HEENT

Question 1

tension headache

Answer 1

Symptoms: bilateral, hatband, stress, anxiety. dull squeezing pain not pulsating. muscle stiff neck
Duration: variable. hours to days.
treatment: analgesic(painkiller), caffeine, stress management

Question 2

migraine headache

Answer 2

Symptoms: Unilateral, throbbing/pulsating due to neuronal or vascular changes. nausea, vomiting, aura
Duration: 4-72 hours
Treatment: refer, dark room, laying down

Question 3

cluster headache

Answer 3

symptoms: unilateral around the eye. severe, constant, sharp pain due to hypoxia, histamine or serotonin release. nasal congestion
duration: 15 mins to 3 hours and clusters can last months
treatment: refer and oxygen

Question 4

headache self treat

Answer 4

ibuprofen, acetominophen, aspirin
heat or cold packs

Question 5

when to refer headache

Answer 5

hypertension, trauma, neck stif, fever fatigue weakness
stroke, confusion, 15x per month
migraines/clusters

Question 6

bacterial conjunctivitis

Answer 6

symptoms: yellow green discharge, worse in the morning, red/pink eyes, eye pain, blurred vision
treatment: refer, antibiotic eye drops

Question 7

viral conjunctivitis

Answer 7

symptoms: usually clear, watery discharge. red/pink eyes, eye pain, sore throat/cough
treatment: OTC eye lubricants, ocular decongestants, oral antihistimines, cold compress

Question 8

allergic conjunctivitis

Answer 8

Triggers: allergens like pollen/dust
symptoms: eye itching, clear watery dischage, red/pink eyes, sneezing
treatment: allergen avoiding, eyedrops antihistimine/vasoconstrictors

Question 9

dry eye conjuntivitis

Answer 9

triggers: old age, female, allergens, dry air, meds
symptoms: sandy/gritty eyes
treatment: artificial tears, avoiding triggers, screen downtime, air humidifiers

Question 10

blepharitis + stys

Answer 10

symptoms: inflammation on edge of eyelid
treatment: artificial tears, cleaning/cleansing eye

Question 11

eye self treat

Answer 11

dry eye conjuctivitis, allergic conjunctivitis, viral conjunctivitis, mild blepharitis or stys

Question 12

when refer eye

Answer 12

eye pain, vision loss, symptoms not improving, exposure to chemicals, severe redness

Question 13

eye drops counseling

Answer 13

wash hands well
make sure nothing touches the tip
tilt head back or lie down
look up and away from drop
wipe excess liquid from face

Question 14

otitis externa (swimmer’s ear)

Answer 14

Trigger: frequent moisture, trauma
Symptoms: inflammation/infection of externa ear. ear pain/swelling, fever, hearing impairment
treatment: ear drops, antiseptic drops, oral analgesics

Question 15

otitis media

Answer 15

Trigger: usually occurs in younger children
symptoms: inflammation of middle ear, ear pain, less hearing, fever
treatment: analgesics, may consider oral antibiotics

Question 16

otitis media effusion

Answer 16

trigger: allergies, post acute otitis media
symptoms: fluid collection in middle ear, fullness in ear/decrease hearing, ear popping when yawning, no pain or fever
treatment: analgesics, no antibiotics, pressure tubes

Question 17

water clogged ears

Answer 17

trigger: swimming or bathing
treatment: drying agents, isopropyl alcohol

Question 18

cerumen impaction

Answer 18

trigger: earwax blocking ear canal, narrow ear canal, cotton swabs, not enough cleaning
symptoms: hearing impairment, pain or ringing ears
treatment: cerumenolytic agents - mineral oil, debrox, acetic acid, saline

Question 19

ototoxicity

Answer 19

triggers: medication, chemicals
symptoms: damage to hearing or function of ear, hearing loss, ringing ears, dizziness
treatment: aspirin, furosemide

Question 20

ear self treat vs refer

Answer 20

self-treat: cerumen impaction, otitis media w/ effusion, water clogged ears.
refer: severe pain, signs of infection, foriegn objects in ear, cognitive impairment

Question 21

eardrops counseling

Answer 21

wash hands before and after use with soap and water.
clean outside of ear
tilt head or lie down
avoid touching tip to ear
wipe excess away

Question 22

allergic rhinitis

Answer 22

trigger: allergens like pollen dust
symptoms: watery eyes, clear rhinorrhea, post nasal drip, coughing, sneezing, itching
treatment: nasal saline rinse, nasal spray like Flonase, oral antihistamines like cetirizine

Question 23

sinusitis

Answer 23

trigger: viral or bacterial
symptoms: inflammation of sinuses, headache, fever, pain
viral: lasts less than 1 week
bacterial: thick colored nasal discharge
treatment: lasts more than 1 week need refer and antibiotics, analgesics, oral or intranasal decongestant

Question 24

nose self-treat vs refer

Answer 24

self-treat: symptoms last more than 1 week, mild symptoms appear to be better
refer: severe sinus pain, signs of bacterial infection, changes in vision, symptoms more than 1 week

Question 25

nasal spray counseling

Answer 25

blow nose before using spray
wash hands w/ soap and water and dry
remove cap
avoid blowing nose for several mins after use

Question 26

pharyngitis:

Answer 26

symptoms: pain swallowing, hoarse voice, tonsil swelling, bad breath, fever
treatment: cough drops, oral analgesics
refer if: lasts more than 7 days, bacterial, high fever, trouble breathing/swallowing

Question 27

canker sores

Answer 27

ulcers on lining of inner mouth
symptoms: white sores inner mouth
treatment: topical benzocaine

Question 28

cold sores

Answer 28

symptoms: red blisters on lips, cheeks, nostils
treatment: topical antiviral (OTC abreva) or oral antiviral(valacyclovir)

Question 29

oral candidiasis (thrush)

Answer 29

trigger: (immunosuppresion)
symptoms: white patches on tongue and in mouth, cotton feeling in mouth, pain swallowing
treatment: refer, antifunguls

Question 30

gingivitis

Answer 30

symptoms: bad breath, red swollen gums
treatment: refer, antiseptic rinses

Question 31

mouth refers

Answer 31

immunocompromised patients
oral candidasies
gingivitis
symptoms for more than 1 week.