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Clinical Medicine > HEENT > Flashcards

HEENT Flashcards

1
Q

Leukoplakia Etiology

A

Inflammatory/Autoimmune

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2
Q

Leukoplakia Presentation

A

Adherent white patches/plaques on oral mucosa or tongue.

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3
Q

Erythroplakia Presentation

A

Type of Leukoplakia that presents with erythema

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4
Q

Leukoeruthroplakia Presentation

A

Type of leukoplakia that is white and speckled

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5
Q

Leukoplakia Treatment

A

Pre-cancerous. Biopsy. ENT referreal

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6
Q

Oral Hairy Leukoplakia Etiology

A

epstein-berr virus. Almost exclusively HIV patients.

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7
Q

Oral Hairy Leukoplakia Presentation

A

Vertically Corrugated white lesions on the lateral side of the tongue.

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8
Q

Oral Squamous Cell Carcinoma Presentations

A

Ulcers/masses that don’t heal. Can be painful if ulcerated. Dental changes. Exophytic.

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9
Q

Oral Squamous Cell Carcinoma Treatment

A

ENT for biopsy and surgical resection.

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10
Q

Oral Melanoma Presentation

A

Painless, bleeding mass. Discolored. Ulceration. Dental changes. ABCDEs.

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11
Q

Oral Melanoma Treatment

A

ENT for biopsy, CT, endoscopy. Surgical resection and radiation.

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12
Q

Amalgam Tattoo presentation

A

blue/black macule seen in area adjacent to amalgam dental filling. benign.

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13
Q

Melanosis

A

common pigmentation change in darker skin types. Appears symmetrically.

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14
Q

Oral Melanotic Macules

A

Dark benign macules that are symmetric with sharp borders

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15
Q

Mucoceles Etiology

A

Mild/minor trauma

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16
Q

Mucoceles Presentation

A

fluid-filled cavities in mucous membranes lining the epithelium. pink/blue soft papule/nodule. gelatinous fluid.

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17
Q

Mucoceles Treatment

A

Resolves on their own.

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18
Q

Oral Herpes Simplex Virus Etiology

A

HSV 1

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19
Q

Oral Herpes Simplex Primary Presentation

A

Herpetic Gingivostomatitis. Painful grouped vesicles on an erythematous base on buccal mucosa. Can have fever.

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20
Q

Oral Herpes Simplex Recurrent Presentation

A

Prodrome with pain/burning/tingling 24 hours before lesion appears. usually occurs withing keratinized areas.

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21
Q

Oral Herpes Simplex Diagnosis

A

Clinical. viral culture. Tzanck prep will show multinucleated larger cells.

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22
Q

Oral Herpes Simplex Treatment

A

Antivirals (acyclovir, valacyclovir, famiclovir) within first three days. Miracle mouthwash, analgesics.

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23
Q

Coxsackie Virus prodrome

A

fever, malaise, sore throat

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24
Q

Coxsackie virus presentation

A

Small, painful, aphthae lesions that usually spare the lips and gingiva. Pale papules also present on hands and feet.

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25
Q

Coxsackie Virus Treatment

A

Supportive. Resolves within 5-6 days.

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26
Q

Oropharyngeal Candidiasis Etiology

A

Candida Albicans. Opportunistic Infection.

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27
Q

Oropharyngeal Candidiasis Presentation

A

Sore mouth/throat. Beefy red tongue. Creamy white patches with erythematous mucosa. “Thrush with Brush”

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28
Q

Oropharyngeal Candidiasis Diagnosis

A

KOH prep shows budding yeast.

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29
Q

Oropharyngeal Candidiasis Treatment

A

Topical. Nystatin suspension/troche or clotrimazole troche.

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30
Q

Erythema Multiforme Major Etiology

A

Acute, immune-mediated condition. Induced by HSV or Mycoplasmic pneumonia.

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31
Q

Erythema Multiforme Major Presentation

A

Target-like lesions on the skin. Diffuse areas of mucosal erythema with erosions/bullae. Also effects genitals and eye.

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32
Q

Erythema Multiforme Major Treatment

A

Resovles within 2 weeks. Topical corticosteriods for relief. miracle mouthwash, antihistamines. Can use oral glucocorticoids for severe mucosal involvement.

