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HEENOT Flashcards

1
Q

Lichen Planus

- overview

A

T-cell mediated

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2
Q

Lichen Planus

- assoc with what

A

Hep C exposure

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3
Q

Lichen Planus

- Clinical

A
  • oral or cutaneous lesions
  • polygonal, purple, pruritic papules
  • Wickham’s striae: lacy, white oral mucosa
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4
Q

Lichen Planus

  • dx
  • mgmt
A
  • clinical and biopsy

- Steroids first line, calcineurin inhibitors second line, avoid irritants

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5
Q

Dacryocystitis

- overview

A
  • infection of lacrimal sac

- dt obstruction: congenital or acquired

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6
Q

Dacryocystitis

- acute bugs

A

Staph aureus

beta-hemolytic strep

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7
Q

Dacryocystitis

- clinical

A
  • rapid onset
  • pain, red, swelling
  • inner eye near tear duct
  • possible purulent material
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8
Q

Dacryocystitis

- mgmt

A
  • mild: oral clinda

- severe: IV vanc + 3rd gen ceph

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9
Q

Dacryocystitis

- risk without tx

A
  • preseptal/orbital cellulitis
  • sepsis
  • meningitis
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10
Q

Croup

- bug

A

parainfluenza virus

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11
Q

Croup

- mgmt

A
  • supportive
  • steroid: dexamethasone usu
  • stridor at rest: racemic epi to open airway
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12
Q

Croup

- type of stridor

A

inspiratory

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13
Q

when to start fluoride supplementation if not on fluorinated water

A
  • 6 months
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14
Q

Open Angle Glaucoma

- overview

A
  • atrophy of optic nerve head

- Most often due to increased IOP

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15
Q

Open Angle Glaucoma

- RF

A
  • age
  • aa
  • hispanic
  • DM
  • HTN
  • CVD
  • myopia
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16
Q

Open Angle Glaucoma

- vision loss

A
  • insidious

- tunnel vision: lose periphery

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17
Q

Open Angle Glaucoma

- dx

A
  • fundoycopic exam: cupping of optic disc and increased cup to disc ratio
  • inc IOP
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18
Q

Open Angle Glaucoma

- mgmt

A
  • Prostaglandin analog drops: latanoprost

- 2nd line: timolol/bb drops

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19
Q

MCC bulls myringitis in children

A

Strep pneumonia

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20
Q

Acute bacterial sinusitis

- mgmt

A
  • oral decongestants
  • NSAIDS
  • Abx: amoxicillin, augmentin if risk for pneumococcal resistance
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21
Q

Sialolithiasis

- MC location

A

Wharton duct: anterior floor of mouth under tongue, drains submandibular gland

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22
Q

Pinna cartilage damage

- what type of closure best

A

first intention

  • if <12 hours old
  • no sign infection/contamination
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23
Q

How to close bite wounds, why

A
  • clean and leave open, treat with abx: assume contaminated with oral flora…
  • Once cleaned, close with secondary or tertiary intention
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24
Q

Strabismus

- overview

A
  • often infants <6 months
  • unclear etiology, genetics?
  • can lead to amblyopia
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25
Q

Strabismus

- mgmt

A
  • Small angle deviation: prism lens and corrective lens +/- patch
  • Angle >40: unlikely to have spontaneous resolution, require surgical realignment, early better
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26
Q

Open globe rupture

- dx

A
  • clinical findings
  • teardrop pupil
  • Seidel test: fluorescein testing
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27
Q

Open globe rupture

- mgmt

A
  • visual acuity
  • pupillary response to light
  • rigid protective patch
  • urgent ophthalmology referral
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28
Q

Labyrinthitis

- overview

A
  • inflammation inner ear

- assoc bacterial/ viral infections

29
Q

Labyrinthitis

- presentation

A
  • acute onset, severe vertigo
  • assoc with tinnitus and hearing loss
  • aural fullness, otorrhea
  • otalgia
  • n/v
  • fever
30
Q

Labyrinthitis

  • dx
  • mgmt
A
  • clinical (r/o stroke, brain tumor)
  • bed rest, hydration
  • meclizine, diazepam ST to suppress vestibular system
  • Steroids, abx, antivirals
31
Q

Aphthous stomatitis

  • RF
  • treatment
A
  • genetics :)

- topical steroids

32
Q

Rhinitis medicamentosa

- common med

A

Oxymetazoline

- don’t use for more than 3 days in a row

33
Q

Normal IOP

34
Q

Acute angle-closure glaucoma

- dx

A

Gonioscopy: gold standard. Special lens on slit lamp

35
Q

Acute angle-closure glaucoma

- mgmt

A
  • alpha-agonist: apraclonidine
  • bb: timolol
  • Cholinergic: pilocarpine
  • Acetazolamide
  • osmotic diuretics: mannitol
36
Q

Diabetic retinopathy

- proliferative dx

A
  • fundoycopic exam: neovascularization

- Fluorescein angiography: GS.

