GP- Eyes + Ears Flashcards
Red Eyes
Differentials?
subconjunctival haemorrhage
Viral conjunctivitis
Uveitis
Corneal abrasion
What is an INR
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)
What is a subconjunctival haemorrhage?
Due to rupture of superficial vessel on the conjunctiva
Is subconjunctival harmorrhage benign or malignant?
benign
What are the predisposing factors of subconjunctival haemorrhage?
HTN
Coagulopathy
management for subconjuctival haemorrhage?
treat underlying cause
like uncontrolled/increased hyperternsion medicaiton
What is conjunctivits
inflammation of the conjunctiva
Can be conjuctivitis be viral, bacteria and fungal?
No
It can be allergic, viral or bacterial
Common causes of viral and bacterial conjuctivitis
Viral- adenovirus
bacterial- staph, strep, Haemophilus
What could be the cause of conjuctivitis in neonates?
Chlamydia
gonococcal
Difference in symptom for viral and bacterial conjuctivitis
Viral conjunctbits has purulent discharge
Viral cold could lead to it too
Symptoms/SIgns for subconjuctival haemorrahage?
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
Symptoms and signs of viral conjuctivitis
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.
What is Uvetitis ?
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.
WHat is the uveal tract?
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
What are the different types of uveitis?
What is classification for Uveitis
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
Eye red flag symptoms for uveitis?
Eye pain
Changes in vision
Photophobia
What would happen if a patient had eye red flag symptoms?
GP would refer urgently ip to hospital that day
Managament for Uveitis ?
- 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
WHat is the name given to adhesions between the iris and lens that distort the pupil?
Synechae
Signs and symptoms of uveitis
Eye redness.
Eye pain.
Light sensitivity.
Blurred vision.
Dark, floating spots in your field of vision (floaters)
Decreased vision.
WHat are corneal abrasion?
Corneal abrasion is a defect in the corneal epithelium
Signs and symptoms of corneal abrasions?
Pain.
A gritty feeling in the eye.
Tearing.
Redness.
Sensitivity to the light.
Headache.
TRUE OR FALSE
Corneal epithelium has often a history of trauma/sensation of foreign body in eye
TURE
Treatment for corneal abrasion?
-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)
Otitis Externa Treatment
Topical steroids/abx
Fungal cause- anti-fungal agents
Earache differentials?
otitis externa
acute otitis media
otitis media with effusion
Cholesteatoma
What is otitis externa?
infection of external auditory canal
Otitis externa is commonly bacteroal but it can be fungal
Name some organisms that cause this?
Bacterial- pseudomona, staph
Fungal- aspergillus, candida
Mx for otitis externa
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
SIgns and symptoms of otitis externa
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.
What is otitis media?
infection in the middle ear
WHat is the duration of symptoms with otitis media?
3-7 days
Complications of otitis media?
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)
Tx for otitis media?
analgesia
consider delayes abx prescription 3/7 (amoxicillin 5-/7, clarithromycin if penicilin allergic)
Signs and symptoms of otitis media?
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.
What is otits media with effusion?
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.
What is the most common cause of hearing impairment in childhood
otitis media with effusion
OME is most common in children between the ages of _ months and _ years. It presents most commonly in the _____ months.
OME is most common in children between the ages of 6 months and 4 years. It presents most commonly in the winter months.
Symptoms of OME
Hearing difficulties.
Tugging or pulling at one or both ears.
Loss of balance.
Delayed speech development.
WHat is cholesteatoma?
Cholesteatoma is an epidermoid structure showing independent growth
causes local destruction to hearing
Complications of cholesteatoma?
facial nerve palsy, vertigo, intracranial abscess, meningitis
