Eye, Ear, Nose and Throat Flashcards
A common staphylococcal abscess on the upper or lower eyelid
hordeolum (stye)
Hordeolums are _______ with an ______ onset
painful; abrupt
A granulomatous (beady nodule) on the eyelid; infection or retention cyst of the meibomian gland
Chalazion
How does a chalazion differ from a hordeolum?
chalazion are typically painless
The most common eye disorder; an inflamattion/infection of the conjunctiva (“pink eye”) resulting from a variety of causes including allergies, chemical irritation, or infection
Conjunctivitis
Treatment for bacterial conjuctivitis:
erythromycin, tetracycline, or polymyxin B solution
What infectious organism causes conjuctivits and is considered an ophthalmic emergency?
Gonococcal
Treatment for gonococcal eye infection
Neonatal: IV Pen G or IM ceftriaxone
In allergic conjunctivitis, there is an increased _________
tearing
Should steroid eyedrops ever be prescribed for conjunctivitis in primary care?
No, it can increase intraocular pressure and activate herpes simplex virus
Viral conjunctivitis differs from bacterial conjunctivits how?
Viral = WATERY discharge not purluent
An abnormal, UNIFORM, progressive opacity of the eye seen in children with comorbid syndromes (i.e. Down syndrome, diabetes, Marfan)
Cataracts
Ocular misalignment as a result of uncoordinated ocular muscles. If acquired after 6 months of age, it usually is related to an underlying problem.
Stabismus
When eyes deviate INWARD
Esotropia
When eyes deviate OUTWARD
Exotropia
When eyes deviate UPWARD
Hypertropia
When eyes deviate DOWNWARD
Hypotropia
When should you refer to ophthalmology
- If fixed or continuous at six months of age or more
2. Immediately for HYPERTROPIA and HYPOTROPIA (likely a brain tumor)
Inflammation of the external auditory meatus
Otitis externa (Swimmer’s Ear)
Physical findings with otitis externa:
Purulent exudate, pain upon manipulation of auricle
What does the tympanic membrane look like with Otitis Externa?
Normal
Treatment option for otitis external if bacterial?
Ciprofloxacin and dexamethasone otic drops, Ofloxacin otic drops
Bacterial infection of the mucosally lined air-containing spaces of the temporal bone in the ear.
Acute otitis media
What is the most common bacterium associated with AOM?
S. Pnumoniae (30%)
What is the second most common bacterium associated with AOM?
H. influenzae (20%)
How does the TM look with AOM?
erythematous and edematous and bulging
How long is the watchful waiting period for AOM?
48-72 hours
1st line treatment for AOM?
Amoxicillin 80-90 mg/kg/day BID x 10 days
What vaccines help prevent AOM? (3)
Hib, Pneumococcal, and Flu
2nd hand smoke increases chances of AOM by __ times
4
The presence of fluid in the middle ears without the signs or symptoms of AOM
Serous otitis media/otitis media with effusion (OME)
OME typically occurs due to what?
Blocked eustachian tubes
Signs/Symptoms of OME:
hearing loss, fullness in the ears, “popping” sensation
Management for OME includes watchful waiting for __ months.
Watchful waiting for 3 months
Do antihistamines and decongestants show efficacy with OME?
NO
Decreased ability to conduct sound from the EXTERNAL to the INTERNAL ear
Conduction hearing loss
In conductive hearing loss, Weber lateralizes sound to the _________ ear, and Rinne will be ______ in the effected ear.
effected
abnormal
Impaired transmission of sound through the nervous system
Sensorineural hearing loss
With sensorineural hearing loss: Weber lateralizes to the _________ ear
unaffected
Viral rhinitis, a self-limiting upper respiratory tract infection
Common cold
Treatment for the common cold?
Supportive care–rest and hydration
Children should not be prescribed antitussives for children less than ___ years old.
Six
Where should pressure be applied during epistaxis and for how long?
Kiesselbach’s triange (Anterior inferior aspect of the nasal septum) for 10 minutes
What is Centor criteria?
Specific criteria that suggest group A beta-hemolytic streptococci
Centor Criteria uses FLEA, which stands for:
Fever
Lack of cough
Pharyngo-tonsillar EXUDATE
Anterior cervical ADENOPATHY
Treatment for strep throat:
Penicillin VK 250 mg PO TID x 10 days
If allergic to PCN, what should be the treatment of choice?
Erythromycin 250 mg QID x 10 days
Sudden, severe swelling of the epiglottis that occurs as a result of bacterial infection; can produce respiratory compromise in a matter of hours.
Epiglottitis
Three common pathogens associated with epiglottitis
Streptococci
Pneumococci
H. Influenzae
Peak incidence for epiglottis is __ and __ years
6 and 10 years
Name two signs/symptoms of epiglottitis:
drooling
hyperextension of the neck
The neck XR will reveal what if the patient is positive for epiglottitis?
Thumb sign–a thumb-shaped patch
Parainfluenza viral infection of the larynx
Croup
Peak incidence of croup is __ months to __ years
3 months to 6 years
When is croup most common (2 seasons)?
fall and winter
Neck XRay reveals what if patient has croup?
Steeple sign – narrowing of the trachea
Epiglottitis is a ______ infection and croup is a _____ infection.
Bacterial
Viral
An acute infectious disease due to the Eptein-Barr virus, usually occurring over the age of 10 years
Infectious Mononucleosis
Mode of transmission for mono:
Saliva
What type of rash could be present with Mono?
maculopapular or petechial rash
Patients with mono should avoid contact sports for how long? Why is this important?
3 weeks to several months to avoid splenic rupture
Occurs when an undrained collection of pus accumulates in one or more of the paranasal sinuses in children
Sinusitis
Sinusitis can be diagosed in children great than __ years old
9
Which two sinus cavities are the most commonly affected in sinusitis
Maxillary and ethmoid
Three typical pathogens (same as AOM)
S. pneumoniae
H. influenzae
M. catarrhalis
Uncomplicated sinusitis is treated with?
Amoxicillin-clavulanate x10 days, if no improvement after 3 days, change to levaquin
What should the PCP do for children with chronic, refractory or recurrent sinusitis?
Refer to otolaryngologist