37
Q

Diabetic retinopathy

- nonproliferative dx

A

fundoycopic exam: hard exudates, cotton wool spots, macular edema, etc.

38
Q

Retropharyngeal abscess

  • location
  • overview
A

posterior to pharynx

  • complication of URI/oral infections or trauma
  • high mortality rate
39
Q

Retropharyngeal abscess

- clinical

A
  • sore throat
  • fever
  • painful swallow
  • pain opening mouth
  • neck pain/stiff
  • diff breathing
  • +/- airway compromise
40
Q

Retropharyngeal abscess

- dx

A
  • lateral neck XR

- CT neck with contrast: best

41
Q

Retropharyngeal abscess

- mgmt

A
  • broad spectrum abx
  • 2nd/3rd gen ceph + clinda
  • Vanc in high risk groups
  • I&D in operating room in some cases
42
Q

AOM

- Most specific clinical finding

A
  • bulging TM
43
Q

AOM

- mgmt

A 
Pain: acetaminophen or ibuprofen
Abx: 
- amoxicillin first line
- cefdinir, etc for mild PCN reaction
- macrolide/clinda for severe PCN allergies
44
Q

Herpes simplex keratitis

- mgmt

A
  • topical/oral antiviral: trifluridine drops, ganciclovir ointment, acyclovir ointment or PO
45
Q

Blepharitis

- RF

A
  • rosacea
  • psoriasis
  • eczema
  • seborrheic dermatitis
    (chronic inflammatory conditions)
46
Q

Blepharitis

- mcc

A

meibomian gland dysfunction (posterior)

47
Q

Dental carries

- mc pathogen

A
  • strep. mutans
48
Q

Gingostomatitis due to herpes simplex

- mgmt

49
Q

Chemical Eye burn

  • worst type of agent
  • mgmt
A
  • alkaline: liquefactive necrosis

- copious eye irrigation, target pH 7-7.4

50
Q

Sampters Triad

A
  • ASA/NSAID allergy
  • Nasal polyps
  • Asthma
51
Q

Orbital cellulitis

- RF

A
  • rhinosinusitis
  • orbital trauma
  • dacryocystitis
52
Q

Orbital cellulitis

- bugs

A
  • s. aureus

- s. anginosus

53
Q

Orbital cellulitis

- clinical

A
  • eye pain, swelling
  • fever
  • deceased vision
  • painful eye movement
  • proptosis
  • chemosis
  • ophthalmoplegia
54
Q

Orbital cellulitis

- dx

55
Q

Orbital cellulitis

- mgmt

A
  • IV vanc + 3rd gen ceph (ceftriaxone)
56
Q

Presbycusis

- overview

A
  • symmetric, progressive hearing loss
  • high frequency then lower
  • elderly pts
  • sensorineural disorder: damage to cochlear hard cells
  • M > F
57
Q

Weber

A
  • goes to Wax: conductive will lateralize to affected side

- sensorineural will lateralize to normal side

58
Q

Rinne

A
  • Normal AC > BC

- Conductive Loss: BC > AC

59
Q

Vestibular Schwannoma / acoustic neuroma

- overview

A
  • Benign tumor of CN VIII

- usu unilateral

60
Q

Vestibular Schwannoma / acoustic neuroma

- presntation

A
  • unilateral sensorineural hearing loss
  • vestibular sx
  • CONTINUOUS disequilibrium (not episodic)
  • Can cause disturbance of trigeminal nerve = facial paresthesia/pain or facial nerve
61
Q

Vestibular Schwannoma / acoustic neuroma

- dx

A
  • clinical testing

- MRI: definitive

62
Q

Scarlet Fever

- overview

A
  • diffuse erythematous rash assoc with strep pharyngitis

- delayed cutaneous reaction to toxins

63
Q

Scarlet Fever

- rash

A
  • diffuse erythema
  • sandpaper
  • papular elevations
  • armpit to trunk and extremities, spears palms and soles
64
Q

Scarlet Fever

- clinical

A
  • strep throat findings

- assoc with circumoral pallor and strawberry tongue

65
Q

Scarlet Fever

- complications

A
  • progression to rheumatic fever
66
Q

Scarlet Fever

- dx

A
  • clinical

- strep test/cuture

67
Q

Scarlet Fever

- mgmt

A
  • pcn, amoxicillin, cephalexin, macrolide
68
Q

Infectious mononucleosis

- virus

69
Q

Infectious mononucleosis

- dx

A
  • labs: lymphocytosis

- heterophiles antibody test

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