HEENT Flashcards
With sensorineural hearing loss, the Rinne test findings would be?
Normal: AC>BC
With conductive hearing loss, Rinne test findings would be?
BC>AC
Pt complains of acute onset severe eye pain, photophobia and blurred vision in one eye. The Fluorescein exam shows fern like lines in the corneal surface. What disorder do you suspect?
Herpes Keratitis
Round corneal abrasions noted in the center are common with this type of keratitis?
Contact Lens-related
Treatment for Keratits/corneal abrasion that is not Herpetic would include coverage for what organism? And which abx are recommended?
Pseudomonas: cirpofloxacin, ofloxacin, or Polytrim (trimethoprim-polymixinB)
What is the treatment for Hordeolum?
Warm compresses 5x a day for 10 min.
Systemic Abx if infection has spread into preseptal cellulitis
This eye condition is caused by excessive UV exposure resulting in thickening of conjunctiva extending across the cornea generally on nasal or temporal side of the eye?
Pterygium
Primary open-angle glaucoma presents with pressures above -___?
22
Primary open-angle glaucoma typically develops slowly and is often insidious in the early stages? T or F
True
Common treatment of primary open-angle glaucoma are?
Timolol 0.5% (beta-blocker)
Latanoprost (Xalatan): topical prostaglandin ey
Patient presenting with sudden onset severe unilateral eye pain, blurred or loss of vision, halos around lights, frontal headache w/ N/A is suspected to have what disorder?
Primary Angle-Closure Glaucoma, a medical emergency
The limbus is what?
The area between the cornea and sclera
Persons with autoimmune disorders such as RA, lupus, ankylosis spondylitis, and sarcoidosis are at risk for what eye disorder?
Anterior uveitis (Iritis)
What helps to differentiate bacterial conjunctivitis from anterior uveitis (iritis)?
Lack of purulent drainage with anterior uveitis
What area of the eye is responsible for central vision?
Macula
Gradual (or sudden) painless loss of central vision in one or both eyes of a smoker is concerning for?
Macular degeneration
The pt complaint of dry, gritty eyes who is using OTC tear solutions more that 3 times a day who is found to have dry mouth and poor dentition is suspected to have?
Sjorgren’s syndrome
Patient has complaint of red, dry and itchy eyes with crusting and flaking at lash border is diagnosed with blepharitis. What is the treatment?
Mild diluted soap scrub (Johnson’s baby shampoo), warm compresses 2-4 times a day. Erythromycin solution 2-3 times a day may be indicated.
Entropion is the ____ turning of the Lowe eyelid?
Inward
Ectropion is the ____ of the lower eye lid?
Outward and downward retraction
Atope is _____?
History of allergic reactions
Pt exam reveals pale and boggy nasal turbinates, posterior pharynx with thick yellow to clear mucus, and dark under eye circles. What are these findings suggestive of?
Allergic rhinitis
What is the recommended treatment for allergic rhinitis?
First line: elimination of allergen, nasal steroids (flucitasone). Adding nasal antihistamines (azelastine), oral decongestants (in adults) and 2nd generation antihistamines if failure to improve.
Prolonged use of what common nasal sprays causes rhinitis medicamentosa?
Afrin
Prolonged use of nasal decongestant sprays can cause what condition?
Rhinitis medicamentosa
What are the risks of untreated GABHS?
Scarlet fever (strawberry tongue and sloughing of the skin
Acute rheumatic fever (heart valve and joint involvement)
PTA
Post-streptococcal glomerulonephritis (abrupt onset proteinurea w/ HTN & edema)
What are the most common pathogens in OM?
Strep pneumoniae
H. Influenzae
Morexella
Bullous myringitis presents with and how is it treated
Conductive hearing loss and sx similar to OM but more painful. Bullae (blisters) on TM.
Treatment: amoxicillin 500mg tie x 5-7 (up to 10) days but may move to augment or omnicef if unresponsive.
Otitis Media w/ Effusion (serous otitis media) appears as?
Bulging or retracted TM w/o erythema. Fluid generally appears amber. Is common after bout of AOM.
What is the treatment for OM w/ effusion?
Oral decongestants & steroid nasal spray
What are the most common organisms in swimmer’s ear (OE)?
Pseudomonas (gram-)
S. Aureus (gram +)
What is the treatment for OE?
Cortisporin (Polymyxin B-neomycin-hydrocortisone) ear 4 gtts 4x a day for 7d
OR
Cipro HC optic bid x7 days