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Diagnosis and Mangement 1 > HEENT > Flashcards

HEENT Flashcards

1
Q

Photophobia and ocular pain are associated with what possible causes:

A

acute glaucoma; migraine, corneal trauma, keratoconjunctivitis, iritis, uveitis, scleritis

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2
Q

N/V and ocular pain are associated with what possible causes:

A

acute glaucoma, endophthalmitis,

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3
Q

Itching and ocular pain are associated with what possible causes:

A

chemical injury, sever dry eye, allergy

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4
Q

pain on eye movement and ocular pain are associated with what possible causes:

A

orbital pseudotumor, myositis, posterior scleritis, optic neuritis, trauma, orbital cellulitis

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5
Q

foreign body sensation and ocular pain are associated with what possible causes:

A

corneal ulcer or abrasion, conjunctivitis, over exposure to UV light, entropion, trichiasis, conjunctival or eyelid lesion( rule out actual corneal or conjunctival foreign body

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6
Q

a complaint of visual disturbance should prompt a history that includes:

A

the rate of vision loss, whether one or both eyes are involved, and whether the vision loss is for distance vision, near vision, or both

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7
Q

Pt presents with eye irritation, foreign body sensation, itching and redness. Most likely:

A

blepharitis

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8
Q

treat blepharitis with:

A

warm compresses and lid hygeine BID. may need erythromycin or bacitracin opthalmic ointment

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9
Q

Red eye alarm symptoms - patient needs referral to opththalmologist urgently:

A

Severe pain; decreased vision; foreign body sensation; photophobia

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10
Q

S/S of Meniere’s

A

fluctuating hearing loss; occasional episodic vertigo;

tinnitus or ringing in the ears; aural fullness

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11
Q

Meniere’s syndrome is caused by

A

excess fluid in the labyrinth that can damage the vesitbular and cochlear hair cells

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12
Q

Labyrinthitis is secondary to :

A

URI or viral infection

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13
Q

Meniers starts ______ and resolves in _______hrs

A

suddenly , 2-3

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14
Q

Labyrinthitis has ______ onset and lasts ______

A

sudden, 10- 15 min

comes on over 2-3 days, declines over 4-5 days

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15
Q

Hallpike - Dix maneuver is used to diagnose:

A

BPPV

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16
Q

what maneuver treats BPPV?

A

Epley’s maneuver

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17
Q

Dizziness of brief episodes with acute onset and no hearing loss which is triggered by head turning is likely:

A

BPPV

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18
Q

nasal polyps are often secondary to :

A

1) chronic allergies/allergic rhinitis
2) cystic fibrosis
3) pts with acute or chronic infections

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19
Q

symptoms of sinusitis

A

nasal congestion; facial or dental pain; postnasal drip;

headache; fever; yellow or green nasal discharge

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20
Q

diagnostics for sinusitis

A

clinical findings; CBC and differential if indicated; CT or MRI scan for recalcitrant infections

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21
Q

possible explanations for facial pain?

A

cold; headache; rhinitis; nasal polyps; tumor; URI; trigeminal neuralgia

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22
Q

recurrent OM is defined as?

A

three or more distinct episodes in 6 months or more than four episodes in 12 months with resolution between episodes

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23
Q

An adult patient with nasal stuffiness, snoring, parital/total loss of smell, headache, sneezing and watery nasal discharge most likely has:

A

nasal polyps

may also have a protruding mass.

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24
Q

A patient with fever, anterior cervical lymphadenopathy,

tonsillar exudate; absence of cough most likely has;

A

Group A strep Phryngitis

25
Q

Sore throat along with other URI symptoms, but no tonsillar exudate and no malaise is:

A

viral infection pharyngitis

26
Q

exudative tonsillitis, fever, lymphadenopathy, palatal petechiae and malaise is:

A

Mononucleosis

27
Q

complications of strep:

A

rheumatic fever; glomerulonephritis; chorea; bacteremia; mononucleosis; airway obstruction; peritonsillar abscess or retropharyngeal abscess; necrotizing fasciitis

28
Q

rheumatic fever is caused by

A

Group A strep

29
Q

rheumatic fever is most common in :

A

5-15 yr olds

30
Q

Rheumatic fever can cause permanent damage to the _______

A

heart; can damage heart valves, lead into heart failure

can also cause rheumatic arthritis as well as neuropathies

31
Q

TX for Rheumatic fever:

