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HEENT Flashcards

1
Q

Hordeolum

A

Painful, acutely inflamed eyelid nodule (aka) Stye

-Caused by a clogged eyelid gland 2 infxn to staph Aureus

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2
Q

Treatment for a Hordeolum?

A

Warm compresses, topical abx, I&D if refractory

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3
Q

Chalazion

A

Non-painful, noni infectious, chronic stye

-Granulomatous rxn arising from clogged internal glands

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4
Q

Tx for Chalzion?

A

Trial of warm compressses but usually need excision by Opthalmology

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5
Q

Blepharitis

A

Diffuse eyelid inflammation, like dandruff of the eye.

-2 to seborrheic dermatitis, Strep, Staph, glandular dysfuntion

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6
Q

Tx for Blepharitis?

A

Gentl lid scrubs with baby shampoor, topical abx

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7
Q

Viral Conjunctivitis

A

Unilateral or bilateral conjunctival injection, watery discharge, +/- preauricular adenopathy
-Usu caused by Adenovirus

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8
Q

Tx of Viral conjuctivitis?

A

Eye rinses, cool compresses, no school**

Usu tx with abx in the real world

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9
Q

Bacterial Conjunctivitis?

A

Copious purluents drainage, eyes glued shut in am
-Usu staph, strep but can by chlamydia or gonnococus
TX: Topical abx, pseudomonas coveragle for contact wearers **Can be an STD

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10
Q

Clogged tear duct with bacterial super-infection?

A

Dacrocystitis Tx with warm compresses and top Abx, may need I&D

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11
Q

Periorbital edema, erythema, Infxn of tissues surronding the eye—Pain with extraocular eye movements***

A

Orbital Cellulitis

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12
Q

Hit in the eye with Limited extraocular movements, Pt can’t look up

A

Blowout fracture—Needs Urgent Opth surgical repair

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13
Q

Exam for Foreign Bodies of eye

A

Topical anesthetic, fluorescein stain, evert eyeleids

Metallic foreign bodies can leave a rust ring….

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14
Q

Painful tearing red eye with persistent foreign body sensation.

A

Corneal abrasion.

Fluorescein stain, look for Ice Rink sign. No patching, no topical anesthetic prescriptions

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15
Q

Deep erosion in cornea on Fluorescein stain?

A

Corneal Ulcer, Pseudomonas in contact lens wearers

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16
Q

Acute blurry vision, bisual field cut, flasher/floaters, +/- trauma. *Like a curtain being drawn over the eye**

A

Retinal Detachment: Opth. Emergency

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17
Q

Hyphema?

A

Blood in anterior chamber, “8 ball” hyphema covers iris. Usually traumatic. Can cause increase IOP.

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18
Q

Gradual onset of blurry vision caused by opacificatoin of the lens

A

Cataract—Ref to Optham, lens removal/implant

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19
Q

Leading cause of irreversible central visin loss, usually age related?

A

Macular Degeneratoin—Drusen Deposits lead to degenarative changes of the retina.

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20
Q

Eyelid turning out

A

Ectropion

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21
Q

Eyellid turning in

A

Entropion

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22
Q

Srabismus

A

Crossed eyes

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23
Q

Pinguecula?

A

Raised fleshy conjunctival mass from chronic sun, wind and dust expusrus. Not tx necessary but if bothersome can be removed

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24
Q

Pterygium?

A

Triangular, wing shaped, vascular thickening of skin. Usu from nasal side toward visual axis

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25
Q

Leading cause of blindness in adults?

A

Diabetic Retinopathy

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26
Q

Rapid, involuntary, rhythmic eye movements (horizontal, vertical, or rotational.

A

Seen with normal horizontal head movement. many causes

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27
Q

Palilledema?

A

Swelling of optic disc indicative of increased intracranial pressure, usu bil. Increased IOP

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28
Q

Glaucoma?

A

Increased IOP >20 mmhg. Impaired aqueous humor drainage from the anterior chamber through the Canals of Schlemm.

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29
Q

Chronic, Open Angle Glaucoma

A

Grad onset symptoms (pain, blurry vision, or asymptomatic) Usu > 40 Outpt. referral for tx

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30
Q

Acute, Angle Closure Glaucoma

A

Sudden onset, severe pain, vision loss, red eye, fixed mid-dilated pupil with steamy cornea and elevated IOP. Emergency, needs STAT Opthal. IV Acetazolamide, BB eye drops. Osmotic diuresis

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31
Q

Sudden unilateral painless vision loss 2 to embolus, thrombus, or vasculitis? Box car arteriolar narrowing, “Cherry Red Spot” Retinal pallor.

A

Central Retinal artery occlusion. Medical Opth emergency** Poor prognosisi

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32
Q

Blood and thunder retina

A

Central retinal venous occlusion***good prognosis

33
Q

Sudden vision loss, esp color vision. Pain with eye movements. Associated with MS, Lupus, syphillis, Lyme, HSV and toxic effect of Methanol and Ethambutolol

A

Optic Neuritis

34
Q

Otitis Media?

A

Infection of the middle ear.
MOst common 4 mos- 2 years but can happen at any age
Usu viral and self limited

35
Q

Conductive Hearing loss?

A

Impaired sound transmission

  • Impacted derumen
  • Otitis Media/externa
  • Otosclerosis
36
Q

Sensorineural loss?

A

Nerve problem: Presbycusis

37
Q

Conductive hearing loss

A

Sound louder in affected ear

38
Q

Sesorineural hearing loss

A

Sound louder in unaffected ear

39
Q

Acoustic Neuroma?

