EO 005 Flashcards
[EO 005.03]
[What is laryngitis?
Inflammation of the larynx
Slide 5
[EO 005.03]
List some causes of laryngitis?
- Viral URTI
- Lower RTI (Bronchitis, pneumonia)
- Excessive use
- Allergic reactions
- GERD
- Bulimia
- Inhalatation injuries
- Bacterial laryngitis (rare)
Slide 5
[EO 005.03]
What is Reinke’s Oedema?
Watery swelling of both vocal cords
Slide 5
[EO 005.03]
List signs and symptoms of laryngitis.
- Change in voice (volume, quality)
- Dysphonia/Aphonia
- Tickling/irritating sensation in throat
- Fever, malaise
- Laryngeal edema/inflammation
Slide 6
[EO 005.03]
Describe a general treatment plan for a patient with laryngitis.
- Symptomatic treatment (up fluid intake, rest, steam/humidity, saltwater gargle)
- Prescriptions (analgesic, antipyretics, NSAIDs)
- MELs if needed
- Pt Education (lower caffeine, cease smoking, lower EtOH)
Slide 7
[EO 005.03]
What is pharyngitis and tonsillitis?
Inflammation/infection of the pharynx or tonsils respectively, AKA sore throat
Slide 8
[EO 005.03]
What are causes of pharyngitis/tonsillitis?
- Acute viral infection
- Acute bacterial infection
- (Rare pokemon) abscess or epiglottitis
Slide 8
[EO 005.03]
List signs and symptoms of pharyngitis
- Acute, severe onset sort throat
- Possible fever & body aches
- Uncommon to have nasal discharge/congestion
Slide 9
[EO 005.03]
What are red flags in pharyngitis?
- Stridor
- Drooling
- Muffled voice
- Visible bulge of pharynx
- Involvement of epiglottis
Slide 9
[EO 005.03]
What are signs and symptoms of tonsillitis?
- Fever
- Malaise/body aches
- Headache
- Halitosis
- Headache
- Edema of tonsils
- Pirulent exudate on tonsils
- Dysphagia
Slide 10
[EO 005.03]
What are the rare signs and symptoms that can occur with tonsillitis?
- Palatal petechiae
- Scarletiniform
Slide 10
[EO 005.03]
What are the main criteria for the Centor score (strep)?
- Fever
- Tonsillar exudate
- Absence of cough
- Tender ant. cerv. lymph nodes
- Age
Slide 11
[EO 005.03]
Describe a general treatment plan for a patient with pharyngitis/tonsillitis.
- Warm saltwater gargle
- Topical anesthetics
- ABX
- Analgesics and NSAIDs
- MELs and rest
Slide 12
[EO 005.03]
What are some diagnostic tools for pharyngitis/tonsillitis?
- Culture Swab
- Rapid strep test
- Centor score
Slide 12
[EO 005.03]
What is sinusitis?
Inflammation of paranasal sinuses, typically accompanied by rhinitis.
Slide 13
[EO 005.03]
What are signs and symptoms of sinusitis?
- Pirulent rhinorrhea
- Pressure/pain/tenderness in face
- Headache
- Nasal congestions/hyposomia
- Productive cough
- Fever and chills
Slide 14
[EO 005.03]
What are red flags of sinusitis?
- Visual changes
- Periorbital edema/erythema
- Altered mental status
Slide 14
[EO 005.03]
What are some diagnostic tools for sinusitis?
- Culture swab
Slide 15
[EO 005.03]
Describe a general treatment plan for sinusitis.
- Hydration
- Steam/humid inhalation
- Elevated head for sleep
- Avoid smoking and dehydrants
- Analgesics and NSAIDs
- Decongestants/nasal rinse
- ABX for bacterial infections
Slide 16
[EO 005.01] Pathology of Chalazion
An acute or chronic inflammation of the eye lid secondary to blockage of one of the Meibomian or Zeis glands in the tarsal plate
[EO 005.01] Which way will most chalazion lesions point
In the direction of the conjunctival surface causing redness and swelling.
[EO 005.01] Chalazion’s are most common in who
More common in people with Blepharitis, Acne Rosacea, and Seborrheic Dermatitis.
[EO 005.01] Chalazion clinical presentation
A painless lump that develops in the lid or the lid margin, with mild erythema.
[EO 005.01] What is a chalazion similar to
Similar to a Hordeolum
[EO 005.01] Management of a chalazion
Warm compress several times/day followed by massaging eyelid towards lid margin
referral to ophthalmologist if not resolved in a few days
[EO 005.01] Hordeolum Pathophysiology
An acute bacterial infection (usually staph)
of the follicle of an eyelash and the adjacent sebaceous glands (Zeis) or sweat glands (Moll)
[EO 005.01] Hordeolum (External)
location & common appearance
Eyelash line and has the appearance of a small pustule
[EO 005.01] An internal Hordeolum affects what and located where
Meibomian glands associated with eyelashes and is located on the inner surface of the tarsal plate
[EO 005.01] Hordeolum Clinical presentation
- Pustule
- Pain
- Edema
- Erythema of the eyelid
[EO 005.01] Hordeolum management
1.Warm compress
2.Erythromycin ophthalmic ointment twice daily for 7 to 10 days
3.Referral to Ophthalmologist
[EO 005.01] Why would a hordeolum require systemic antibiotics
Significant cellulitis of surrounding tissue
[EO 005.01] What is a Hordeolum also known as
A Stye
[EO 005.01] What is keratoconjunctivitis Sicca
A malfunction disease of the tears and ocular surface resulting in symptoms.
