GP- Eyes + Ears

Question 1

Red Eyes

Differentials?

Answer 1

subconjunctival haemorrhage

Viral conjunctivitis

Uveitis

Corneal abrasion

Question 2

What is an INR

Answer 2

international normalized ratio

Most often, the prothrombin time is monitored if you are taking the blood-thinning medication warfarin. In this situation, the prothrombin time is expressed as an international normalized ratio (INR)

Question 3

What is a subconjunctival haemorrhage?

Answer 3

Due to rupture of superficial vessel on the conjunctiva

Question 4

Is subconjunctival harmorrhage benign or malignant?

Answer 4

benign

Question 5

What are the predisposing factors of subconjunctival haemorrhage?

Answer 5

HTN

Coagulopathy

Question 6

management for subconjuctival haemorrhage?

Answer 6

treat underlying cause

like uncontrolled/increased hyperternsion medicaiton

Question 7

What is conjunctivits

Answer 7

inflammation of the conjunctiva

Question 8

Can be conjuctivitis be viral, bacteria and fungal?

Answer 8

No

It can be allergic, viral or bacterial

Question 9

Common causes of viral and bacterial conjuctivitis

Answer 9

Viral- adenovirus

bacterial- staph, strep, Haemophilus

Question 10

What could be the cause of conjuctivitis in neonates?

Answer 10

Chlamydia

gonococcal

Question 11

Difference in symptom for viral and bacterial conjuctivitis

Answer 11

Viral conjunctbits has purulent discharge

Viral cold could lead to it too

Question 12

Symptoms/SIgns for subconjuctival haemorrahage?

Answer 12

Red eye

Little uncomfortable

no pain

feel well

HTN

The most obvious sign of a subconjunctival hemorrhage is a bright red patch on the white (sclera) of your eye. Despite its bloody appearance, a subconjunctival hemorrhage looks worse than it is and should cause no change in your vision, discharge or pai

Question 13

Symptoms and signs of viral conjuctivitis

Answer 13

Pink or red color in the white of the eye(s)

Swelling of the conjunctiva (the thin layer that lines the white part of the eye and the inside of the eyelid) and/or eyelids.

Increased tear production.

Feeling like a foreign body is in the eye(s) or an urge to rub the eye(s)

Itching, irritation, and/or burning.

Question 14

What is Uvetitis ?

Answer 14

Uvetitis is a potentially blinding condition - 10% of people with visulal impairment in the western world

Uveitis meas nflammation at any point of the uveal tract.

Question 15

WHat is the uveal tract?

Answer 15

THe uveal tract is the middle layer of the eye, made up of the iris, the ciliary body and the choroid which covers the eyes like a coat

Question 16

What are the different types of uveitis?

Answer 16

Question 17

What is classification for Uveitis

Answer 17

Uveitis may be acute, recurrent or chronic

Acute- sudden onsent of inflammation which resolves within 3 months

Recurrent - repeated episodes, separated by periods of inactvity without treatment for more than 3 months

CHronic- persistent nflammation lasting more than 3 months, in which prompt relapse (within 3 months) occurs when treatmnet is discontinured

Question 18

Eye red flag symptoms for uveitis?

Answer 18

Eye pain

Changes in vision

Photophobia

Question 19

What would happen if a patient had eye red flag symptoms?

Answer 19

GP would refer urgently ip to hospital that day

Question 20

Managament for Uveitis ?

Answer 20

• In hospital corticosteroids are used to reduce inflammation and prevent adhesion in the eye
• A cycloplegic-mydriatic drug is also given to paralyse the ciliary body
• this relieves pain and prevents adhesions between the iris and lens

Question 21

WHat is the name given to adhesions between the iris and lens that distort the pupil?

Answer 21

Synechae

Question 22

Signs and symptoms of uveitis

Answer 22

Eye redness.

Eye pain.

Light sensitivity.

Blurred vision.

Dark, floating spots in your field of vision (floaters)

Decreased vision.

Question 23

WHat are corneal abrasion?

Answer 23

Corneal abrasion is a defect in the corneal epithelium

Question 24

Signs and symptoms of corneal abrasions?

Answer 24

Pain.

A gritty feeling in the eye.

Tearing.

Redness.

Sensitivity to the light.

Headache.

Question 25

TRUE OR FALSE Corneal epithelium has often a history of trauma/sensation of foreign body in eye

Answer 25

TURE

Question 26

Treatment for corneal abrasion?

Answer 26

-Remove any foreign body chloramphenicol to prevent infection and development of corneal ulcer eye patch/pain relief corneal epithelial healing time relatbely quick (most heal within 2-3 days)

Question 27

Otitis Externa Treatment

Answer 27

Topical steroids/abx Fungal cause- anti-fungal agents

Question 28

Earache differentials?

Answer 28

otitis externa acute otitis media otitis media with effusion Cholesteatoma

Question 29

What is otitis externa?

Answer 29

infection of external auditory canal

Question 30

Otitis externa is commonly bacteroal but it can be fungal Name some organisms that cause this?

Answer 30

Bacterial- pseudomona, staph Fungal- aspergillus, candida

Question 31

Mx for otitis externa

Answer 31

oral abx topoical agents work best- topical abx and steriods, acetic acid 7-14 days. Oral used if ear canal too narrow for topical agent or cellitlitis Acetic acid and quinolones can be used iin patietns with Hx of TM perforation Analgesia

Question 32

SIgns and symptoms of otitis externa

Answer 32

Redness of the ear canal, ear pain, draining fluids and discharge of pus are signs of swimmer's ear (otitis externa). Untreated, the infection can spread to nearby tissue and bone. Swimmer's ear is an infection in the outer ear canal, which runs from your eardrum to the outside of your head.

Question 33

What is otitis media?

Answer 33

infection in the middle ear

Question 34

WHat is the duration of symptoms with otitis media?

Answer 34

3-7 days

Question 35

Complications of otitis media?

Answer 35

COmplications are rare but include menngitis, mastoiditis, intracranial abscess, sinus thrombosis and facial nerve paralysis assess for severity of infection (NICE traffic light system for assessing fever in children) asses for risk of developing complications above (otorrhoea or age under 3 with bilateral infection)

Question 36

Tx for otitis media?

Answer 36

analgesia consider delayes abx prescription 3/7 (amoxicillin 5-/7, clarithromycin if penicilin allergic)

Question 37

Signs and symptoms of otitis media?

Answer 37

Unusual irritability. Difficulty sleeping or staying asleep. Tugging or pulling at one or both ears. Fever, especially in infants and younger children. Fluid draining from ear(s) Loss of balance. Hearing difficulties. Ear pain.

Question 38

What is otits media with effusion?

Answer 38

Otitis media with effusion (OME), also known as 'glue ear', is characterized by a collection of fluid within the middle ear space without signs of acute inflammation.

Question 39

What is the most common cause of hearing impairment in childhood

Answer 39

otitis media with effusion

Question 40

OME is most common in children between the ages of _ months and _ years. It presents most commonly in the _____ months.

Answer 40

OME is most common in children between the ages of **6** months and **4** years. It presents most commonly in the **winter** months.

Question 41

Symptoms of OME

Answer 41

Hearing difficulties. Tugging or pulling at one or both ears. Loss of balance. Delayed speech development.

Question 42

WHat is cholesteatoma?

Answer 42

Cholesteatoma is an epidermoid structure showing independent growth causes local destruction to hearing

Question 43

Complications of cholesteatoma?

Answer 43

facial nerve palsy, vertigo, intracranial abscess, meningitis