A

Erythromycin 250 mg PO BID or Pen G 500 mg PO QD x minimum of 5 yrs

32
Q

Fever, painful and tender joints( more often ankles, knees, elbows, wrists), pain in one joint that migrates to another joint, red, hot, swollen joints, small painless nodules under skin, chest pain, heart murmur, fatigue, flat or slightly raised painless rash with a ragged edge, outbursts of unusual behavior, such as inappropriate crying or laughing, jerky uncontrollable body movements is most likely:

A

rheumatic fever

33
Q

the most common causes of a high number of eosinophils are:

A

allergic disorders
infections by parasites
certain cancers

34
Q

A Pterygium is caused by ______ and _____

A

collagen degeneration and fibrovascular proliferation

35
Q

an external, elevated, superficial ocular mass formed over the perlimbal conjunctiva and extending into the corneal surface is:

A

a pterygium

36
Q

a condition in which the eyelid turns inward and eyelashes rub against the eye:

A

Trichiasis

37
Q

_______ are an acute, focal infectious process, while ______ are a chronic, noninfectious granulomatous reaction

A

Hordeolums, chalazions

38
Q

sudden onset severe ocular pain, headache, N/V, blurred vision with haloes around lights, loss of vision -condition most likely:

A

Acute angle-closure glaucoma

39
Q

facial pain on one side, in the jaw, sensitive to touch is most likely:

A

dental ( tooth abscess)

40
Q

facial pain on one side, stuffy nose, tearing around the eye, lasts 30 minutes to 2 hrs most likely:

A

cluster headache

41
Q

facial pain with a painful blistering skin rash is most likely:

A

shingles

42
Q

facial pain with dull pain around the eyes and cheeks that are worse bending forward is most likely

A

sinusitis, often associated with or follows a URI

43
Q

facial pain preceded by an aura, pain on one or both sides, nausea, pounding or throbbing headache is most likely

A

migraine

44
Q

trigeminal neuralgia affects the face:

A

face - electric, stabbing pain that comes in bursts, no pain inbetween attacks; often precipitated by eating, laughing, talking, shaving, make up application

45
Q

most effective medication for trigeminal neuralgia

A

tregretol ( carbamazepine)

46
Q

IV dilantin is effective for acute severe episodes of :

A

trigeminal neuralgia - heart effects, must be on cardiac monitor, short term tx, meant to stop acute sever attack only

47
Q

surgery to cure trigeminal neuralgia:

A

microvascular decompression surgery: neuro surgery, incision behind ear, opening in skull about size of quarter, nerve and blood vessel abrading nerve are visualized, the two are separated and a pad (teflon felt) is inserted to prevent the blood vessel “bumping” the nerve.
pt experiences immediate and permanent relief of pain.
effective in 95% of people.

48
Q

cluster headaches are treated with:

A

triptans ( imitrex) and anti - inflammatory ( steroids) starting with a high dose and tapering over 2-3 weeks

49
Q

shingles are treated with:

A

acyclovir; prednisone; antihistamines to reduce itching; pain medications, zostrix( cream ) my reduce the risk of postherapuetic neuralgia

50
Q

shingles can be prevented by taking:

A

the zoster immunization

51
Q

treatment for sinusitis:

A

drink plenty of fluids to thin mucus, inhale steam 2-4 times per day; spray with nasal saline several times/day; use a humidifier; antibiotics;
chronic sinusitis: allergy shots, nasal corticorsteroid sprays , sometimes nasal surgery.

52
Q

correct tx for acute otitis externa:

A

hydocortisone/neomycin/ polymixin B drops

53
Q

peices the NP must document in H&P objective assessment of tympanic membrane?

A

color, position (retracted/bulging); mobility; translucency

54
Q

what is epiphora:

A

excessive tearing

55
Q

most common cause of epiphora:

A

reflex overproduction of tears due to a deficiency or the tear film ( occurs in the elderly)

lacrimal pump failure and obstruction of the nasolacrilmal outflow system may also cause excessive tearing

canalicular infections caused by streptothrix and candida

56
Q

normal intraocular pressure

A

10 to 20 mmhg

57
Q

amaurosis fugax is:

A

transient, periodic visual loss

58
Q

Indications for immediate ophthalmology referral:

A

nonhealing epithelial defects; metallic foreign bodies; chemical injuries( after prompt irrigation) ; infectious keratitis; hypopyon ( fluid line in anterior chamber near the bottom caused by inflammatory cells); full thickness corneal laceration; elevated eye pressure on tonometry

Diagnosis and Mangement 1 (5 decks)

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