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Primary > Eye, ear, nose and throat issues and disorders > Flashcards

Eye, ear, nose and throat issues and disorders Flashcards

1
Q

A common staphylococcal abscess on the upper or lower eyelid

A

Hordeolum (Stye)

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2
Q

Cause of this eye condition/ Hordeolum (Stye):

1) _______________
2) Extremely common

A

1) Staphylococcus

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3
Q

Differential diagnosis of Hordeolum ( Stye):

a) Conjunctivitis
b) __________
c) Blepharitis
d) Dacryocystitis

A

Chalazion

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4
Q

Signs and symptoms of Hordeolum

1) _____ onset
2) Localized pain (acutely tender) and edema
3) Pain proportional to the amount of edema

A

Abrupt

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5
Q

Management of Hordeolum is:

a) Warm compresses
b) Topical ______ or erythromycin ophthalmic ointment may be considered
c) Refer to an ophthalmologist for possible incision and drainage (I & D) if there are no resolution within ___ hours

A

b) bacitracin

c) 48 hours

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6
Q

A granulomatous (beady nodule) on the eyelid; infection or retention cyst of the meibomian gland

A

Chalazion

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7
Q

Note: A Chalazion is a hard, non-tender cyst; it differs from styes (Hordeola) in that this is usually ______?

A

Painless

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8
Q

Signs and symptoms associated with Chalazion include:

a) __________
b) Red conjunctiva
c) itching
d) Visual distortion if the cyst is large enough to impress cornea; may cause astigmatism (blurred vision) due to pressure on the cornea
e) Eyelid swelling
f) Light sensitivity
g) Increased tearing

A

Asymptomatic

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9
Q

Management of Chalazion include:

1) ____ ____
2) Referral for surgical removal

A

1) Warm compresses

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10
Q

The most common eye disorder; an inflammation/infection of the conjunctiva (“pink eye”) resulting from a variety of causes including allergies, chemical irritation. or infection (bacterial, viral, gonococcal/chlamydial)

A

Conjunctivitis

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11
Q

Signs and symptoms of conjunctivitis:

a) Inflammation, redness, irritation
b) itching, burning
c) increased tears
d) ____ _____ possible
e) eyelid swelling
f) foreign body sensation
g) eyelids may be crusty and sticky with mucopurulent discharge

A

blurred vision

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12
Q

Laboratory/Diagnostics for conjunctivitis commonly are gram stain and cuture when indicated (e.g. if _____ is suspected)

A

gonococcal

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13
Q

______ conjunctivitis is treated by:

1) Self-limiting
2) FLushing with normal saline

A

Chemical

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14
Q

______ conjunctivitis discharge is purulent

A

bacterial

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15
Q

Bacterial conjunctivitis is treated by:

1) _________ 0.5% ophthalmic oitment
2) Tetracycline 1%
3) Polymyxin B ophthalmic solution or ointment

A

1) Erythromycin

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16
Q

_______ (ophthalmic emergency) discharge is purulent

A

Gonococcal

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17
Q

Treatment for Gonococcal conjunctivitis is?

A

IV Pen G or ceftriaxone IM

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18
Q

_______ conjunctivitis is treated with

1) Erythromycin ophthalmic ointment
2) Oral: Tetracycline, erythromycin, clarithromycin, azithromycin, doxycycline

A

Chlamydia

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19
Q

______ conjunctivitis discharge is stringy, increased tearing

A

Allergic

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20
Q

_______ conjunctivitis is treated with

1) Oral antihistamines
2) Refer to allergist/ ophthalmologist
a) Steroids are not ordered in primary care because of increased intraocular pressure and activation of herpes simplex virus

A

Allergic

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21
Q

_____ conjunctivitis discharge is watery

A

Viral

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22
Q

Treatment for this ____ conjunctivitis:
Symptomatic care
1) Mild: Sline gtt/ artificial tears (refrigerated, cool is best)
2) Moderate: Decongestants/ antihistamines, mast cell stabilizers, NSAIDs
3) Sulfacetamide 10% ophthalmic solution for bacterial (secondary) prophylaxis

A

Viral

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23
Q

______ conjunctivitis discharge is bright red and irritated

A

Herpetic

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24
Q

______ conjunctivitis refers to ophthalmologists with this virus

A

Herpetic

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25
Q

An abnormal, uniform, progressive opacity of the eye seen in children with the co-morbid syndrome (e.g., Down syndrome, diabetes mellitus, Marfan syndrome, and atopic dermatitis)

A

Cataracts

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26
Q

Cause/ incidence of _______

a) Congenital
b) Prolonged steroid use
c) Infection
d) Injury
e) Radiation

A

Cataracts

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27
Q

One of the main causes of cataracts is this. It naturally occurs from this because of _____.

