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LIEK Review > HEENT 2 > Flashcards

HEENT 2 Flashcards

1
Q

hordeolum aka

A

stye

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2
Q

hordeolum (style) is what

A

an external hordeolum is an abscess of a hair follicle and sebaceous gland in the upper or lower eyelid

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3
Q

an external hordeolum is an abscess of a hair follicle and sebaceous gland in the upper or lower eyelid

A

hordeolum/style

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4
Q

internal hordeolum/stye involves

A

inflammation of the meibomian gland

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5
Q

hordeolum/style tx
3

A
  1. most resolsve on own
  2. hot compresses 5-10minutes 2-3 x day
  3. if infection spreads (preseptal cellulitis), start empiric abx tx
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6
Q

keratitis

A

inflammation of the cornea

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7
Q

infectious keratitis - pt c/o
5

A

acute onset of red eye
blurred vision
water eyes
photophobia
sometimes a foreign body sensation

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8
Q

red, painful eye in any contact lens wearer

A

infectious keratitis

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9
Q

infectious keratitis tx plan
7

A
  1. always check visual acuity and pupils with penlight
  2. if suspect bacterial infection, obtain C&S of eye discharge
  3. flush eye with sterile NS to remove foreign body
  4. urgent opthalmologic referral & start topical empiric abx tx
  5. stop contact lens use, do not patch eye
  6. consider pain script
  7. consider topical pain meds (ketorolac tromethamine 1 gtt 4 x day)
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10
Q

open angle glaucoma is characterized by

A

progressive peripheral visual field loss followed by central field loss (late manifestation)

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11
Q

open angle glaucoma classic case

A

most often in elderly with diabetes; gradual changes in peripheral vision (lost first) then central vision; complains of missions portions of words when reading

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12
Q

open angle glaucoma opthalmoscopic exam reveals

A

cupping, the optic nerve taking on a hollowed appearance; if cupping, the IOP is too high, refer to opthalmologist

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13
Q

open angle glaucoma tx plan
2

A
  1. check IOP with tonometer; normal range is 8-21 mmHg
  2. IOP 30 or more is considered very high, urgent referral within 24 hours to opthalmologist or referral to ED
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14
Q

1st and 2nd leading cause of blindness in the world

A
  1. cataracts
  2. open angle glaucoma
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15
Q

open angle glaucoma meds
2

A
  1. xalatan (Latanoprost) - topical prostaglandin eye drops to increase aqueous outflow
  2. timolol 0.5% (Betimol) - beta blocker eye drops to decrease aqueous production
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16
Q

pterygium

A

“surfers eye” - a yellow, triangular (wedge shaped) thickening of the conjunctiva that extends across the cornea on the nasal side

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17
Q

“surfers eye” - a yellow, triangular (wedge shaped) thickening of the conjunctiva that extends across the cornea on the nasal side

A

pterygium

18
Q

pterygium results from

A

chronic sun exposure

19
Q

pterygium tx plan
3

A
  1. manage sx with topical lubricants (eye drops)
  2. good quality sunglasses
  3. surgical removal if encroaches on cornea and affects vision
20
Q

pinguecula

A

raised, yellow to white, small, round lesions arising at the limbal conjunctiva next to the cornea; caused by chronic sun exposure

21
Q

sjogrens syndrome

A

chronic autoimmune disorder characterized by decreased function of the lacrimal and salivary glands

22
Q

chronic autoimmune disorder characterized by decreased function of the lacrimal and salivary glands

A

sjogren’s syndrome

22
Q

subconjunctival hemorrhage

A

blood that is trapped underneath the conjunctiva and sclera secondary to broken arterioles

23
Q

subconjunctival hemorrhage resolves in

A

1-3 weeks like a bruise, blood reabsorbed

23
Q

inflammation of the nasal cavity and paranasal sinuses

A

acute bacterial rhinosinusitis

24
Q

acute bacterial rhinosinusitis classic case

A

pt c/o unilateral pain or upper molar pain (maxillary sinus) with nasal congestion for 10 days or longer with purulent nasal and/or postnasal drip

25
Q

maxillary sinus location

A

front cheek

26
Q

ABRS tx plan

A

self limiting disease, symptom mgmt with oral fluids and saline nasal irrigation f/u in 10 days, if better no abx needed

27
Q

ABRS abx tx first line

A

augmentin 500/125 PO TID or 875/125 PO BID

28
Q

ABRS PNC allergy or alt abx
2

A

doxy BID 100 mg PO
3rd gen cephalosporin like cefixime 400 mg or cefpodoxime 200 mg BID

29
Q

ABRS - for drainage, what oral decongestants

A

pseudoephedrine (Sudafed) or pseudoephedrine combined with guaifenesin (Mucinex D)

30
Q

most common bacterial pathogens for AOM
2

A

stept pneumoniae
hemophilus influenzae

31
Q

AOM first line treatment for any age group

A

augmentin 875/125 PO BID

32
Q

AOM tx PNC allergy

A

cefdinir

33
Q

may mimic AOM

A

bullous myrinigits - limited to the TM and does not affect the contents of the middle ear

34
Q

infectious condition characterized by the presence of blisters (bullae) on a reddened and bulging TM

A

bullous myringitis

35
Q

most common organisms to cause otitis externa
3

A
  1. pseudomonas aeruginosa (gram neg)
  2. staphylococcus epidermidis (gram pos)
  3. S. aureus (gram pos)
36
Q

otitis externa med tx (intact TM)

A

topical abx with a glucocorticoid - cipro hydrocortisone for 1 week

37
Q

otitis externa med tx (TM not intact)
2

A

topical fluoroquinolone (e.g. ciprofloxacin) or oral abx (e.g. levofloxacin 500 mg PO 1 x day)

38
Q

otitis externa tx plan - keep what out of ears

A

keep water out of ear during treatment; hearing aids and other devices should not be worn until pain and discharge subsides

LIEK Review (44 decks)

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