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33
Q

Stevens-Johnson Syndrome Etiology

A

Medication induced.

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34
Q

SJS Prodrome

A

Fever, flulike symptoms. conjunctivitis/photophobia.

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35
Q

SJS skin Lesions

A

Tender erythematous purpuric macules leading to vesicles leading to skin sloughing.

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36
Q

SJS mucosal involvement

A

Erythema, edema, bullae that rupture. Can also effect genitals and eyes.

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37
Q

SJS treatment

A

biopsy, discontinue offending med, corticosteroids, hospital admission (hydration and secondary infections: S. aureus and P. aeruginosa).

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38
Q

Pemphigus Vulgaris Etiology

A

Chronic Auto-immune disorder

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39
Q

Pemphigus Vulgaris Presentation

A

Flaccid bullae in oropharynx that spread to the scalp/face/axillae. Nikolsky sign.

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40
Q

Nikolsky Sign

A

gentle application of lateral pressure in uninvolved area causes the superficial layer to slough off. Diagnostic for Pemphigus.

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41
Q

Pemphigus Vulgaris Diagnosis

A

Nikolsy Sign. 2 biopsies (lesion and perilesional) for direct immunofluorescence.

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42
Q

Pemphigus Vulgaris Treatment

A

Systemic corticosteroids, immunosuppressants, Topical lidocaine or oralone. Derm referral.

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43
Q

Pemphigoid Etiology

A

Chronic auto-immune disorder

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44
Q

Pemphigoid prodrome

A

pruritic eczematous, papular/uticaria-like lesions

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45
Q

Pemphigoid Presentation

A

Tense bullae that remain intact. erythematous plaques in mucosal membrances.

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46
Q

Pemphigoid Diagnosis

A

2 biopsies (lesion and perilesional) for direct immunofluorescence.

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47
Q

Pemphigoid Treatment

A

Topical or oral corticosteriods. Derm referral.

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48
Q

Apthous Ulcers Etiology

A

Idiopathic. Predisposing factors: infection, HIV, genetic, vitamin/mineral deficiencies.

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49
Q

Apthous Ulcers Presentation

A

single/multiple oral lesions. Shallow round/oval, painful with grey base and ring of erythema. on buccal and labial mucosa.

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50
Q

Apthous Ulcers Treatment

A

Resolve within 10-14 days. Topical steroids for symptomatic relief.

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51
Q

Bechet’s Syndromd Etiology

A

Neutrophilic Inflammatory disease.

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52
Q

Bechet’s Syndrome Presentation

A

Recurrent oral/genital ulcers. Painful, deep, central yellow necrotic base. Often multiple.

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53
Q

Bechet’s Syndrome Diagnosis

A

Recurrent oral ulcers >3 times per year with 2 other clinical findings (genital ulcers, eye or skin lesions).

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54
Q

Bechet’s Syndrome Treatment

A

Refer to Rheumatology

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55
Q

Oral Lichen Planus Etiology

A

Chronic inflammatory disorder

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56
Q

Oral Lichen Planus presentation

A

Reticular: Lacy white plaque on buccal mucosa (wickham’s straie)
Erythematous: Painful, red patches due to atrophy.
Erosive: painful erosions and ulcers

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57
Q

Oral Lichen Planus Diagnosis

A

biopsy and ENT

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58
Q

Oral Lichen Planus Treatment

A

pain relief, high potency corticosteroids (clobetasol proprionate).

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59
Q

Black Hairy Tongue Etiology

A

antibiotic use, candida albicans, poor oral hygeine.

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60
Q

Black Hairy Tongue Presentation

A

Elongated filliform papillae. Yellow/white/brown. Drosal aspect of tongue.

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61
Q

Black hairy tongue Treatmen

A

better oral hygeine. brush the tongue.

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62
Q

Geographic tongue presentation

A

Erythematous patches on dorsal tongue with circumferential white borders. Transient. Asymptomatic.

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63
Q

Geographic Tongue Treatment

A

Reassurance.

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64
Q

Atrophic Glossitis Etiology

A

Nutritional deficiencies (VB12), dry mouth, celiacs, candida. Inflammatory disorder causing atrophy of the filliform papillae.