A

Age

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28
Q

Signs and symptoms of cataracts:

a) Hallmark is ______
b) decreased visual acuity
c) clouded, blurred, dim vision
d) white fundus reflex
e) poor visual fixation
f) photophobia

A

a) painless

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29
Q

Laboratory/ diagnostics for cataracts include?

A

None indicated

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30
Q

Management of cataracts include?

A

Refer for surgical removal

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31
Q

1) Ocular misalignment as a result of uncoordinated ocular muscles
2) If acquired after six months of age, it is usually related to an underlying problem

A

Strabismus

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32
Q

Signs and symptoms of Strabismus:

a) Squinting
b) _____ visual acuity
c) Head tilt
d) Face turning
e) Esotropia
f) Exotropia
g) Hypertropia
h) Hypotropia
i) Hirschberg papillary light reflex is unequal

A

b) decreased

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33
Q

Eyes deviate inward

A

Esotropia

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34
Q

Eyes deviate outward

A

Exotropia

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35
Q

Eyes deviate upward

A

Hypertropia

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36
Q

Eyes deviate downward

A

Hypotropia

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37
Q

Management Strabismus:

1) Refer to ophthalmology
a) If fixed or continuous at ___ months of age or more
b) Immedicatley for hypertropia and hypotropia
c) Signs of underlying cause present

A

six months

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38
Q

Inflammation of the external auditory meatus

A

Otitis Externa ( Swimmer’s Ear)

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39
Q

Cause/ Incidence of Otitis External include

1) Infection
a) ______ ( usually gram-negative)
b) Fungal
c) Viral
2) Recent history of water exposure
3) History of mechanical trauma, foreign body, or excess cerumen may be present

A

a) Bacterial

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40
Q

Signs/ symptoms of Otitis Externa include:

a) Otalgia
b) ______
c) Purulent discharge

A

b) Pruritus

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41
Q

Physical examination of Otitis Externa is found:

a) _____ of the ear canal
b) Edema of the ear canal
c) Purulent exudate (something with odor)
d) Pain upon manipulation of the auricle
e) The lateral surface of the tympanic membrane may be erythematous
f) Tympanic membrane is _______

A

a) Erythema

f) Normal

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42
Q

Laboratory/ diagnostics for Otitis Externa?

a) Pneumatic otoscopy should demonstrate _______

A

Mobility

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43
Q

Management of Otitis Externa include

1) Remove ____ debris
2) Protect from moisture or injury
3) Topical ear medications

A

1) Purulent

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44
Q

Bacterial management of Otitis Externa:

a) ____ ____ with or without hydrocortisone
b) Cortisporin ( Neomycin, polymyxin B, HC)

A

Acetic acid

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45
Q

Fungal management of Otitis Externa:

a) Antifungal drops (e.g. ________ 1% solution)

A

Clotrimazole

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46
Q

_____ is a bacterial infection of the mucosally lined air- containing spaces of the temporal bone. ___ _______ is responsible for about 30% and __ ______ for about 20% of AOM cases.

A

S. Pneumoniae

H. Influenzae

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47
Q

Signs and symptoms of Acute Otitis Media (AOM)

a) _______ hearing
b) Otalgia
c) Fever
d) Aural pressure
e) vertigo
f) nausea/vomiting

A

a) decreased hearing

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48
Q

Physical exam findings for AOM include:

a) Tympanic membrane
1) _________
2) Edematous
b) Purulent exudate
c) Tympanic membrane rarely bulges

A

1) Erythematous

49
Q

Laboratory/ Diagnostics of AOM include:

1) Impaired mobility of tympanic _____ with pneumatic otoscopy

A

1) membrane

50
Q

Management of the AOM include:

1) Pain management: ________, benzocaine otic drops
2) The observation period for healthy children: “Watchful waiting “ for __ to ___ hours
3) Medications
4) Prevention with immunization and avoidance of ___ hand smoke

A

1) Acetaminophen
2) 48 to 72 hours
4) Second-hand smoke

51
Q

Medications commonly used for AOM include?