A

Vestibular Schwannoma (Benign tumor of acoustic nerve)
Unilateral grows slowly
Tx surgical resection

40
Q

A destructive epidermoid cyst of the middle ear, 2 to retracted TM?

A

Cholesteatoma

41
Q

Peripheral causes of Vertigo

A

Meniere, Labyrinthitis

42
Q

Central causes of vertigo

A

Brain stem dz, tumors, AVM, MS

43
Q

Dix-Hallpike

A

Quickly turn head to side while lying supine

Often positive in Peripheral causes of vertigo

44
Q

Severe acute vertigo+hearing loss+tinnitus s/p viral illness or an otitis

A

Labyrinthitis: tx vertigo symptomatically

45
Q

Progressive hearing loss, tinnitus, and vertigo

A

Tx with diuretics, salt restriction, surgery for severe cases

46
Q

Button battery foreign body, ear.?

47
Q

Inflammation of the sinus cavities usu after a URI?

A

Most common is viral Sinusitis.
Headache, facial pain, purulent drainage
+/- fever
Can lead to osteomyelitis, cavernous sinus formation, orbital cellulitis Get CT if resistant or immunocompromised

48
Q

Tx for Sinusitis?

A

Saline nasal spray, decongestants, Abx for 10-14 days Amoxicillin is TOC

49
Q

Allergic Rhinitis?

A

Allergic mediated by IgE. Common in Atopic people.

Discharge is clear and watery

50
Q

Atopic Triad?

A

Eczema, Asthma, Atopic dermatitis

51
Q

Tx Allergic rhinitis?

A

Avoid allergens, antihistamines, nasal/systemic steroids, saline drops, immunotherapy

52
Q

Nasal polyps?

A

Benign polyps on nasal mucosa. Often in allergic rhinitis. Tx with steroid sprays, surgery

53
Q

Semter’s triad

A

Nasal polyps + asthma + aspirin sensitivity

54
Q

Most common site of Epistaxis?

A

Kiesselbach’s plexus on the anterior aspect

Tx with pressure, anesthesia, cauterize

55
Q

Posterior nose bleeds?

A

From Woodriff’s plexus and is very serious!! Uncommon.

Need posteiro packing and inpt admission for cardiac/airway monitoring.

56
Q

Odynophagia, dysphagia, =/- fever, redness, lymphadenopathy, +/- exudate?

A

Acute Pharyngitis

57
Q

Centor criterior for Pharyngitis?

A 
Fever > 38
Tender anterior cervical lymphadenopathy
No cough
Exudates
3-4 points = Group A strep
1 point = unlikely Group A strep
2 points = consider culture
58
Q

Tx Pharyngitis?

A

If Bacterial = PCN, EMYCN

If Viral = Supportive tx

59
Q

Peritonsilar abcess?

A

Severe throat pain, trismus, asymmetric/deviated soft palate, muffled (hot potato) voice

TX: I& D followed by abx

60
Q

Life threatening infxn of epiglottis and surrounding tissues?

A

Epiglottitis

Sudden onset fever, dysphagia, drooling, sore throat, tripod/sniffing position 2 to H flu

61
Q

What imaging for Epiglottitis?

A

Lateral soft tissue nect X ray Thumb print sign

Tx with IV fluids, Abx, may need intubate

62
Q

Hoarsness typically after a URI?

A

Laryngitis: Usu viral, usu no pain, tx supportive and voice rest

63
Q

Aphthous Ulcer?

A

Cankder sores
Bucal mucosa. Painful ulcers with a red halo
Tx Supportive, saline rinses, analgesics

64
Q

Painless white area on the tongue, cheek or lower lip that can’t be scraped off?

A

Oral Leukoplakia

Get Bx, prob malignancy

65
Q

White patches, sometimes with burning pain?

A

Cand be scrapped off, leaves underlying red friable tissue. Oral candidiasis. Tx with Nystatin or similar oral rinse

66
Q

Painful oral-lip vesicles, reccurent and contagious?

A

Herpes Simplex HSV-1

67
Q

Inflammation of the parotid gland?

A

Parotitis, blockage from stone, tumor with bacterial superinfection. Tx symptomatic, Sialogogues

68
Q

Sialadentis?

A

Inflammation fo the salivary glands from salivary gland tumors. Submandibular glands. Many are calcium, Tx with abx, sialogogues, analgesia

69
Q

Typical OM bacteria?

A

Strep Pneum, H flu, Moraxella

70
Q

OM?

A

Presents with pressure, pain, irritability, +/- fever.

71
Q

Complication of OM?

A

Mastoiditis

72
Q

First line OM tx?

A

Amoxicillin, Augmentin, TMP/SMX

73
Q

Tx of OM if meds fail?

A

Myringotomy, tympanostomy

74
Q

OM in PE?

A

TM: Mobile, erythematous, may be bulging

75
Q

Otitis Externa?

A

Swimmers Ear Usu from Pseudomonas
Inflammation of ear canal
Ear pain/tenderness of the tragus and auricle

76
Q

OM complication in diabetics?

A

Malignant Otitis Externa: Necrtoizing infectin extending to cartilage,bone etc
Need inpt IV abx

77
Q

Painful ear bain 2 to airplane descent, diving, altitude changes?

A

Barotrauma, may lead to perforation.

78
Q

Perforated TM?

A

Most small ones heal on their own
Larger ones may require tympanoplasty for closure
No water in ear until closure

79
Q

Complication of Cauliflower Ear?

A

Hematoma of external ear, need to drain hematomas and leave pressure dressing to prevent it.

PANRE (14 decks)

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