Eyes! (+throat)

Question 1

Preseptal cellulitis

Answer 1

Infection of soft tissue anterior to orbital septum, due to trauma or dermal infection

Question 2

Orbital cellulitis

Answer 2

Inflammation of orbital contents posterior to orbital septum (more common in kids, elderly, immunocomp’d)

• conjunctival injection, proptosis, pain with eye movement all present
• ocular mobility decreased and vision diminished

Question 3

Dacryocystitis

Answer 3

Acute or chronic infection of the lacrimal sac due to obstruction of the nasolacrimal duct

Pain, swelling, redness over lacrimal sac at medial canthus, crusting, tearing, fever

Question 4

Dacryocystitis

Answer 4

Inflammation of lacrimal gland (outer third of upper eyelid)

Question 5

Allergic conjunctivities

Answer 5

Red eyes (ball and lid) due to seasonal or other allergens

Cold compress and avoiding helps

Question 6

Giant papillary conjunctivitis

Answer 6

Immune reaction to mucus debris on lenses in contact lens wearers, leading to large papilae on inner eyelid

Looks like pink cottage cheese on inner eyelid

Question 7

Vernal conjunctivities

Answer 7

COBBLESTONE papillae on inner eyelid

• seasonal
• occurs in kids and lasts for 5-10 years before resolving (ew wtf)

Think Vernon Dudley from harry potter, and they have cobblestone streets in England (idk lol)

Question 8

Viral conjunctivitis

Answer 8

“Pink eye”: itchy, pain, swelling + serous discharge
-contagious for 12 days

Don’t fart on your pillow, silly

Question 9

Bacterial conjunctivities

Answer 9

Red eye with “purulent” discharge–pus-y from bacteria

MC organisms: n. Gonorrhea, chlamydia
-in sexually active individuals or neonates (vertical transmission)

Question 10

Trachoma

Answer 10

chronic, contagious form of conjunctivitis that typically leads to blindness–leading cause of infectious blindness in the world

Due to chlamydia trachomatis

• *you’ll see Arlt’s line on inner eyelid
• this is safe enough to google, not too disgusting

Question 11

Scleritis (inflammation of sclera) is associated with what systemic diseases

Answer 11

lupus, rheumatoid arthritis, ankylosing spondylitis, TB, gout..

Question 12

Scleritis clinical features (3)

Answer 12

Severe pain

Photophobia

Red eye

If anterior eyeball: pain radiates to face

If posterior eyeball: rapid progressive blindness (due to retinal detachment)

Question 13

Herpes simplex keratitis

Answer 13

corneal inflammation caused by the herpes simplex virus

Triggered by stress, fever, sun exposure

Question 14

Acanthamoeba keratitis

Answer 14

Exclusively in contact lens wearers

“-oeba”: water-borne parasite that invades cornea
-pools, lakes, sea water

• google with caution
• cloudy iris and pupil

Question 15

Anterior uveitis (or Iritis) is associated with which conditions

Answer 15

HLA-B27

• reactive arthritis (“can’t see…”)
• AS
• PsA
• IBD

You’ll see a red ring around the iris

Question 16

What is the most common bacterial infection of the oropharynx

Answer 16

Group A beta-hemolytic streptococcus (GABHS)

-the oropharynx “Gabs” a bunch and gets sore

Question 17

Common pharyngitis viral infections

Answer 17

1. EBV 😘
2. Coxsackie 🖐👄
3. Herpes simplex virus

Question 18

EBV clinical features

Answer 18

• Tonsilar exudate (cottage cheese-y)
• fever
• fatigue
• lymphadenopathy
• peak incidence: 15-19

Question 19

If you have pharyngitis, absence of [ ] indicates it’s a bacterial cause

Answer 19

Absence of cough

Question 20

Leukoplakia

Answer 20

thickened, white, leathery-looking spots on the inside of the mouth that can develop into oral cancer

Strong association with tobacco use and alcohol consumption

Question 21

Squamous cell carcinoma of larynx

Answer 21

Most common malignancy of the larynx
Strong association with smoking, alcohol, and HPV
Hoarseness >2 weeks, persistent throat/ear pain, neck mass, hemoptysis, stridor
CT or MRI for imaging
Biopsy
Tx: radiation therapy, partial or full laryngectomy, chemo

Question 22

Sinus tachycardia

Answer 22

> 100 bpm

Can occur in normal individuals with exercise, emotions, pregnancy, caffeine***

There’s probably going to be a question like “Tina has a high HR after drinking coffee. What’s the deal?” And the answer is Sinus tachycardia

Question 23

Paroxysmal supraventricular tachycardia