HEENT Flashcards
1
Q
ACUTE VISION LOSS
- Defintion/Causes
- SX
- Physical Exam Findings
- Labs/Rad
- Tx
- Disposition
- DDX
A
1. 2. 3. 4. 5. 6. 7.
2
Q
BLEPHRITIS
- Defintion/Causes
- SX
- Physical Exam Findings
- Labs/Rad
- Tx
- Disposition
- DDX
A
ANTERIOR AND POSTERIOR
- Common chronic bilateral inflammatory condition of the lid margins.
- Itch, burn, mild pain, FBS, **crusting around the eyes upon awakening
- **frothy tears, erythema of the lids
- None
- Baby soap, warm compress, massage, artificial tears, abx if caused by staph
- ROB
- Conjunctivitis, pediculosis, rosacea
3
Q
CONJUNCTIVAL HEMMORHAGE
- Defintion/Causes
- SX
- Physical Exam Findings
- Labs/Rad
- Tx
- Disposition
- DDX
A
- Ruptured blood vessels from pressure, HTN, topical steroid therapy, etc.
- Red eye, FBS, usually asx
- Blood in conjunctiva, often unilateral.
- Complete eye. Bleeding studies, CT/MRI
- None or artifical tears
- ROB
- Conjunctivitis, Scleritis, Conjunctival Lacerations, Foreign Body, Open Globe
4
Q
Conjunctivitis (Viral)
- Defintion/Causes
- SX
- Physical Exam Findings
- Labs/Rad
- Tx
- Disposition
- DDX
A
- Inflammation of the conjunctiva (Adenovirus)
2.Itching, burning, tearing, gritty or FBS; hx of URI or contact with someone with viral conjunctivitis. - Watery discharge, red and edematous eyelids, pinpoint subconjunctival
hemorrhages, punctate keratopathy (epithelial erosion in severe cases),
membrane/pseudomembrane (severe cases). - None
- tears, Antihistamine drops, steroids (consult ophthalmology first)
- ROB
- Acute uveitis, Foreign body, Chlamydial keratoconjunctivitis
5
Q
OCULAR FOREIGN BODY
- Defintion/Causes
- SX
- Physical Exam Findings
- Labs/Rad
- Tx
- Disposition
- DDX
A
- superficially or partially embedded on the cornea or conjunctiva
- FBS, tearing, hx of trauma
- Conjunctival injection, eyelid edema, mild AC reaction, rust ring and SPK.
- Fluorescein( corneal abrasions), Slit lamp, US or CT.
- visual acuity, anesthetic, antibiotics
- MEDEVAC (I think?)
- Laceration, Penetrating wound
6
Q
CORNEAL ABRAISION
- Defintion/Causes
- SX
- Physical Exam Findings
- Labs/Rad
- Tx
- Disposition
- DDX
A
1.
- Severe pain, tearing, photophobia,
- **foreign body (fingernail, contact lens)
- Slit lamp
- Antibiotic, NSAID)
- MEDADVICE
- Conjunctival abrasion, Subconjuctival hemmorrhage, Foreign body
7
Q
HORDEOLUM
- Defintion/Causes
- SX
- Physical Exam Findings
- Labs/Rad
- Tx
- Disposition
- DDX
A
- Staphylococcus, blepharitis or acne rosacea.
- FBS
- eyelid tenderness, swelling, visible, palpable
- None
- Warm compresses, massage, no makeup
- ROB
- chalazion, Blepharitis, Cellulitis
8
Q
CHALAZION
- Defintion/Causes
- SX
- Physical Exam Findings
- Labs/Rad
- Tx
- Disposition
- DDX
A
- outflow of these sebaceous secretions is obstructed
- hard, nontender
- Edema, Erythema
- None
- Warm compresses, massage, no makeup
- ROB
- chalazion, Blepharitis, Cellulitis
9
Q
HYPHEMA
- Defintion/Causes
- SX
- Physical Exam Findings
- Labs/Rad
- Tx
- Disposition
- DDX
A
- Trauma or recent ocular surgery, red blood cells within the anterior chamber, Herpes, zoster
- Pain, photophobia, blurred/clouded vision, trauma hx
- Blood or clot in anterior chamber
- Complete eye exam, CT
- opthalmology NOW, bed rest-head elevated, rigid shield
- MEDEVAC
- Ruptured globe, penetrating ocular injury
10
Q
UVEITIS/IRITIS
- Defintion/Causes
- SX
- Physical Exam Findings
- Labs/Rad
- Tx
- Disposition
- DDX
A
- inflammation of the uveal tract. Herpes, syphilis, SLE
- Pain, redness, photophobia
- Hypopyon, Keratic precipitates
- Complete ocular examination
- Cycloplegic, Topical steroid
- MEDEVAC
- Keratitis, Conjunctivitis, Hypopyon
11
Q
ORBITAL CELLULITIS
- Defintion/Causes
- SX
- Physical Exam Findings
- Labs/Rad
- Tx
- Disposition
- DDX
A
- infection that can affect the skin and/or the eyes. Paranasal sinus infection. periorbital/dental infection. Staph, strep.