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65
Q

Atrophic Glossitis Presentation

A

smooth, glossy, erythematous tongue. Burning sensation.

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66
Q

Atrophic Glossitis Treatment

A

Address the underlying condition.

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67
Q

Otitis Externa Etiology

A

Psuedomonas, S. Epidermis, S. Aureus, aspergillus, candida.

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68
Q

Otitis Externa Causes

A

Heat and moisture leading to swelling and maceration of the EAC.

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69
Q

Otitis Externa Presntation

A

Ear pain that worsens with movement of the external ear. pruritc especially with fungal. Decreased conductive hearing. Erythematous and edematous.

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70
Q

Otitis Externa Green Discharge

A

pseudomonas

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71
Q

Otitis Externa yellow discharge

A

S. Aureus

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72
Q

Otitis Externa black/white fluffy growth

A

Fungal

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73
Q

Otitis Externa fungal treatment

A

clotrimazole 1% BID x 14 days. Acidifying solution (acetic acid). Keep EAC dry.

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74
Q

Otitis Externa Bacterial Treatment

A

cortisporin otic suspension (polymyxin B, neomycin, hydrocortisone). Keep EAC dry. Resolves within 5-7 days.

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75
Q

Malignant Otitis Externa Etiology

A

Pseudomonas. Seen with DM and immunocompromised.

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76
Q

Malignant Otitis Externa Presentation

A

Intense ear pain (out of proportion), otorrhea, red granulation, lymphadenopathy, edema, trismus, elevated inflammatory markers in the blood.

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77
Q

Malignant Otitis Externa Treatment

A

Admission. IV ciprofloxacin. Debridement.

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78
Q

Acute Otitis Media Etiology

A

Streptococcus pneumoniae, Haemophilus influenzae, moraxella cararrhalis

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79
Q

AOM Pediatric Presentation

A

Irritability, decreased apetite, +/- Fever, ear pain, discharge, vomiting, diarrhea, conjunctivitis (H. Influenzae).

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80
Q

AOM Adult Presentation

A

Otalgio without fever.

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81
Q

AOM exam findings

A

opaque/reddend, bulging TM. Decreased TM mobility. Conductive hearing loss. Can have blisters. Type B tympanogram.

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82
Q

AOM Antibiotics indicated for…

A

102.2, or bilateral AOM

>24 months: severe symptoms

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83
Q

AOM antibiotics NOT indicated for…

A

6-23 months with unilateral and non severe AOM

>24 months with uni/bilateral and non severe AOM

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84
Q

AOM Antibiotic Treatment

A

Amoxicillin (80-90 mg/kg/day) for 7-10 days.

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85
Q

AOM first line antibiotic Treatment contraindicated

A

antibiotics in last 30 days, purulent conjunctivitis or recurrent AOM. Instead use Augmentin (amoxicillin and clavulanate).

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86
Q

AOM Treatment with Penicillin Allergery

A

cefdinir, cefuroxime, cefpodoxine

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87
Q

AOM treatment failure

A

IM rocephin (ceftriaxone) 50 mg.

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88
Q

Recurrent AOM

A

more than 3 in the last 6 months or more than 4 in the last 12 months. Treat with ceftriaxone or augmentin. Consider ENT consult.

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89
Q

Chronic Otitis Media Etiology

A

Recurrent AOM, trauma or cholesteatoma.

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90
Q

Chronic Otitis Media Presentation

A

Drainage from middle ear for longer than 2 weeks with a painless TM perforation. Conductive hearing loss.

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91
Q

Chronic Otitis Media Treatment

A

Refer to ENT

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92
Q

Otitis Media with Effusion Etiology

A

Viral URI, AOM, allergic rhinitis.

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93
Q

OME Presentation

A

painless, ear fulness and decreased hearing. Amver colored fluid behind TM. Type B tympanogram.

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94
Q

OME Treatment

A

Watchful waiting. intranasal steroids for allergeris. ENT for T tubes if longer than 3 months.

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95
Q

Eustachian Tube Dysfunction Presentation

A

Retracted TM. Type C tympanogram. Ear fullness, recurrent OME, hearing loss.

