HEENT Flashcards
Leukoplakia
white to light grey patch on tongue, floor of mouth, or inside cheek.
R/O oral cancer
Aphthous stomatitis
Canker sores- painful ulcer on soft tissue of mouth resolves in 7-10 days
What are the three primary salivary glands
Parotid, submandibular and sublingual. May become blocked with calculi or infectied
Sialadentitis/sialadenosis
infected salivary glands
Parotitis
swollen or infected salivary gland
acute fevere, headache, fatigue, myalgia and anorexia in school aged child to adult. salivary glands become swollen and tender within 48 hours
Mumps
cause of thick white exudate from tonsils
Mononucleosis
cause of yellow-green purulent discharge from tonsils
Strep throat
Hoarse voice, deviation of uvula, severe sore throat and difficulty swallowing, unilateral swelling of pertonsillar area and soft palate
Peritonsillar Abscess
Papilledema
optic disc swollen due to increased intracranial pressure 2nd to bleeding, brain tumor, abscess, pseudotumor cerebri
Disc cupping
optic nerve cupping r/t glaucoma caused by increased intraocular pressure. determined by cup to disc ratio
arteriovenous nicking, retinal hemorrhadges copper and silver wire arterioles
Hypertensive retinopathy
microaneurysms in retinal blood vessesl, neo vascularization , cotton-wool spots
Diabetic retinopathy
Opacity in the lens of eye that can be central or on the sides. pt. experiences difficulty with glare halos around light and blurred vision
Cataracts
Blue tinged or pale and swollen nasal turbinates associated with increased clear nasal discharge. May be accompanied by itchy nose, sneezing, and nasal congestion
Allergic Rhinitis
Kopliks’s spots
clusters of small red papules inside of cheeks near gums that are indicative of measles(rubeola)
Painless soft round growths within the nose
Nasal Polyps
Elongated papilla on the lateral tongue pathognomonic for HIV infection.
Can be caused by Epstein Barr virus
Hairy Leukoplakia
Painful skin fissures and maceration at the corners of the mouth
Cheilosis
treatment for cheilosis
Check B12
if yeast suspected, microscopy for hyphae & treat topically, mupirocin if bacteria suspected
Ptosis
drooping of the upper eyelid
amblyopia
lazy eye, reduced vision in affected eye.
Test for vision
Snellen test
color blindness test
ishihara chart
Weber test
Place tuning fork midline forehead should be even sound detection
Rinne test
place tuning fork on mastoid then front of ear, time response, bone conduction should be half of air conduction
Acute onset of severe eye pain with tearing sensation of foreign body
Corneal abrasion, always inquire if patient wears contacts
Severe eye pain acute onset, photophobia, blurred vision in affected eye.
Herpes keratitis
How is Herpes Keratitis Diagnosed
Dx. by fluorescein stain appearance of fernlike lines with black lamp
Paitent complaint of acute onset of red eye, blurred vision, watery eyes, photophobia, or foreign body. Hx of sleeping with contacts in / or wearing longer than recommended
Contact lens related keratitis
Where are contact lens associated abrasions located
Generally located in the center of the eye and round.
Hordoleum
Stye (Horrible) Hordoleum
Tx for Hordoleum
Hot compress 2-3 times a day
Chalazion
chronic inflammation of meibomian gland may resolve spontaneously 2-8 weeks
Pinguecula
raised yellow to white small round growth in bulbar conjuctiva. Cause: chronic sun exposure.
Pterygium
A yellow trianguar thickening of conjuctiva,
Tx of pinguecula or pterygium
Surgical removal if affecting vision, refer to ophthalmology
Subconjunctival Hemorrhage
Blood trapped underneath the conjunctiva and sclera secondary to broken arterioles
primary open angle glaucoma
increased intraocular pressure related to blockage of drainage of aqueous humor
Sx of primary open angle glaucoma
asymptomatic during ealry stage
gradual change in peripheral vision then central vision cupping during fundoscopy
Tx for primary open angle glaucoma
0.5% timolol beta blocker eye drops decrease aqueous production
xalatan topical prostaglandin eye drops increase aqueous flow
anterior uveitis ( iritis)
onset of eye pain with conjuctival injectionno purulent discharge. Can result in blindness.
age related macular degeneration.
asymptomatic in early stages. caused by gradual damage to the pigment of the macula. leading cause of blindness in the elderly more common in smokers.
sjogrens’s Syndrome
chronic autoimmune disorder. decreased function fo the lacrimal and salivary glands.
increase in dental carie
Tx. OTC tear-substitute eye drops 3x daily
Entropion
lower eyelid turned inward.
ectropion
eyelid turned outward.
Prolonged use of topical nasal decongestants causes rebound effects that result in sever and chronic nasal congestion
Rhinitis medicamentosa
Epistaxis
Nosebleeds, anterior are milder. more common, than posterior.
Tx. apply direct pressure, apply triple antibiotic or vaseline in front of the nose.
abrupt onset of fever, sore throat, pain on swallowing, and mildly enlarged submandibular nodes. anterior cervical nodes enlarged and tender
Streptococcal pharyngitis ( Strep throat)
complaint of ear pain (otalgia), popping noises, muffled hearing. recent hx of a cold or flare up of allergic rhinitis. adult infections usually develop slower than in child. May be accompanied by rupture of the TM report of blood or pus on pillowcase with relief of pain
Acute Otitis Media
Tx of Strep throat
- Rapid antigen test
- first line: Penicillin V 500mg three times a day for 10 days
-
Alternatives: Amoxicillin 500mg twice a day for 10 days
*
Tx of Strep in penicillin or beta-lactam allergy
Azithromycin (Z-pak) 5 days
Streptococcus pneumoniae has a high resistance to
beta lactamase
Type of AOM that is more painful due to the presence of blistes on reddened bulging tympanic membrance
Bullous myringitis
treatment of Bullous myringitis
Amoxicillin 500mg Po TID 5-7 days. 10 days for severe case.
alternative Augmentin TID, levofloxacin Daily 5 days
this condition may follow AOM. can be caused fy chronic allergic rhinitis. pt. c/o ear pressure popping nosies and muffled hearing in affected ear
Otitis media with effusion
(Serous otitis media)
TM may bulge or retract, tympanogram abnormal, TM non reddened, fluid level or bubbles may be visible inside the TM.
Otitis medica with effusion
bacterial infection of outer ear canal, may have drainage, external ear pain, swelling, dishcarge, pruritis,
Otitis Externa
disorder of the vestibular apparatus of the inner ear or by the inflammation of vestibular nerve CN VIII
Peripheral vertigo