- Red eye, pain, nasal congestion/discharge, sinus
headache/pressure/congestion, tooth pain - warmth, tenderness, restricted extraocular motility
- HX, Complete eye examine, CT, CBC w/ diff
- IV antibiotics Augmentin
- MEDEVAC
7.
12
Q
ORBITAL FRACTURE
- Defintion/Causes
- SX
- Physical Exam Findings
- Labs/Rad
- Tx
- Disposition
- DDX
A
1. 2. 3. 4. 5. 6. 7.
13
Q
PTERYGIUM
- Defintion/Causes
- SX
- Physical Exam Findings
- Labs/Rad
- Tx
- Disposition
- DDX
A
- degeneration of fibrovascular. sunlight exposure, chronic inflammation and oxidative stress
- Irritation, redness, decreased vision; may be asx
- Wing-shaped fold from the interpalpebral conjunctiva and extending onto the cornea. Usually nasal in location
- Slit lamp
- Protect eyes, tears, Corticosteroids
- ROB (i think)
7.
14
Q
RETINAL DETACHMENT (Rhegmatogenous retinal detachment) 1. Defintion/Causes 2. SX 3. Physical Exam Findings 4. Labs/Rad 5. Tx 6. Disposition 7. DDX
A
- Most common. Usually spontaneous. Nearsightedness and cataract extraction- most common predisposing causes.
- Flashes of light, a curtain or shadow over the field of vision, peripheral or central visual loss, or both
- retina is seen hanging in the vitreous like a gray cloud, One or more retinal tears or holes
- Complete eye exam, us, ct
- urgent ocular surgery
- MEDEVAC
- Ocular trauma, Choroidal detachment
15
Q
BURNS
- Defintion/Causes
- SX
- Physical Exam Findings
- Labs/Rad
- Tx
- Disposition
- DDX
A
- sunlamp without eye protection, welding
- pain, FBS, photophobia, hx, sx worsen 6 to 12 hours after the exposure. Usually bilateral.
- numerous, microdots on the corneal
- Slit lamp
- Oxycodone, Antibiotic, pressure patch
- MEDADVICE (I think?)
- Ocular foreign body, Corneal abrasion
16
Q
PENETRATING WOUND TO THE EYE
- Defintion/Causes
- SX
- Physical Exam Findings
- Labs/Rad
- Tx
- Disposition
- DDX
A
1.
2. Pain, decreased vision, loss of fluid from eye
3.
4. DX by penlight, indirect ophthalmoscope, slit lamp, x ray
5. Protect, Systemic antibiotics, within 6 hour
6. MEDEVAC
7. Hyphema, Intraocular foreign body,
17
Q
HERPATIC LESION TO THE EYE
- Defintion/Causes
- SX
- Physical Exam Findings
- Labs/Rad
- Tx
- Disposition
- DDX
A
- Herpes simplex
- Hx of herpes, photophobia, pain
- Conjunctiva can be injected, Dendritic keratitis,
- None
- antiviral,
- MEDEVAC
- Corneal ulcer, Fungal keratitis, Herpes zoster opthalmicus
18
Q
LEGEND
FBS
A
- Foreign Body Sensation
19
Q
CORENAL ULCER
- Defintion/Causes
- SX
- Physical Exam Findings
- Labs/Rad
- Tx
- Disposition
- DDX
A
1. Bacteria: Pseudomonas, Strep, Staph Viruses: Herpes, Varicella Fungi: candida Contact use 2. discharge, FBS, photophobia, 3. hypopyon, opacity or infiltrate 4. None 5. antibiotics, NO PATCH, ophthalmologist within 12 to 24 h. 6. MEDEVAC 7. None
20
Q
HORDEOLUM
- Defintion/Causes
- SX
- Physical Exam Findings
- Labs/Rad
- Tx
- Disposition
- DDX
A
- painful, localized to eyelid margin. photophobia, FBS
- tearing, small, yellowish pustule at base of eyelash, edema
- none
- warm compress, no eye makeup (antibiotics if it doesnt resolve)
- ROB
- Chalzion, blephritis
21
Q
CHALAZION
- Defintion/Causes
- SX
- Physical Exam Findings
- Labs/Rad
- Tx
- Disposition
- DDX
A
- nontender
- small nodule in eyelid center, edema, swelling
- none
- warm compress, no eye makeup (antibiotics if it doesnt resolve)
- ROB
- hordeolum, blephritis