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96
Q

Eustachian Tub Dysfunction Treatment

A

Steroid nasal spray (afrin/neo-synephrine for ONLY 3 days), allergy management, decongestants, T tubues.

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97
Q

Ear Barotrauma Presentation

A

Discomfort or drainage with pressure changes. Ear fullness. Hemotympanum.

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98
Q

Ear Barotrauma Treatment

A

supportive

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99
Q

Labrynthitis Etiology

A

Viral URI causing acute inflammation/infection of the vestibular system.

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100
Q

Labrynthitis Presentation

A

Acute onset of vertigo, N/V, balance problems, tinnitus, hearing loss. Positive head thrust (can’t maintain visual fixation). Horizontal nystagmus.

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101
Q

Labrynthitis Treatment

A

Bed rest, hydration, Meclizine (antivert) 25mg TID for vertigo.

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102
Q

Allergic Rhinitis Etiology

A

Hyper-responsiveness to allergens. IgE (basophils/mast cells). Increase in histamine, cytokines, leukotrienes, prostaglandins.

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103
Q

Allergic Rhinitis symptoms

A

Rhinorrhea, sneezing, itchy eyes/nose, congestion, PND (clear), cough.

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104
Q

Allergic Rhinitis Signs

A

pale/blue boggy nasal mucosa, clear discharge, palpebral conjunctival injection, allergic shiners, denier morgan lines.

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105
Q

Allergic Rhinitis Diagnosis

A

Skin test or Immunoassays (less risk but more expensive)

106
Q

Allergic Rhinitis Treatment

A

Remove allergen, intranasal glucocorticosteroids (flonase), antihistamines, decongestants (sudafed), leukotriene antagonists (singulair), immunotherapy.

107
Q

First Generation Antihistamines

A

Chlorpheniramine (chlor-trimeton) or diphenhydramine (benadryl). Can cause dry mouth, sedation and constipation.

108
Q

Second Generation Antihistamines

A

Loratadine (claritin), fexoxedadine (allegra), cetrizine (zyrtec). Less sedating, same effect as first generation.

109
Q

Sympathomimetics

A

Decongestants. Vasoconstriction decreases edema and secretions. Psuedoephredrine (sudafed). Contraindicated in patients with HTD and cardiac disease.

110
Q

Immunotherapy

A

Hypersensitizes IgE. Takes about 6 months to start working.

111
Q

Perennial Non-allergic (vasomotor) Rhinitis Etiology

A

Abnormal autonomic response triggered by stress, temperature changes, sexual arousal and blood pressure meds.

112
Q

Vasomotor Rhinitis Presentation

A

Congestion and rhinorrhea without itching or sneezing. Nasal mucosa and IgE levels are normal.

113
Q

Vasomotor Rhinitis Treatment

A

Avoid triggers, topical steroids, topical antihistamines (azelastine), topical antichollinergics (ipratropium) and first generation oral antihistamine.

114
Q

Nasal Polyps Etiology

A

Associated with allergic rhinitis, vasomotor rhinitis, chronic sinusitis and smatter’s triad.

115
Q

Smatter’s triad

A

Asthma, nasal polyps and NSAID sensitivity.

116
Q

Nasal Polyp presentation

A

pedunculated, non-tender, soft, grey tissue growths.

117
Q

Nasal polyp Treatment

A

intranasal glucocorticoids. ENT referral if obstruction occurs.

118
Q

Rhinitis Medicamentosa Etiology

A

Tachyphylaxis with overuse of topical decongestants like afrin.

119
Q

Rhinitis Medicamentosa Presentation

A

Erythematous mucosa

120
Q

Rhinitis Medicamentosa Treatment

A

discontinue the intranasal glucocorticoid.

121
Q

Common Cold Etiology

A

Rhinovirus, Parainfluenza and Respiratory Syncytial Viruses in pediatric patients

122
Q

Common Cold Symptoms

A

Rhinitis, congestion, sore throat, cough, malaise, +/- fever, HA (mild), Myalgias (mild).

123
Q

Common Cold Signs

A

Mucosal edema, congestion, pharyngeal erythema, +/- lymphadenopathy, conunctival injection.

124
Q

Common Cold Treatment

A

Rest, Hydrate, NAIDS, anti-tussive, decongestant. 1-2 week duration.

