tender anterior cervical lymphadenopathy