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MVU Adult 1 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Pharmacological treatment for blepharitis

A

topical abx drops: bacitracin, macrolides- erythromycin, azithromycin

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2
Q

Indications for pharmacological treatment for blepharitis

A

signs of infection- red and inflamed

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3
Q

Other treatment options for blepharitis

A

warm compress

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4
Q

S&S of hordeolum

A

very sudden, tender, swollen, red eyelids

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5
Q

Treatment for hordeolum

A

warm compress, don’t pop it; if continued inflammation antibiotic drops are OK

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6
Q

Difference between hordeolum and chalazion

A

Hordeolon- sudden onset, very painful
Chalazion- slow onset, not painful

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7
Q

When to refer a patient to ophthalmology for chalazion

A

If persistent- may need incision and drainage

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8
Q

S&S of iritis/uveitis

A

severe pain, photophobia, constricted pupil with no response

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9
Q

Treatment for iritis/uveitis

A

immediate referral to opthalmology

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10
Q

Differenceinpresentation between bacterial/viral/allergic conjunctivitis

A

Bacterial- purulent discharge (wipe and comes back right away); unilateral at start
Viral- purulent discharge in AM, watery in PM; unilateral at start; gritty, burning sensation
Allergic- watery, stringy discharge; bilateral; INTENSE itching

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11
Q

Tx for bacterial conjunctivitis

A

Azithromycin drops (1 drop BID x 2 days, then 1 drop daily for 5 days)
Polymyxin-trimethoprim (polytrim)- 1-2 drops QID x5-7 days

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12
Q

Tx for bacterial conjunctivitis for contact lens wearers

A

NO POLYTRIM
Fluroquinolone drops- oxfloxacin or ciprofloxacin (1-2 drops QID x5-7 days)

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13
Q

What would you not want to give a patient with allergic conjunctivitis?

A

Do not give corticosteroids- can lead to keratitis

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14
Q

Tx recommendations for allergic conjunctivitis

A

Cold compress, lubricant drops, antihistamine, decongestants, mast cell stabilizer drops (ketorolac 1 drop QID, olopatadine 0.1-0.2% BID)

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15
Q

Treatment for viral conjunctivitis

A

antihistamine/decongestant drops, lubricants, cold compress

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16
Q

Tx for gonorrheal conjunctivitis

A

ceftriaxone and azithromycin

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17
Q

S&S for gonorrheal conjunctivitis

A

profuse discharge within 12 hours; SEVERE AND SIGHT THREATENING, preauricular adenopathy

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18
Q

Treatment for Herpes zoster conjunctivitis

A

refer to ophthalmologist for slit lamp evaluation; pyrimidine drops, acyclovir PO start within 72 hours

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19
Q

S&S Chlamydial conjunctivitis

A

Persistent eye infection lasting > 3 weeks despite treatment; preauricular adenopathy; may also have ear infection or rhinitis

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20
Q

Tx for chlamydial conjunctivitis

A

Doxycycline 100 mg BID x 7-10 days
Azithromycin 1 gm PO
AND ABX drops

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21
Q

Pharmacological treatment for corneal abrasion

A

Tobramycin or quinolones (NO POLYTRIM IF CONTACT LENS)

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22
Q

Assessments for corneal abrasion

A

visual acuity, penlight/fundoscopic exam, fluorescein stain with slit lamp (cobalt blue filter)

23
Q

In relation to a corneal abrasion, what signs or symptoms would indicate need for immediate referral to opthalmologist?

A

Corneal infiltrate, white spots or opacities, inability to remove foreign body, pus, change in vision, not healed in 3-4 days

24
Q

What diagnosis related to the eye require immediate ophthalmology referral?

A

Uveitis/Iritis, Keratitis, Glaucoma, Maculardegeneration, Retinal detachment

25
Q

Difference between open-angle and closed-angle glaucoma

A

Open- slow onset, halo vision
Closed- SUDDEN, eye pain, N/V, HA, rainbow around lights; EMERGENCY

26
Q

Tx for glaucoma

A

laser or surgery (if closed-angle); eye drops: timolol, pilocarpine, azeta

27
Q

Risk factors for developing macular degeneration

A

> 60 years, female, fair skin, excessive sun exposure, tobacco use, HTN, vascular disease, family Hx, high intake of fats and cholesterol

28
Q

Rx factors for otitis externa

A

Swimmer (swimmer’s ear)

29
Q

Risk factors for otitis media

A

Hx of chronic allergies, down syndrome, cleft lip/palate, smokers, acid reflux, Hx of URI, immunodeficient