125
Q

Influenza Etiology

A

Influenza virus A and B

126
Q

Influenza Symptoms

A

Abrupt onset, HA, Fever (100-104), chills, myalgias, malaise, cough, sore throat, conjunctival injection.

127
Q

Influenza Signs

A

Flushed, hot, dry skin. Mucosal membrane injection, mild lymphadenopathy.

128
Q

Influenza Diagnosis

A

Rapid antigen test, immunofluorescense (A from B), Viral culture (gold standard), Polymerase chain reaction.

129
Q

Influenza Treatment

A

Antivirals (within 24-48 hours of onset). Oseltamivir, Zanamivir.

130
Q

Oseltamivir Dosing

A

Tamiflu. For influenzae. 70mg BID for 5 days. Can cause delirium, N/V.

131
Q

Zanamivir Dosing

A

Relenza. For influenzae. 10mg BID for 5 days. indicated for pregnancy. Can cause bronchospasm.

132
Q

Pharyngitis/tonsilitis Symptoms

A

sore throat, fever, HA, malaise, lymphadenopathy, URI symptoms.

133
Q

Pharyngitis/tonsilitis signs

A

pharyngeal erythema, tonsilar hypertrophy, purulent exudate, tender/enlarged anterior cervical nodes, palatal petechiae.

134
Q

Group A strep Presentation

A

Pharyngeal exudate, cervical lymphadenopathy, fever, lack of a cough.

135
Q

Group A strep Diagnosis

A

Rapid antigen detection. Even if negative follow up with a throat culture.

136
Q

Herpetic Pharyngitis Presentation

A

ulcerations in the throat.

137
Q

Herpetic pharyngitis treatment

A

acyclovir or famcyclovir

138
Q

Diptheria Presentation

A

gray membrance in the pharynx with significant bleeding.

139
Q

Diptheria treatment

A

antitoxin plus penicillin or erythromyocin.

140
Q

HIV Presentation

A

If pharyngitis sxs aren’t improving in 5-7 days or are worsening.

141
Q

Group A strep Treatment

A

Penicillin V. 500mg BID-TID for 10 days.

142
Q

Group A Strep Treatment alternatives

A

amoxicillin, penicillin G benzathine (IM), cephalexin.

143
Q

Group A strep treatment with penicillin allergy

A

macrolides or clindamycin.

144
Q

Scarlet fever rash

A

sand papery feeling. complication of strep.

145
Q

Emergent Acute Pharyngitis disorders

A

epiglottitis, peritonsilar abscess, submandibular space infection, retropharyngeal space infection.

146
Q

Epiglottitis Presentation

A

severity of sore throat is out of proportion to exam findings. stridor, respiratory distress.

147
Q

Peritonsilar abscess Etiology

A

Group A strep, S. aureus.

148
Q

Peritonsilar abscess Symptoms

A

severe, unilateral sore throat. muffled voice, drooling, trisumus, fever, neck swelling/pain, ipsilateral ear pain, fatigue.

149
Q

Peritonsilar abscess Signs

A

swollen, fluctuant tonsil. Uvula deviation towards opposite side. soft palate with palpable fluctuance. Lymphadenopathy.

150
Q

Peritonsilar abscess diagnosis

A

CBC, throat culture, Ct with contract to rule out spread to parapharyngeal space.

151
Q

Pharyngitis/tonsilitis signs

A

pharyngeal erythema, tonsilar hypertrophy, purulent exudate, tender/enlarged anterior cervical nodes, palatal petechiae.

152
Q

Group A strep Presentation

A

Pharyngeal exudate, cervical lymphadenopathy, fever, lack of a cough.

153
Q

Group A strep Diagnosis

A

Rapid antigen detection. Even if negative follow up with a throat culture.

154
Q

Herpetic Pharyngitis Presentation

A

ulcerations in the throat.

155
Q

Herpetic pharyngitis treatment

A

acyclovir or famcyclovir

156
Q

Diptheria Presentation

A

gray membrance in the pharynx with significant bleeding.

157
Q

Diptheria treatment

A

antitoxin plus penicillin or erythromyocin.