[EO 005.01] Keratoconjunctivitis Sicca 2 different pathos
Aqueous tear deficient dry eye (inadequate tear production).
&
Evaporative dry eye (abnormality of tear production)
[EO 005.01] Aqueous tear-deficient dry eyes patho
The lacrimal gland does not produce enough tears to keep the entire conjunctiva and cornea covered by a complete layer of tears
[EO 005.01] Evaporative dry eye patho
Abnormality of tear composition that results in rapid evaporation, entire surface of the eye cannot be kept covered with a complete layer of tears during certain activities/environments.
[EO 005.01] Factors effecting Keratoconjunctivitis Sicca
- Can result in ocular surface damage and vision impairment
- Ageing can be a factor with women being more at risk
- Occupational risk factors (prolonged visual attention).
- Environmental factors (heat, wind, low humidity, and pollution).
- Diet deficiency with low vitamin A or omega-3 fatty acid.
- Medication (anticholinergic), contact lens wearers.
[EO 005.01] The 3 layers that compose the tear film
- Mucous layer
- Aqueous layer
- Lipid layer
[EO 005.01] Mucous layer produced where
Produced by goblet cells in the conjunctiva
[EO 005.01] Mucous layer function
Coats the cornea providing a hydrophilic layer which allows for even distribution of the tear film
[EO 005.01] Aqueous layer produced where
The Lacrimal gland and is the thickest part of the tear film.
[EO 005.01] Aqueous layer function
- It hydrates the mucous layer,
- Supplies oxygen, electrolytes to the ocular surface
- Provides antibacterial defense
- Wound healing
[EO 005.01] Lipid layer produced where
Secreted by the meibomian glands and is the outermost layer of the tear film.
[EO 005.01] Lipid layer function
- Slows tear evaporation
- Enhances tear film spreading
- Provides a smooth optical surface
[EO 005.01] Keratoconjunctivitis Sicca Clinical presentation
- Foreign body sensation (sandy/gritty feeling)
- Burning, itchy, tired sensation
- Photophobia
- Blurred vision
- Redness
- Discomfort
- Difficulty moving lids
- Increase tearing in windy conditions or when concentrating on
tasks
[EO 005.01] Keratoconjunctivitis Sicca Management
- Reducing or eliminating environmental factors
- Proper education on use of contact lenses
- Artificial tears, ocular lubricants, or prescription options (consult with MO/PA)
- Continue to monitor and adjust treatments as requiredMay require a referral to ophthalmology.
[EO 005.01] Corneal Abrasions factors
- Very painful
- When damaged, it causes an entry for bacteria, viruses, and fungi
- If not treated will develop into an associated inflammatory Iritis
- Healing time is usually within 24-48 hrs
[EO 005.01] Corneal Abrasions Clinical Presentation
- FB Sensation
- Photophobia
- Redness
- Swelling
- Pain
[EO 005.01] Corneal Abrasions Tx
- Pain relief (Tetracaine)
- Infection prevention(antibiotic eye drops)
- Flourescein stain to confirm and examine with a Slit lamp
- Caution with eye patch (if pt is comfortable).
[EO 005.01] Blepharitis Pathophysiology
Inflammation of the eyelash follicles along the edge of the eyelid (secondary to another pathology)
[EO 005.01] Blepharitis associated pathophysiology’s
- Seborrheic dermatitis
- Atopic dermatitis, acne rosacea
- Eyelash lice infestation
[EO 005.01] Blepharitis Clinical presentation
- Conjunctival injection
- Crusting
- Swollen, and pruritic eyelids
- Possible eye pain
- Chalazion or Hordeolum may also be present
- Foreign Body Sensation
[EO 005.01]Blepharitis Management
- Tx of underlying condition
- Warm compresses
- Gentle scrubbing of the eyelid margins
- Refer to MO/PA/Ophthalmologist
- Mechanical expression done by an ophthalmologist
- Aseptic technique
- patient education
[EO 005.01] What is Hyphema
Blood or blood clots in the anterior chamber of the eye.
[EO 005.01] Types of Hyphema
- Traumatic
- Spontaneous
[EO 005.01] Causes of Traumatic Hyphema
Usually results from a ruptured iris root vessel
[EO 005.01] Causes of Spontaneous Hyphema
Usually associated with sickle cell disease
[EO 005.01] Clinical presentations of Hyphema
- Blurred vision
- Pain
- Photophobia
- Blood may be visible behind the lower part of the cornea
[EO 005.01] Hyphema important Hx questions
- Is the pt on anticoagulant or anti-platelet medications
- history of bleeding disorders
[EO 005.01] Hyphema Management
- Referral to MO/PA/ophthalmologist
- Elevate the patients head to promote settling of suspended RBC’s. (This will prevent occlusion of the trabecular meshwork)
- Avoid pupil activity (Dilation of pupils, use of eye patch, put in dark room).