30
Q

Triad of symptoms for otitis media

A

abrupt onset, effusion, inflammation of middle ear

31
Q

Pharmacological treatment for otitis media

A

amoxicillin (1st choice), macrolide (azithromycin, clarithromycin), fluoroquinolone (cefdinir, bactrim)

32
Q

When to treat AOM with antibiotics

A

bilateral infections, high fever, severe pain, Sx lasting > 48 hours

33
Q

S&S of Meniere’s disease

A

tinnitus, vertigo, sensory hearing loss, + Romberg, N/V

34
Q

Treatment for Meniere’s disease

A

Treatments for acute attacks only- meclizine, scopolamine, diphenhydramine

35
Q

S&S of Benign Positional Vertigo (BPV)

A

vertigo in specific positions, episodic; Diagnosis: Dix hallpike test

36
Q

Treatments for BPV

A

Epley maneuver, Meclizine, promethazine, dramamine, benzodiazepines

37
Q

Describe the dix-hallpike maneuver

A

1, Patient sitting, turn head 45 degrees to one side
2. Lie the patient down the head overhanging the edge of the bed and look for nystagmus
3. Repeat on other side
POSITIVE if maneuver provokes paroxysmal vertigo and nystagmus

38
Q

When to start ABX for acute bacterial rhinosinusitis

A

If symptoms don’t improve after 10 days, if they worsen after 7 days, fever over 102F, severe pain

39
Q

Pharmacological treatment for acute bacterial rhinosinusitis

A

1st line: Augmentin (875/125) PO BID x10 days OR high dose augmentin (2000/125) if not effective; if PCN allergy then Doxycycline 100 mg BID x10 days, if can’t tolerate then clindamycin 150mg PO QID + cefixime 400 mg PO daily x10 days, then last line levofloxacin 500 mg PO daily x10days (avoid in elderly)

40
Q

When should you refer a patient with acute rhinosinusitis to ENT?

A

Recurrent- more than 4 cases in 12 months, Chronic- symptoms greater than 12 weeks

41
Q

S&S of EBV-Mononucleosis

A

Fever, exudative pharyngitis, POSTERIOR ADENOPATHY, HA, Fatigue, enlarged spleen, elevated LFTs

42
Q

Treatment options for EBV mononucleosis

A

steroids for severe fatigue/swollen tonsils, avoid contact sports for 3-4 weeks d/t risk of spleen rupture

43
Q

Treatment plan for Mono + concurrent strep

A

Macrolides- erythromycin BECAUSE of increased risk of rash with amoxicillin

44
Q

S&S of acute strep pharyngitis

A

Acute onset, fever, headache, ANTERIOR cervical adenopathy, petechia, erythema, exudate, breath odor

45
Q

Pharmacological treatment for Group A Strep Pharyngitis

A

First line: PCN V 500 mg BID x 10 days; if allergy to PCN than a macrolide (erythromycin), or cephalosporin (cephalexin)

46
Q

S&S of tonsillar abscess

A

Fever, severe sore throat, hot potato muffled voice, drooling, tripod position, deviated uvula, peritonsillar edema, neck edema with lymphadenopathy

47
Q

Tx for tonsillar abscess

A

Medical emergency if suspected airway restriction- needle aspiration or excision of abscess; Augmentin 875mg BID x 14 days, Clindamycin 300-450 mg QID x 14 days

48
Q

What is the cause of epistaxis?

A

Anterior- trauma, dry mucosa rarely HTN or Co-ag problems
Posterior- carotid and sphenopalatine artery

49
Q

Difference between otitis media, otitis media with effusion, and swimmer’s ear (otitis externa)

A

Otitis media- inflammation, fever, bulging inflamed TM
Otitis media with effusion- afebrile, fullness in ear, popping, cracking with yawning, dull TM but no bulging
Otitis externa- painful pinna & tragus, inflamed ear canal, white or green discharge

50
Q

Risk factors for otitis externa

A

exposure to water or excessive use of headphones, earplugs, Q-tips

51
Q

How to treat patients with otitis media + conjunctivitis

A

Augmentin- most likely cause is H. Influenzae

52
Q

S&S of allergic rhinitis

A

allergic shiners, hypertrophic turbinate, COBBLESTONE THROAT, swollen eyelids

53
Q

Difference in presentation between rhinosinusitis and allergic rhinitis

A

Allergic rhinitis- inflammation of lining of nose, runny nose, pale/edematous mucosa
Rhinosinusitis- nasal obstruction, facial pain, purulent discharge

54
Q

Risk factors for rhinosinusitis

A

smoking, swimming, immunodeficient, dental disease, asthma, allergies

MVU Adult 1 (4 decks)

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