158
Q

HIV Presentation

A

If pharyngitis sxs aren’t improving in 5-7 days or are worsening.

159
Q

Group A strep Treatment

A

Penicillin V. 500mg BID-TID for 10 days.

160
Q

Group A Strep Treatment alternatives

A

amoxicillin, penicillin G benzathine (IM), cephalexin.

161
Q

Group A strep treatment with penicillin allergy

A

macrolides or clindamycin.

162
Q

Scarlet fever rash

A

sand papery feeling. complication of strep.

163
Q

Emergent Acute Pharyngitis disorders

A

epiglottitis, peritonsilar abscess, submandibular space infection, retropharyngeal space infection.

164
Q

Epiglottitis Presentation

A

severity of sore throat is out of proportion to exam findings. stridor, respiratory distress, drooling.

165
Q

Peritonsilar abscess Etiology

A

Group A strep, S. aureus.

166
Q

Peritonsilar abscess Symptoms

A

severe, unilateral sore throat. muffled voice, drooling, trisumus, fever, neck swelling/pain, ipsilateral ear pain, fatigue.

167
Q

Peritonsilar abscess Signs

A

swollen, fluctuant tonsil. Uvula deviation towards opposite side. soft palate with palpable fluctuance. Lymphadenopathy.

168
Q

Peritonsilar abscess diagnosis

A

CBC, throat culture, CT with contrast to rule out spread to parapharyngeal space.

169
Q

Peritonsilar abscess treatment

A

Drainage via aspiration/incision. IV ampicillin-subactan or clindamycin. Oral amoxicillin-clavulanate or clindamycin for 14 days.

170
Q

Trismus

A

Spasm of the internal pterygoid muscle so can’t open mouth.

171
Q

Submandibular space infection (ludwig’s angina) Presentation

A

elevated oropharyngeal floor, protruding tongue, double chin

172
Q

Retropharyngeal space infection Presentation

A

difficulty swallowing/breathing, neck stiffness. can follow intubation or trauma.

173
Q

Abscess of parapharyngeal space

A

bulging behind tonsilar pillars

174
Q

Acute Laryngitis Causes

A

Viral, bacterial or vocal abuse, trauma, GERD, carcinoma.

175
Q

Acute Laryngitis Viral

A

rhinovirus, influenze and parainfluenza

176
Q

Acute Laryngitis Bacterial

A

Strep, M. cattarrhalis, H. influenzae, S. Aureus.

177
Q

Acute Laryngitis Symptoms

A

Hoarseness, URI symptoms

178
Q

Acute Laryngitis Signs

A

Laryngoscopy can reveal erythema, edema, vascular ingorgment, nodules and ulcerations.

179
Q

Acute Laryngitis Treatment

A

Address underlying cause, humidification, resolves within 3 weeks.

180
Q

Acute rhinosinusitis Causes

A

Usually viral URI followed by a secondary bacterial infection.

181
Q

Acute rhinosinusitis Viral

A

rhinovirus, influenza, parainfluenza

182
Q

Acute rhinosinusitis Bacterial

A

H. influenzae or S. pneumonia.

183
Q

Acute rhinosinusitis Symptoms

A

Congestion, purulent discharge, facial pain, fever, fatigue, cough, HA, ear pressure.

184
Q

Acute rhinosinusitis treatment 1-9 days

A

analgesics, irrigation, decongestants.

185
Q

Acute rhinosinusitis indication for antibiotics

A

symptoms >10 days or a fever (102) with purulent discharge for 3 days. Or worsening symptoms following a viral URI.

186
Q

Acute rhinosinusitis antibiotics

A

Amoxixillin-clavulanate (augmentin) 500mg TID or 875mg BID. for 5-7 days

187
Q

Acute rhinosinusitis with penicillin allergy

A

Doxycycline, levofloxacin or moxifloxacin for 5-7 days.

188
Q

Chronic Rhinosinusitis Presentation

A

Mucopurulent discharge, congestion, facial pain/pressure and loss of smell (cough for pediatrics) for longer than 12 weeks with treatment.

189
Q

Chronic Rhinosinusitis Treatment

A

Saline lavages, intranasal corticosteriods, oral corticosterious/antibiotics, antihistamines, antifungals, sinus surgery.

