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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
Leading cause of blindness in adults?
Diabetic Retinopathy
26
Rapid, involuntary, rhythmic eye movements (horizontal, vertical, or rotational.
Seen with normal horizontal head movement. many causes
27
Palilledema?
Swelling of optic disc indicative of increased intracranial pressure, usu bil. Increased IOP
28
Glaucoma?
Increased IOP >20 mmhg. Impaired aqueous humor drainage from the anterior chamber through the Canals of Schlemm.
29
Chronic, Open Angle Glaucoma
Grad onset symptoms (pain, blurry vision, or asymptomatic) Usu > 40 Outpt. referral for tx
30
Acute, Angle Closure Glaucoma
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
31
Sudden unilateral painless vision loss 2 to embolus, thrombus, or vasculitis? Box car arteriolar narrowing, "Cherry Red Spot" Retinal pallor.
Central Retinal artery occlusion. Medical Opth emergency**** Poor prognosisi
32
Blood and thunder retina
Central retinal venous occlusion***good prognosis
33
Sudden vision loss, esp color vision. Pain with eye movements. Associated with MS, Lupus, syphillis, Lyme, HSV and toxic effect of Methanol and Ethambutolol
Optic Neuritis
34
Otitis Media?
Infection of the middle ear. MOst common 4 mos- 2 years but can happen at any age Usu viral and self limited
35
Conductive Hearing loss?
Impaired sound transmission - Impacted derumen - Otitis Media/externa - Otosclerosis
36
Sensorineural loss?
Nerve problem: Presbycusis
37
Conductive hearing loss
Sound louder in affected ear
38
Sesorineural hearing loss
Sound louder in unaffected ear
39
Acoustic Neuroma?
Vestibular Schwannoma (Benign tumor of acoustic nerve) Unilateral grows slowly Tx surgical resection
40
A destructive epidermoid cyst of the middle ear, 2 to retracted TM?
Cholesteatoma
41
Peripheral causes of Vertigo
Meniere, Labyrinthitis
42
Central causes of vertigo
Brain stem dz, tumors, AVM, MS
43
Dix-Hallpike
Quickly turn head to side while lying supine | Often positive in Peripheral causes of vertigo
44
Severe acute vertigo+hearing loss+tinnitus s/p viral illness or an otitis
Labyrinthitis: tx vertigo symptomatically
45
Progressive hearing loss, tinnitus, and vertigo
Tx with diuretics, salt restriction, surgery for severe cases
46
Button battery foreign body, ear.?
Emergency
47
Inflammation of the sinus cavities usu after a URI?
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
Tx for Sinusitis?
Saline nasal spray, decongestants, Abx for 10-14 days Amoxicillin is TOC
49
Allergic Rhinitis?
Allergic mediated by IgE. Common in Atopic people. | Discharge is clear and watery
50
Atopic Triad?
Eczema, Asthma, Atopic dermatitis
51
Tx Allergic rhinitis?
Avoid allergens, antihistamines, nasal/systemic steroids, saline drops, immunotherapy
52
Nasal polyps?
Benign polyps on nasal mucosa. Often in allergic rhinitis. Tx with steroid sprays, surgery
53
Semter's triad
Nasal polyps + asthma + aspirin sensitivity
54
Most common site of Epistaxis?
Kiesselbach's plexus on the anterior aspect | Tx with pressure, anesthesia, cauterize
55
Posterior nose bleeds?
From Woodriff's plexus and is very serious!! Uncommon. | Need posteiro packing and inpt admission for cardiac/airway monitoring.
56
Odynophagia, dysphagia, =/- fever, redness, lymphadenopathy, +/- exudate?
Acute Pharyngitis
57
Centor criterior for Pharyngitis?
``` 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
Tx Pharyngitis?
If Bacterial = PCN, EMYCN | If Viral = Supportive tx
59
Peritonsilar abcess?
Severe throat pain, trismus, asymmetric/deviated soft palate, muffled (hot potato) voice TX: I& D followed by abx
60
Life threatening infxn of epiglottis and surrounding tissues?
Epiglottitis | Sudden onset fever, dysphagia, drooling, sore throat, tripod/sniffing position 2 to H flu
61
What imaging for Epiglottitis?
Lateral soft tissue nect X ray Thumb print sign Tx with IV fluids, Abx, may need intubate
62
Hoarsness typically after a URI?
Laryngitis: Usu viral, usu no pain, tx supportive and voice rest
63
Aphthous Ulcer?
Cankder sores Bucal mucosa. Painful ulcers with a red halo Tx Supportive, saline rinses, analgesics
64
Painless white area on the tongue, cheek or lower lip that can't be scraped off?
Oral Leukoplakia Get Bx, prob malignancy
65
White patches, sometimes with burning pain?
Cand be scrapped off, leaves underlying red friable tissue. Oral candidiasis. Tx with Nystatin or similar oral rinse
66
Painful oral-lip vesicles, reccurent and contagious?
Herpes Simplex HSV-1
67
Inflammation of the parotid gland?
Parotitis, blockage from stone, tumor with bacterial superinfection. Tx symptomatic, Sialogogues
68
Sialadentis?
Inflammation fo the salivary glands from salivary gland tumors. Submandibular glands. Many are calcium, Tx with abx, sialogogues, analgesia
69
Typical OM bacteria?
Strep Pneum, H flu, Moraxella
70
OM?
Presents with pressure, pain, irritability, +/- fever.
71
Complication of OM?
Mastoiditis
72
First line OM tx?
Amoxicillin, Augmentin, TMP/SMX
73
Tx of OM if meds fail?
Myringotomy, tympanostomy
74
OM in PE?
TM: Mobile, erythematous, may be bulging
75
Otitis Externa?
Swimmers Ear Usu from Pseudomonas Inflammation of ear canal Ear pain/tenderness of the tragus and auricle
76
OM complication in diabetics?
Malignant Otitis Externa: Necrtoizing infectin extending to cartilage,bone etc Need inpt IV abx
77
Painful ear bain 2 to airplane descent, diving, altitude changes?
Barotrauma, may lead to perforation.
78
Perforated TM?
Most small ones heal on their own Larger ones may require tympanoplasty for closure No water in ear until closure
79
Complication of Cauliflower Ear?
Hematoma of external ear, need to drain hematomas and leave pressure dressing to prevent it.

PANRE (14 decks)

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