A

Amoxicillin 80 to 90mg/kg/day, twice daily orally x 10 days

52
Q

Common vaccinations for AOM include?

A

Hib, PCV13, annual flu

53
Q

The presence of fluid in the middle ears without the signs or symptoms of AOM; also known as chronic otitis media with effusion?

A

Serous Otitis Media/ otitis Media with Effusion (OME)

54
Q

Cause/ incidence of Serous Otitis Media/ otitis Media with effusion (OME) include:

1) Blocked _______ tube; inability to equalize pressure
2) Allergy, barotrauma influence

A

1) eustachian tubes

55
Q

Signs and symptoms of Serous Otitis Media/ Otitis Media with effusion (OME)

1) Hearing loss
2) _____ sensation when pressure altered
3) Fullness in ears

A

2) Popping sensation

56
Q

Physical exam findings of Serous Otitis Media/ Otitis Media with Effusion (OME):

1) ___ ____ behind the tympanic membrane
2) Decreased membrane mobility
3) ____ and ____ test suggestive of conductive hearing loss

A

1) Air bubbles

3) Weber and Rinne tests

57
Q

Laboratory/ diagnostics for Serous Otitis Media/ Otitis Media with Effusion (OME):
1) Decreased _____ via audiometry

A

1) hearing

58
Q

Management of Serous Otitis Media/ Otitis Media with Effusion (OME):

1) Watchful monitoring: ____ months
2) Antibiotic therapy: No long- term efficacy
3) Antihistamines/ decongestants: Ineffective
4) Re-evaluate in ___ to six months

A

1) three

4) three

59
Q

Any degree of impairment in the ability to apprehend sound

A

Hearing Loss

60
Q

Hearing loss may be ______ or sensorineural

A

conductive

61
Q

Conductive hearing loss may be caused by:

a) Decreased ability to conduct sound from external to the inner ear
1) ______ inpaction/ foreign body ( most treatable)
2) Hematoma
3) Otitis Media
4) Perforated tympanic membrane

A

1) Cerumen

62
Q

Sensorineural hearing loss is associated with the impaired transmission of sound through the _____ system.

A

nervous system

63
Q

Cause of the hearing loss include:

a) acoustic _________
b) syphilis
c) Central nervous system disease
d) Medication toxicity

A

a) Neuroma

64
Q

The signs and symptoms of hearing loss include:

a) Understanding ___ and _____ test

A

Weber and Rinner Tests

65
Q

Normal findings for ____ test: Sound should be heard equally in both ears and not lateralize

A

Weber test

66
Q

Normal findings for ____ test: Air conduction (AC) is greater than bone conduction (BC)

A

Rinne test

67
Q

Findings with hearing loss:

1) Conductive hearing loss
a) _____ test: Sound lateralizes to the affected ear

A

a) Weber test

68
Q

Findings with hearing loss:
1) Conductive hearing loss
b) ____ test: Abnormal in the affected ear (i.e. AC greater
than BC)

A

b) Rinne test

69
Q

Findings with hearing loss:

2) Sensorineural hearing loss
a) ____ test: Sound lateralized to the unaffected ear

A

Weber test

70
Q

Findings with hearing loss:

2) Sensorineural hearing loss
a) ____ test: sound lateralized to the unaffected ear

A

Weber test

71
Q

Findings with hearing loss:

2) Sensorineural hearing loss
b) _____ test: Normal in the affected ear

A

Rinne test

72
Q

Laboratory/ diagnostics for hearing loss:

1) _______ exam: inspect canal and tympanic membrane
2) General neurological exam
3) Audiometric testing
4) ___ scan if a neurological condition is suspected
5) Serum blood tests as needed

A

1) Otoscopic

4) CT

73
Q

Management of hearing loss include:

a) Remove _____ body/ cerumen
b) Refer for audiogram
c) Refer for further evalutation / hearing aid

A

foreign

74
Q

Viral rhinitis, a self-limited upper respiratory tract infection

A

Common cold

75
Q

Signs and symptoms of Common cold include:

a) headache
b) watery ________
c) sneezing
d) Cough
e) Sore throat
f) Malaise

A

b) rhinorrhea

76
Q

Management of the common cold:

1) Rest and hydration
2) ____ ____ ___, humidifier
3) No OTC cold preparations (e.g. decongestants, antihistamines, antitussives, expectorants)
4) No antibiotics