190
Q

Infectious Mononucleosis Etiology

A

Epstein-Barr virus

191
Q

Mono Prodrome

A

1-2 weeks with fatigue, fever and malaise.

192
Q

Mono Presentation

A

cervical lymphadenopathy, fever, sore throat (resembles strep), malaise, splenomegaly.

193
Q

Mono diagnosis

A

CBC, elevated LFT, Monospot (weeks 2-3), antibody testing.

194
Q

Mono antibody testing

A

IgM and absence of IgG indicates an acute infection.

195
Q

Mono Treatment

A

Supportive. Can last up to 6 months. Sports restrictions for 4 weeks.

196
Q

Cataracts

A

Any opacity of the lens, usually age-related.

197
Q

Cataracts Presentation

A

gradual, chronic, painless loss of vision. Glare at night. yellow/opalescent lenses.

198
Q

Cataract Treatment

A

Refer. Intraocular lens implant has good prognosis.

199
Q

Glaucoma

A

Increase in intraocular pression leading to optic nerve damage causing visual field loss.

200
Q

Closed Angle Glaucoma

A

Emergency. Crescent shadows. Acute. Painful. Aqueous fluid can’t flow outwards at all.

201
Q

Glaucoma Presentation

A

Peripheral vision loss. Increased intraocular pressure. increased cup/disc ratio.

202
Q

Rhegmatogenus Retinal Detachment

A

associated with myopia

203
Q

Tractional Retinal detachment

A

Associated with diabetes.

204
Q

Retinal detachment Symptoms

A

Floaters, photopsias (flashes of light), Acute loss of vision “curtain-like”

205
Q

Retinal Detachment Signs

A

decreased vision, raised, whitish retina. posterior vitreous detachment.

206
Q

Macular Degeneration (ARMD)

A

number one cause of blindness. Degeneration of the phororeceptors.

207
Q

ARMD Symptoms

A

gradual or acute blurred vision, metamorphopsia (wavy lines), central scotoma.

208
Q

ARMD Signs

A

Decreased visual acuity, amsler grid distortion. Dry then Wet ARMD.

209
Q

Dry ARMD

A

Drussen bodies (dead cells), pigment mottling, geographic atrophy.

210
Q

Wet ARMD

A

Subretinal fluid/blood, neovascularization.

211
Q

ARMD Treatment

A

Referral. Stop smoking. Vitamins (omega 3, antioxidants, zinc).

212
Q

Central Retinal Artery Occlusion (CRAO).

A

Embolic

213
Q

CRAO symptoms

A

Acute, painless, total loss of vision.

214
Q

CRAO signs

A

no light perception, afferent pupil defect, white retina with cherry red spot.

215
Q

Central retinal Vein Occlusion (CRVO)

A

Thrombotic

216
Q

CRVO Presentation

A

acute, painless, variable vision loss. Afferent Defect. “blood and thunder”

217
Q

CRVO Treatment

A

Referral and aspirin.

218
Q

Hypertensive Retinopathy Presentation

A

Usually asymptomatic. Copper wiring (narrowing), sliver wiring (sclerosis), A-V nicking, cotton-wool spots, disc edema.

219
Q

HTN retinopathy Treatment

A

Control systemic BP. Referral if severe or any vision loss.

220
Q

Diabetic retinopathy

A

number one cause of blindness in people younger than 50.

221
Q

Non-proliferative DM retinopathy

A

microaneurysms, cotton-wool spots, venous bleeding

222
Q

Proliferative DM retinopathy

A

neovascularization, traction retinal detachment.

223
Q

Macular edeam with DM retinopathy

A

graying/opacification, microaneurysms.

224
Q

DM retinopathy treatment

A

Sugar control. Ophthalmology dilated exam once a year.

225
Q

Blepharitis Symptoms

A

Eyelid inflammation. chronic itching, burning, scratchy. Worse in the AM.

226
Q

Blepharitis Signs

A

Erythema, scales, debris, meibomian gland disease, chalazion.

227
Q

Blehparitis treatment

A

warm compresses, baby shampoo. antibiotics/steroid topical if severe.

228
Q

Pingueculum

A

yellow bump on the sclera associated with aging.