A

Nasal saline drops

77
Q

Signs and symptoms:

1) Bleeding usually only from one nostril
2) Upset stomach because of blood dropping from the back of the throat into the stomach

A

Epistaxis ( Nosebleed)

78
Q

Management of Epistaxis:

1) Sit upright
2) Pressure at ________ ____: Anterior inferior aspect of the nasal septum (end of body ridge) x 10 minutes
3) Apply ice

A

Kiesselbach’s Triangle

79
Q

Inflammation of the pharynx or tonsils

A

Pharyngitis/ Tonsillitis

80
Q

Cause/ Incidence of Pharyngitis/ Tonsillitis:

a) Viruses (RSV, influenza A; B, Epstein Barr Virus)
b) Group ___ ___- hemolytic streptococci
c) Neisseria Gonorrhoeae
d) Mycoplasma
e) Chlamydia trachomatis
f) Corynebacterium Species

A

A and B

81
Q

Signs and symptoms of pharyngitis/ tonsillitis:

a) Erythematous pharynx
b) _______; cough
c) Malaise
d) Phinorrhea (viral)
e) Fever ( more pronounced in ____ infections)
f) Anterior cervical adenophathy (______)
g) Painful throat
h) exudate
i) _____ fever (strep infection) with sandpaper like rash

A

b) dysphagia
e) bacteria
f) bacteria
i) Scarlet

82
Q 
Centor Criteria
Clinical features most suggestive of group \_\_\_\_ beta-hemolytic streptococci (GABHS) include FLEA:
F
L
E
A
A

F–Fever
L– Lack of cough
E– Pharyngo- tonsillar Exudate
A– Anterior cervical Adenopathy

83
Q

Laboratory/ diagnostics of Pharyngitis/ Tonsillitis include:

1) ____ routine testing
2) Consider throat culture only if suspicious of strep

A

1) No

84
Q

Management of Pharyngitis/ Tonsillitis

1) Supportive Care
a) Fluids/ hydration
b) Warm _____ water gargles
c) Antipyretics (acetaminophen)
2) Anbitioitis only for streptococcal infection

A

salt

85
Q

Antibiotics for Pharyngitis/ Tonsillitis include

a) _____ ___ 250 mg orally three times daily x 10 days
b) if allergic to PCN give _______ 250 mg four times dialy x 10 days

A

a) Penicillin VK

b) Erythromycin

86
Q

Sudden, severe swelling of the epiglottis that occurs as a result of bacterial infection; can produce respiratory compromise in a matter of hours

A

Epiglottis

87
Q

Epiglottis:

  1. Common pathogens include _______, Pneumococci, and H. influenza
  2. Peak incidence occurs between the ages of 6 to 10
A

1) Streptococci

88
Q

Signs/ Symptoms of Epiglottis:

1) Sudden onset ____ fever
2) Drooling
3) Choking sensation
4) Restless, fearful
5) Hyperextension of the neck
6) Rapidly progressive signs of respiratory distress

A

high

89
Q

Laboratory/ Diagnosis of Epiglottis:

1) Blood and tracheal ______ for the causative organism
2) “ ___ _____,” and thumb-shaped patch, appearing on a radiograph of the neck

A

2) “Thumb sign”

90
Q

Management of Epiglottitis:

1) Immediate ________
2) Do not perform a pharyngeal exam
3) Keep child calm
4) Intubation capabilities as soon as possible
5) IV third generation _______ until pathogen identified

A

1) hospitalization

91
Q

Parainfluenza viral infection of the larynx

A

Croup

92
Q

This is seen with croup:

1) Severity can range from ___ to quite severe
2) Peak incidence is from ____ months to six-year of age
3) Affects ____ more often than females
4) Most common in fall and winter

A

1) mild
2) three
3) males

93
Q

Signs and symptoms of Croup:

1) Recent symptoms of a ___ ____ ___ (__ )
2) Bark- like cough
3) Low-grade fever
4) Vital signs consistent with infection
5) Dyspnea
6) Stridor if severe
7) Lungs typically clear

A

1) Upper respiratory infection (URI)

94
Q

Laboratory/ Diagnostics:

1) Pulse oximetry: Show hypoxic in sever forms
2) The appearance of a “____” shaped narrowing of the trachea on a frontal radiograph of the neck

A

2) steeple

95
Q

Management of croup includes:

1) ____disease: Outpatient supportive care

A

1) Mild

96
Q

Management of croup includes:

2) _____ disease: Hospitalize for respiratory support: IV fluids

A

2) Moderate

97
Q

Management of croup includes:

3) May require nebulized racemic _________

A

3) epinephrine

98
Q

Management of croup includes:

4) Short course of __________

A

corticosteroids

99
Q

________

a) bacterial infection
b) supraglottic structure
c) six to 10 years of age
d) high fever drooling
e) x-ray; thumb sign

A

Epiglottitis

100
Q

_______

a) viral infection, bacteria rare
b) Larynx
c) Three months to six years of age
d) Low fever, “barky cough”
e) x-ray: Steeple sign

A

Croup

101
Q

An acute infectious disease dire to the Epstein-Bar virus, usually occurring over the age of 10

A

Infectious Mononucleosis

102
Q

Infectious Mononucleosis:

a) Mode of transmission is _______

A

saliva

103
Q

The incubation period of Infectious Mononucleosis is?

A

One to two months

104
Q

Usually, Infectious Mononucleosis is ______ limited, but malaise and fatigue may last months

A

self

105
Q

Signs and symptoms of Mononucleosis are?

A

a) Fever
b) Pharyngitis ( most severe)
c) Malaise, anorexia, mylagia

106
Q

Physical examination of Infectious Mononucleosis is?

a) __________ cervical lymphadenopathy
b) Generalized lymphadenopathy
c) _______ exudate on tonsils
d) Splenomegaly
e) Macolpapular or petechial rash

A

a) Posterior

c) White

107
Q

Laboratory/ Diagnosis: Mononucleosis

a) Lymphocytic Leukocytosis: _________

A

Neutropenia

108
Q

Laboratory/ Diagnosis: Mononucleosis

b) Positive _______ and monospot

A

heterophil

109
Q

Laboratory/ Diagnosis: Mononucleosis

Early rise in Immunoglobulin ____ (Ig___) EBV

A

M (IgM)

110
Q

Laboratory/ Diagnosis: Mononucleosis

Permanent rise in Immunoglobulin ___ (Ig__) EBV

A

G (IgG)

111
Q

Management of Mononucleosis:

a) Supportive ( ______ ____ , warm saline grargels)

A

non-steroids

112
Q

Management of Mononucleosis:

b) Oral ________ when enlarged lymph tissue threatens airway obstruction

A

corticosteroids

113
Q

Management of Mononucleosis:
c) Avoidance of _____ _____ (three weeks to several months) to avoid splenic rupture (even without clinically detectable splenomegaly)

A

c) contact sports

114
Q

Occurs when an undrained collection of pus accumulates in one or more of the paranasal sinuses in children 9 years of age or older

A

Sinusitis (Rhinosinusitis)

115
Q

The _____ and ethmoid sinus are the most commonly affected

A

Sinusitis (Rhinosinusitis)

116
Q

Typical pathogens are the same as those of acute otitis media with Sinusitis (Rhinosinusitis) what are they?

A

S. Pneumoniae, H. Influenzae, and M. catarrhalis

117
Q

Signs and symptoms of Sinusitis (Rhinosinusitis):

a) Pain and _____ over the cheek
b) Headache
c) DIscolored nasal discharge, halitosis
d) Postnasal drip and cough (usually during the day and maybe worse at night)
e) Dull, throbbing pain worsening when headed is _______

A

a) pressure

e) dependent

118
Q

Laboratory/ Diagnostics: Sinusitis (Rhinosinusitis)
1) Diagnosis is often made on clinical presentation
2) Radiological studies are not needed in uncomplicated presentations
a) CT scan preferred over standard x-rays because it is
more sensitive and no more expensive; only for more
complicated sinusitis
b) May culture purulent nasal discharge
c) Children under the age of nine have poorly differentiated sinus cavities (________)

A

c) honeycomb

119
Q

Management: Sinusitis (Rhinosinusitis)
1) Uncomplicated with mild symptoms treat as an outpatient
a) ______-______ for 10 days; change to ______ if no
improvement in 3 days
b) Decongestants, antihistamines are not useful in acute sinusitis; maybe in chronic sinusitis
c) Pain management with acetaminophen
d) Nighttime humidification to reduce mucosal drying
e) Supportive care
2) Chronic, refractory or recurrent sinusitis: Refer to an otolaryngologist

A

a) Amoxicillin- Clavulanate

Levaquin

Primary (44 decks)

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