229
Q

Pterygium

A

Triangular thickening of the bulbar conjunctiva. Grows from nasal side to the surface of the cornea. Can interfere with vision.

230
Q

Cellulitis Symptoms

A

acute onset of pain, swelling, +/- systemic sxs.

231
Q

Cellulitis Signs

A

+/- vision decrease, warm erythematous, edema, tenderness. Loss of EOMS with orbital cellulitis.

232
Q

Cellulitis Treatment

A

referal. and systemic antibiotics.

233
Q

Dry eye Sxs

A

chronic, itching, burning, scratching, tired eyes especially at night.

234
Q

Dry eye signs

A

vision fluctuation, poor tear film, punctate epithelial erosions.

235
Q

Viral conjunctivitis Presentation

A

Acute, bilateral, itching/burning/soreness, mild-severe injection, watery discharge, URI symptoms, preauricular lymphadenopathy.

236
Q

Viral conjunctivitis Treatment

A

Tears, compresses, vasoconstictors.

237
Q

Bacterial conjunctivitis Presentation

A

Acute, unilateral, burning, irritation, moderate-severe injection, mucopurulent discharge, adherent lids.

238
Q

Bacterial conjunctivitis Treatment

A

topical antibiotics

239
Q

Allergic Conjunctivitis Presentation

A

Chronic, bilateral, itching, mild-moderate injection, stringy mucoid discharge, chemosis.

240
Q

Chemosis

A

swelling of the conjunctiva

241
Q

Allergic conjunctivitis treatment

A

tears, topical antihistamines/mast cell stabilizers

242
Q

Subconjunctival Hemorrhage Presentation

A

Acute, asymptomatic diffuse red patch on the sclera. Usually results from trauma. No treatment neccessary.

243
Q

Episcleritis/Scleritis Etiology

A

Can be associated with systemic autoimmune diseases.

244
Q

Epi/scleritis Presentation

A

Subacute. Feeling of foreign body, pain. Focal injection, inflammation of episclera/scleral tissue, scleritis is a deep bluish hue.

245
Q

Corneal Abrasion presentation

A

Acute onset of pain and foreign body sensation. Epiphora. +/- vision.

246
Q

Epiphora

A

overflowing tears.

247
Q

Corneal abrasion diagnosis

A

epithelial defect seen with flourescein drops and blue light.

248
Q

Corneal abrasion treatment

A

lubricants, antibiotics, pain meds, NO anesthetic drops.

249
Q

Chemical Injury Presentation

A

Acute pain, burning, decreased vision, red/pink/white eye.

250
Q

Chemical injury treatment

A

irrigate and refer.

251
Q

Corneal Foreign Body Presentation

A

Acute onset of foreign body sensation. Can sometimes see the foreign body with or without rust rings.

252
Q

Corneal Foreign Body Treatment

A

Irrigation or use of cotton-tip applicator to remove the foreign body.

253
Q

Keratitis/corneal ulcer Etiology

A

Usually from contact lense abuse. Or use of anesthetic drops with a corneal abrasion.

254
Q

Keratitis/corneal ulcer Presentation

A

acute onset of pain, mucous discharge, decreased vision, white infiltrate can have a hypopyon. Treated with topical antibiotics.

255
Q

Keratitis HSV Presentation

A

Dendritic pattern. Treated with topical anti-viral. Referral.

256
Q

Iritis/uveitis Presentation

A

Acute onset of photophobia, ciliary flush, +/- vision decrease. Hypopyon.

257
Q

Hyphema Etiology

A

Blood in the anterior chamber usually due to trauma.

258
Q

Hyphema Presentation

A

Acute onset of pain and photophobia, +/- vision, layered heme in anterior chamber.

259
Q

Hyphema Treatment

A

Eyeshield and immediate referral.

260
Q

Angle Closure Glaucoma Etiology

A

Acute rise in intraocular pressure die to outflow obstruction.

261
Q

Angle closure glaucoma symptoms

A

Acute, decreased vision, halos, nausea, pain, feeling of pressure in the eye.

262
Q

Angle closure glaucoma Signs

A

Crescent shadow, ciliary flush, decreased vision, steamy cornea.

Clinical Medicine (7 decks)

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